Narrative Medicine Monday: Creating a Clearing

In “Creating a Clearing,” storyteller Lance Weiler interviews the originator of Narrative Medicine, Columbia University’s Rita Charon. Charon describes how she ended up in medicine and primary care and the origins of the field of Narrative Medicine. She felt she was missing something as a physician from her formal medical training at Harvard. So instead she sought out the English Department: “I figured they were the ones on campus who knew something about listening to stories…” Her time there led to a PhD and, in her words, it taught her “how to be a doctor.”

Charon points out that we are all patients. What do you think of her idea that “we do not have to divide ourselves into mind on one side and body on the other or body on one side and self or personhood on the other, but instead we are all mortals inextricably bound to our bodies, our health, our frailties, our eventual mortality. This is how it is within that element that we don’t become ourselves, but [we] are ourselves”? Do you feel that the medical system tends to separate our bodies from our minds, from our personhood?

Charon explains how Narrative Medicine has grown over the years and now attracts all kinds of people in fields of health care, art, history and beyond. She states that the field of Narrative Medicine has “created a clearing,” a safe space for patients and clinicians and artists to “show people how to listen with great attention and respect.”

Charon describes how we’re traditionally trained as physicians to address a patient’s problem. Western Medicine is a disease model, focused on diagnosing, preventing or treating a problem. Charon takes a different approach. She first listens, focusing on what is important to the patient. I like how Charon begins: “I will be your doctor. I need to know a lot about your body, your health, your life. Tell me what you think I should know about your situation.”

She notes that both sides suffer from the typical patient-physician encounter: “[patients] come in armed with their list of questions that they’ve written down so as not to forget any in their precious twelve minutes, which is all they’re allotted. The clinician, on his or her side, is already looking at the wristwatch aware that there’s another three people in the waiting room waiting for what’s going to amount to the same brusk, impersonal, divided attention. So nobody’s getting what they want or need or desire or can benefit from.” Does this sound familiar to you? Are you hopeful, as is Charon, that if patients and clinicians lead on medical reform we can find a better way? What would that look like?

Writing Prompt: What skills do you find most helpful to listen to another person’s story? What would it be like as a patient to have a doctor ask you: “Tell me what you think I should know about your situation”? How would that question change the conversation? Think about what aspect of your training was most pivotal to teaching you how to be a doctor/nurse/physical therapist, etc. Are you surprised that for Charon it was her studies in English? Write for 10 minutes.

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Free Write Friday: Feed

She feels bound, normal routine punctuated by the dread of each day, a scrolling feed of ominous news. Her three-year-old collapses in a tantrum, a heap of hot tears as he pounds his fists on the front door; he wants out. She wants out too, of the surreal reality of this reality show. She doesn’t want to contribute to over dramatization but this present darkness needs no assistance; the prognosis is dire.

So she gets up in the dark, shuffles into her day. Some days it takes effort to exercise, to chat with the barista, to get the kids into the car and off to school, to carry others’ burdens of illness throughout the day. She does it all, simultaneously avoiding while craving the news, the next shocking headline of the day.

She needs to write but struggles to find the words. She reads articles from The Atlantic, The New York Times, The Guardian. She listens to NPR and watches PBS. She streams The Daily Show and Saturday Night Live but finds it hard to laugh. The jokes are funny, but also so not. She follows the ACLU and World Relief on Twitter and avoids Facebook. The bombardment of outraged posts inevitably clog her feed. She feels like she needs to be fed, but slowly, so she can consider, in moderate, sustaining bites. But instead she is gorged on the glut of it all.

She wonders: this must be what it feels like to live during one of those eras, the kind she read about in school textbooks. Protests erupt, world powers align and misalign, everyone feels on edge. She looks at her chubby baby, not even a year old, and wonders what the textbooks will record of this time, how the era will be remembered, deconstructed. What will she tell her infant daughter about this nagging sensation of creeping dread, like struggling to find the surface as your lungs begin to burn underwater, knowing you need to break free and gulp the air.

So she writes anyway and moves about her day. She resolves to be resolute and find the ways a young mother can contribute. She gathers her people and marches with the crowd. She donates to persecuted causes and writes letters to her representatives. She mutes the static on her feed, will not tolerate xenophobia or the lies of alternative facts. She worries about the isolation of her liberal northwest bubble, she worries about her children’s distant future. She’ll read books and write more. She’ll feed herself with knowledge, with the lessons of history; she’ll feed her children and her tribe the same. She hopes this will sustain her and free her, or at least nourish her with a steady diet of discernment and tempered hope.

 

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