The stories patients bring to healthcare encounters are not exclusively narratives of illness, but narratives of health and personal engagement. Analysis of small stories told through the use of direct reported speech reveal an attempt at constructing an identity of a whole person or an identity beyond the patient in the room. This is done through stories of personal humor, accountability in medical care and engagement with both family members and other providers.
With a growing interest in narrative medicine, health communication scholars and applied linguists have helped usher in an approach to medical care that places great importance on patient narratives and how these narratives integrate the voices of medicine and the lifeworld (Mishler, 1984). While this focus on patient narratives, coupled with the patient-centered approach, has brought greater attention to the voice of the patient in the healthcare interaction, what has been overlooked is the small stories patients tell rather than the grand narratives of illness. In this presentation, I focus on small stories, or "fleeting moments of narrative orientation" (De Fina & Georgakopoulou, 2012: 116), in particular those told through the use of direct reported speech (DRS) and ones that seem ancillary to the patients' illness or medical concerns. DRS allows the speaker to present their narrative in an ostensibly impartial way, thereby allowing the hearer to make their own objective assessment of it (Holt & Clift, 2007). I analyzed 26 medical visits between nurse practitioners and patients during annual well-care visits in the US and found that patients typically use DRS in describing interactions with family members and interactions with other providers. Patients in this study use these small stories to narrate a variety of events in their daily lives in which they report complaints with the healthcare system, positive encounters with providers and humorous exchanges with both providers and family members. I argue that each of these tellings actively contribute to a construction the teller as a whole person rather than simply the institutional role of the patient within a medical encounter. Furthermore, interactions with other providers and medical representatives allow the patient to make claims of knowledge and even share relevant health information without challenging the role of the provider by framing the information within the story world. The stories patients bring to their healthcare encounters are often not simply narratives of illness but narratives of health. Providers should make note of these small stories as they reveal the complexity of the lifeworld that patients bring to their medical encounters and the whole person they wish to present in these encounters.
