Narrative and metaphor can be viewed as literary terms without much use in the world of medicine other than to prettify language and decorate ivory tower treatises on medical esoterica. However, since narrative and metaphor are integral to how we think, how we analyse and process information, how, in fact, we perceive and thus act, it would be naive and arbitrary to exclude such concepts from an understanding of the practice of medicine. Furthermore, with its compression and crystallization of communication with the patient, the complex interplay between human and machine, the draconian consequences of poor communication and the emotional toll of a high stress environment, the practice of anaesthesia lends itself well to a closer look at how narrative and metaphor imbue and inform what anaesthetists do. The relationship between narrative and story is largely determined by context. Interchangeable in some respects, the terms both mean an account of events, and each can be contained in the other. For instance, a narrative can be woven from various stories and a story can contain narratives of various characters. The term narrative is mostly used here primarily because it encompasses text, however fragmentary, dialogue, and the study of narrative in medical education and practice, termed ‘narrative medicine’. Nonetheless, ‘story’ is also understood here, and is a useful term, particularly in relation to a point of view or a retelling of an experience, in Rashomon fashion, from differing perspectives. As noted in Chapter 2, inflection and emphasis change the meaning of even a single sentence. The idea of differing perspectives deserves special attention in the anaesthetist–patient relationship. The ‘narrative incommensurability’ between doctor and patient is one of the prime driving forces behind the need for good communication pre- and post-operatively. That is, the unknowableness of another person, indeed a stranger, for whom we anaesthetists assume vital and personhood responsibilities during the operation, makes clear and comprehensive communication that much more important. People develop not only as individuals, but also as social beings. Just as we try to understand another’s actions through, among other ways, the mirror neuron system, we try to understand another’s perspective, all the while recognizing that we are, by definition, distinct.
Overall Design and Optimization of Mining Sequence in High-Stress Environment of Thick Orebody
