Language: English

Teaching with “The Nocturnist”

Podcast series created by physician Emily Silverman that focuses on humanizing medical practice through healthcare workers' storytelling. Some topics: interview with author of a book on forced sterilization, "Black Voices in Healthcare" and "Post-Roe America". Episodes run 35-55 minutes; first 10-15 is story, the rest is wide-ranging interviews about (e.g.) why did you become a doctor? With related interview (see Farrell, 2022) could be used both to discuss storytelling as a way to address burnout, and to introduce oral history interviews.

In need of a prayer

Physician's story of visit to a suspected-COVID patient from early days of pandemic. Details the stress of not knowing how to protect herself, patients' isolation from his family, lack of treatment options, frantic pace of ER when infections and frequent deaths taxed medical professionals' emotional and physical stamina. Relates patients' conditions to her own father. Vivid starting point to discuss burnout (contrast with simple exhaustion and overwork), remind all audiences of what early months of uncontrollable COVID were like as memories fade. Ends by evoking a Celine Dion/Andrea Bocelli song about prayer that could contribute to discussion of music in healing.

(Not so) golden years

Daughter describes the stress of caring for her aging parent from geographically distant place. Details many issues that created burnout in her caregiver role, including feeling isolated and embarrassed about her struggle until she found out all of the problems she faced were very common for caregivers in her position. Useful to discuss how difficult it is to care for elderly parents, especially from a distance, and caregiver burnout.

Bullet journaling to save a life

An African American woman at a predominantly white institution is diagnosed with bipolar disorder. Along with therapy, she works through her struggles with various mindfulness strategies, including a method described by Ryder Carroll as "bullet journaling." Her story encourages consideration of writing as a mental health practice, describes the author's adaptations of the bullet journal technique, and contains links to a TED talk and a book that go into more detail about this particular approach to intentionality. Useful starting point for talking about therapeutic (and general mental health maintenance) uses of writing. Glances of POC experiences in PWI's, though not much detail.

Listening to Patient Narratives Exercise: Anju’s Breast Cancer story

This is an outline for a class exercise utilizing a video from the Look Now Project. The short documentary tells Ajnu's story of treatment for breast cancer. The class exercise is part of a one-hour session entitled "Between the Lines," part of a training by the Northwest Narrative Medicine Collaborative in collaboration with Lewis & Clark College, which brought together undergraduate students, medical students, and medical professionals for a one-day workshop. In the "Between the Lines" session, we examined how clinical interactions are framed by medical scripts and encourage changing these frames to make room for patient stories. Then we engage in practicing listening closely to patient stories for what is said, how it is said, what is not said, and how our own experiences and identities shape what we hear.

Graphic Medicine: Ill-conceived and well drawn.

An online collection of graphic medicine texts and teaching resources for introducing graphic medicine to different audiences: high school grades 7-10, undergraduates. Features a well-designed module "Comics for health and medicine," organized as an introduction to graphic medicine for undergraduates. The module offers outlines for 7 class sessions, links to suggested readings (graphic texts as well as reference material such as PubMed), discussion questions, activities and assignments, adapted from a Penn State College of Medicine course offered to fourth year medical students. Also offers a lesson plan for grades 7-10.

“A lifespan the length of a dog’s”: Illness as loss in the novel So Much for That

"The clinic and the person" is a podcast series that follows Russell Teagarden's blog "According to the Arts," in which he juxtaposes clinical descriptions of illness and disability with literary texts about characters who live with those conditions. In the podcast, he and another medical professional discuss the condition that is the focus of each episode based on their medical experience, and react to the literary text as attentive, sensitive readers. This episode based on the novel, So Much for That, brings discussion of various ways catastrophic illness puts an end to a family's plans: economically, physically, socially. The website describes the goal of the series as: "developed to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide. ... The Clinic represents all that Biomedicine brings to bear on disease processes and treatment protocols, and The Person, represents all that people experience from health problems. Our episodes draw from works in the humanities--any genres that relate directly to how people are affected by specific clinical events such as migraine headaches, epileptic seizures, and dementia, and by specific health care situations such as restricted access to care and gut-wrenching, life and death choices. We analyze and interpret featured works and provide thoughts on how they apply in patient care and support; health professions education; clinical and population research; health care policy; and social and cultural influences and reactions."

Extreme Measures: Finding a Better Path to the End of Life.

A critical care/palliative care specialist describes hard cases at the end of life, admitting times when she has been unclear about how to advise families making difficult decisions about taking loved ones off of what she describes as the "end of life conveyor belt" of extreme measures seen in emergency rooms. From NYT book review: "Medical training fosters a heroic model of saving lives at any cost. American can-do optimism assumes all problems can and should be solved. Both doctors and patients tend to subscribe to a 'more is better' philosophy. If technology exists, surely it should be used. Physicians' fears of litigation plays a part, as do patients' fantasies of perpetual life. For too many, death remains unthinkable and unspeakable." A 25-minute documentary that features her and shows some of these kinds of conversations is available on Netflix ("Extremis," 2016)

Extremis

25 minute documentary filmed in a hospital that shows patients, families and health care professionals (Dr. Jessica Zitter, pulmonary/ER specialist and palliative care, is featured. See her book Extreme Measures: Finding a Better Path to the End of Life") dealing with end of life moments. Talking through concrete decisions of whether to take a loved one off a ventilator in the same room where the patient lies captures the difficulty of those decisions in agonizing detail. Short enough to show in a class, might be too intense for many audiences (maybe to stimulate discussion among pre-med or medical students). Could be used with a reading like "Letting go," by Atul Gawande, but content warnings are essential. Academy Award nominee.

Creative writing as a medical instrument

"Writing stories can create better doctors." Baruch is convinced that narrative medicine - focusing on close reading - isn't enough to prepare physicians to deal with ambiguities, confusions and conflicts inherent in medical practice. He urges teaching them to write stories so they can hear their patients' stories better. References and describes courses he has taught (one with an MFA creative writer) to teach medical students about characters, conflict, selecting key details ... storytelling elements often emphasized in creative writing. The goal is to encourage them to struggle with words on the screen (or page) to prepare to more deeply understand the fragmented, often confusing stories presented by patients. Good preparation for a teacher contemplating a narrative assignment; maybe less so for the students themselves.