Integrative Family Medicine, a primary health care provider based in the Asheville River Arts District, recently created a page on its website inviting anyone to share their stories of navigating these times of pandemic and social unrest as part of a narrative-based medicine approach to helping people stay healthy. Go here to submit your story. And go here to read stories from others.
Let me add my disclaimer here: Integrative Family Medicine is my primary health care provider, and I think they’re great. Also, the idea of connecting storytelling to health care really appeals to me as a writer/reporter. So for those reasons, and because I think it’s just really cool, I asked Dr. Chad Krisel if he could tell me more about narrative-based medicine. He in turn asked Ariana Figueroa, a board-certified wellness coach
Q: Where does the concept of “narrative-based medicine” come from?
Ariana Figueroa: The idea of connecting the humanities to medicine is not a new one. However, Dr. Rita Charon was the first person to coin the term “narrative-based medicine” in 2000. She is the executive director of Columbia University’s Division of Narrative Medicine and a professor of Columbia’s Vagelos College of Physicians and Surgeons. Dr. Charon obtained her PhD in english literature while simultaneously practicing as an internist. During that time, she noticed that the literary strategies she was learning translated to her medical practice really well. Dr. Charon and her colleagues created the Columbia program in Narrative Medicine, the first of its kind. Since its creation, other programs and certifications have been founded. Lenoir Rhyne University’s Asheville campus has a master’s degree program in Narrative Healthcare (only the second nationally accredited program of its kind aside from the one at the Medical School of Columbia).
Q: Can you explain the concept?
Figueroa: Narrative-based medicine pulls from the disciplines of art, literature, and writing. The goal is to help providers to listen to their patients, using narrative techniques – paying attention to body language, tone, and even what is not said. This “radical listening” (as Dr. Rita Charon calls it) allows the patient’s story to become a part of the healthcare they receive. It can also help medical providers to see the stories behind their patients’ diagnoses in order to ask, “How can I help this person?” instead of, “How can I treat this diagnosis.” Aside from employing narrative techniques in listening, narrative-based medicine encourages providers and patients alike to write down their own experiences using narrative prompts and techniques.
Q: How does the work of telling a story, of self-reflection, help a patient heal? I know this is a broad question, so maybe you can break it down in some way.
Figueroa: Narrative-based medicine is about training patients and health-care providers to listen “radically,” and to apply the concepts of story-telling and writing to the practice of giving and receiving healthcare. This can help increase empathy on both sides, which is a big deal, as the degree to which a provider is empathetic has been scientifically documented to affect outcomes for their patients. I will add that illness is hard. There’s some evidence that writing down one’s experiences, while in the grips of illness, can reduce somatic symptoms. It can also offer empowerment and agency.
Q: Does the narrative medicine process help the healer? How?
Figueroa: Yes, absolutely. Narrative-based medicine offers providers tools for how to listen more effectively to patients – to listen with awareness, curiosity, and non-judgement. It also offers a platform for providers to articulate their experiences in medicine. This can help roll back the “numbing” that medical providers sometimes combat, and that in turn can bring both meaning and healing.
Q: What else would you like people to know about narrative medicine?
Figueroa: As humans, we breathe in air as much as we think in stories. When we begin to pay attention to the storylines that are running in our minds, and when we get curious about why and how those around us feel the way they do, we collectively open a door, ne that can lead away from biases or quick judgements and toward a more authentic way of relating to one another. I think this is especially important in light of the socio-economic and racial disparities in our healthcare system today.
Note: Integrative Family Medicine also held an online presentation on narrative-based medicine by Anthony Layman, a graduate student in Lenoir-Rhyne University’s Masters in Fine Arts program in Writing with a Narrative Health certificate.
He offered the following resources:
A TED Talk titled “How boredom can lead to your most brilliant ideas” by Manoush Zomorodi
Finally, here’s an interview with Layman that was conducted by Figueroa in advance of his talk.