In Praise of the Case Study

Psychiatrist and writer Peter Kramer wrote an article this weekend in the New York Times praising the value of stories in medical research.  A friend of his who usually sends him emails about research statistics shared an article that included a vignette about an individual patient: 

It concerned a man hospitalized at age 30 in 1954 for what today we call severe panic attacks. The treatment, which included “narcoanalysis” (interviewing aided by a “truth serum”), afforded no relief. On discharge, the man turned to alcohol. Later, when sober again, he endured increasing phobias, depression and social isolation.
Four decades later, in 1995, suicidal thoughts brought this anxious man back into the psychiatric system, at age 70. For the first time, he was put on an antidepressant, Zoloft. Six weeks out, both the panic attacks and the depression were gone. He resumed work, entered into a social life and remained well for the next 19 years — until his death.

There is a constant tension in the worlds of medicine and psychology between researchers and clinicians.  Researchers are interested in means, normal curves, and probabilities--in other words generalizations.  In the consulting room, however, it is the individual that matters.  A treatment that helps 60% of the population is a great starting place, but in that moment the client needs something that will work for him or her as an individual.  At that moment, personal stories matter. 

Source: Why Doctors Need Stories