All Heart Matters

Dr. Rita Charon at AMSA

A week ago I witnessed medical students discover new conversations and engage in narrative writing exercises at the American Medical Student Association Humanities Institute program. Thirty-four medical students converged in Sterling, Virginia to explore how the power of story helps them become better physicians.

As one of the invited presenters, I spoke to these future doctors about the writing process in crafting an illness narrative. I also shamelessly publicized my newly published anthology, The Art of Medicine in Metaphors. I was compelled and honored to share my heart surgery event in a graphic power point presentation. It was a simple message: those who tell their story are most concerned about being heard and my session celebrated the subjectivity and uniqueness of my illness experience.

AMSA has been hosting this program for several years and I am grateful to the organizers, Dr. Aliye Runyan and her associate, Niki Rarig, who offered their unstinting generosity during this 3 day collegial forum in creative workshops in poetry, medical journalism and story development.

I first met the enthusiastic Dr. Runyan at the University of Iowa and the Carver College of Medicine Examined Life Program in April 2011. She founded the AMSA Medical Humanities Scholars Program in 2008.

Runyan shared her views on the recently held program,  “I am inspired by the energy, enthusiasm, and professed need for this kind of work among students attending the institute. I believe the medical field will have to pay more attention to the need for wholeness in healthcare, for both practitioner and patient alike. Writing, reflecting, observing, and paying attention to one’s own wellness are critical elements in this endeavor.”

One of the conference participants, Elise Schlissel, a 4th year med student at the Perelman School of Medicine at the University of Pennsylvania, has been interested in literature and writing before she was an undergraduate.

Although Elise’s Match Day is fast approaching on March 15,  she did not reveal any anxiety about her imminent residency plans.  She was also quick to point out that like other medical schools in the nation, Penn’s  students have their own annual literary journal, Stylus. The publication includes poetry, prose and visual art.

Across the nation, more and more med students are becoming narrators since they welcome coherence and closure in their story. Additionally, it appears the Grand Rounds offer these future physicians more tools for listening to patients’ stories.

” I am going into pediatrics. My friends at school have a book club and I am involved in that but this was an opportunity that I did not want to miss, ” adds Elise.  Two weeks before this illness narrative writing workshop, I had sent these busy students a prompt to write a narrative about illness. In Elise’s story, “Sick versus Not-Sick” she conveys a meditative scene about her grandfather and the life lessons learned outside medical school.

” I wanted to learn that lesson in a lecture hall back in Philadelphia, surrounded by other eager, soon-to-be doctors, not in an over cramped hospital room in a small community hospital in New Jersey, surrounded by the people who loved him most. I wanted to learn sick versus not sick in medical school, not in life, but I guess you don’t get to choose this sort of thing,” writes Elise.

Other med students like  Shawen Ilaria and Julian K Hinson listened attentively to poets Veneta Masson, Dr. Richard Bronson and Dr. Marie Basile. Here is a link on Facebook of the many faces of these dedicated students engaged in workshops.

Dr. Basile, a recognized poet, spoke with me about her work as a colorectal surgeon, who has had many end-of-life conversations with patients and their families.  “Those conversations are never easy,” claims Basile. As a clinical assistant professor in the Department of Surgery at Stony Brook, she instructs med students in clinical rounds but appears to be an inspiring poet mentor for many of them.

Because I had to catch a return flight back to beautiful Myrtle Beach, I was unable to listen to the Dr. Rita Charon’s closing keynote address. However, I spoke with her on this wintry Sunday morning. I quickly expressed my deepest appreciation and respect for her continuing evangelism about the power of story in medicine. For that matter, I have adopted her book, Honoring the Stories of Illness, for my Literature and Medicine course at Coastal Carolina University.

Charon has been an indefatigable guiding force in helping health professionals, especially future physicians, recognize the need for empathy and sustained reflection about matters of the heart; not mere examination of clinical charts.

Her pioneering and celebrated Narrative Medicine Program at Columbia continues to offer bridges for those chasms that exist between patient and doctor. Her work in narrative medicine has been widely recognized by the Association of American Medical Colleges, the American College of Physicians, the Society for Health and Human Values, the American Academy on Healthcare Communication, and the Society of General Internal Medicine.

“I first used the phrase “narrative medicine” in 2000 to refer to clinical practice fortified by narrative competence—the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness. Simply, it is medicine practiced by someone who knows what to do with stories,” claims Dr. Rita Charon.

For sure, AMSA’s focused Medical Humanities Institute guided writing program offers sustaining encouragement and hope to more students of medicine to write their poems and stories. There’s even discussion from several of the students and AMSA’s administration about producing their own literary journal.

I am reminded what another evolved physician, Dr. Abraham Verghese wrote, ” As physicians, we become involved in the stories of our patients’ lives, sometimes as witnesses telling the story through a medical chart. At other times, we become players in the story.”

Send me your valued stories.