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On the record
  1. John Launer
  1. Correspondence to Dr John Launer, London Deanery, Stewart House, London WC1B 5DN, UK; jlauner{at}

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Doctors are prolific writers, often without realising it. We each spend a great deal of time writing in patient files or on computer records. During a medical career, every one of us probably writes the equivalent of many full length novels or even an encyclopaedia. We write automatically, often at great speed, drawing mainly on a repertoire of verbal formulas that we have learned from others. Yet our notes reveal more than we are aware of—not just about our patients but about ourselves and the wider culture in which we live. Medical notes written a century ago, carefully entered with pen and ink into leather-bound ward ledgers, are vastly different from the notes in modern case folders, bulging with computer printouts and copies of correspondence. The differences are testimony not only to changing technologies and scientific knowledge. They show radically altered forms of thinking and social relations as well.

Patient files

A number of scholars in the last few years have looked closely at medical notes, examining how we listen selectively to patients' stories and transmute these into oral and written texts, often radically altering their meaning as we do so. One of the most impressive of these scholars is Petter Aaslestad, a professor of literature at Trondheim in Norway. During the 1990s he decided to apply …

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