Narratives are important because they help us understand ourselves, other people, and the world around us. They can capture our attention, arouse our emotions, stimulate our imagination, and challenge our thinking; thus they can inspire us to act, learn, improve, and innovate. Medical narratives are part of our stories that can help us understand diseases, issues, and processes. In the article “Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins,” the authors use two narratives about a set of identical twins, both of whom get back pain, to illustrate how one twin fares well, while the other’s course ends with chronic pain and unnecessary suffering. The narratives are easily recognizable, also in a Danish context, and should give any clinician reason for self-reflection and afterthought when they are read.
The authors use medical narratives to present a scenario where a hypothetical pair of twins with identical episodes of low back pain enter a health system where one twin is handled in an appropriate manner, and the other inappropriately. While one twin experiences a rapid improvement, the other twin ends up in a chronic condition with persistent pain despite identical conditions to begin with. During the narrative, The authors indicate critical points and actions of fictitious health professionals that become crucial for why the two stories develop so markedly differently. Based on the story where one twin ends up in a chronic condition, the authors present what goes wrong in the health system point by point, what contributes to the worsening, what could have been done differently and with what result. All the elements are supported by research with an indication of the level of evidence.
The narratives show how significant our words and actions as health professionals are to our patients, and how the handling of low back pain within a health system can both support and promote healing and understanding in our patients, but how it can also to a large extent contribute to pathologizing and worsening the situation. The authors use medical narrative as an innovative way to illustrate the problem with how some patients with low back pain are handled, and to recommend solutions and promote changes in clinical behaviour.
Murphy, D.R., Justice, B.D. & Borkan, J. Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins. Chiropr Man Therap 31, 25 (2023).
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