In his recent book “The healing tradition” David Greaves ¹, a former editor of this journal, describes accompanying a hospital consultant on a ward round. He describes how the consultant, having been through the notes, charts, x-rays, and lab reports, sat on the edge of the bed, took the patient’s hand and asked “And how are you feeling in yourself?” To a lay person such a question may be unsurprising. We tend not to describe our feelings in a reductive way, certainly when it comes to illness rather than injury. We may have specific pains in our backs or knees or hips, but we are not usually conscious of pains in the liver or spleen and even “stomach ache” is actually a non-specific complaint. And even when we can be more precise we tend, having discussed the specific problem, to move to a more general account. We say things like “The trouble is, it (whatever it is) makes you feel so rotten” and “you” here stands for “yourself” or “in your self”. As Bruner suggests, “’self’ is the common coin of our speech: no conversation goes on long without its being unapologetically used” (Bruner,² p 63).

The human body may be reducible to its constituent parts and our ailments may be capable of being described by reference to very few points of data, but indicators such as the partial pressure of oxygen in the blood or the rate of clearance of creatinine by the kidney or the haemoglobin level tell us nothing, necessarily, about how the person feels, in his or her self. Not only do the patient and the clinician tend to have different frames of reference for the experience of illness or disease, the different …