The Principles and Practice of Narrative Medicine

Rita Charon, Sayantani DasGupta, Nellie Hermann, Craig Irvine, Eric R. Marcus, Edgar Rivera Colsn, Danielle Spencer, and Maura Spiegel

An all-in-one source for the ideas and practices of Narrative Medicine
A synthesis of literary, philosophical, and creative approaches to health care
Includes practical descriptions and guidelines for teaching narrative medicine in diverse settings
A handbook of practice along with précis of theory for those who contemplate narrative medicine practice
Addresses the question of what distinguishes narrative medicine from other forms of medical humanities or patient-centered care

Winner of The Perkins Prize 2017

The Principles and Practice of Narrative Medicine

Rita Charon, Sayantani DasGupta, Nellie Hermann, Craig Irvine, Eric R. Marcus, Edgar Rivera Colsn, Danielle Spencer, and Maura Spiegel

Description

Narrative medicine is a fresh discipline of health care that helps patients and health professionals to tell and listen to the complex and unique stories of illness. The Principles and Practice of Narrative Medicine expresses the collective experience and discoveries of the originators of the field. Arising at Columbia University in 2000 from roots in the humanities and patient-centered care, narrative medicine draws patients, doctors, nurses, therapists, and health activists together to re-imagine a health care based on trust and trustworthiness, humility, and mutual recognition.

Over a decade of education and research has crystallized the goals and methods of narrative medicine, leading to increasingly powerful means to improve the care that patients receive. The methods described in this book harness creativity and insight to help the professionals in being with patients, not just to diagnose and treat them but to
bear witness to what they undergo. Narrative medicine training in literary theory, philosophy, narrative ethics, and the creative arts increases clinicians' capacity to perceive the turmoil and suffering borne by patients and to help them to cohere or endure the chaos of illness.

Narrative medicine has achieved an international reputation and reach. Many health care settings adopt methods of narrative medicine in teaching and practice. Through the Master of Science in Narrative Medicine graduate program and health professions school curricula at Columbia University, more and more clinicians and scholars have obtained the rigorous training necessary to practice and teach narrative medicine. This text is offered to all who seek the opportunity for disciplined training in narrative medicine. By clearly articulating our principles and practice, this book provides the standards of the field for those who want to join us in seeking authenticity, recognition, affiliation, and justice in a narrative health care.

Winner of The Perkins Prize 2017

The Principles and Practice of Narrative Medicine

Rita Charon, Sayantani DasGupta, Nellie Hermann, Craig Irvine, Eric R. Marcus, Edgar Rivera Colsn, Danielle Spencer, and Maura Spiegel

Acknowledgments
Introduction
Part I: Intersubjectivity
Chapter 1. Accounts of Self: Exploring Relationality through Literature
Maura Spiegel and Danielle Spencer
Introduction
Self-Telling: Colm Tóibín and the Need to Tell
Monologue and Dialogue: Dostoevsky and Bakhtin
Recognition in Bechdel's Fun Home: Thickening the Story
Identification and Refusal in Kazou Ishiguro's Never Let Me Go
Conclusion
Chapter 2. This Is What We Do, and These Things Happen: Experience, Emotion, and Relationality In The Classroom
Maura Spiegel and Danielle Spencer
Socio-relational dynamics and medical education
The Narrative Medicine Classroom / Workshop
Conclusion
Part II: Dualism, Personhood, and Embodiment
Chapter 3: Dualism and its Discontents I: Philosophy, Literature, and Medicine
Craig Irvine and Danielle Spencer
"Hi. How are you feeling today?": Tales of Alienation in Healthcare
Biomedicine in recent history
The Cave and the Machine: Philosophical Roots of Dualism
Chapter 4: Dualism and its Discontents II: Philosophical Tinctures
Craig Irvine and Danielle Spencer
Philosophical Tinctures: Phenomenology and Narrative Hermeneutics
Philosophical Narratives: Complexity and Multiplicity
Soul
Chapter 5: Deliver us from Certainty: Training for Narrative Ethics
Craig Irvine and Rita Charon
Narrative Ethics of Reading
Narrative Ethics of Clinical Practice
Ethics of Narrative Medicine
Part III: Identities in Pedagogy
Chapter 6: The Politics of Pedagogy: Cripping, Queering and Un-homing Health Humanities
Sayantani DasGupta
Introduction
Crip Politics and the Medicalization of Health Humanities
Queer Politics and the Problems of Intelligibility
Un-Homing Narrative Medicine: Pedagogical Frames
Conclusion
Part IV: Close Reading
Chapter 7: Close Reading: The Signature Method of Narrative Medicine
Rita Charon
The Origin and Fate of Close Reading
Why Narrative Medicine Is Committed to Close Reading
Close Reading and Its Progeny, Attentive Listening
The Interior Processes of Close Reading
Close Reading Enacts the Principles of Narrative Medicine
Coda
Chapter 8: A Framework for Teaching Close Reading
Rita Charon
One Way to Teach Close Reading
Choosing Texts and Creating Prompts
Time
Space
Voice
Metaphor
Conclusions and Room for Further Thought
Part V: Creativity
Chapter 9: Creativity: What, Why, and Where?
Nellie Hermann
Creativity in Our Everyday Lives
What is Creative Writing for, particularly in the clinical context?
Forms and Dividends of Creative Writing
Creative Writing and Reflective Writing
Chapter 10: Can Creativity be Taught?
Nellie Hermann
Strategies for Writing in the Health Professions
A Teaching Tool: The Reading Guide for Reflective Writing
The Approach to the Writing Student
Finally: focus on the creative spark
Part VI: Qualitative Ways of Knowing
Chapter 11: The Ethnographic Field: Narrative, Visual, Contextual
Edgar Rivera Colón
Narrative Prelude
Demystifying Qualitative Research Methods
An Embodied, Reflexive Practice
Making the world visible
The Ethnographic Witness
Part VI: Clinical Practice
Chapter 12: A Narrative Transformation of Health and Health Care
Eric Marcus and Rita Charon
RC Tells the Clinical Story
EM: Concepts-Transference and Transitional Space
RC: Concepts-Creativity, Reflexivity, Reciprocity
Coda
Chapter 13: Clinical Contributions of Narrative Medicine
Rita Charon
Individual Interview/Relationship Techniques
Clinician and Health Care Team Development
Novel Narrative Practices
Clinicians See
Author Biographies
Bibliography
Index

Winner of The Perkins Prize 2017

The Principles and Practice of Narrative Medicine

Rita Charon, Sayantani DasGupta, Nellie Hermann, Craig Irvine, Eric R. Marcus, Edgar Rivera Colsn, Danielle Spencer, and Maura Spiegel

Author Information

Rita Charon, Columbia University, Sayantani DasGupta, Columbia University, Nellie Hermann, Columbia University, Craig Irvine, Columbia University, Eric R. Marcus, Columbia University, Edgar Rivera Colsn, Columbia University, Danielle Spencer, Columbia University, and Maura Spiegel, Columbia University

Rita Charon is a general internist and literary scholar at Columbia University who originated the field of narrative medicine and directs the Program in Narrative Medicine at Columbia. She researches, publishes, and lectures extensively on the relationship between narrative knowledge and the care of the sick.

Edgar Rivera Colón, Ph.D. teaches at Columbia University's program in Narrative Medicine. Dr. Rivera Colón is a sexuality and gender anthropologist. For the last fifteen years, he has been conducting ethnographic research on New York City's House Ball community.

Sayantani DasGupta teaches in the MS Program in Narrative Medicine at Columbia University as well as Columbia's Center for Comparative Literature and Society. She also co-chairs Columbia's University Seminar in Narrative, Health and Social Justice and teaches at the Health Advocacy Program at Sarah Lawrence College.

Nellie Hermann was born in Boston, Massachusetts, and lives in Brooklyn, New York. Her second novel, The Season of Migration, was published by FSG in January and was a New York Times Editor's Choice. She is the Creative Director of the Program in Narrative Medicine at Columbia University and has taught and lectured widely on the use of creativity in nontraditional contexts.

Craig Irvine is Director of the Masters Program in Narrative Medicine at Columbia University and Director of Education of the Program in Narrative Medicine at the College of Physicians and Surgeons of Columbia University.

Eric R. Marcus is Director of the Columbia University Center for Psychoanalytic Training and Research and is a training and supervising analyst there. He is a professor of clinical psychiatry at the Columbia University College of Physicians and Surgeons.

Danielle Spencer is a Faculty member of the Program in Narrative Medicine at Columbia University as well as the Einstein-Cardozo Master of Science in Bioethics program in New York. Spencer presents regularly at medical humanities and bioethics conferences and has been published in The Lancet, WIRED, Creative Nonfiction, Esopus and The Hungarian Review.

Maura Spiegel has been teaching fiction and film at Columbia University and Barnard College for the past 20 years. She is a founding member of the Program in Narrative Medicine at Columbia College of Physicians and Surgeons, where she offers film courses to first-year medical students.