Clinicians trained in narrative medicine are more able to listen for what their patients tell them, to see from others’ perspectives – including patients and families and colleagues, says Rita Charon, M.D. PhD, Professor and Executive Director of Columbia Narrative Medicine at Columbia University.
– Because these clinicians know a great deal about stories and how they work, they hear even the unsaid parts of what patients tell them. They are more curious about not just the illness itself but its context. They know themselves as clinicians, including being aware of their own biases and prejudices. Narrative medicine also helps us in our efforts toward social justice and health equity.
The starting point of the discipline of narrative medicine, a relatively new discipline at the intersection of humanities, the arts, clinical practice, and health care justice, is that the arts have the ability to open us up to the world. They lead us to be more attuned to our surroundings, more curious, more alive in all our senses.
I hope to describe ways that narrative medicine expands the presence of creativity in clinical worlds, in the worlds of biosciences, and in the lives of the clinicians and patients who work together.
– Without the arts, and this includes all imaginative, aesthetic engagements, we are less connected to self and others, we are less ready to perceive what is inside and outside us, we are more hermetically sealed within our small spaces.
Person-centered, respectful health care
Professor Rita Charon has developed pioneering educational programs at Columbia University in the field of narrative medicine. Principles and practices developed within the discipline aim to equip clinicians to better comprehend their patients’ experiences and perspectives so as to deliver equitable and effective health care. Narrative medicine also engages with writers, artists, scholars, activists, and human services professionals of all kinds to improve health care from the perspectives of patients and providers.
Working with nurses, social workers, physicians, mental health professionals, chaplains, academics, and everyone interested in person-centered, respectful health care, this discipline aims to deepen self-awareness, clinical effectiveness, collaborative skills, and creative capacities through rigorous narrative training and practices.
– I hope to describe ways that narrative medicine expands the presence of creativity in clinical worlds, in the worlds of biosciences, and in the lives of the clinicians and patients who work together. I will tell some stories of patients who have benefited and of students and clinicians who have worked in our field.
According to Rita Charon all narrative skills enlarge what clinicians can harvest from their time with patients—noticing gestures, moods, emotions, wondering about what the patient doesn’t or cannot talk about.
Decades-long partnership in creativity, health, and health care
– The relationship with a patient and the patient´s family becomes more collaborative, a partnership where patients have far more liberty to talk about what matters to them and more power to make decisions. The deepening of the personal relationship with individual patients enables patients to ask questions, talk about their fears, brag about wonderful things in their lives, talk over decisions in their lives. Because the doctor or nurse becomes able to “read” the patient’s moods and concerns, he or she can more readily understand what the patient needs or wants – and join them in the search for solutions, says Rita Charon and continues;
– Training in narrative medicine is spreading to many medical and nursing school around the world. It is more prominent in palliative care, oncology, and general medicine but is also taught in ophthalmology, intensive care medicine, and obstetrics and gynecology. Scholars and clinicians from the Nordic countries have made enormous conceptual and patient-centered contributions to the discipline. The Sandblom Lecture is a powerful symbol of Sweden’s and the United States’ decades-long partnership in creativity, health, and health care.