Tuesday, October 28, 2008

Narrative Medicine: Better Doctors, Better Patients?

One of the best classes I’ve ever taught—and by “best” I mean the most interesting, engaging, and rewarding, the class I learned the most from as an instructor—was a writing course for pre-med and health sciences students. It was called “Constructions of Health in Contemporary Literature” and it contained various essays from physicians, writers, and patients about illness, healing, social justice, etc. I was so fortunate to have the chance to read these types of works with a class of future health professionals and see the way they responded to these personal stories and how their readings might inform their identities as they develop their careers.

Of course, physician-writers are hugely popular outside the classroom; the best-selling work of authors like Atul Gawande and Jerome Groopman are probably the most well known examples of this. Narrative medicine is an important topic (now more than ever, I would argue), which is why I was so pleased to come across Dr. Pauline Chen’s article on combining literature and medicine on Tara Parker-Pope’s Well blog in the New York Times.

Among other things, the article discussed how incorporating literature and writing workshops during residency can help doctors view patients with more empathy and compassion—and by extension, it can help them provide better care. It is no easy thing for the well to be able to understand what it feels like to be sick, and no insignificant thing when doctors can do this. As a patient, I am encouraged by programs that incorporate literature and medicine and as a writer I am appreciative of the value others see in studying these works.

Perhaps it is from the dual point of view that I see another strong benefit to narrative medicine beyond fostering more empathy and compassion in doctors: I think it makes us better patients, too. It is useful for me to see the other perspectives, the thoughts and fears and reflections of the people charged with healing (not curing) me. I hope it makes me more understanding and more open-minded, too.

Between writing about illness, living with it, and teaching it for a living, I’ve done my fair share of reading. Here’s a short list of some of the best examples of both narrative medicine and all-around riveting health writing I’ve found:

A Life in Medicine: A Literary Anthology, edited by Dr. Robert Coles and Randy Testa. I’ve used this book as a basis for undergrad and grad classes and have even given it as a gift. It’s a great mix of classic and contemporary pieces.

The Tyranny of the Normal: An Anthology (Literature and Medicine, Vol 2), edited by Carol C. Donley and Sheryl Buckley. An interesting combination of scholarly and personal essays and poetry on illness and disability.

Complications: A Surgeon’s Notes on an Imperfect Science, by Dr. Atul Gawande.

How Doctors Think, by Dr. Jerome Groopman. I loved this book so much and it made me think about so many things that I quoted it in my own book when discussing the doctor-patient relationship.

Mountains Beyond Mountains: The Quest of Paul Farmer, a Man Who Would Cure the World, by Tracy Kidder. I was originally assigned this book in graduate school, where the obsession began. It is one of my favorite books of all time, and one I recommend to students, family, and friends every chance I get.

The Spirit Catches You and You Fall Down, by Anne Fadiman. An utterly engrossing and emotional narrative about one family’s quest to cure their daughter and what happens when Western medicine and other cultural ideals and norms clash. I’ve used excerpts of this in classes and recommend it to everyone.

Illness as Metaphor and AIDS and Its Metaphors, by Susan Sontag. Every time I read it and teach it I come away with something new.

Have you enjoyed any of these titles? Have any more to suggest? I am always on the lookout for new material!

***
Speaking of writing about medicine, another fantastic edition of Grand Rounds is up today at Emergiblog. Check it out!

11 comments:

Maureen Hayes said...

Laurie,

Thanks for the list of great reads. I am always on the lookout for good books, and each one of these sounds well worth my time. I appreciate the information you provide, that isn't found easily elsewhere.

I think you also hit upon an important point that many with chronic illness shy away from, the responsibility we as patients have to understand others point of view. It is easy, when you feel overwhelmed, not believed or just misunderstood, to let anger cloud your judgment. I applaud you for bringing up this important topic. The more we try to understand others, the more we can be understood.

Thanks,
Maureen
Beingchronicallyillisapill.blogspot.com

Leslie said...

Laurie,
It's funny, I just finished the Sontag book (and am in the midst of writing a post sort of about it) and I own the Kidder and the "Spirit Catches You..." but have yet to read those. While I try and put up reviews of chronic illness books I've read (yours included) on my blog, it's nice to have a list in one place. Sounds like a great class! Wish I had one like that!
Leslie

Genevieve said...

Thanks for the insightful links. Perspective plays a huge part and frankly mine's a mess right now. Once you've been burnt by those in the medical community not once but repeatedly, you tend to view everyone in that area of expertise as insensitive monster's one should beware of.

Desperately trying to change my perspective. This should provoke it.

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Raj said...

Nice blog with good articles.
www.spothealth.blogspot.com

Sara Baker said...

Laurie,

I enjoy your blog very much. Like you, I am a writer with chronic illness. I also teach creative writing to cancer patients, and am in the process of developing a literature and medicine course myself. Your list is very helpful, and I agree with you, we all need to develop compassion and use our imaginations to maintain our humanity in a very difficult healthcare climate. Please check out my blog: http://saratbaker.com/blog/index.html

Dragonfly said...

The literature and writing workshops sound awesome, I would be up for it personally. The only problem I would have is that I wouldn't want to really share if the workshop was full of people who didn't agree with the idea and didn't want to be there.
What to do, what to do....start a blog!!

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Priscilla said...

Laurie,

Thanks for this good list. Some items serve as reminders to me of books I've meant to read and others are new.

just wanted to say hello,

Priscilla

Ellie said...

I highly recommend "Intoxicated by My Illness" by Anatole Broyard.

 
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