McMaster University

McMaster University

Faculty of
Health Sciences

 

 

Narrative medicine restores disconnect between patients and their doctors

By Suzanne Morrison
Published: April 22, 2009
Rita Charon
Dr. Rita Charon, professor of clinical medicine and director of the Program in Narrative Medicine at Columbia University

It troubles Dr. Rita Charon to hear patients lament their doctors don’t listen to them and sometimes seem indifferent to their suffering.

As a pioneer and national authority in the field of literature and medicine, her research has focused on communication between doctors and patients, seeking ways to improve the ability of doctors to understand what their patients tell them.

"It is a very urgent and perilous time in medicine," Charon said from New York where she is professor of clinical medicine and director of the Program in Narrative Medicine at Columbia University.

She said there is a disconnect today between patients who want to talk about their pain, suffering, worry and anguish and their doctors who don’t really listen to what they are saying. "That should not be," she said.

With this in mind, she invented the term "narrative medicine". Columbia University is the only medical school with a program in narrative competence, in which medical students learn how to better "read" their patients’ stories through literary studies.

Charon will speak on "A Health Care Transformed by Stories: Narrative Medicine for Clinicians and Patients" when she delivers the Henry and Sylvia Wong Forum in Medicine Wednesday, April 29. The forum takes place from 4:30 p.m. to 6 p.m. in McMaster University’s Michael G. DeGroote Centre for Learning and Discovery, Room 3020.

Charon said Narrative Medicine is not false nostalgia or a yearning for the good old days when lives of patients and their doctors often intertwined. Both her father, and grandfather, were doctors. In one of her father’s patient files she recently learned why their family vacation had to be delayed one summer - to accommodate the late birth of a baby.

"What has happened to our capacity for contact?  That’s the question," Charon said. Narrative medicine — reading fiction and writing ordinary narrative prose about patients — works to restore that contact and makes physicians better doctors, she said.

Charon is a general internist and literary scholar specializing in the works of Henry James. She is the author of Narrative Medicine: Honoring the Stories of Illness and co-editor of Psychoanalysis and Narrative Medicine and Stories Matter:  The Role of Narrative in Medical Ethics.  She and her colleagues at Columbia offer intensive training in narrative medicine for health care professionals and trainees, including a new masters degree program which begins this fall.

She has said that the literary skills she learned in her English studies made her a better doctor. "The better I was as ‘reader’ of what my patients told me, the more deeply moved I was by their predicament, making more of myself available to patients as I tried to help," she said.

While little evidence is available to show patients and physicians benefit from narrative medicine, Charon said the little there is shows patients spend fewer days in hospital and require less pain medication. "What is really needed is a big, well-funded demonstration project," she said.

This is the sixth year for the innovative Henry and Sylvia Wong Forum in Medicine. The annual forum provides for an eminent medical practitioner or researchers to come to Hamilton to talk shop with a group of physicians, nurses, medical and graduate students and other health professionals while giving a public lecture on a topical health issue.

The Wongs established the forum in repayment of both the education and enjoyment they had as McMaster students. Dr. Wong was part of the second MD class to graduate from McMaster in 1973. Mrs. Wong graduated in 1969 with a BA in psychology and worked in the Health Sciences library.

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