Narrative medicine is a form of medicine that draws on literary theory, narratology, and aesthetics. Its intellectual foundations come from literary theory, continental philosophies, and aesthetic studies. Narrative medicine also has clinical foundations in primary care practice, psychoanalysis, and cultural studies. In short, it’s a way to bring value back to the subjective experience of suffering.
Stories about illness
Narrative medicine is an emerging form of health care that seeks to address the commodification of health care, a system in which corporate concerns are given precedence over the needs of patients. These stories aim to provide a human voice in a commodified health system. While many people are skeptical of the concept, there are a number of advantages to this new practice. Below are three of the most compelling reasons to use stories about illness as part of your health care strategy.
Narrative medicine attempts to address the psychological and relational aspects of illness. It seeks to validate a patient’s experience and promotes creativity in physicians. In addition to helping doctors understand a patient’s experience, it can help patients connect with themselves and their doctors. Narratives about illness can be incredibly moving. This book addresses this issue head-on. It offers a valuable perspective and practical guidance for physicians interested in applying narrative methods in health care.
A key step in using stories to improve health care is to tell a healthcare provider that you are interested in narrative medicine. Even if they do not specialize in narrative medicine, they should be open to sharing stories about your health and illness. In fact, many practitioners will even begin a new patient’s first visit by asking, “What would you like me to know about you?” Having this conversation before you go to see your practitioner can help you build a compelling narrative.
Stories about illness should be read in their cultural, social, and structural contexts. Underresourced patients often have trouble following complicated treatments. Their illness narratives can offer a powerful means of addressing these issues, and a critical reflection on the effects of implicit biases and structural inequities. While this approach might not be practical for every practitioner, it can be beneficial for those who are seeking to develop holistic healthcare and cultural competency.
Relational healing
When couples are struggling to make their marriage work, storytelling can be a powerful tool to help them heal. Narrative medicine is an emerging field that uses tools from several disciplines to create a more effective clinical encounter. The Keck School of Medicine’s Master of Science in Narrative Medicine seeks to develop the skills necessary to do this kind of work, including bear witness, act upon trauma, and facilitate ongoing healing.
The field of narrative medicine began in medical education at Columbia University. Rita Charon, a doctor who holds a Ph.D. in literature, is one of the founding members of the Department of Medical Humanities and Ethics at Columbia. She has dedicated herself to defining the field and establishing similar programs at medical schools around the country. Narrative medicine is a way of looking at the body, mind, and spirit as a whole.
During the study, sociologists examining the practice of medicine noted that physicians often exhibited a lack of empathy toward patients. Their concern for the patient was often centered on the disease and not the person. However, narrative medicine is a new field that integrates the skills of storytelling with empathy and analysis. This article explores the potential of narrative medicine in treating relationships between doctors and patients. The benefits of storytelling in medical practice are significant, and include a new approach to dealing with trauma.
Using narrative medicine improves a patient’s care and physician’s understanding of their life. It requires more time and effort from the clinician. Without compassion and humaneness, medical care results in a high rate of dissatisfaction among patients and a higher incidence of reoccurring ailments. The biopsychosocial model of medicine carries the same holistic approach to patients and physicians, but emphasizes a caregiver’s thoughtfulness toward the sufferer.
Empathy
This study investigated whether physicians can learn to show empathy through story-telling. Participants included physicians, traditional Chinese doctors, dentists, nurses, paramedics, and other health care professionals. Participants were split into two groups: single groups and team groups. Each group produced a narrative article about a clinical case, and the teams performed a drama based on the story of the patient. The results show that physicians can learn to show empathy through stories.
Developing empathy in medical students requires careful consideration of a physician’s approach. Developing empathy in patients is an essential part of building trusting relationships. Moreover, it may improve the outcome of medical procedures and treatments. A factor analysis study found that empathy contributed to 52% of the variance in patient satisfaction with care. Empathy in doctors can be defined as the capacity to experience warmth and compassion toward others. Empathy is also characterized by concern for the other person’s feelings and thoughts.
A common misconception about empathy is that physicians cannot experience the suffering of each patient. The patient cannot fully express her or his emotions to a physician, but the physician must have knowledge about the patient’s situation. This assumption is rooted in a medical mindset that considers emotion a secondary factor. Empathy in physicians does not require a medical professional to experience any pain or suffering – the physician simply needs to understand the patient’s perspective to provide effective care.
In practice, however, this understanding may not be so easy to achieve. Empathy must be cultivated by being aware of a patient’s symptoms, emotional reactions, and future expectations. This is a complex process that requires considerable discernment. However, it is essential for empathy to be fostered in the patient’s treatment. It is possible to develop empathy by analyzing a patient’s story in the context of a narrative.
Restoring value to subjective experience of suffering
The principles of narrative medicine are not new but their implementation takes time, particularly for medical professionals. Two prominent advocates are Pam Ressler, a registered nurse and faculty member at Tufts University School of Medicine, and James Stark, a physical therapist at Bronson Healthcare System in South Haven, Michigan. Both argue that narrative medicine provides a framework for processing complex emotional and social experiences and encourages sustainable methods of self-reflection.
Some critics argue that narrative medicine has no place in clinical care. Dr. Stephen Ressler maintains that concepts of narrative medicine fit within the scope of the work of medical practitioners. However, some others argue that narratives can help clinicians avoid making incorrect assumptions about patients. However, there is no consensus on the exact role of narrative medicine in clinical care. It is important to note, however, that narrative medicine should not replace traditional medical care.
Narrative medicine can enhance medical education by increasing self-awareness and promoting humanistic content. One medical student who undertook the process of writing her narrative during a neonatology elective module wrote a narrative as part of a project to foster self-awareness. In addition, the reflective writing encouraged her to engage with her negative emotions, leading to a greater sense of empathy for both the baby and the mother. After all, she had originally seen baby G as a passive object – a position she had been accustomed to holding.
While the language of a chronic pain patient is not a narrative, there is an unavoidable complication: Western medicine is unable to interpret their patients’ nonnarrative language. Moreover, neoliberal corporate capitalism measures health care in terms of efficiency and has reduced the amount of time patients spend with doctors. As a result, physicians do not have enough time to understand the patient’s narrative and interpret it in a meaningful way. As a result, Western medicine is doomed to fail.
Reducing physician burnout
The AMA’s Moving Medicine video series aims to raise physician voices. Here, chief experience officer Todd Unger talks with Jillian Horton, MD, associate professor of internal medicine and author of the national bestseller We Are All Perfectly Fine. They discuss physician burnout and mindful practice of medicine. Watch the full video to hear the conversation and learn more about how narrative medicine can help doctors find balance in their careers.
The authors are grateful to the Stanford Medicine Residency program leadership, the Med-X nursing and administrative teams, and the medical residents who participated in narrative medicine workshops. In addition, they acknowledge the contributions of Donn Galvert, PhD, and Candice Kim for their contributions to data analysis and regional presentations. The authors also acknowledge the support of other colleagues in the medical field for the creation of this program. They encourage more medical schools and residency programs to adopt this model.
The application of narrative medicine has many benefits, especially for the dynamic between physician and patient. Physicians who develop narrative competence walk with patients through their disease processes, offer support to their colleagues, and reflect on their own challenges as physicians. Narrative medicine has been shown to reduce physician burnout, and Rosenberg hopes to make this new approach more widely accepted. Let us explore how storytelling can reduce physician burnout. The benefits of narrative medicine are endless.
One of the biggest challenges for residency programs is implementing narrative medicine workshops on highly demanding inpatient teaching services. However, residents and faculty were highly rated for this technique. The authors analyzed their results to determine the factors that made this approach successful. The facilitators of the Narrative Medicine workshop identified specific elements that increased physician empathy, self-compassion, and peer support. Narrative medicine can also counter the effects of perfectionism, exhaustion, and depersonalization.