An open-source guide
There are several considerations to make when writing autobiographical case reports that do not apply to the typical process, including ethics, narrative style, and adaptations.
Only undertake writing an autobiographical case report if it will benefit you or others, and will not harm you or anyone else1. Consider justice; for example, in your literature review, highlight the relevant experiences of marginalized people.
You will not completely avoid issues of confidentiality by choosing yourself for a subject. While the story of your own life and actions is yours to tell, it is also fundamentally interwoven with many other stories. Writing that mentions others in any way — a provider, supportive family member, fellow patient, etc. — opens you to potential personal and legal risks, even if you have made an effort to anonymize their involvement2:
When others are mentioned, anonymize any details that can identify them and/or that they might not want public, such as private medical history or mental health issues3.
While you should present the facts of your own case as accurately as possible, consider each piece of confidential information as if a doctor were considering disclosing it in a case report. Focus on information that supports your case presentation, and leave out extraneous details.
By definition, you consent to participation in autobiographical writing. However, be sure that your consent is informed; for example, be aware that personal details shared may be read by a much larger audience than initially intended. Consider the potential harms of writing and sharing your case report.
If you intend to include details involving anyone besides yourself, obtain informed consent from them, as well3. This essential step communicates respect for their dignity and autonomy. (Written consent does not need to be included with a case report, but you should keep it with your personal records.) Always be sensitive to cultural and personal differences that arise.
Autobiographical work is generally viewed with healthy skepticism, because warping one’s own story in the course of telling it is arguably unavoidable. Always consider how your personal biases have affected your written narrative, and take care not to exagerrate or cherry-pick.
Only speculate explicitly, such as under Discussion. Fact-check information, and cite the data and references you find to support your conclusions. Be transparent about methodology, findings, and other processes. Avoid elaborate narrative devices and overly descriptive language, which detract from your perceived objectivity.
As with all writing, avoid plagiarism and fabrication. Replace stereotypes with complexity based in cited literature and personal experience.
List yourself as the first author. Only list authors if they had some involvement in putting together your case report, never as a gift or shout-out3.
Because writing one’s own case report is a more subjective process, it is important to disclose that the work is autobiographical. Displacing the details of your case onto a fictional subject is arguably misrepresentation.
Instead, address potential biases and any dual roles (e.g. therapist and patient), and what steps you have taken to navigate these complexities. Disclose any conflicts of interest, such as a treatment you hope to qualify for upon presenting your case report.
If you are a member of a professional organization or affiliated with a university, utilize their ethics resources. Consider these ethical decision-making models:
Most published autobiographical case reports are written from the first-person perspective4. The benefit of this approach is that it emphasizes the subjective nature of the work.
Some examples use objective, fact-based information, while others include more experiential information and poetic language. Your choice depends on your own written voice, and the intended audience. For example, you might disclose that you are the subject, write in predominantly objective third-person, except for a Discussion section that features more subjective, first-person language.
When following the CARE Guidelines for case report structure5, integrate the following considerations if the work is autobiographical.
The keywords included in paper titles help identify them, both to human readers and automated systems. Be sure to include ‘autobiographical case report’ in your title. (A ‘case study’ usually involves further data-gathering, such as interviews or a survey.)
In addition to summarizing the condition(s) discussed, the abstract to an autobiographical case report should state (from first- or third-person perspective) that it is the author’s first-hand experience. If the abstract does not disclose the autobiographical nature of the work, it is possible that this detail might be missed in the future, such as if a researcher only reads the abstract and not the entire work.
While ‘autobiography’ is a valid MeSH keyword6, it is rarely used in published autobiographical case reports. Focus on keywords relevant to the condition, treatments, etc described within.
Describe the condition(s) as typically defined, including symptoms and outcomes, with citations. The idea is to ensure that a reader without your conditions has some idea of what they are before they begin reading about your specific case.
Introduce the author as subject. Emphasize why this case is unique and worth reading about. Cite the CARE Guidelines as required, as well as this guide if desired. (The introduction is sometimes written from third-person perspective even when the narrative is first-person, possibly to accommodate readers who expect third-person academic writing.)
Note that many published autobiographic case reports do not include the following sub-headings, and instead integrate the information into a single narrative. When presenting comorbidities, this section may instead be split up by condition.
Clearly indicate that you are both patient and author, ideally by writing from first-person perspective.
Provide a comprehensive background, starting with basic demographic details. Include essential medical history that is relevant to the case. Your social history should include any psychological and environmental factors that have influenced your condition(s). Reflect on previous interactions with providers, and any long-standing personal goals or concerns.
Objectively describe symptoms, physical examination findings, and relevant personal observations. Aim for accuracy and lack of bias, but where possible, take advantage of opportunities to enrich the portrayal of your condition(s). Where academic narratives can lack complexity (e.g. ”patient presented to emergency room”), autobiographic writing makes space for nuance and detail (e.g. how your symptoms emerged and when/why you decided to visit the ER). For example, readers might not be aware of the ways your condition causes you inconvenience or invites judgment.
When presenting key dates and significant changes in condition, be sure to include important details that seem obvious but may be unclear from outside.
As you present diagnostic findings, reflect on how being the patient influenced your perception of the diagnostic process. Explore your internal and external reactions to diagnosis, bearing in mind that others with your condition may eventually read about your experiences.
Discuss treatments you have undergone, including lifestyle changes, medications, therapeutic regimens, surgeries, and alternative interventions. Provide insight into the decision-making process behind each intervention, and mention any adjustments made, challenges faced, and impacts on your daily life. Readers will be interested in whether you found certain treatments easy, challenging, effective, pointless, and so on.
Describe the observable results of the therapeutic interventions, especially improvements or deteriorations in your condition(s). Provide both objective results, such as changes in lab results, and personal reflections. Be specific about how these changes have impacted your daily life, functionality, and overall well-being. Include long-term outcomes, if available.
Highlight any ongoing treatments and their efficacy, as well as any future plans for managing your condition. Reflect on how providers engaged with the follow-up process.
Present a review of relevant academic literature that explores your presentation. Highlight the gaps, similarities, and differences between this broader research and your individual experiences. Support your conclusions with existing studies wherever possible.
Discuss the uniqueness of an autobiographical perspective, and how this experience has impacted your understanding of your condition(s) and management. Suggest ways in which your personal narrative can contribute to a better understanding of the condition.
Finally, present your conclusions (optionally, under a ‘Conclusion’ heading) and suggest that your findings be integrated into evidence-based practice and further research.
This section is redundant in autobiographical work and is usually omitted.
This section is usually omitted from autobiographical works. If you include it, clearly state that you have given informed consent for the publication of your own case.
Varkey B. (2021). Principles of clinical ethics and their application to practice. Medical Principles & Practice: International Journal of the Kuwait University, Health Science Centre, 30(1), 17–28. https://doi.org/10.1159/000509119 ↩
Knight, M. (2018, March 31). The legal risks of writing memoirs. Sidebar Saturdays. https://www.sidebarsaturdays.com/2018/03/31/https-wp-me-p7vddb-ao/ ↩
Cornock, M. (2021). Case reports and ethics: Focus on consent, privacy and authorship. Case Reports in Women’s Health, 32. https://doi.org/10.1016%2Fj.crwh.2021.e00358 ↩ ↩2 ↩3
See Example Case Reports. ↩
Riley, D. S., Barber, M. S., Kienle, G. S., Aronson, J. K., von Schoen-Angerer, T., Tugwell, P., … & Gagnier, J. J. (2017). CARE guidelines for case reports: explanation and elaboration document. Journal of Clinical Epidemiology, 89, 218-235. https://doi.org/10.1016/j.jclinepi.2017.04.026 ↩
NIH National Library of Medicine. (2019, July 10). ‘Autobiography’ MeSH Descriptor Data 2024. https://meshb.nlm.nih.gov/record/ui?ui=D020493 ↩