Narrative medicine

Narrative Medicine connotes a medicine practiced with narrative competence and marked with an understanding of the highly complex narrative situations among doctors, patients, colleagues, and the public.

History

Since the 1970s critics have alleged that Western medicine has fallen victim to the professionalism movement. According to this critique, many medical schools and residency programs train physicians to treat medical problems merely as problems to be solved, without taking into account the specific psychological and personal history of the patient. As of late 1990s physicians like Rachael Niomi Remen and Rita Charon have emphasized that medical practice should be structured around the narrative. As Charon stated:

"The sick need people who can understand their diseases, treat their medical problems, and accompany them through their illnesses"

The value of Narrative Medicine is summarized as follows in an article in the British Medical Journal:

• In the diagnostic encounter, narratives:
  • Are the phenomenal form in which patients experience ill health
  • Encourage empathy and promote understanding between clinician and patient
  • Allow for the construction of meaning
  • May supply useful analytical clues and categories

• In the therapeutic process, narratives:
  • Encourage a holistic approach to management
  • Are intrinsically therapeutic or palliative
  • May suggest or precipitate additional therapeutic options
  • In the education of patients and health professionals, narratives:
  • Are often memorable
  • Are grounded in experience
  • Encourage reflection

• In research, narratives:
  • Help to set a patient centered agenda
  • May challenge received wisdom
  • May generate new hypotheses

Narrative Medicine aims not only to validate the experience of the patient, but also to encourage creativity and self-reflection in the physician.

Obstacles

As Remen notes,

People who are physicians have been trained to believe, that it is a scientific objectivity that makes them most effective in their efforts to understand and resolve the pain that others bring them, and a mental distance that protects them from becoming wounded from this difficult work.

Additional sources

• Coyote Healing: Miracles in Native Medicine. Lewis Mehl-Madrona M.D. Ph.D. Bear & Company (2003) ISBN 1591430100 ISBN 978-1591430100

Healing Narratives (HSSC 009) undergraduates at the University of Pennsylvania under the guidance of Dr. Mackenzie (Spring 2007). Tricia Greenhalgh and Brian Hurwitz. "Narrative based medicine: Why study narrative?" BMJ 1999, 318:48-50.

External links

• http://www.utne.com/Spirituality/Narrative-Medicine-Heals-Bodies-and-Souls.aspx
• http://www.npr.org/templates/story/story.php?storyId=1480863