What Is Narrative Medicine and Why Does It Matter?

The practice of narrative medicine is at the crossroads of humanities and science. It focuses on the needs of patients and caregivers to voice their experiences and for medical professionals to closely listen to and value their patients’ narratives. The art and science of its practice is taught in numerous American medical schools and in continuing medical education courses.

I am the daughter of a physician, so when I first heard about the practice of narrative medicine, it sounded familiar. During dinner-table conversations with my father, he told me that he always asked his patients these questions: Who do you live with at home? Who is your family’s primary caregiver? Have you had medical challenges in the past? Through these discussions, I became keenly aware that the broader story of my father’s patients’ lives—not just what brought them into the hospital or into his office—was of great interest to him.

My father began his internal medicine practice in 1960, and he retired in 2005. Even though my physician-father practiced during an era when doctors had more time per appointment, I believe that he always had an innate understanding of the importance of listening to and reflecting upon his patients’ life stories. Today, that type of understanding is being celebrated and taught throughout the country.

Keen to learn more, in mid-October, I participated in the three-day Narrative Medicine Basic Workshop at Columbia University. The workshop, attended by doctors, nurses, psychiatrists, social workers, and writers, was led by Rita Charon, MD, PhD, who is the Chair of Medical Humanities and Ethics and the Professor of Medicine at Columbia University’s Vagelos College of Physicians and Surgeons and Columbia’s College of Arts and Sciences. Dr. Charon originated the field of narrative medicine, and recently was awarded the 2018 Jefferson Lecturer in the Humanities by the National Endowment for the Humanities. The Jefferson Lecturer is the highest honor the federal government bestows for distinguished intellectual achievement in the humanities.

My Workshop Experience

In plenary sessions and in small group settings, we dove deeply into the three primary tenets of narrative medicine: close reading, close listening, and reflective writing. The practice of these criteria guide building respectful and effective healthcare. In one of my small groups led by Dr. Charon, we read a girl’s narrative of her dying father. The acuity of Dr. Charon’s observations illuminated how subtle but critical details in this narrative expand our understanding of the daughter’s plight.

In the practice of close listening, we learned that the medical practitioner attentively listens to the patient’s telling of his/her ailments and is alert to subtle changes in the patient, like a shift of mood, while simultaneously forming hypotheses about possible conditions. The practitioner is also reflecting on how he or she feels while listening and is considering how these thoughts might inform the diagnosis.

The third tenet, reflective writing, involves asking medical practitioners to write about difficult experiences by sharing what might have been kept shut inside for years. It’s counter to traditional medical training that teaches medical and nursing students and practicing medical staff that in order to remain objective one must impose an emotional distance in their practice and keep difficult episodes to themselves. But in fact, recent data has shown that the process of reflective writing and sharing clinical experiences with colleagues has been both illuminating and healing for medical students and professionals.

Of course, this is a humble summary of a complex practice, so if you are interested in learning more, several resources are listed below. What impressed me the most was Dr. Charon’s belief that the practice of narrative medicine has the power to create more empathic awareness of patients’ conditions, and its practice has the potential to open a gateway to a more humane and improved delivery of healthcare. Wouldn’t that be wonderful?


Narrative Medicine

Columbia University’s Master of Science in Narrative Medicine

What Can Doctors Learn From Narrative Medicine?

Medical Humanities at Harvard Medical School

Principles and Practice of Narrative Medicine by Rita Charon et al

Faith Wilcox