[A shared room of reflection where the patient's symptoms are valid sources of knowledge].
BACKGROUND
The consultation is supposed to clarify the origin of the patient's complaints and what can be done to alleviate them. Diagnostic work and interaction are challenged by subjective symptoms with no objective findings. In our project "Symptoms as a source of knowledge" we studied women's medically unexplained disorders from the viewpoint that the patient's knowledge represents significant potential for creative understanding.


METHODS
Concepts and hypotheses about symptoms applied as diagnostic sources of knowledge were drawn from qualitative analysis of findings from the subprojects. We have explored issues of relevance and validity that shape the consultation as a medical and cultural space.


RESULTS
Symptoms beyond established categories can disturb a room of reflection which includes patient as well as doctor. The patient may feel dismissed as a person, the process of objectivising becomes defocused, and the diagnostic activity deals with the patient's credibility. Signs related to "either-or" appear as a more comprehensible medical pattern than signs of 'more-or-less'. The probability of a common room of reflection may be related to cultural attitudes to time, blame, and womanliness.


CONCLUSIONS
When traditional medical analytic tools fail, alternative rooms of reflection can be established from recognition, resources, and dialogue, enhancing surprises and curiosity.
Malterud
K
K
Seksjon for allmennmedism Universitetet i Bergen Ulriksdal 8 C 5009 Bergen. kirsti.malterud@isf.uib.no
Taksdal
A
A
D002983:Clinical Competence; D003142:Communication; D030881:Disclosure; D005194:Family Practice; D005260:Female; D006801:Humans; D008487:Medical History Taking / Q000379:methods; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000628:therapy; D012017:Referral and Consultation; D016387:Women's Health