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The Narrative Medicine Elective

"Reflection allows us to recognize the tension between our human selves and our professional roles, creating a space to understand our emotions and their impact on the care we provide." — Danielle Ofri, What Doctors Feel

What is this elective?

Storytelling and close listening are core elements of medicine—clinical practice is the art of exchanging accounts of the human condition. Rarely, however, is the imperative role of narrative intentionally performed by trainees in the form of close-reading, reflective writing, and story sharing, given time constraints. This elective offers the unique opportunity to explore various genres of writing, empowering residents to hold new models for interpreting and articulating ethical challenges, emotional turmoil, and patient stories. The ultimate goal of this elective is to examine the role of reflection in physician wellbeing, as a therapeutic experience and a tool to use in clinical practice.

 

The Narrative Medicine elective is a two-week elective available to first and second year residents and often the group of residents taking the elective will span across all disciplines from surgery to psychiatry.

 

At the end of the elective residents are asked to submit a piece of reflection in whatever medium they desire to be published here for other residents to see and engage with, ultimately fostering a space and a community dedicated to growth and health
 

What is narrative medicine?

Narrative medicine, conceived by Dr. Rita Charon at Columbia University, is a practice rooted in the belief that listening to and interpreting patients' stories is central to effective and compassionate care. As Dr. Charon explains, “Attention to narrative enables the physician to practice medicine with empathy, reflection, professionalism, and trustworthiness.” This approach emphasizes the human connection at the heart of medicine, urging healthcare providers to listen deeply to their patients and view illness not just as a collection of symptoms, but as an experience deeply intertwined with identity and story.

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This perspective addresses a critical need in modern medicine, where the rapid pace of technology and efficiency often overshadows the human elements of care. Dr. Abraham Verghese, a prominent physician and author, echoes this sentiment: “The patient’s story is the thing that will reveal what’s wrong with them; it will point you to the diagnosis. But it’s also where the healing begins.” By engaging with the narratives of their patients, clinicians build trust and uncover insights that foster deeper understanding and better care.

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While the stories of patients take center stage, narrative medicine also underscores the importance of reflection for healthcare providers themselves. Reflective practices allow practitioners to process the emotional and ethical complexities of their work, helping them build resilience and rediscover the purpose that drew them to medicine in the first place. At NYU Grossman School of Medicine, Dr. Abigail Winkel has conducted groundbreaking research demonstrating how structured narrative medicine curricula improve medical trainees' ability to manage stress, reduce burnout, and cultivate empathy. Her findings underscore how reflecting on one’s experiences enhances both personal well-being and professional effectiveness.

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Practitioner stories and reflections reveal the profound lessons learned in the act of caregiving. Dr. Richard Selzer, a surgeon and writer, captured this beautifully: “Every patient you see is a lesson in something far deeper than the mechanics of the body. They are lessons in humanity.” By sharing and analyzing these experiences, healthcare providers not only honor their patients but also grow as compassionate and thoughtful caregivers.

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Narrative medicine, therefore, is a practice that serves both patient and practitioner. It reminds us that medicine is, at its core, a deeply human endeavor. The act of listening—to others and to ourselves—is where healing begins. Stories connect us, teach us, and ultimately make us better healers and human beings.

Principles of Narrative Medicine

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The six principles of narrative medicine—creativity, intersubjectivity, relationality, personhood and embodiment, action toward justice, and close reading—originate from the foundational text The Principles and Practice of Narrative Medicine (2016), edited by Rita Charon, Sayantani DasGupta, Craig Irvine, and colleagues. These principles are designed to enhance the practice of medicine by integrating a humanistic and narrative approach to patient care. Here's a brief explanation of each principle:

01

Creativity

Utilizing imaginative approaches, such as storytelling and artistic expression, to explore and convey patient experiences, fostering deeper understanding and empathy.

03

Relationality

Emphasizing the importance of relationships in healthcare, focusing on building meaningful connections between patients and healthcare providers.

05

Action Toward Justice

Advocating for equity in healthcare, addressing disparities, and striving to provide care that is fair and just for all patients.

02

intersubjectivity

Recognizing the shared, mutual experience between clinician and patient, acknowledging that both bring their own perspectives and emotions to the clinical encounter.

 

04

Personhood and Embodiement

Valuing the whole person, considering both their physical presence and personal identity, and understanding how illness affects their sense of self.

06

Close Reading

Engaging deeply with patients' narratives, paying careful attention to language, tone, and context to fully understand their experiences and needs.

Further Reading

1 / Books

  • Narrative Medicine: Honoring the Stories of Illness by Dr. Rita Charon

    • A foundational text by Dr. Rita Charon, exploring the theory and practice of narrative medicine.

  • The Wounded Storyteller: Body, Illness, and Ethics by Arthur W. Frank

    • A profound look at how patients narrate their experiences of illness and what these stories reveal about humanity.

  • Cutting for Stone by Abraham Verghese

    • A novel that intertwines themes of medicine, storytelling, and human connection in a moving narrative.

  • Kitchen Table Wisdom: Stories That Heal by Rachel Naomi Remen

    • A collection of poignant stories that illuminate the wisdom patients and caregivers bring to medicine.

  • Narrative Medicine: The Use of History and Story in the Healing Process by Lewis Mehl-Madrona

    • An exploration of how indigenous storytelling traditions inform patient care.

2 / Articles
  • “Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust” by Dr. Rita Charon

    • Published in JAMA, this seminal article outlines the principles and benefits of narrative medicine. (Read here)

  • “Narrative Medicine: Every Patient Has a Story” by AAMC

    • Highlights how understanding patients’ stories enhances care delivery. (Read here)

  • “The Power of Shared Stories to Enhance Patient Care” from The Permanente Journal

    • Discusses how narratives can improve outcomes for both patients and providers. (Read here)

3 / Podcasts and Multimedia
  • The Nocturnists

    • A podcast where healthcare workers share their personal stories from the frontlines of medicine. (Visit here)

  • Narrative Medicine Rounds

    • A series of discussions featuring experts in medicine, literature, and ethics. (Visit here)

  • Thriving in Scrubs​

    • Thriving in Scrubs is a podcast series that comes from research into how physicians develop resilience. Annie Robinson (who leads this elective) is a co-founder. (Visit here)​

3 / Online Resources
  • Columbia Narrative Medicine Program

    • Learn more about workshops, events, and training opportunities at the birthplace of narrative medicine. (Visit here)

  • The Intima: A Journal of Narrative Medicine

    • A literary journal featuring works by healthcare providers and patients. (Visit here)

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