Asking the right question about pain: narrative and phronesis.

A project shared by humanities in medicine, bioethics, social scientific studies of medical practice, and related studies can be summarized by the following question: How can we reduce the gap between suffering caused by the body's deteriorations, whether the result of illness, disability, or aging, and the total suffering that attends these deteriorations? In approaching this question, a significant clinical, scholarly, and personal ideal is thinking with a story, as opposed to the more conventional academic and scientific approach of thinking about stories.' Thinking about stories is useful, and I will engage in that kind of thinking in this article; but a problem arises in what gets lost when stories are only thought about. Like most distinctions-including my distinction above between natural and socially incurred suffering-thinking with and about stories marks a continuum, not a dichotomy, but the terms suggest real differences of interest and method. Thinking about stories implies making a story the object of the gaze of an expert who produces an analysis. Analysis requires stable objects, so the story that exists in the transitory activity of telling becomes fixed as a narrative text. Thinking with stories involves a hermeneutic of mutual engagement; a story is one aspect of a complex of nested relationships that remain in process. Thinking with stories involves taking one's own place in that process, in which all participants will continue telling stories about each other and about themselves? In thinking with stories, one story necessarily leads to another, just as the attempt to define a word leads to other words that require definition. A person stops looking up subsequent definitions not because some end has been reached, but because she or he has the feel for the word that started the process-or has simply had enough. A