The Mirror and the Lake
(Creating a Space to Speak for) Gadamer's Philosophical Hermeneutics to Explore the Role of Dialogue as Practical Wisdom – During the 'Good' Medical Consultation
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Historically, a patient's body 'belonged' to the doctor and the medical consultation was a one-way communication where the patient offered up information on the 'body' only on request from the doctor. Today, in a shift towards patient-centered care, individuals are increasingly involved in their healthcare, which relies on an understanding of what is happening to their physical/biological body, in order to make informed decisions with their health professional to develop care plans. While the power dynamic between patient and health professional is hotly debated, the heart of every 'good' consultation is held to be the dialogue between patient and health professional, which is presented as an instrumental tool to enable the exchange of ideas through the spoken or written word or gestures within the enclosed walls of the clinical space. Drawing on fieldwork findings, this article offers an alternative view of the role and nature of shared dialogue within the consultation space, which is complex, dynamic, embodied, and (potentially) transformative for both patient and health professional. Here dialogue moves beyond words/gestures, and our somatic body/senses (can) merge with, and are extended through (though not replaced by), technologies that (can) enrich our understanding of and interaction with the everyday world around us. This article builds on the work of the German hermeneutic philosopher Hans-Georg Gadamer and his concept of dialogue-as-play, within an alternative concept of health, that he reworked for forty years, until his death at the age of 102. At the age of 91, Gadamer stated that he had focused too much on language and not enough on the Lifeworld (Gadamer 2000 ). Building on this statement, in this article, I extend Gadamer's concept of language, and hence dialogue-as-play, beyond only spoken words to include the sensing body and technologies-to-hand, that I argue is not at odds with his overall body of work. Importantly, his work has wider implications for good scientific/ethical practices beyond medicine, as through his concept of dialogue he invites us (as players) to be courageous and courteous, and to learn, think critically and creatively, and develop practical wisdom continuously as we move through our everyday lives.