IN SEARCH OF THE GOOD - NARRATIVE REASONING IN CLINICAL-PRACTICE

Based on ethnographic work among North American occupational therapist s, I compare two forms of everyday clinical talk. One, ''chart talk,'' conforms to normative conceptions of clinical rationality. The second , storytelling, permeates clinical discussions but has no formal statu s as a vehicle for clinical reasoning. I argue that both modes of disc ourse provide avenues for reasoning about clinical problems. However, these discourses construct very different clinical objects and differe nt phenomena to reason about. Further, the clinical problems created t hrough storytelling point toward a more radically distinct conception of rationality than the one underlying biomedicine as it is formally c onceived. Clinical storytelling is more usefully understood as a mode of Aristotle's ''practical rationality'' than the technical rationalit y of modern (enlightenment) conceptions of reasoning.