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Sandra--
I'm so tickled to have a cluster of essays, this time round, written from the perspective of future practitioners. What is the use-value of the claim that all stories are "constructed," "fabricated," "fictional" "lies, in the work of lawyers, or veterinarians or--here--nurses? You ask a very pointed question, as a future nurse, about the relevance of story-construction in the reporting, recording and interpretation of medical histories: "constructedness," you now see, "has serious implications when trying to relate your medical woes.

You attend first to the problem of how unreliable patients are as reporters of their own medical history: "patients do not know what may be of interest to the staff"; or they may be "embarrassed or feel that they cannot confide in their doctor." Your own account of adolescent "lying" in this regard certainly brings this point home.

Of more interest to me are your speculations about how doctors and nurses can learn to "sift through all the information, or lack of it, and pull out what is important and relevant to helping their patient." As Charon says, this is “knowing what to do with stories.” It's what we do mostly in English classes: learning the art of interpretation. And Columbia's program in Narrative Medicine tries to teach that art, applying the techniques of literary analysis to better understand what a patient is saying.

It interests me that you seem so skeptical of this program, skeptical, for instance, of medical practitioners' attending to their emotional reactions to a patient (do you really think that such reactions "have nothing to do with how the patient is treated"??). I'm struck, too, by your comparison of the work of psychiatrists w/ that of most doctors: the first listening to their patients' life stories, the second focusing on physical stories. All the psychiatrists I know (and they are many) say that they realized, taking case histories, that they were much more interested in the life stories than accounts of physical ailments.

So: all of this is very rich and very much worthy of further exploration. Let me close w/ one  stylistic "nudge": let's talk about how you can go about "setting up" your quotes, explaining to your reader what's coming, and why; otherwise they can feel like meteors, dropping in on the essay w/out any warning of what's about to happen. (Talk about story construction!)