This paper considers the methodological implications arising from competing narratives of an organizational change process in a large acute city teaching hospital. This qualitative case study was informed by a processual-contextual perspective, and relied on an interpretive, constructivist epistemology. Two forms of contradiction are revealed. First, differing accounts were offered of substantive dimensions of the change programme. Second, the impact of change on organizational effectiveness was indeterminate. This study suggests that the unitary, authentic narrative is illusory. Political motivations underpinning account-giving, and phenomenological variations in the lived experience of change, make competing narratives a naturally occurring phenomenon, not a methodological aberration. These findings have two main implications. First, case narrative validation through triangulation should be abandoned in favour of the pursuit of polyphony and ambiguity. Second, the researcher faces the choice of being either an arbiter of accuracy, or of holding the less comfortable, more challenging, but creatively constructive role of exposing organizational tensions, disputes and contradictions.