Informed by Geertz’s identification of the need for ‘thick descriptions’, but influenced too by Wenger’s Biographical Narrative Interpretive Method (BNIM) and Hollway and Jefferson (Wengraf, 2001, Hollway and Jefferson, 2000), I settled on an in-depth, face-to-face, narrative-inducing interview approach with individual doctors. Each would be unique and unreproducible, intended not be considered as representative of doctoring experience in its totality but as a representation of the experience of an individual doctor. Aiming for an ethnographic style of interviewing, equipped with a framework to serve as an aide-memoir (Wengraf, 2001, Heyl, 2001, Hollway and Jefferson, 2000, Riessman, 2008), I sought a pattern where the interviewee spoke at length to develop narratives, while I focussed on content and maintained emotional engagement with minimal encouraging verbal and non- verbal responses (see Appendices 7-8).
Exactly half of the participants chose to meet at their family home, five at their workplace and one in a university office. Photographs of scenes from close to their workplaces together with field notes about physical environments and interactions added ethnographic dimensions to the spoken interview. Pre- interview notes were simple jottings about what I could recall about the person I was to meet and impressions from our preparatory email contacts (Emerson et al., 2001). Each interview began with re-confirmation of consent, a brief summary of objectives, and a reminder that at any stage we could stop or change focus.
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As expected, one story led to another; an interviewee might launch into detailed explanation, or slip over something of interest to which we would later return to explore further, constantly negotiating a flow of talk. Specific incidents were explored with visual detail and reflection on the effects of such events. Giving precedence to the voice of the interviewee, I would listen and begin a process of interpretive thinking; an interviewing style designed to utilise a socially interactive capacity to learn from what is new and to develop greater objectivity (Hammersley and Atkinson, 1995).
Iterative development of interviews continued as I explored more deeply in new areas which had been introduced by earlier participants and, as data opened through analysis, additional data and understanding built layer on layer as fieldwork progressed (Charmaz, 2001). I followed the BMIN principle of probing by re-using terms first used by interviewees. Specific incidents to which interviewees attached particular significance preceded explanation of subsequent decisions and actions.
Interviews continued for 85 to 140 minutes with a short period before or after the recording where social ‘catching-up’ occurred but this did not upset our tacit understanding that my presence was dedicated to the ‘work’ of an interview (Pope, 2005). All were informal and suffered little interruption. Narratives developed as we spoke, to and fro, as equals negotiating in a language where one is attempting to understand what the other is attempting to communicate. To comments like, ‘you know how it is’ I frequently responded by asking them to clarify what they meant by particular statements, believing it better to partially estrange myself from this assumed shared knowledge while trying to avoid an incongruous naivety (Rock, 2001, Hammersley and Atkinson, 1995). Transcripts confirmed that my interjections were minimal as the balance of talk was dominated by interviewees.
Naturally, doctors differed in how they preferred to present both themselves and their stories. All were fluent, as is often the case in elite groups accustomed to holding an
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audience (Pope, 2005), and conversed freely on a wide range of topics and links with previous comments. Occasional hesitance or experimenting with how best to express thoughts confirmed likelihood of ideas which had not previously been voiced – perhaps developing a story in the telling of it or one which had only been shared with a very restricted audience (Smith, 1978). A sense of performance marked particular stories (Riessman, 2008); the single most shocking statement was delivered from behind my back at a point immediately before a doctor left allowing me to absorb it before we resumed. This carefully managed pause, together with use of speech patterns and shared humour, indicated that in many respects this interview approach allowed interviewees to mimic the structure of naturally occurring conversations. Stories of decision-making were often accompanied by a reasoned explanation and a message of things having turned out ‘quite well in the end’ was common. My prepared list of pre-selected topics proved unnecessary and since participants had arranged an open schedule; the talking continued for as long as seemed necessary.
Interview conclusions differed; after a comprehensive account, one doctor appeared satisfyingly drained of her ‘whole story’, another’s optimistic mid-interview stories ebbed away to reveal a darkly pessimistic view of future NHS medical practice– I was relieved that when I left his lively family were already home. For some it felt cathartic to speak about things which had been semi-forgotten, good to ‘get it out’ and surprise that it could prove interesting. Usually, as recording ended, talk transferred briefly to asking about contacts with other colleagues; ‘normalising’ activity which effectively returned us to our former non- research, social relationship. Afterwards I paused to make notes of anything which might help situate the interview; smart surgery building, dingy office, thoughtful choice of refreshments, frank opinions which escaped the recording. I also set down my immediate reactions to what I had heard; what was expected or surprising, enlightening or depressing and, in a temporary shadow of fatigue and uncertainty, naively wondered if the interview would yield useful data.
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Although my original intention was to conduct an interviewing process over more than one interview (as per BNIM) this proved unworkable; participants were instead willing to devote time to a prolonged initial interview, talking until they had covered everything they wished to say. Although we agreed on opportunities to have later email contact, no participants spontaneously offered further data. Clarification of specific points was only partially successful; it appeared that having stepped away from the context of the interview, it was difficult to re-visit the conversation in a meaningful way; one responded only to say that she had ‘moved on’.