The Art of Narrative Medicine

Over the past six years, narrative medicine and the physicians who have worked to enhance and promote its efficacy have gained traction within the mainstream health care system. Dr. Rita Charon of the Columbia University School of Medicine, the architect of narrative medicine, contends in an article in the Journal of the American Medical Association that “sick people need physicians who can understand their diseases, treat their medical problems and accompany them through their illnesses.” The development of narrative medicine in academia and practice grew from this need Dr. Charon identified among her patients.

In 2008 she published a book on the subject, in which she explained her rationale for moving from a commoditized system of care delivery to a more subjective, patient-centered approach to holistic care. Narrative medicine, says Dr. Charon, is designed to recognize and interpret the stories of patient illness in a comprehensive way, using an integration of humanities, primary care medicine, narratology and the study of doctor-patient relationships. Narrative medicine emphasizes the chronological order of a patient’s illness in order to establish connections between behaviors and symptoms and provide more humane, ethical and effective health care.

Dr. Charon, who was trained in medicine and literary studies, applied her understanding of literature – how stories are put together, told and translated – to patient care. According to The New York Times she believed so strongly in the practice that she proposed a Master of Science in narrative medicine at Columbia University in New York. The field of study she envisioned is now a robust program in the College of Physicians and Surgeons, offering students with diverse the opportunity to study the “intersection between narrative and medicine [to] improve the effectiveness of care by developing skills with patients and colleagues.”

Should physicians be encouraged to study narrative medicine in medical school? What do you think are the practical benefits of narrative medicine to physicians, patients and the health care system more generally?