"The true healer neither knows nor seeks boundaries between the arts and medicine."
- Richard A. Lippin, M.D. (President of the IAMA)

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Dr. Rita Charon, M.D., Ph.D., founder and director of the pioneering Program in Narrative Medicine at Columbia University‘s College of Physicians and Surgeons, “invented the term ‘Narrative Medicine’ [in 2001] to connote a medicine practiced with narrative competence and marked with an understanding of the highly complex narrative situations among doctors, patients, colleagues, and the public” (Dr. Charon, Narrative Medicine). While narrative medicine is still a burgeoning, relatively new field of study - with only several medical schools in the nation that require “narrative competence” - narrative medicine has deep academic roots in biopsychosocial medicine, primary care, medical humanities, and patient-centered medicine. It is designed to teach healthcare professionals “to listen very expertly and attentively to extraordinarily complicated narratives -- told in words, gestures, silences, tracings, images, and physical findings -- and to cohere all these stories into something that makes at least provisional sense, enough sense, that is, to be acted on” (Charon, Narrative Medicine). Narrative medicine works to create the conceptual framework through which to better understand the often incredibly complex relationships in the realm of healthcare - doctor-patient, doctor-family, doctor-colleague, doctor-public, etc. As Dr. Charon explains, narrative medicine “gives us [the] theoretical means to understand why acts of doctoring are not unlike acts of reading, interpreting, and writing and how such things as reading fiction and writing ordinary narrative prose about our patients help to make us better doctors” (Narrative Medicine). At Columbia, every second-year medical student is required to take a seminar in narrative medicine and all medical students are encouraged to take additional classes, such as figure-drawing classes at the Met and poetry and fiction-writing workshops; Dr. Charon is confident that these experiences “will create more imaginative, empathetic doctors.” In rapidly increasing numbers, physicians across the nation are becoming convinced that “narrative competence” makes for better doctors - doctors who not only make diagnoses with a stethoscope and blood-work, but who listen to their patients, who read their stories and who pay close attention to how their patients communicate “illness narratives.” “Narrative medicine brings a useful set of skills, tools and perspectives to all doctors. Not only does it propose an ideal of medical care -- attentive, attuned, reflective, altruistic, loyal, able to witness others’ suffering and honor their narratives -- that can inspire us all to better medicine, it also donates the methods by which to grow toward those ideals. Any doctor and any medical student can improve his or her capacity for empathy, reflection, and professionalism through serious narrative training … Ultimately, narrative medicine may offer promise as a means to bridge the current divides between doctors and patients, between doctors and doctors, between doctors and themselves, illuminating the common journeys upon which we all are embarked” (Dr. Rita Charon).

"The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care." (Abstract from "Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust" by Rita Charon, 2001)

"Physicians who are able to appreciate the nuances of their patients' stories will enjoy their patient encounters more, will understand the patient's illness more confidently (not to mention more economically) and, in relating back to the patient what's going on, will more effectively treat the problem. For his part, the patient will feel that he's been heard and will believe he is known and understood and is more likely to accept the story the doctor tells him back even if diagnosis does not involve tests, and treatment is reassurance and/or watchful waiting." (from "The Role of Narrative in Medical Education and Practice," by David Svahn, M.D., director of the Humanities and Medicine Program at Bassett Healthcare in Cooperstown, N.Y.)

Questions about this page? Contact nicole.saint.louis@uphs.upenn.edu