Background: Clinical reasoning and decision making within health care are as important as ever in a world where evidence-based health care and patient outcomes are highly valued. It is increasingly recognized that decisions are not made in isolation, and are influenced by many factors, both intrinsic and extrinsic. Expert and novice practitioners share reasoning techniques, and there are many interpretations of reasoning paradigms within the field of health care. Methods: A reflective diary was kept for 3 months linking personal reflections on a particular clinical decision with theoretical learning on clinical reasoning. Several decision-making paradigms were looked at in relation to the decision, with a deeper focus on narrative reasoning. Narrative reasoning resonated particularly with the author's previous experience studying literature. Results: The clinical decision was usefully analyzed using a narrative reasoning strategy. The decision made by the author was perhaps contrary to the evidence, and yet had a positive outcome. The positive outcome of the decision was looked at within the context of evidence-based practice and ethical practice. Conclusions: Narrative reasoning comes from within the interpretive research model and puts the patient's experience at the heart of decision making. Narrative reasoning can be a valuable way of combining diagnostic, management, and ethical aspects of care. Further research—particularly in podiatry, where research is lacking—could identify helpful reasoning strategies for care of patients with long-term chronic conditions or complex conditions.