Sharing explorative and expressive writing can facilitate deep and effective insight, understanding, and discussion with trusted confidential appropriate others. ‘Doctors felt the process of writing and talking about the stories was both profound and helpful. The process stimulated clarification of personal values and priorities, created a context for peer support (which doctors often seem to resist), and fostered recognition of opportunities to make constructive changes in their professional lives … Amid so much discussion of what is wrong with medicine, the workshops seemed to help them remember what is right’ (Horowiz, p 774).¹

The narratives and metaphors by which practitioners structure their lives, the taken-for-granteds, are questioned and challenged: making the familiar strange, and the strange familiar. All life-stories can be questioned; many can be altered or struggled against. Life does not present with inevitable chronological consequences of certain actions or events: people are free to choose how to act and influence others.

Writing can develop awareness of narrative structure (plot, characterization, chronology, environment), sensitivity to perspective (from whose point of view is the story told?), and the function of metaphor, simile, metonymy, alliteration assonance, etc. Interpretive abilities can be developed: the narrator’s role (omniscient? reliable?), the value of multiple perspectives (viewing the same situation from the point of view of doctor and patient, teacher and student), and inherent ethical and value structures depicted.

Carefully observed, detailed descriptions of events are a sophisticated reflective form because ‘we theorise every time we look at the world’.² Acute observation is required: not the narrowly focused observation skills required by practice, but the detached and impartial detailed observation of a writer. Awareness of detail can enable insight, pushing away assumptions and habitual perspectives and modes of understanding. ‘God is in the details’ (Verghese, p 1014).³ A closely observed event, however …