Nalini Velayudhan, DO, Health and Wellness Committee
We are born, and so begins the story of our lives. Our bodies carry within them primeval stories encoded in our DNA, which helps inform our health as we grow. The environments we are exposed to and experiences we have further direct our personal chronicle. The collection of stories we bring to our physician helps inform our personal health history and family history. The story that the physician records about us then becomes part of our medical history. The stories we tell and hear about ourselves become our identity, and our life story.
The field of narrative medicine arose at Columbia University in 2000 with its roots in the humanities. Story as medicine, however, is in many ways much older, and narrative medicine may only be reintroducing us back to an ancient form of healing, an art of storytelling practiced by indigenous healers for hundreds of years being rebirthed as narrative medicine. In many indigenous cultures stories were listened to deeply, held with care and treatment rendered with generosity. The concept of story is as ancient as human beings sharing tales with one another. Many forms of healing have been practiced by Native Americans and Ayurvedic practitioners and Ancient Chinese and African healers, with story as a healing modality being just one of the tools used. Modern Western medicine as we know it is more and more commodified, where doctor-patient visits are shrunk down to 10 or 15 or 20 minutes, making it harder and harder to fully listen, understand, and care for the stories the patients so desperately want us to hear.
Author and teacher Rita Charon states that narrative medicine develops skills of listening to “narratives of illness, to understand what they mean, to attain rich and accurate interpretations of these stories, and to grasp the plights of patients in all their complexity.” These skills may be developed in workshops using art, poetry, videos followed by group discussions, and reflective writing. These forums serve to sharpen skills of attention, listening, witnessing, and re-presentation, which in turn increases narrative competence. She uses the term “narrative medicine” to mean “medicine practiced with these narrative skills of recognizing, absorbing, interpreting, and being moved by the stories of illness.” According to Rita Charon, narrative medicine can ultimately lead to more humane, ethical, and effective health care that serves both patients and doctors alike.
When narrative skills are honed, we can strengthen doctor-patient relationships by being more present to the patients’ experience of illness and in so doing offer a sense of wholeness despite it. This subtle movement that occurs within us connects us more deeply to the suffering of others, and we are bonded more fully in our shared humanity. We can hear ourselves echoed back to us in the stories of others. When we listen more deeply to other’s stories, we can tell and own our story with more honesty and dignity. When we can see ourselves in others’ stories, the separation and hierarchy between doctor and patient is reduced. This sharing of stories thus nourishes, heals, and connects those affected by illness and those caring for the ill. When narrative medicine is practiced, trust, humility, compassion, connection, and mutual recognition grow between doctor and patient, elevating and reforming medical care one interaction, one encounter at a time. Medicine can then be transformed to a sacred art.
For some hands-on practice, look for a workshop on “Introduction to Narrative Medicine” at the ACOFP annual conference in April 2024 in New Orleans. It will be featured during the Women’s Leadership event. Sign up and be a part of building narrative competence!
Narrative Medicine Honoring the Stories of Illness, Rita Charon
Narrative Medicine the Use of History and Story in the Healing Process, Lewis Mehl-Madrona, MD, PhD.
Northwest Narrative Medicine Collaborative