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While physicians are generally thought to be more science leaning than humanities driven, narrative medicine is an intriguing field of study that bridges that gap, all with the goal of encouraging humility and compassion both for the self and for others.
Interestingly, the two disciplines have more in common than one might think. To best understand the goal of narrative medicine, it’s described as existing at the “intersection of humanities, the arts, clinical practice, and healthcare justice” to equip doctors to better understand their patients’ experiences and perspectives.
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Amanda Caleb, PhD, MPH, professor of medical humanities at Geisinger Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania, said narrative medicine has been integrated throughout the medical school’s clinical education track since 2021. The required courses focus on reflective writing, listening to patient stories, and cultivating empathy.
“We incorporate narrative medicine during the preclinical phase up through the transition to residency,” Caleb told Medscape Medical News. “The vast majority of our students enjoy the classes and this makes sense: Narrative medicine is a lot about slowing down, which is antithetical to so much of medicine. It gives our students the space to process the patient stories they’re hearing — as well as their own emotional responses.”
For example, during a neurology clinical rotation this past year, Geisinger students were tasked with completing what’s known in narrative medicine as a “parallel chart.”
“The way this works is that each student thinks about one patient and takes a few minutes to write about their hopes and fears for that patient — essentially stuff that can’t go in a patient’s chart,” she said. “We picked neurology because there is usually very complex health issues associated with it and it’s a hard space for students.”
Now an internist at Allina Health in Minneapolis, Dominic Decker, MD, said what he learned during the Master of Science program in narrative medicine at Columbia University permeates every aspect of his clinical practice.
Decker initially enrolled in the course to continue developing his interest in the humanities — and make sure his communication skills were top notch.
“I realized early on that doctors need to be able to effectively and efficiently convey information to their patients, and I knew that communication skills would help me just as much as if I had majored in biology and chemistry,” said Decker, who was a premed and English literature major during his undergraduate years.
“I’m tasked with meeting new patients on a regular basis and having to synthesize a complex set of symptoms, lab results, or imaging studies, but that’s only a small part of the job,” Decker said. “The other part is being able to relate that to a patient or a patient’s life and make it so that what I’m talking to them about is understandable and actionable to them.”
Again, Decker said narrative medicine training was an invaluable skill-builder.
“As a formal training, narrative medicine taught us to engage with the humanities as a way to help better understand the type of information we are being presented within a medical context,” he said. “I think the strength of the program is that it hones your skills of observation, analysis, and critical thinking in ways that my medical training didn’t necessarily address because medical training isn’t set up to address those types of things.”
That takeaway mirrors the experiences Rachel Sturley had as a Columbia master’s student. Sturley said that studying narrative medicine helped her identify her motivations within the field, her connection to acts of service, and, ultimately, what it means to be a doctor.
“Identifying these motivations and being able to describe them to myself and others has been so important,” said Sturley, who has just begun her coursework at Harvard Medical School, Boston. “The program also gave me a concrete understanding of health equity, compassionate care, disability justice, anti-racism, and how those things intersect in the clinic space.”
Ask Natalia Romano Spica, MD, MSc, a second-year psychiatry resident at UCLA, and she’ll tell you that she pursued a career in medicine because of her interest in the sciences as well as the fact that medicine is rooted in people and their stories.
“Narrative medicine has helped me be a better doctor and has helped me pay attention to the story of the patient in front of me,” said Romano Spica, who attended Columbia’s program from 2017 to 2019. “I see a lot of parallels between the techniques of paying attention to a poem or piece of prose and the granular attention that you should pay attention to when learning a patient’s story.”
While some may be skeptical about the power of narrative medicine, Sturley said it’s worth looking into, no matter what phase of your medical career you’re in.
“For example, it includes thinking about how to teach compassion, how to engage students on issues of equity early on, how to energize doctors after burnout and what skills are needed to tackle these problems. Narrative medicine is a powerful solution at a time when we’re looking for some concrete ways to answer these questions.”
For physicians who might want to consider a narrative medicine workshop, which are held both in-person and virtually, the gains can be impactful. Another option: Go online and search for a narrative medicine prompt, of which there are plenty, Caleb said.
Then read the poem that goes with the prompt and write down your reflection, she added. “See what happens — and how it changes your entire perspective.”
In the end, narrative medicine is an important tool that can make all the difference in how you relate to your colleagues and patients.
“When you meet with a patient, you’re already five steps down the road trying to assess this person’s situation,” Caleb said. “It’s hard to be present and listen well, but everyone can learn to be a better listener, and this makes all the difference when you’re interacting with patients.”
Lambeth Hochwald is a New York City-based journalist who covers health, relationships, trends, and issues of importance to women. She’s also a longtime professor at New York University’s Arthur L. Carter Journalism Institute.
