The plot thickens: archetypal narrative structure in the melanoma patient journey

In the normative narrative of patient-centered healthcare, physicians, ancillary healthcare providers, administrative personnel and ill people are collaborative multi-protagonists in the patient journey story. In recent years this normative tale has been written into policy documents to replace the traditional healthcare narrative in which a physician is the central character and the clinical management of disease is the central plot. Yet healthcare services still struggle to “conceptualize, institutionalize and operationalize” (Dubbin, Chang, & Shim, 2013) patient-centeredness.

Patients still tell of being treated as secondary characters in a healthcare provider’s sub-plot. The narrative remains more normative than lived. This article empirically examines a healthcare narrative in which there is a central protagonist—the patient. In this narrative, healthcare providers are defined by their medical, ancillary and administrative functions in a patient’s bio-psychosocial-medical journey plot. We identified an archetypal personal journey narrative and examined its relevance to experiential data collected in our ethnographic study of the healthcare experiences of a group of people with the skin cancer melanoma. Our analysis of the events of their patient journeys and their reflections on their encounters with healthcare providers is reflected in a plot structure of the archetypal journey narrative.