Several scholarly trends, such as narrative medicine, patient-centered and relationship-centered care, have long advocated for the value of the patient's voice in the practice of medicine. As theories of textual analysis are applied to the understanding of stories of illness, doctors and scholars have the opportunity to develop more nuanced and multifaceted appreciation for these accounts. We realize, for example, that a patient's story is rarely "just a story," but is rather the conscious and unconscious representation and performance of intricate personal motives and dominant meta-narrative influences. Overall, this complexifying of narrative is beneficial as it reduces readers' and listeners' naïve assumptions about reliability and authenticity. However, the growing body of scholarship contesting various aspects of personal narratives may have the unintended effect of de-legitimizing the patient's voice because of concerns regarding its trustworthiness. Further, the academy's recent focus on transgressive, boundary-violating counternarratives, while meant to right the balance of what constitutes acceptable, even valuable stories in medicine, may inadvertently trivialize more conventional, conformist stories as inauthentic. While acknowledging the not inconsiderable pitfalls awaiting the interpreter of illness narratives, I argue that ultimately, physicians and scholars should approach patient stories with an attitude of narrative humility, despite inevitable limits on reliability and authenticity. While critical inquiry is an essential part of both good clinical practice and scholarship, first and foremost both types of professionals should respect that patients tell the stories they need to tell.

As editor the Medical Humanities section, Shapiro provides an introduction and discusses how the articles in this section of the journal use reflective writing in medical education contexts to explore the perspectives and priorities of a range of others - patients, family members, other health care professionals - involved in the clinical encounter.

To explore how primary care clinician-teachers actually attempt to convey empathy to medical students and residents, the author carried out a qualitative study in 1999-2000 in which 12 primary care physicians reflected on their views of empathy, how they demonstrated empathy to patients, and how they went about teaching empathy to learners. Interview data were triangulated with observations of actual teaching sessions and informal questioning of students and residents who had been taught by the faculty participants. Grounded theory was used to interpret the data. The faculty had clear conceptualizations of what empathy meant in clinical practice, but differed as to whether it was primarily a measurable, behavioral skill or a global attitude. Respondents stressed the centrality of role modeling in teaching, and most used debriefing strategies, as well as both learner- and patient-centered approaches, in instructing learners about empathy. Findings suggest that limiting the teaching of empathy to a skill-based approach does not reflect the richness of what actually occurs in the clinical setting, and that it is important to teach empathy comprehensively, acknowledging both behavioral and attitudinal tools.