Recently, I’ve seen a large number of references to a relatively new form of patient care called narrative medicine. The idea behind this is that healthcare providers can provide better care by understanding the humanity of our patients.

This method utilizes the very basic human characteristic: we experience our lives through a series of stories. It makes sense in many ways. Consider your own life. Take a minute and think back to the time when you were a child starting, say, middle school. Do you remember this as a series of steps (you woke up that morning in your eleventh year of life, got dressed, and went to school) or do you recall the story of starting school?

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Healthcare providers can provide better care by understanding the humanity of our patients

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For me, I recall going to a brand new school in Arizona, having just moved there two months previously after living in New York. I remember the loneliness and nervousness of a young, shy child in a completely new environment. My teacher had a large puffball of hair – set in that old fashioned 1950s style like a bee’s nest – and was an intimidating woman. The kids had a slightly different accent from my New York one, and they loved to ask me to say, “Water,” which sounded more like “wau- tah.” The best word to sum up my experience was “foreign.”

If you analyze my memory for a moment, you’ll note a couple of interesting things. First, there is nothing of the procedural type of narration in it (what I did from one moment to the next). Second, these memories take the form of a reflection. It’s constructed of images and feelings.

Now, put yourself in the shoes of the most recent patient you’ve treated and reflect on that experience from their perspective. For me, it was a young lady with a bone infection that required an amputation. After a long period of time, this infection worsened and left the control of her self-ministrations. The patient was admitted to the hospital and saw a procession of people in white coats, coming to the bedside informing her of her options. Mostly, she lay alone in the hospital bed, worrying about what was going to happen to her. Despite her fears, she bravely decided to have the surgery and did well. Can you imagine how she felt? Scared, anxious, uncertain, to say the least.

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“Sick people need physicians who can understand their diseases, treat their medical problems, and accompany them through their illnesses”

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This patient’s story is clearly not presented in the typical dry, emotionless manner we as students are taught. The story above would not contain the same sense of humanity if I described this as a 30-year-old female presenting with two years of digital osteomyelitis who failed outpatient therapy and underwent digital amputation.

Narrative medicine is a pursuit first coined by Dr Rita Charon, a primary care physician who currently works at Columbia University. According to Dr Charon, "Sick people need physicians who can understand their diseases, treat their medical problems, and accompany them through their illnesses.¹”

At first glance, this quote may seem obvious. Of course, physicians understand diseases and treat medical problems. But it’s the last part of this statement that really strikes home to me: “accompanying [patients] through their illnesses.”

This is the hard part of medicine, the human part. It’s more than simply executing a technical procedure or making the proper device to help someone walk. “Accompanying a patient” through medical treatment means listening to that patient’s needs, desires, goals, and fears, and then working to understand and integrate them into care. It also means being there for that patient as much as possible. This is why consistent hospital rounds by the surgeon and not just his partner who happens to be on call after a surgery is important. Or making a phone call to a patient the day after surgery to see how she’s doing. This is why I provide my personal cell phone number to my surgical patients. I want to be there as they proceed through their illness. We can’t do this for all of our patients, of course. That would be impossible. But we can make the effort to do this as much as possible.

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“ ‘Accompanying a patient’ through medical treatment means listening to that patient’s needs, desires, goals, and fears, and then working to understand and integrate them into care”

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This is where the benefits of narrative medicine comes in. By learning more about this movement and it’s methods we build the individual tools to become more aware of our patients in a way that’s different from the patient as complaint – the heel pain in room 3; the ulcer in room 5 – and more so the patient as a fellow suffering human with a name, identity, and story of his own.

For those of you interested in learning more about the narrative medicine movement, consider looking at the following resources:

Best wishes on your exploration of narrative medicine.