Lesson 1: Story vs Truth vs Narrative

Consider that history of present illness immediately follows your chief complaint.

• Your encounter begins with a reason someone hopes to seek help.

• You already have context of what’s in the medical record.

• You have biases, preconceived notions, or the inkling you may or may not get the “truth”.

• At this point, how could you re-frame your own thinking?

• Do I need the truth?

• Do I need the story?

• Do I need the narrative?

The truth could change into a story which could change into a narrative because your patient hopes to trust you with the reason they need help. As is the case for natural use, retrieval, and consolidation of short- to long-term memory, they will likely not remember, recall, and retrieve the exact sequence of events or timeline.

Give yourself and your patient the grace to delineate when the story is important, when the truth is important, and when the narrative matters.

For example, the truth of recent travel history changes medical management but the story or narrative about transmission and risk may not be as relevant.