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Searching for the Patient’s Presence in Medical Case Reports


Magdalena Zabielska

The book addresses the issue of the patient’s presence in specialist medical publications in the context of a patient-centered approach to medical practice. The author combines both quantitative and qualitative approaches in order to analyze the discourse about the patient in one of the oldest medical genres, case reports. She traces textual references to patients throughout the reports to show that their nature and frequency depend both on the structure of the genre and the context of the production of these texts. The author touches upon the topical issue that although specialist communication may seem to exclude patients, it does not mean it does not concern them. Indeed, they are written about and it appears critical how this is done.
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Chapter Four: Theoretical aspects of the analysis of medical case reports


The empirical part of the present work is comprised of two chapters. Firstly, in Chapter Five, the analysis of the compiled corpus of medical case reports will be presented and followed by the discussion of the results. Next, in Chapter Six, an attempt will be made to determine whether patient imaging as revealed in the study of the corpus can be corroborated or refuted by other readers of the texts in question. Lastly, the discussion of the results yielded in both stages will be given. The following chapter will be devoted to the theoretical grounding, which served as the basis for the construction of the analysis in Chapter Five and will start from the macro- and move on to micro-perspective on the texts. Consequently, Chapter Four will give an account of the hierarchical levels of medical description, two modes of disease presentation (Blois 1984), its semiotics, the definition of metaphor and its types illustrated by relevant examples from medical discourse, as well as selected analytical tools necessary for the analysis of the corpus.

According to Alan McKee (2003), textual analysis attempts to delve into how individuals understand reality, i.e., “to gather information about sense-making practices” (2003: 68). Consequently, medical discourse constitutes one of the many vantage points which dictate certain modes of thinking (2003: 128) and medical texts exemplify such “making sense” of the world in the medical context. On this reasoning, as Suzanne Fleischman (1999) observes, not only is disease a “biological event” but it is also...

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