Humanity before Science: Narrative Medicine, Clinical Practice, and Medical Education (original) (raw)

From Doctors' Stories to Doctors' Stories, and Back Again

The AMA Journal of Ethic

Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise.

Between Patients and Doctors: It Takes a Person

Beyond Diagnosis: Relating the Person to the Patient - The Patient to the Person, 2014

Thank you, I feel so much more like a person now,' I told the Intensive Care Unit (ICU) nurse after the morning bath. The words came out spontaneously, and she was startled. What made me feel 'more like a person' at a time when my life was at risk, and I was tied to machines and entirely dependent on others' care? If becoming a patient entails the experience of vulnerability and ultimately the exposure to one's mortality, how does a patient remain a person in the midst of acute illness? Can a patient remain a person if she is regarded primarily as a malfunctioning body and/or mind? To what extent is the patient's self-perception shaped by others' perceptions of her? Can she contribute by reshaping those that prove harmful? By arguing for the need to listen to the patient's 'biological and biographical stories' in the interest of good clinical practices, John Launer pinpoints the limitations of a biomedical approach that splits the body from the person, and argues for the need to reconnect biology and biography within the therapeutic relation. 1 Indeed, one of the most striking conclusions of Klitzman's study on doctors who became patients is the stigmatisation of patienthood among the medical profession. Not only did doctor-patients feel diminished as patients and experienced the dissociation between body and person, but they also complained of the split between professional and personal responses from their colleagues. 2 The patient's split between body and person thus seems to find a correlate in the physician's split between professional and person, and both may be symptomatic of pervasive cultural practices. How to connect biology and biography, the professional and the personal in the clinical encounter is the question addressed in this chapter, which draws on personal testimony, illness memoirs, and literature on clinical practice.

Narrative Medicine and Healthcare Reform

Narrative medicine is one of medicine's most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is not easy to describe. Many of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context.

Physicians’ Stories

International Review of Qualitative Research, 2014

This article reflects on a project in which the author guided several physicians as they wrote their first autoethnographic research articles, which were then presented at the International Congress of Qualitative Inquiry in 2011. Revisiting three of the physicians' stories, the article articulates the significance of having physicians-scientists by trainingengage autoethnography as an emotional, literary, poetic, and embodied practice. The author discusses the limitations of the ''bridge'' metaphor to capture the full impact of this project and other autoethnographic efforts and argues instead for the ''rhizome'' as more descriptive of the multiple, messy, boundary-crossing connections that are generated through autoethnographic writing and performance.