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Im Rahmen neuroonkologischer Gespräche dient das MRT-Gerät den Ärzten als primäre diagnostische Grundlage, da es bei diesem Krankheitstyp keine einheitlichen Symptome gibt und der direkte Blick auf die ursächliche Läsion versperrt ist. Fokus dieser gesprächslinguistischen Studie ist die analytische Erfassung des für diese Gespräche konstitutiven Moments der Unsicherheit, welches u.a. durch die ständige Anwesenheit von technischen Apparaten evoziert wird. Grundlage der Analyse sind über 140 Arzt-Patient-Gespräche, aufgenommen in der neuroonkologischen Ambulanz eines Uniklinikums. Bei der Auswertung des Datenkorpus werden Latours Akteur-Netzwerk-Theorie, Clarkes Situationsanlyse sowie Flecks Denkstilkonzept gesprächsanalytisch genutzt. Entsprechend werden die beteiligten situativen und diskursiven Akteure als gleichrangig handelnde Partner betrachtet. Die Untersuchung zeigt, wie trotz der vorliegenden Unsicherheiten Vertrauen aufgebaut werden kann. Denn obwohl der Arzt Entscheidungen auf Basis von unsicherem Wissen treffen muss, vermag er durch seine erfahrungs- und denkstilbasierte Analyse des Netzwerkes die Situation und das apparativ gewonnene Wissen partiell zu sichern.

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With over forty years of experience as a sought after diagnostician, Dr. Stuart Mushlin has cracked his share of medical mysteries, ones in which there are bigger gambles than playing the ponies at the track. Some of his patients show up with puzzling symptoms, calling for savvy medical detective work. Others seem to present cut-and-dry cases, but they turn out to be suffering from rare or serious conditions. In Playing the Ponies and Other Medical Mysteries Solved, Dr. Mushlin shares some of the most intriguing cases he has encountered, revealing the twists and turns of each patient's diagnosis and treatment process. Along the way, he imparts the secrets to his success as a medical detective-not specialized high-tech equipment, but time-honored techniques like closely observing, touching, and listening to patients. He also candidly describes cases where he got things wrong, providing readers with honest insights into both the joys and dilemmas of his job. Dr. Mushlin does not just treat diseases; he treats people. And this is not just a book about the ailments he diagnosed; it is also about the scared, uncertain, ailing individuals he helped in the process. Filled with real-life medical stories you'll have to read to believe, Playing the Ponies is both a suspenseful page-turner and a heartfelt reflection on a life spent caring for patients.

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Patients-partenaires, patients-experts, patients-intervenants dans l'éducation thérapeutique de leurs pairs, patients-enseignants… Le rôle grandissant des patients dans le système de santé questionne, tant sur les fondements de ce phénomène que sur les modalités pratiques de leur engagement. Le slogan associatif « Rien sur nous, sans nous » inscrit ce mouvement dans une revendication morale. C'est aussi lui faire justice que de présenter son intérêt pour la qualité du système de santé. L'engagement des patients dans le système de soins sert de levier supplémentaire à la qualité des soins, à partir de différents constats : les actions verticales ne fonctionnent pas, l'expérience des soins des patients peut servir à améliorer les parcours de soins, leur parole a une légitimité particulière auprès des autres malades. Enfin, leurs savoirs situés et leur perspective singulière permettent de concevoir des actions de santé innovantes, ou plus pertinentes au regard des attentes des malades. Ainsi, des patients engagés participent aux actions de prévention en santé, aux soins de leurs pairs, aux recherches, à la formation des médecins. Dans certains champs, leur participation devient un critère de qualité des actions de santé. Cet ouvrage décrit le processus sociohistorique dans lequel s'inscrit le mouvement de l'engagement des patients. Il dresse un panorama des expériences étrangères et françaises et un état des recherches. Il contient de nombreuses références bibliographiques utiles au milieu scientifique et estudiantin, et apporte des éléments de compréhension et des conseils pratiques de mise en oeuvre aux acteurs de terrain.

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