Type of Course: Professional

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.

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.

List of resources on Grief

In February 2024, the following request was posted to the Health Humanities listserv: "I'm in the process of compiling a reading list for people (of all ages) who are grieving /working through loss. I'd like to include: poetry anthologies, graphic or traditional memoirs, novels/short story collections, children's picture books/youth fiction, and story-based films." The request came from Allan Peterkin at the University of Toronto, who is compiling a list. Not surprisingly, recommendations also included works on death and dying. The attached document provides a list I compiled from this thread of the listserv.

Literature and medicine: A short course for medical students

This article describes an informal course on literature and medicine for medical students. A wide range of books, plays and poems were used with medical and non-medical themes. Students enjoyed the course and particularly welcomed the non-medical components. Several book lists are provided with an emphasis on classic authors (e.g. Jane Austen, Harper Lee, Lewis Carroll, although The Color Purple is also included in one). Description focuses on general structure and students' reactions rather than details of discussions. The author urges informality for this kind of literary discussion and suggests even calling it a "club" rather than a "course." Could be useful to discuss ethics of care or as a starting place for a more diverse reading list.

Bibliography of poetry collections

In this blog post, poet Celeste Lipkes recommends poems she characterizes as "confronting difficult-to-discuss medical diagnoses." Her list includes a variety of conditions and the poems are written from a variety of perspectives, including health care providers, family members, and patients. She provides a brief synopsis of each collection, including examples.

She reviews (and provides links to purchase) the following poetry collections:

Radium Girl by Celeste Lipkes: A physician writes about her experience as a young woman with Crohn’s disease
Black Aperture by Matt Rasmussen: A man writes about his brother’s suicide
Big–Eyed Afraid by Erica Dawson: A black woman writes about her experiences of bipolar disorder and obsessive compulsive disorder
Blue Sonoma by Jane Munro: A wife writes about the progression of her husband’s Alzheimers
We Mad Climb Shaky Ladders by Pamela Spiro Wagner: A woman writes about her experience of schizophrenia
The Hemophiliac’s Motorcycle by Tom Andrews: A motocross racer writes about having hemophilia
Deluge by Leila Chatti addresses medical care for women’s reproductive health, including her treatment for heavy uterine bleeding
The Tradition by Jericho Brown: A black man writes about, among other things, his HIV diagnosis
Impossible Bottle by Claudia Emerson: poems published posthumously by a woman who died from cancer
Still Life by Jay Hopler: poems published posthumously by a man who died from prostate cancer

Depression Quest

This is a choose-your-own adventure game that aims to illustrate what having depression is like, specifically for those who have not experienced or have not been diagnosed with depression. The creators stress on the opening page that the game is not representative of everyone’s experience with depression, but is an amalgamation of different or shared experiences from people with depression. Each “level” has a different description of what the character, you, do or can do throughout the day. You then have the opportunity to choose between a few options that lead to different results or storylines. Some of the options are portrayed as beneficial while others are harmful. Some levels, specifically when the character’s depression is particularly extreme, show answers that are red-lined and unavailable to us, although we can read them. There are many different endings that appear depending on what choices you make throughout the game, meaning that everyone in the class who plays could have a different outcome or experience, which can lead to an opportunity for discussion. The creators end the game with this message : “Instead of a tidy ending, we want to just provide a series of outlooks to take moving forward. After all, that's all we can really do with depression - just keep moving forward. And at the end of the day it's our outlook, and support from people just like you, that makes all the difference in the world.” This narrative experience could be used to discuss themes such as immersive and experiential learning, including controversial learning models such as disability simulations It can also be used to discuss what we value in narratives: does the ability to act as the character immerse us more? Do we feel distanced without an author to connect with? The game play could be supplemented with other reading materials to compare and contrast different uses of narrative. When the game was released, it was also caught up in the “gamer-gate controversy” (described in a New Yorker feature article: https://www.newyorker.com/tech/annals-of-technology/zoe-quinns-depression-quest). This larger context for the game could prompt discussion about stigma associated with depression, and the appropriateness of using a “game” to educate in this way. Users have the option to "play for free" or "pay what you want."

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.

Health Humanities syllabus repository

The Health Humanities Consortium's Syllabus Repository is a searchable database of syllabi from academic, professional development, and public education programs with a connection to health humanities. Not all of the syllabi are focused on health narratives, but many are, and many of the syllabi on broader health humanities-related topics include narrative readings, assignments, and other material. For example, a search for the topic, "narrative," brought up numerous results, including courses on narrative medicine, illness stories, medicine and literature, autobiography, media, writing, social history, and gender and race. The site is searchable by course topic, discipline, level of course, and modality. Users are also invited to share their own syllabi.