Type of Course: Graduate

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.

The tennis partner

Abraham Verghese is a bestselling novelist (Cutting for Stone; The Covenant of Water) and this memoir is written with elegance as deep as his medical expertise as an internist. The story of his close relationship with a medical student whose life unravels through addiction gives profound insight into physicians who struggle with addiction (like anyone else, but also quite differently). His role as a teacher and mentor for medical students gives an up close view of what medical education can be: sensitive and humane, without denying how much physicians must learn under often-stressful conditions. Pre-health professions students, medical students and graduate health humanities courses committed to reading the whole book would find much to discuss about both those issues. I used Chapter 11, an extended examination of and conversation with a patient, hospitalized for various complications of being both a heroin addict and unhoused, to talk through humanistic approaches to medical care with undergraduates.

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.

“Final del juego” por Julio Cortázar

The story revolves around a young narrator, her sisters Holanda and Leticia, their mother, and their aunt Ruth. Leticia suffers from an unidentified back ailment and often directs their play. Told from the point of view of a child learning to understand disability, with emotions ranging from pity to envy: Leticia is excused from chores and catches the eye of an appealing stranger. Could begin discussion of how people with disabilities are perceived and responded to by able-bodied peers and family members, portrayals of relationships. 8 pps (4500 words); Argentinian dialect; some very funny moments.

Para vivir con salud: Leyendo la salud y la literatura.

This open-access resource describes itself this way: "Para vivir offers an introduction to reading different literary and cultural texts from the Spanish-speaking world with a thematic focus on health. It can be used as an alternative to the standard Introduction to Hispanic Literature course texts, as it also teaches techniques of close reading. It incorporates authors from seventeen counties, has an almost even representation of male and female authors and diverse communities in the Hispanic world (European, Creole, Afro Hispanic, Latinx, Indigenous, Jewish). In addition to introductions to reading different genres (narrative, poetry, theater, and film) we have scaffolded supporting material such as biographies, notes on the historical contexts, pre and post-reading questions." Although framed in terms of its uses for literature courses, the literary selections here could be incorporated into many other intermediate and higher level Spanish courses in which reading and composition are central activities. Much primary source material is included in the book itself; when not available due to copyright, there are suggestions on how instructors might be able to access them on their own. Beyond the readings themselves, the book includes a great deal of pedagogical material (introduction to genres and reading strategies), a bibliography that introduces health humanities and links literature to the work of health professionals; ideas for syllabus construction. It is downloadable.

“Rosario Tijeras” Jorge Franco

"Rosario Tijeras" by Jorge Franco is a Colombian novel that explores the world of drug trafficking and its impact on individuals. The story follows Rosario as she grapples with the trauma of sexual abuse, which has driven her into a life of crime within the violent drug trade. The novel also delves into Rosario's mental health and the relationships she forms. Additionally, it sheds light on the effects of child sexual abuse and the physical toll of her criminal lifestyle as they lead to hospitalization. Undergraduates would be highly motivated by the storyline, dialect and characters. 160 pages, only available in print or electronic (paid) edition, but inexpensive ($10 used) and readily available.

“Una puerta se abre” por Adolfo Bioy Caseras

Almeyda considers suicide through internal dialogue that evokes the struggle to weigh life-sustaining alternatives against death. His contemplation turns surreal in an encounter with the idea that "time heals everything" and the possibility to sleep for 100 years. Theme throughout the story is that even in the darkest moments, there are options and opportunities to overcome life's challenges. The final twist, with the reappearance of a key character, emphasizes that love and human connection can overcome even the most desperate times, making clear that suicide is not reasonable or desirable. 10 pages, upper intermediate readers; Argentinian dialect. Useful for a Latin American literature course.

“El sur” por Jorge Luis Borges

"El Sur" follows Juan Dahlmann's journey from a sanatorium on the brink of death due to a head injury. He experiences eight days of intense suffering and pain before his transfer to the sanatorium. Inside, he feels imprisoned and faces the risk of sepsis. His doctor promises a recovery and return to his southern estate. The narrative highlights the impact of physical injury on mental health. Short story appropriate for a Latin American literature course for advanced students; focus on illness and healing brings a different lens to Borges that health-oriented students could appreciate. Available online for free.

LitMed: Literature Arts Medicine Database

Scholars, educators, patients, students, and anyone interested in medical humanities can search this site for annotated entries that describe works of literature, fine art, visual art and performing art related to medicine. Housed at the NYU School of Medicine, the annotations are written by an editoral board of medical humanities scholars from across North America. Users of the site can search by words or phrases of their own, peruse an alphabetical index of titles, or use the extensive system of tags. It is possible to narrow a search to a particular kind of work (e.g., "All visual arts" or just photography, painting/drawing, or sculpture) or to medical humanities topics (e.g., history of medicine, medical anthropology, science and medicine). Stories by "physician" or "nurse" can also be searched. The site has over 3000 items at the time of this submission. An entry includes a summary description of the work as well as a commentary.

The ones we sent away

The author found out at age 12 that her mother had a sister who was institutionalized before age 2 with intellectual disabilities that left her unable to speak. She traces her aunt's life through various institutions, most of them deplorable, and hears her mother's grief over the separation from her only sibling. She contrasts the attitudes and treatment of such disabilities in the 1950's through the 1980's with much more open acceptance and inclusion of nonverbal persons in the 2020's, based on a photo that went viral on Twitter. Detailed memoir of three generations' relationships with the sister: the author's grandmother, her mother, and herself. Traces the evolution of attitudes toward intellectual disabilities in the 20th and 21st centuries from close relationship to the issue, noting that children born today with her aunt's condition are able to live much fuller lives because of greater inclusion in educational, social and family contexts. Includes many links to relevant sources, from memoir to scientific works. About 15 pages; also has audio version.