Type of Submission: Teaching Material

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.

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.

Worlds Apart Facilitator’s Guide

This is a thorough facilitator’s guide on how to facilitate class discussions on the cross-cultural healthcare documentary Worlds Apart (a detailed summary can be found in the Search for Stories tab). In brief, Worlds Apart is a documentary split into four 10-15 minute sections that each focus on a different cross-cultural health experience, including a Muslim man’s journey with stomach cancer, a Lao woman with a hole in her heart, a Black man waiting for a kidney transplant, and a Puerto Rican woman with diabetes, hypertension, asthma and depression. This documentary showcases narratives that illuminate the limits of Western medicine and expand our ideas of how the American medical system can grow to be more inclusive, equitable, and sensitive.

The facilitator’s guide provides background on the filmmakers and their intentions. It includes suggestions for facilitators such as setting ground rules for discussion and asking students to jot down notes during the documentary. The four-part narrative-driven documentary is summarized, and then each section is broken down in great detail, so even someone who did not watch the film could understand the exact circumstances of each family and individual being featured. After each synopsis we also receive medical background information and a variety of discussion questions specifically tailored to different issues discussed in the stories. Each section has a separate “focus” also outlined, ranging from language barriers to explanatory modules to informed consent to racial/ethnic healthcare disparities to non-adherence to medications. This guide was created “to give health care professionals an engaging experience through which to explore ideas about cross-cultural issues in health care and to learn from the actual experiences of both patients and clinicians,” but could also easily be adapted to a university classroom setting to guide student discussions. The guide does not include any assignments, but any of the issues headlining the discussion topics could work well as research essay prompts.

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.

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.

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.

The Almost Right Word: The Move From Medical to Health Humanities.

Concise summary of the history of medical humanities and how a distinct understanding of health humanities (using disability studies as an example, emphasizing how much of living with disabilities does not happen in medical contexts) contributes to analyzing and understanding human factors in health. Useful as background for undergraduate courses; expanding conversation for pre-health and health professional students.

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 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.