Bartimaeus and Narrative Inertia in the Electronic Medical Record
Schuyler Bain, Duke Divinity School, Durham, NC, University of North Carolina School of Medicine, Chapel Hill, NC
The electronic medical record (EMR) is a ubiquitous and powerful tool constitutive to the modern practice of medicine. The EMR provides greater transparency to all members of the healthcare team, allowing plans, data, patient encounters, and general updates to be stored in a readily accessible location. Oftentimes quick consultation of the notes section of the EMR can be relied upon to provide a helpful snapshot of the most relevant features of a patient’s hospital admission, as told by the healthcare team. In this way the EMR functions as a heuristic, helping providers understand more about a new patient than the simple reporting of data would relay. However, as a heuristic of convenience, the notes of the EMR necessarily convey narrative regard of patients, as information written by staff will implicitly and explicitly invoke interpretative lenses in the recording of patient events. In this way, the particular descriptions assigned to patients, and the specific details of their various interactions with staff, can serve to create and perpetuate harmful bias.
In exploring the features of an admission of a black woman with an acute on chronic heart failure, I will demonstrate the ease with which interpretive bias against a patient can be generated and propagated in the EMR, attaining a “narrative inertia.”
Jesus also encountered heuristics of convenience that crowds offered to him as explanations regarding particular members of their society. Such narratives were offered to Jesus as convenient ways to bypass genuinely knowing socioeconomically marginalized individuals. However, as seen in Jesus’ encounter with Bartimaeus and the crowd outside Jericho, Jesus rejected reductive narratives and surprisingly enlisted onlookers in the work of healing Bartimaeus. In exploring Jesus’ treatment of the crowd and Bartimaeus, I will reflect on how his example can be instructive for healthcare providers. The challenge is to resist narrative heuristics that, although efficient and readily available, condition colleagues to see patients through an interpretive bias, and therefore to fail to truly see such patients.
In exploring the features of an admission of a black woman with an acute on chronic heart failure, I will demonstrate the ease with which interpretive bias against a patient can be generated and propagated in the EMR, attaining a “narrative inertia.”
Jesus also encountered heuristics of convenience that crowds offered to him as explanations regarding particular members of their society. Such narratives were offered to Jesus as convenient ways to bypass genuinely knowing socioeconomically marginalized individuals. However, as seen in Jesus’ encounter with Bartimaeus and the crowd outside Jericho, Jesus rejected reductive narratives and surprisingly enlisted onlookers in the work of healing Bartimaeus. In exploring Jesus’ treatment of the crowd and Bartimaeus, I will reflect on how his example can be instructive for healthcare providers. The challenge is to resist narrative heuristics that, although efficient and readily available, condition colleagues to see patients through an interpretive bias, and therefore to fail to truly see such patients.