Narrative medicine and narrative practice: partners in the creation of meaning

Abstract

Background

Narrative medicine has emerged as an approach to whole person care and to support the clinician-patient therapeutic relationship. Although training in narrative medicine is usually based on the study of literary or artistic works, the same attitude of close reading can also be applied in conversations with patients or learners.

Method

We held a two-day narrative medicine workshop, incorporating two approaches: 'Conversations Inviting Change' (CIC) and humanities-based narrative medicine as taught by Columbia University. The workshop was primarily experiential, with theoretical components of both approaches. Participants brought active concerns for confidential breakout sessions and engaged in text-based and reflective writing exercises. Participants generated metaphors to describe these approaches to narrative medicine.

Results

Participants included a mix of community and hospital-based practitioners, pre-dominantly doctors. Participants considered the two approaches to be compatible and enhance each other. One metaphor generated was that Columbia style narrative medicine is ’like an individual lens which allows you to see things clearer’, it allows practitioners a different perspective on their patients and that CIC teaching ‘is a frame of glasses in which the lenses could be placed to enhance the ease of use’. Another metaphor was that the former ‘is like learning from a cadaver in the anatomy lab’, while the latter ‘is like running a clinical simulation’.

Conclusion

We believe this was the first workshop integrating these approaches to narrative medicine. They appear to be highly complementary. Both approaches lead to enhanced attention to narratives which has clear applicability to clinical practice.