Web Roundups

Dear Patient, tell me a story

This month’s web roundup will take the opportunity to discuss “Narrative Medicine.” In “The Art of Narrative Medicine,” the editors of the blog of The American Resident Project write that “Over the past six years, narrative medicine and the physicians who have worked to enhance and promote its efficacy have gained traction within the mainstream health care system.”

Back in 2001, Rita Charon of Columbia University’s School of Medicine, argued in an article in JAMA that “sick people need physicians who can understand their diseases, treat their medical problems and accompany them through their illnesses.” Charon strongly believed that “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.” That’s why, according to  The New York Times she proposed a Master of Science in Narrative Medicine at Columbia. The program now exists and the answer to the questions — “Should physicians be encouraged to study narrative medicine in medical school? Is this a real benefit?” — seems to be a resounding “yes.”

But what’s happening outside the U.S.? Narrative-based-medicine isn’t yet part of regular medical practices, and it is still in search of legitimation. An important step has been the Second International Congress “Narrative Medicine and Rare Diseases” hosted in Rome from the 11th to the 13th of June.

At the end of this Consensus Congress, the Jury stated that “Narrative-based medicine (NBM) should be integrated with Evidence-based medicine (EBM): it is the integration of the patient narrations in the clinical practice – explains Sandro Spinsanti, a major figure of medical humanities in Italy (biography, Italian) – It is the element which allows the personalisation of the diagnosis and of the treatment and it improves the efficacy and the therapeutic adhesion; narrative medicine is a ‘tailored medicine’. The narration is a fundamental method to purchase, understand and integrate the different points of view of all the people involved in the illness and the treatment. The final goal is to co-build a personalised and shared path (story of treatment)”.

The Story Telling on Record (S.T.o.R.E) project takes the next step toward raising awareness about the importance of Narrative-based medicine in Europe. The program seeks to identify effective practices of NBM and aims at forming a case history of patients with their own stories, so that patients will no longer be regarded as a “collection of symptoms and body parts, but as fully-fledged human beings.”

This new approach implies that the healthcare provider should accompany the patient in the journey. The physician and writer Robert Coles writes, “The people who come to see us bring us their stories. They hope they tell them well enough so that we understand the truth of their lives. They hope we know how to interpret their stories correctly. We have to remember that what we hear is their story.”

In his article “Creative Writing as a Medical Instrument,” Jay Baruch proposes that healthcare professionals should become story experts: they must think creatively, through the mind’s eye of a writer: “Story becomes the ground that patients and healthcare professionals travel together: an unpaved road, potholed and puddled, that often lacks signposts, that makes no great rescue promises. But it’s a meaningful journey where we will get muddy together.”

On the same subject:

Souchon, Fiona. « L’approche narrative avec la personne atteinte du cancer » , (French)

DasGupta, Sayantani. « Narrative Medicine, Narrative Humility – Listening to the Streams of Stories »

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