«Nach Aufnahme arterielle Hypotonie»: Personenkonzept und Kommunikationsformen in der Experten-Medizin

Abstract

“Arterial hypotonia after admission”: concepts of personhood and types of communication in clinical medicine This article deals, from the perspective of textual and narrative theory, with certain forms of communication in current clinical medicine. It will be argued that diagnostic and therapeutic procedures in highly specialized medical contexts tend to be fragmented and pluralistic and that this compromises a distinct concept of personhood. Therefore, clinical experts should adopt an integrative understanding of the patient as coherent entity. The phenomenon of depersonalization in clinical medicine is, among others, reinforced by a quasi ‘hegemonial’ expert genre that organizes almost all case-based communication among specialists: the discharge report or epicrisis. However, there is hardly any research about this genre. Against this background, a brief overview will be given over the historical development of the medical report in the 20th century and its epistemological function, using archival sources. Certain narrative peculiarities such as deagentivization, reductionism and fundamental linearity indicate that the medical report has the function of ordering past courses of events and of making causal connections evident – therefore it works anyway in a depersonalizing manner. In this context, the Medical Humanities have a serious didactic task: they should raise critical awareness of the relationship between talking, writing, thinking and acting among future clinicians already during their academic education.