title: [My clinical experience in interaction with patients].
abstract: In clinical practice, many kinds of stories are told by patients, stories such as those about distress associated with illness, those about their interaction with the people surrounding and those about the medical experiences. Stories are never fixed. They are always revised. Several dimensional stories are interrelated and affect one another, and the modification of any influences the others. The stories told by patients are coded and interpreted so as to fit the doctors' paradigm. The coding and interpretation are sometimes willingly accepted by patients for the purpose of being recognized as patients by the community, or because the patients need to close their eyes to their real mind state. In other cases they are rejected because patients perceive the application of paradigms either as doctors' indifference about patients' stories or even as a kind of violence. There are various kinds of paradigms. The choice of a paradigm is determined not only by the patients' disease nature but the personal history of individual doctor and the academic group which the doctor is belonging to. So the paradigm has always has the cultural aspect. Through the interaction between patients' stories and doctors' explanation model based on the paradigms, new stories start developing. How the application of the doctors' explanation models impact each patient should be intuitively considered beforehand, keeping in mind the patients' past histories, the situation the patients are now put in, past experiences with medical services. This is because the medical explanations offered to the patients could change their experience of illnesses in various ways, sometimes making them more distressful. To indorse my opinions, I extracted some pieces from my description about two patients.
mesh_terms: D002648:Child; D003142:Communication; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D011570:Psychiatry