I'm in the midst of getting a foundational certificate in Narrative Medicine and haven't done a blog entry for a while. Here was my first paper for the class:
“Cure sometimes, treat often, comfort always,” were sentiments, expressed by Dr. Edmund Livingston Trudeau, in the late 19th century.
But “when sociologists studied medicine in the 1960s, they
observed physicians to practice with detached concern (1).”
And historically, physicians-in-training have been taught:
“Don’t get too close to patients.” The thinking was that keeping a safe
distance from patients emotionally would reduce the risk of getting burned out
(2).
Although getting to know the whole patient was emphasized during
residency and fellowship training, admittedly, once practicing full-time, I would
navigate as quickly as possible through encounters, trying to be as productive
as the other physicians in the group.
But I couldn’t envision this as my modus operandi for years
to come and, occasionally, daydreamed about walking away from medicine.
I had only been out of medical school for about ten years.
Fortunately, a quote in 1996, by Dr. George S. Poehlman,
struck a chord: “Always ask your patients something that is totally non-medical
before closing out the patient encounter. You will become an amateur
anthropologist on whom stories are bestowed.”
I started to do just that and would briefly document, in a
journal, a story from an encounter each day that was, in my opinion, unique,
uplifting, or humorous.
It didn’t add a lot of time to encounters, it improved my
interactions with most patients and their families, and I had a renewed
appreciation for my career.
Occasionally, I would even cognitively reframe a less-than-optimal
encounter by teasing out a portion that still highlighted their humanity.
Over time, I added stories of personal life events,
including health related issues that affected myself or family members.
“In Frank’s book, The Wounded Storyteller, there is a
sentence…, “The ill person who turns illness into story transforms fate into
experience; the disease that sets the body apart from others becomes, in the
story, the common bond of suffering that joins bodies in their shared
vulnerability (3).”
I’ve encouraged my patients, my family, and other health
care providers, to journal and tell their stories, if applicable.
“Other people are going to find healing in your wounds. Your
greatest life messages and your most effective ministry will come out of your
deepest hurts.”-Rich Warren
Not everyone is a writer, as Arthur Frank has noted: “So,
having a lot more to say, I did what I do, which is to write. Had I been a
painter or sculptor, a musician, or a dramatist, I would have said what I had
to say in that idiom (4).”
Storytelling, “in whichever medium they have resources…may communalize
suffering…generates communities of vicariously shared experience…is a way out
of isolation and a way into alliances. Stories turn loneliness into affiliation
(4).”
That’s a wonderful consequence.
“Through the narrative process of reflection and
self-examination, both physicians and patients can achieve more accurate
understanding of all the sequelae of illness, equipping them to weather its
tides (1).”
I completely agree.
I suspect Dr.
Trudeau would as well.
References:
2.
Trzeciak, S., Mazzarelli, A. Compassionomics-The
Revolutionary Scientific Evidence That Caring Makes A Difference. 2019.
ISBN: 978-1622181063.
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