Do you need reasons (and citations) for building storytelling into courses or curricular proposals? Do you need to provide background for a grant or community workshop proposal? This page provides arguments and an annotated bibliography for anyone seeking to make the case for incorporating health narratives into their teaching in various contexts.
Stories and storytelling are recognized across disciplines and contexts as a central human activity. Narratives bring people together and are an important way in which they construct meaning, on the level of partners and families, institutions and cultural groups, professions and communities. Within the realm of health, illness and healing, stories bring together patients, caregivers, health care providers, creative writers, and scholars. Reading and writing stories about mental and physical health, caregiving, and grief contextualizes experiences of illness within broader perspectives on language, meaning, relationship, and ethics.
Recognizing this power, many medical schools now offer some form of narrative medicine instruction (Remein et. al 2020), and creation of written and visual health narratives is part of many humanities curricula among undergraduates and programming for adult learners in community settings. Undergraduate programs in the health humanities have grown, from 15 in 2000 to over 120 in 2022 (Lamb et. al 2022).
Additionally, as students and faculty have recognized the need for health professionals to communicate with patients and clients from Spanish-speaking cultures, undergraduate courses in medical Spanish have proliferated, as have Spanish courses in medical schools (Martinez 2018). Beyond the focus those courses provide on linguistic, and to a lesser degree cultural, aspects of communication, Spanish courses that focus specifically on health narratives help students make connections between literature, creative writing, community involvement, and pre-health preparation.
The study and teaching of health narratives is part of the health humanities, an interdisciplinary field that draws upon literature, history, philosophy and the arts to better understand the multiple meanings and impacts of illness and healing; health beliefs and practices in different communities; and health care disparities. Bringing the humanities into pre-health professional education, as well as health professions training itself, has been essential for humanizing medicine and for providing holistic, ethical care. The significance of the health humanities goes well beyond training of practitioners, however. Humanistic perspectives on health are valuable for everyone: those who experience illness themselves as well as those family and friends who care for the ill, and the full spectrum of healthcare providers, from physical therapists to nurses to hospice volunteers. No one, however fortunate, goes through life completely untouched by health issues. To study health and illness, life and death, grief, healing, and suffering, both individual and communal, through literature, culture, history, philosophy and art, we recognize our shared humanity.
Health care is also a site where social inequalities are revealed, and where they may be critically addressed. Health disparities take many forms, from rates of illness and injury to access to prevention and cures. Statistical and demographic studies that document those differences across racial, class, geographical, and age groups are one way to understand the nature and scope of how identities and positions predict health outcomes. Storytelling that illustrates preventable suffering and deaths with names, faces and relational ties of human beings can provide equally rich avenues for advocacy (Dawson et. al, 2011.)
Health narratives are especially powerful in preparing students to make sense of health and to navigate complex health systems as patients, caregivers, health care providers, and citizens. Illness disrupts our taken-for-granted assumptions about our own biographies and about the larger world of which we are a part, and narrating our experience is a way to make sense and rebuild identities and relationships (Becker 1997; Frank 2013). Telling our stories is also a way of seeking and receiving support for illness (Goldsmith 2004). Health narratives have the capacity to humanize illnesses that are stigmatized and to amplify voices that are marginalized (Ensign 2018), and can thus be instrumental in making a compelling case for change in health care systems (Charon 2001). It is not surprising, then, that scholars have turned to narratives (broadly defined to include fiction, nonfiction, poetry, visual images and digital videos) as an important site for the humanistic study of health and illness (Charon 2006; Frank 2013; Kleinman 1988).
Becker, Gay. Disrupted Lives: How People Create Meaning in a Chaotic World. Berkeley, CA: University of California Press, 1997.
Charon, Rita. Narrative Medicine: Honoring the Stories of Illness. Oxford: Oxford University Press, 2006.
Charon, Rita. “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust.” Journal of the American Medical Association JAMA, Vol 286, No. 15, October 17, 2001, pp. 1897-1902.
Couser, G. Thomas. Recovering Bodies: Illness, Disability, and Life Writing. 1997.
Dawson, P., Farmer, J., & Thomson, E. (2011). The power of stories to persuade: The storying of midwives and the financial narratives of central policy makers. Journal of Management & Organization, 17(2), 146-164.
Ensign, Josephine. Soul Stories: Voices from the Margins. San Francisco, CA: University of California Medical Humanities Press, 2018.
Frank, Arthur W. The Wounded Storyteller: Body, Illness & Ethics. 2nd ed. Chicago, IL: University of Chicago Press, 2013.
Goldsmith, Daena J. Communicating Social Support. Cambridge, UK: Cambridge University Press. 2004.
Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books, 1988.
Klugman, Craig M. “How Health Humanities Will Save the Life of the Humanities.” Journal of Medical Humanities, vol. 38, 2017, pp. 419–430.
Lamb, Erin Gentry, Sarah L. Berry and Therese Jones. Health Humanities Baccalaureate Programs in the United States and Canada. Cleveland, OH: Case Western Reserve University School of Medicine. April 2021.
Martínez, Glenn, and Karmin San Martín. “Language and Power in a Medical Spanish for Heritage Learners Program: A Learning by Design Perspective.” Multiliteracies Pedagogy and Language Learning. Eds. Zapata, G. and M. Lacorte: Springer International Publishing, 2018. 107-28.
Remein, Christy DiFrances, et al. “Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019.” BMJ open vol. 10,1 e031568. 26 Jan. 2020, doi:10.1136/bmjopen-2019-031568