Medicine teems with anecdotes, brief, pointed accounts of healthcare episodes, informed by observations and narrative arguments. Initially denoting hitherto undivulged, but notable, historical events, anecdotes narrated by doctors were not easily distinguishable from clinical cases. Those recounted by patients and carers in the modern era are the subject of this chapter, which investigates how they grasp, size up, and characterize human vulnerabilities, resulting from illness and inequalities in healthcare knowledge and power. An unregulated and anti-authoritarian idiom that does not seek to isolate events and experiences from subjective thoughts and feelings about them, these sorts of anecdotes can critically evaluate medical services and glimpse the truth about healthcare situations. Contemporary medicine, however, views anecdotal observations and viewpoints as biased and untrustworthy. Despite the current climate of scepticism concerning anecdotal information, anecdotes remain prolific oral and literary interventions, that provide vital insights into the interpersonal and social relations of healthcare.

This chapter examines the narrative and epistemic coordinates that underpin the way anecdotes notice and reason about the situations they recount. A selection of anecdotes from medical publications over the last two-and-a-half centuries is examined for the way they marshal their materials, present and reframe information, entertain explanations and bring situations and conceptual frameworks for their understanding into close relationship with each other. Through swapping perspectives on their objects of contemplation in heuristics centring on observational and conceptual vantage points, anecdotes bring before their audience’s eyes scenes viewed in a new light. By changing the domains in which phenomena become explicable, anecdotes effect ‘epistemic switches’ – for example, from a biomedical to a sociopsychological domain or from a non-medical to a pathological one. In highly abbreviated tales of the unexpected, their ‘nutshell narratives’ persuade prime audiences that prior assumptions and understandings require to be adjusted in the light of experience.

Narratives are the discursive form in which issues in medical ethics are apprehended, and communicated. What stories do ‘is to narrate the life in time’ (Forster 1971), not just in novels, but also in fact. Narrative discourse – ‘someone telling someone else that something happened’ (Smith 1981) – is an archetypal means of relating and reporting what is going on, one which also patterns understanding of events.

Many stories turn on conflicts of value, clashes of principle and the promise of resolution. Literature, understood broadly to include novels, biography, memoirs and journalistic accounts, offers readers and professional ethicists alike, potentially rich representations of situations finely graduated by moral viewpoint, ambiguity and complexity (Widdershoven and Smits 1996, Widdershoven and Sohl 1999). Literature can also depict and explore moral doubts and reasoning, and subject argument, motive and character to the scrutiny of a wide readership. In these ways stories both embody and structure our encounters with notions of ‘right’ and ‘wrong’ (MacIntyre 1981: 201, Guroian 1998).

Some narrative scholars argue that ‘the most interesting parts of the moral world have to be ‘read’, rendered, construed, glossed, elucidated, and not merely described’ (Walzer 1987) and find that novelists have more to teach them than philosophers about how to grapple with moral complexities (Booth 2002). Comprehending the moral content of stories involves making sense of feelings, thoughts and behaviour which engage narrative skills, knowledge of the fine grain of medical case histories and some fluency in philosophical analysis too (Levine 1998: 43).