METAPHORICALLY TRANSMITTED DISEASES - HOW DO PATIENTS EMBODY MEDICAL EXPLANATIONS

Background. The examination was guided by recent theories on metaphors , holding that our conception of the physical world in many ways deriv es from personal bodily experiences. Such experiences are fundamental to the elaboration of abstract structures of meaning, which, through m etaphorical projections, provide a constitutive role in our overall co mprehension of the world. It is thus to be assumed that patients will bring their own cluster of metaphors into the consultation room to str ucture the doctor's explanations. Our study was an attempt to identify some manifestations of this work of structuring and to learn about it s consequences for interpersonal communication between patient and doc tor. Objective. The aim of this study was to examine how, and to what extent patients in a general practice understand pathoanatomical and p athophysiological disturbances as explanations of their illness. Metho d. The empirical basis of the study comprised interviews with a group of patients from a general practice, who were asked to narrate their u nderstanding of medical disturbances. Based on these interviews we ide ntified and classified a number of metaphors they used to describe bod ily problems and relations. A deviating mechanical understanding of th e body, which we characterize as ethnomechanics, was manifest in all t he interviews. This understanding is expanded upon and its significanc e discussed. Although patients do not feel qualified to understand sci entific explanations of their health problems, they do relate to a sci entific disease mode of understanding. They do not, however, relate to the fine details and professional implications of this mode. Instead they will associate medical explanations with their pre-established, i llness-based system of understanding through imaginative projections. Conclusions. Doctors need to be aware that patients possess such imagi native and experiential resources to make sense of medical explanation s. Attempts to draw patients radically away from these resources may c ause confusion and undesired breakdowns in the communication between t hem and their physician.