Tell Me a Story: Giving a Voice to Patients Through Narrative Medicine

Lisa Moss Calderwood, MASenior Medical Writer

“I’m a doctor and so I need to know a great deal about your body, your health, and your life.”Can you imagine your doctor saying that to you, and then just sitting back and listening as you share your history?  Well, that’s what Rita Charon, MD, PhD, a well known proponent of narrative medicine, says to her patients.

Dr. Charon describes narrative medicine as the place where medicine and literature meet. This relatively new field of study aims to replace impersonal care with listening and empathy. When practiced effectively, narrative medicine puts the patient’s life story in context with his or her illness, presumably leading to care that is more attuned to the individual patient.

Dr. Charon had a busy clinical practice and found she wasn’t really listening to her patients. After receiving a PhD in Literature, she found that the focus on storytelling helped her listen better to her patients’ personal stories. It shifted the whole focus of her practice. She went on to develop a Master’s degree in narrative medicine for Columbia University that has attracted students who are patients, healthcare professionals, and literary scholars. In a 2009 NYTimes.com article, one physician said she enrolled in the program to “become a better doctor.”

According to Columbia University’s Web site for the Master’s program, narrative medicine addresses the “need of patients and caregivers to voice their experience and to be heard and to be valued… And it acknowledges the power of narrative to change the way care is given and received.” With this approach, a patient presents symptoms as part of the bigger picture of his or her life. In turn, a healthcare professional takes a more empathic approach and may be prompted to ask questions such as: “What’s really behind that chronic pain? What kind of work does the patient do? What cultural influences need to be considered?”

The narrative medicine curriculum, now being taught internationally in several academic institutions, typically includes philosophy, literary and psychoanalytic theory, autobiography, and literature focused on illness. Training is given in close reading, attentive listening, reflective writing, and bearing witness to suffering.  Narrative medicine workshops are also appearing in community colleges and for faculty development to get conversations started among patients, caregivers, educators, and healthcare professionals.

Given the political and economic stressors on our healthcare system, narrative communication strategies may offer a tool to help support today’s focus on patient-centered care.

Artcraft Health Education’s CARE™ principles also empower patients to have a voice by providing health education tools that are clear, actionable, relevant, and engaging. To learn more, visit http://www.artcrafthealthed.com/.

1 TEDxAtlanta, Dr. Rita Charon. Honoring the Stories of IllnessTEDxAtlanta - Dr. Rita Charon - Honoring the Stories of Illness - YouTube. Accessed October 1, 2013.

Resources:

Charon R. Narrative Medicine: Honoring the Stories of Illness. New York: Oxford University Press; 2006.

Charon R. What to do with stories: the sciences of narrative medicineCanadian Family Physician. Vol 53: August 2007.

Kolata G. Narrative Medicine: Learning to Listen. NYTimes.com. Published online: December 29, 2009.  Accessed September 29, 2013.  (Published in print, The New York Times, January 3, 2010.)