Galen and the words of patients

Abstract Galen’s most deeply held professional values included clarity of expression and the epistemological importance of clinical experience. Therefore, it is not surprising that he thought and wrote about communication with patients. His stories about patients show that he questioned them about their symptoms and history, and some stories explicitly teach the lesson that this type of questioning is important. His stories often quote patients indirectly or directly; they are often told partly from the patient’s perspective, and some contain constructions indicating that Galen paid attention to an individual patient’s exact words. In On the Affected Parts , his discussion of the vocabulary of pain – a problem in medical communication still important today – he privileges the common usage of patients over the technical vocabulary invented by Archigenes. He argues that only by listening to patients and their words can we construct a useful vocabulary of metaphors for pain that can bridge the gap in experience between physician and patient. He does not dismiss the words of women or enslaved patients; on the other hand, in a few stories where the patriarch of a family is present and the patient is female or enslaved, Galen’s dialogue tends to engage the head of the household rather than the patient. While some of his stories show off his ability to diagnose patients without talking to them, and others raise the problem of the lying patient, none of these stories would have meaning unless the patients’ words were normally crucial to clinical practice.