Tag: narrative medicine

Medicine, Meaning, and Identity: Essays from Early-Career Physicians

A female resident navigates modern dating. A critical care doctor becomes one of the first physicians in the United States to contract COVID-19. A pediatrician reflects on her father's passing during her final year of medical school. A Muslim surgeon contemplates whether residency has replaced his faith. An orthopedic surgeon wonders, after a decade of training, if he made the right choices after the death of his brother-in-law. An African American resident painfully asks: Do Black lives truly matter to white coats? For decades, medical humanists have advocated for attending to patients as "whole persons." So, too, the time has come to see physicians as "whole persons." In this urgent, moving collection of essays, a diverse group of early-career physicians write about common experiences in medicine--such as the grueling nature of internship and residency--from a fresh, up-to-date perspective. With particular attention how to the intersections of race, ethnicity, gender, and identity influence clinicians' experiences as caregivers, the featured practitioner-authors reflect on endurance, suffering, and the politics of wellness across their personal and professional lives, delicately capturing a new dimension of healthcare previously unfamiliar to wider audiences. Medicine, Meaning, and Identity invites readers to reconsider the doctor not as a hero, but rather as a complex, whole person; not merely as a healer, but as an integral community member in acute need of healing.

Narrative Medicine activity using Rearranged: An Opera Singer’s Facial Cancer and Life Transposed

Rearranged: An Opera Singer's Facial Cancer and Life Transposed is Kathleen Watt's memoir of her diagnosis and treatment for osteosarcoma. In an article in Teaching and Learning in Medicine, medical student Emmanuel Greenberg and internal medicine hospitalist Elizabeth Lahti provide a narrative medicine activity using Watt's book. Greenberg and Lahti provide a brief summary of the work, noting how Watts' short chapters narrate jher movement through the healthcare system as well as the day-to-day realities of her illness and the ways it impacts her identity and relationships. Greenberg and Lahti each reflect on their own responses to Watts' work. They note that clinicians' own life stories are part of any clinical encounter and they explore (and model) how this kind of self-reflection can improve understanding and patient care. Their article concludes by identifying a passage from Watts' book and providing brief instructions and writing prompts for a narrative medicine activity.

Lost and Found Narrative Medicine workshop outline

This is an outline for a workshop I led for the Northwest Narrative Medicine Collaborative Community of Practice, May 26, 2020. Although this workshop occurred on zoom during the pandemic, it could be modified to address other time periods or other kinds of shared experience of loss. At the time it was offered, we gave the workshop the following description: This pandemic has produced so many losses—some devastating, others disruptive or disappointing. This workshop will provide a space to name our losses, both large and small, and also to name and articulate what we may be finding. In the spirit of narrative medicine, we will use reading, writing, and listening to acknowledge, absorb, interpret, and act on our own and others’ stories of what we have lost and found. The audience for the workshop included Health Care Professionals, Patients, Caregivers, Artists, Scholars, and Students (15 to 25 people) and no previous preparation was expected of them. The outline provides time-markers for a 90-minute session.

Accessible Narrative Medicine digital library

The Accessible Narrative Medicine digital library includes outlines for narrative medicine workshops, as well as "third objects" (poems, short essays, stories, images, items that can be the catalyst for conversation, reflection, and writing). The goal of the site is to encourage the practice of narrative medicine in a wide range of community settings by making available detailed workshop outlines and resources that can be adapted by community workshop facilitators for their particular audience and setting. The developers of the site believe that "narrative medicine workshops should be led by trusted members of a community. In order to create an inclusive safe space, the content and leadership of a workshop should reflect the lived experience of those attending." The outlines and materials focus on the health narratives of BIPOC, LGBTQ+, and persons living with disability. Registration is required to access the materials; once registered, site users can find workshops on core narrative medicine ideals, including attention, witness, and re-presentation. The library of third objects is searchable by topic and genre and includes not only written works but also images and art. The site has secured permission for use of narratives and many of the third objects include a bio for the author/artist, as well as a downloadable PDF of the object.

Honoring and Witnessing Stories

This is an outline for a 90 minute undergraduate class on narrative medicine. It draws on readings by Arthur Frank and Rita Charon to talk about the importance of patient stories for patients to make sense of illness and for health care providers to provide care. It also addresses the importance of witnessing stories as a means of addressing power inequalities and health disparities. In addition to excerpts from classic works by Frank and Charon, the class session incorporates essays by a medical student (Ali) and a practicing physician (McMullen) on the significance of stories in their practice. The outline is from a practicum class, and so the class session includes narrative medicine practices of close reading and reflective writing, as well as class discussion of the assigned readings.

Honoring the Stories of Illness

In this TedX presentation in Atlanta, Dr. Charon describes her practice of narrative medicine and the connections between close reading of a text and paying close attention to what her patients tell her in clinical practice. She describes how she interacts with patients and receives their stories and the ways in which this builds an affilitation that is the foundation for care. I have assigned this video as an introduction to narrative medicine (often in conjunction with one or more readings by Charon about narrative medicine). The video is 18 minutes long so it can also be shown in class to provide a shared reference for discussion.

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.

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.

Please See Me

Online literary journal that features health-related stories in the form of fiction, creative nonfiction, poetry, and art, as well as the occasional film and interview. Issues include multiple works around a specific theme (e.g., Pain, Hope, Mental Health, Women's Health). Work features voices of patients, providers and "healthcare consumers" from their own experiences and perspectives. Written submissions are 4000 word maximum. Examples of featured works include: A mixed media art piece on pain, grief, and hopelessness from an artist dealing with loss and addiction (lil peep in Issue #2: Pain), a poem about medical debt ("Johns Hopkins Sues Patients, Many Low-Income, for Medical Debt" in Issue #9: Open Call), and a mother’s experience raising a son with intellectual disabilities and grappling with an Alzheimer’s diagnosis (Forgetting Aiden in Issue #1: Conversation).

Syllabus Spanish Health Narratives

This 3000-level course is of particular interest to Spanish majors and minors with health professions interests, although readings and assignments are aimed at any Spanish student with intermediate level proficiency. Creative writing majors from English, students interested in editing and publishing, International Studies and Global Health Studies majors, Communication Studies majors with general interests in health, all have succeeded. Readings are from Latinx and Latin American authors; some in English, many in Spanish. Assignments are four creative writing projects, one that becomes a digital video.