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At some point in your life you will almost certainly have read the story of the Odyssey, even if it was only in your childhood. It is among the great epic tales of world literature, as well as one of the oldest. As you may recall, it describes the return of its hero, Odysseus (known sometimes as Ulysses), after fighting alongside other Greek kings in the Trojan war. It takes 10 years for Odysseus to return to his kingdom, his palace and his wife, Penelope. On the journey, he encounters a formidable series of adversaries, including the giant Cyclops, and the enchantress Circe, as well as being held captive by the goddess Calypso. He also faces tremendous storms and other natural calamities. When he finally arrives in his native Ithaca, none of his companions has survived, and no one recognises him except for his faithful dog. The story ends with his triumph as he slaughters all the suitors who are occupying his palace, consuming his estate, and vying with each other to displace him in Penelope's bed.1–3
I recently reread the Odyssey after an interval of many years, and was surprised how much of the story I remembered—including all the episodes above—but also how much I had forgotten. The biggest surprise was realising that the entire action of the narrative actually takes place not over 10 years, but during a mere 41 days. This is how long it takes for Odysseus to escape from Calypso's island, travel on the final leg of his journey home, and reclaim his wife and his throne. The fabulous tales of his adventures in the preceding years appear in an extended flashback when Odysseus recounts them to the king and queen of an island where he stops for 3 days on the final stage of his journey. This flashback takes up less than a fifth of the book, and the rest is largely taken up with the intricacies of how Odysseus and his son Telemachus come together and devise a strategy to overwhelm the suitors.
In fact, we learn a great deal of the story of the Odyssey through flashbacks like this. We know from the very beginning of the story that it is going to end with Odysseus's return, but we have to wait all the way through to hear the details of how he kills the suitors. In between, the plot weaves backwards and forwards, as the author explains at various points what happened long ago and gives characters an opportunity to share their memories with each other. Some important events from the past—like the dreadful murder of Odysseus's fellow warrior, Agamemnon—are mentioned over and over again. The narrator has a purpose, indeed a whole range of purposes, in telling the story in this way. He wants us to pay attention and to understand how all the different parts of the history fit together. He hopes to influence our views about who the virtuous and evil characters are, and how fate interacts with human choice in determining our destinies. He also aims to affect us emotionally and morally. He knows that a good story has more than a beginning, a middle and an end. It has twists and turns, suspense, and lessons to teach.4
If the way Homer tells the Odyssey is familiar, this may be because it became the model for a great deal of story-telling afterwards, from the epics of classical Rome to the modern detective novel. However, there are other reasons too. Even if we look at stories written by people who would never have read his works—for example, the accounts of the patriarchs in the Bible, or the sagas of Hindu gods—we find many of the same narrrative devices. Human beings seem to have standard approaches to telling each other stories, weaving events together in more or less the same way in order to convey moral points and influence people. Some philosophers have argued we may even experience life like this, looking constantly backwards and forwards to work out how the past connects with the present, how fate interacts with our own behaviour, and how we can share the lessons with others in order to affect their conduct towards us. Good story-telling affects the way we see the world, but it also captures the very ways we understand reality.5
Taking a history
Story-telling also lies at the heart of medicine. Indeed, the whole enterprise of medicine is dependent on one core activity: taking a history. Yet, when we take histories, we often ignore its story-telling elements. For instance, if patients break off near the very beginning of their story to talk about a quite different and apparently irrelevant episode, just like Homer does, we feel impatient. If they go on at length, miss out essentials, explain things in fragments, repeat themselves for emphasis, or quote the views of many different characters—again, exactly like Homer—we get irritated. When they try to make sense of what has happened to them in terms of fate or moral judgement, we ignore them in the firm conviction that what they are describing shows something else at work, like genes or pathogens. If the story seems slanted in order to influence our own conduct (the main purpose of the Odyssey, or any great story) we become firm in our resolve to resist this and to act as we consider best, regardless of their intent.
We could behave differently. We could see all these story-telling elements not as distractions from the history, but as their absolute essence.6 The problem we face is very rarely that we are hearing a ‘poor history’ or facing a ‘poor historian’. It is that the people we meet have been moulded by their cultural, and possibly even their neurological inheritance to see the world, and to talk about it, in ways that are ancient, innately human, and entirely different from the logic of medicine.7 As doctors, we may have set ourselves the task of extracting specific data from their flow of words, and we may have done so for very good reasons. But the activity is not a natural one, and we cannot expect patients to abandon the narrative traditions of millennia in order to oblige us. Read the opening five or six pages of the Odyssey, with its rapid switches of topic, its host of apparently unconnected characters and events, its puzzling allusions and mystifying hints, and you may never listen to a patient in the same way again.
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.