Narratives and Metaphors of the Middle

Abstract

The dying think that they will live / The healthy think they are dying -Glenn Colquhoun, Playing God A physician/poet wrote the words in the epigraph above. Showing through is his frustration that the healthy seem unable to focus on living, on the going-forth that is the gift of the healthy. The dying, on the other hand, look back to that goingforth and want to reclaim it within the narrative of their lives. Fictional accounts and personal narratives that relate to encounters with the world of medicine concern primarily beginnings or endings -miraculous births or the processes of preparing to die. This is not true, however, of poetry and children's literature. Both these genres tend to prefer the middle parts -what happens as life moves between birth and death. These two genres, filled with metaphors, frequently recount touching moments of encounter with the humanity of medicine. These metaphors, often in the form of epigrams or proverbs, reflect the middle, the long passage of life carried on beyond medical reports, diagnoses, and emergencies.Is there preparation for the middle narratives within the medical professions? Nurses and other medical personnel receive extensive training in managing end-of-life narratives. Aside from certain diseases or chronic conditions, such as diabetes, medical personnel spend relatively little time narrating with individuals what it will be like to live with specific diagnoses. When such diagnoses pertain to children, and parents know that the condition named and ascribed will not be fatal for the child, the middle looms long and arduous. When an apparently healthy three-or four-year-old is placed on the autism spectrum, parents and grand parents often need to assume responsibility for a very long