{"id":723,"date":"2015-04-02T08:40:48","date_gmt":"2015-04-02T12:40:48","guid":{"rendered":"https:\/\/www.themspress.org\/blog\/?p=723"},"modified":"2015-04-01T17:00:35","modified_gmt":"2015-04-01T21:00:35","slug":"ishmaels-narrative-an-emotional-response","status":"publish","type":"post","link":"https:\/\/www.themspress.org\/blog\/ishmaels-narrative-an-emotional-response\/","title":{"rendered":"Ishmael’s narrative: an emotional response"},"content":{"rendered":"

“Call me Ishmael” is the first line in Moby Dick and probably the most famous opening line in all of American Renaissance era literature. Taken in a different context: “Call me Ishmael,” or perhaps: “My name is Ishmael,” could also be a first exchange between a doctor and patient. Coincidentally, our Ishmael in Moby Dick tells readers something that resembles what a patient might say to a doctor following initial greetings:<\/p>\n

\"moby
Photo courtesy of Tony Sun<\/figcaption><\/figure>\n

[So doc,] Some years ago\u2014never mind how long precisely\u2014having little or no money in my purse, and nothing particular to interest me on shore, I thought I would sail about a little and see the watery part of the world. It is a way I have of driving off the spleen, and regulating the circulation…whenever my hypos get \u00a0\u00a0such an upper hand of me, that it requires a strong moral principle to prevent me from deliberately stepping into the street, and methodically knocking people’s hats off\u2014then, I account it high time to get to sea as soon as I can.<\/p><\/blockquote>\n

So, translation? That is to say, can a physician translate Ishmael\u2019s opening account into a chief complaint and past medical history? Here is my attempt: Ishmael is a middle-aged male (his age is not given) who complains about feelings of boredom and tiredness. He also describes a history of behavioral symptoms that suggest underlying feelings of anger. Ishmael mentions he looks for ways of \u201cdriving off the spleen\u201d\u2014the most fitting definition of “spleen” given by the Oxford English Dictionary is: “irritable or peevish temper.” Imagine now, if a patient used that exact phrase, “driving off the spleen,” to describe his anger and how he tries to rid it. As a student, I encountered patients during my preceptorships that mentioned similar behavioral symptoms including becoming “more irritable” and “losing their temper.” I found it challenging but helpful to imagine such feelings and consider them in the context of the patient’s chief complaint and past medical history. This allowed me to move with the patient\u2019s sorry and avoid awkward moments and responses. As an exaggerated example, responding with a huge smile to a patient saying they\u2019re \u201cirritable\u201d is not an ideal reaction and creates a difficult situation. Many times, these problems may not even be apparent until later reflection. To give students more chances to reflect, some medical schools such as Weill Cornell Medical College offer students recorded sessions of them interviewing mock patients. As a student, taking complete patient histories is not an easy task, and we can use all the practice we can get.<\/p>\n

To wrap the above discussion into the ongoing theme of my posts\u2014how reading imaginative literature is useful to doctors and scientists\u2014I would suggest that my classmates, and also upper years and residents, make time to read poems and imaginative fiction that elicit a wide range of emotions. To this end, I can give the example that reading Othello<\/em> and King Lear<\/em> elicits very different emotional responses than reading, say, A Midsummer Night\u2019s Dream<\/em> and As You Like It<\/em>. Yes, readers should read deeply into the variety of emotions in these plays, but they must remember to feel those emotions within the characters of Othello and Lear, or in our case, Ishmael and Ahab. This reading<\/em> followed by feeling<\/em> is a practice that physicians can use while taking a patient history: read and hear the patients\u2019 situation, and then feel with the patient. Importantly, students and doctors can practice this even outside the clinic, while reading a poem, play, or novel.<\/p>\n

Coming back to Melville\u2019s novel, Ishmael announces his decision to go on a whaling journey at the end of Chapter 1: \u201cBy reason of these things, then, the whaling voyage was welcome; the great flood-gates of the wonder-world swung open.\u201d Ishmael’s decision to “get to sea” then brings readers into Ahab’s infamously mad pursuit of the white whale.<\/p>\n

My future posts will follow Ishmael\u2019s narrative and bring to light elements that relate to medicine and science.<\/p>\n

 <\/p>\n

Featuring image:
\nSea and sky by Theophilos Papadopoulos<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

“Call me Ishmael” is the first line in Moby Dick and probably the most famous opening line in all of American Renaissance era literature. Taken in a different context: “Call me Ishmael,” or perhaps: “My name is Ishmael,” could also be a first exchange between a doctor and patient. Coincidentally, our Ishmael in Moby Dick […]<\/p>\n","protected":false},"author":20,"featured_media":724,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false},"categories":[118],"tags":[135,134,133,119],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/723"}],"collection":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/comments?post=723"}],"version-history":[{"count":5,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/723\/revisions"}],"predecessor-version":[{"id":731,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/posts\/723\/revisions\/731"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/media\/724"}],"wp:attachment":[{"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/media?parent=723"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/categories?post=723"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.themspress.org\/blog\/wp-json\/wp\/v2\/tags?post=723"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}