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YO R K C O M E D S O C . O R G

Narrative Medicine, continued from page 9
Eastern Kentucky where I was introduced to the narrative culture
of Appalachia. I thought I was pretty good at taking a history when
I finished my Family Medicine Residency, but I was privy to a
remarkable education from the patients I encountered there, whose
response to every historical inquiry was a story. Ask all the scripted
questions you want, there were no scripted answers. But there were
stories. After six months I came to realize the great gift patients
were giving me in these stories. They were telling me how to better
care for them. They helped me become a better doctor and a better
human being. When asked why I am so interested in patients' and
families' stories I can only reply, "I can't work without them."

in blue surgical garb kneeling at a prie-dieu, praying. That same
night, the cities around the country lit themselves with lights of
blue. This is a powerful example of the impact of Narrative Practice
on a patient and their relationship with their doctor.

The power of writing and sharing

A patient's painting

Writing our narratives has an important role. Writer Nellie
Herman, Creative Director of the Narrative Medicine Program at
Columbia University, tells us that when we write we exteriorize
something that is interior. This permits the examination of our
experiences from a different perspective and perhaps with a different
set of lenses. One of my residents said, after writing a short reflection,
"I never knew how beautiful this was until I read it."
When we share what we write, our listeners provide even
more perspectives and may also don a different set of lenses. So,
the potential for growth is substantial. This writing component
differentiates Narrative Medicine from other disciplines of reflective
practice, elevating its value.

Patients
Narrative Practice lets patients know they are heard and seen.
The principles of attention and representation are the primary way
this occurs. Patients will readily tell you about a physician who
listened carefully to them, who turned away from, or even turned
off their computer to talk to them. Close listening gets the patient's
attention.

Union Station, Kansas City, MO alight in blue

Patients will also tell about a physician who represents them
well. A physician's primary way of representing the patient's story is
via their progress note. In Narrative Medical practice we also take
advantage of writing narratives in creative ways.
Additionally, listening carefully to a patient's story positions one
to present back to the patient their story in such a way that the
patient can view their story differently. They may revise a piece of
their story or even "begin a new chapter." This "re-presentation" is a
variation on the concept of representation.
Careful attention and crafted representation results in strong
affiliation between a clinician and their patient. I propose that
every reader of this article can provide a personal example of when
they established a strong affiliation consequent to paying attention,
bearing witness and sound representation. I would encourage readers
to write for 5 minutes, "about a time you forged a strong affiliation
with someone because you listened carefully and represented them
well."
Just before the COVID pandemic arrived I advised a patient,
as part of her care plan, to read a poem by the Irish poet John O'
Donohue titled, Morning Offering. I also advised her to try to get
back to her hobby of painting. On Holy Thursday I received a
thank you note attached to a canvas showing a masked physician
8

York County Medicine | SUMMER 2020

The Kosciuszko Bridge connecting Brooklyn and Queens, NYC
[Urban Images from https://www.cnbc.com/2020/04/10/in-photosus-cities-light-up-landmarks-blue-in-support-of-health-careworkers.html]

Narrative Medicine for All
For the past three years we have also presented a monthly dropin session open to all in the system. Participants represent many
disciplines and include, in addition to Physicians and Medical

http://www.YORKCOMEDSOC.ORG

York County Medicine Summer 2020

Table of Contents for the Digital Edition of York County Medicine Summer 2020