Tag: provider-patient communication

The Desperate Son

Witnessing his father's decline from cancer, an oncologist wrestles with his own fears and desperation. The story illustrates what happens when roles are flipped and a health professional finds himself at the centre of a family health crisis. What would you, as a health professional, do when faced with a similar situation? The story could be used to promt discussion about care at end of life and provider-patient communication.

Bibliography: Patient-provider communication stories

A student got interested in patient-provider communication in a part of a course devoted to health narratives. I pulled this together for them as a starting place for them to look further.

Silenced

Donna Lambers, a maternal/fetal medicine specialist, describes the impact on her medical practice and sense of self when her vocal cords are affected by a thyroidectomy for thyroid cancer. She loses the ability to control vocal inflection. "For instance," she writes, "I’m unable to raise my voice at the end of a question... I can no longer tease or kid or be sarcastic with my family and friends, because it comes off sounding mean. My voice, having lost its cadences, is unpleasant to hear; and now, when giving perinatal counseling to my patients, I have no way to convey the empathy and emotion I feel for them..." She describes with great insight the many ways this has affected her interactions with patients, their families, and co-workers, as well as the frustrations she experiences. The story could open up a discussion about the ways in which effective communication requires more than simply clear transmission of information and the taken-for-granted ways that we construct relationships and enact identities through subtle cues. It also speaks to the challenges of this particular non-visible disability.

Close reading a Twitter thread: Blind on the NHS

2 page (total) text presented here is a health narrative presented as a Twitter thread that raises issues that could be connected to several themes in courses related to health communication, reproductive justice, public health, narrative medicine, or more general writing courses to which the instructor wanted to add a health component. The outline includes detailed instructions for close reading the text, a central form of inquiry in narrative medicine. The goal of this instructional strategy is to can help participants attend closely to the narrative and find a point of personal connection to it. The format of the health narrative - a thread of about 20 tweets - lends itself to analyzing the role or impact of the medium on circulation of the message. Short enough to read aloud in a 45-50 minute class and work from there; could also be used in a workshop or storytelling group centered on prenatal care and/or disability.

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.

Pulse- Voices from the Heart of Medicine

Pulse- Voices from the Heart of Medicine is an online publication that features stories, poems, haikus, and visual works from various voices within the healthcare field. Stories come from health care providers in various roles and from patients and family members. For example, “Cultivation Also Starts With C” is a poem that uses the invasive, difficult to remove plant Japanese knotweed as a metaphor for cancer and “Another GSW” details a young doctor’s encounter with a patient who had extensive injuries from a single bullet wound, and how the experience made her consider the ramifications of gun violence in America. Length of items ranges from 40 to 400 words for written works. Each month's issue is on a theme (recent examples included Alone, Coming Undone, Unsung Heros) and the "New Voices" section features "stories by those whose faces and perspectives are underrepresented in media and in the health professions." The website offers several ways to search. For example, one can click through content by year, all the way from 2023 to 2016. When you click on a story, you can also see a lengthy list of “popular tags” that you can click on to search by subject matter. The "visual works" tab includes an option to see a slideshow of submissions, as does the "haikus" tab, which could be helpful for more efficient browsing. Other notable features are that the stories and poems tabs display a phrase from each submission as an attention-getting preview. Similarly, the “more voices” tab displays a themed photograph with each submission.

Health Narratives syllabus

This is a syllabus for an undergraduate junior/senior level semester-long course at Lewis & Clark College. The course focuses on how stories of health and illness are a place to explore the rhetoric of identities, relationships, health care, and public policy. For example: How do we use narratives to (re)construct identities altered by illness? How can narratives (re)shape interactions between patients and health care providers? What narratives capture public attention and with what implications for health care decision-making and policy? The course covers theories and research on health narratives and narrative research methods. It serves as an overview to this area of research as well as a training ground for doing your narrative research. The course is an elective for students in the Rhetoric & Media Studies major but also draws students from sociology, English, and pre-health. The course is a 25 person seminar-style course for juniors and seniors.

Class outline for teaching Parsons’ Sick Role

Outline for a 60 minute lecture/discussion on Talcott Parsons' concept of "the sick role." Arguments for the significance of patient voice and narrative (e.g., Arthur Frank's Wounded Storyteller) often take Parson's sick role as a point of contrast. Likewise, the practice of narrative medicine by physicians is a rejection of the paternalistic and objective physician that is the counterpart to the "sick patient" in Parson's analysis. The outline is from an upper-division undergraduate course on health narratives offered in a department of Rhetoric & Media Studies (the course also enrolls students studying sociology, English, and pre-health). The class outline provides a very brief background to Parsons' larger project, goes into some detail about the elements of the sick role and the corresponding role of the physician. The session ends with discussion questions about the implications of this concept.