Halkowski: Realizing the illness Flashcards
What is the name of the Halkowski piece and what is the theme?
Realizing the Illness: Seeking and Providing Information
What is narratives of symptoms discovery?
By “narratives of symptom discovery” we mean stories that reveal how we came to recognize a potential health problem.
What are the two key features?
- “At first I thought X, but then I realized Y”
2. Attempts to first address the problem without “running to the doctor”
What is the patient’s problem?
Parson’s coined the term “the sick role”, which means the obligations and entitlements that come with being a sick person (exemptions from normal responsibilities)
What are the obligations and entitlements?
Things such as departures from normal responsibilities, you have the obligation to do certain things such as doing things to make you feel better, isolation
True or False.
Entry into/out of the sick role is socially monitored/policed
TRUE.
Sick people shouldn’t pretend to be well and well people shouldn’t pretend to be sick
Medical professionals are the experts, expected to gauge whether a person is in fact sick.
True or False.
Before going to a physician, patients attempt to determine whether their symptoms are “doctor-able”
True.
Worthy of being brought to a physician’s attention
What is doctorable mean?
It means worthy of being brought to a physician’s attention.
It is not always obvious, esp, to laypeople whether their symptoms are doctor-able
Once they go to the doctor, patients generally want confirmation that their symptoms were doctor-able.
While at home patient’s are not expected to be “experts” in evaluating their symptoms.
True or false
False.
While at home, patients are expected to be “experts” in evaluating their symptoms
Being neither too lax nor too vigilant (hypochondria)
While at the physicians office, patients are expected to defer to physician’s evaluations
What are key questions to ask themselves?
Is this a reasonable problem to bring to the doctor?
Did I bring this problem to the doctor at the right time?
Am I monitoring my bodily sensations appropriately?
Narratives of symptom discovery represent one resource that patients can use to manage the patient’s problem
True or false
True
Describe the expression…
“At first I thought X, but then I realized Y”
Typically the “X” would be routine or mundane and the “Y” would be more unusual or special
In ordinary conversation, this device is used to:
foreshadow that the initial assumption turned out to be incorrect
show that the speaker did/does not jump to worst case scenarios
A method for displaying reasonableness in how we experience the world
What is the purpose of using this device?
In doctor-patient interaction, the device is closer to, “At first I thought X, but the problem continued (or got worse) and I decided to see a doctor.”
In both cases, the patient initially considered routine/mundane hypothesis, but eventually had to abandon it; this conveys the reasonableness of seeking medical care
What is a sequence of noticings?
Similar in some ways to the “At first I thought X” device, but does not convey any initial hypotheses
The “first noticing” is typically put forward as unmotivated, meaning that the patient was not actively searching for symptoms, but symptoms intruded into his/her field of everyday experience
See case [8] on p. 101
Note the word “noticed” in line 5 (objective/detached)
Note how the story implies she is neither too lax nor too vigilant in monitoring her bodily symptoms
What is the importance of the use of certain words?
Noticed over found or discovered
