Step 5 – “Narration”

Narration has 4 Parts (usually 4 paragraphs). They are Me1, Me2, Me3 and LONS. 

Me1

• Me1 is the second paragraph of a letter.
• It has only Medical (M) and Emotional (E) information about the patient.
• Medical: Accident, burn, pain or any other physical issues.
• Emotional: Any psychological issues such as stress, anxiety, suicidal ideation, bereavement, etc.
• We write Me1 in Simple Past Tense. Was admitted; Was diagnosed; Underwent MRI, etc.
• We include very recent history.
• The most common pattern is PADC TDT (Patient + Admitted + Date + Complaints. Tests + Diagnosis + Treatment).

Sample:

Mr Miller visited on 14th May, 2025, with fever, cough and shortness of breath for the last 4 days. His chest X-ray revealed bilateral infiltrates, CBC showed leukocytosis; however, his COVID-19 tests showed negative. He was diagnosed with community-acquired pneumonia and his treatment was commenced on Ceftriaxone, Azithromycin, Paracetamol along with Oxygen administration.

Me2

• Me2 is the third paragraph of a letter (if Me1 did not exceed more than 1 paragraph).
• It also has only Medical (M) and Emotional (E) information about the patient.
• We write Me2 in Simple Present Tense. Was admitted; Was diagnosed; Underwent MRI, etc.
• We include the current status of the patient’s condition.
• Usually we start the Me2 with “At Present, Mr Miller is stable….”
• Do not follow any pattern. Include the present progress / worsening, current medication, etc.

Me3

• Me3 is the fourth paragraph of a letter (if Me1 and Me2 did not exceed more than the usual 1 paragraph each).
• It also has only Medical (M) and Emotional (E) information about the patient.
• We write Me3 in Past Tense. He was diagnosed with diabetes mellitus in 2022; underwent appendectomy in 2024, etc.
• We include the patient’s past medical history / family medical history.
• Usually we start the Me3 with “Please note, Mr Miller underwent angioplasty in 2025….”
• Me3 is mostly not required. It is included when the patient is unknown to the recipient. 

LONS

• This is usually the fifth paragraph of a letter (if Me1, Me2 and Me3 did not exceed more than the usual 1 paragraph each).
• LONS is different from Me1, Me2 and Me3.
• LONS stands for the patient’s Lifestyle, Occupation, Nutrition and Social information.
• We write LONS in Present Tense. A retired teacher, Mr Miller smokes less than 10 cigarettes per day and consumes a large amount alcohol.
• Usually we start the LONS with the patient’s occupation. “A truck driver, Mr Billy lives in a rented accommodation. 
• Like Me3, LONS also is not entirely required.  

Now, let’s move to Me1 Paragraph.