The Emerging Science of Narrative Medicine

Last week’s Education Life section of the New York Times carried an article outlining a new offering at Columbia’s College of Physicians and Surgeons: a one-year graduate degree program in narrative medicine.

The offering is the brain child of Dr. Rita Charon, clinical professor of medicine at Columbia, and a leading advocate in this “emerging field” that “aims to treat the whole person, not just the illness.”

For the paltry sum of $50,000, participants can pursue courses in “philosophy, literary theory, psychoanalytic theory, and autobiography,” culminating with a “reading of literature that involves experiences of illness.”

This academic year 28 professionals have matriculated in the course.  At $50,000 per student, that’s a whopping $1,400,000 added to Columbia’s coffers per annum.  To me that seems rather outlandish, even if Dr. Charon does possess a Ph.D. in English in addition to her M.D. degree.

The gist of the program is to produce better doctors—those who can relate with a higher degree of empathy to patients—as well as leaders who can set up similar programs in other institutions of higher learning.

Anyone who has spent any time wrestling with literature will recognize the concept of irony, one of the dominant themes in the discipline.  To my humble way of thinking, as one who has spent untold hours delving into the writings of past medical authors and mentors, the concept of a $50,000 graduate degree program to learn the art of narrative medicine is, well, rather ironic in itself.

My father was a teacher.  He spent most of his career in the classroom, teaching students.  (He eventually rose to the rank of department chairman, a position which required more administrative duties in his final work years.)  I remember his words one afternoon in quiet conversation:  “The only ones who know anything about teaching are those who work in the field.” (Lest readers accuse me of nepotism, let me add that I’ve heard the same sentiment echoed by any number of other teachers worth their salt.)

If I read former physicians like William Osler, Francis Peabody, William Carlos Williams and Albert Schweitzer, as well as any number of literary types such as Tolstoy, Chekhov, Cronin, et. al., I find that the “emerging discipline of narrative medicine” has been emerging for quite some time—decades, I’ll warrant, if not centuries; perhaps millennia.

Personally, over a thirty-year career in clinical medicine, I became involved in “narrative medicine” by listening to patients and trying to make some sense of their stories as I melded them with my own.  I frequently visited with mentors (both living and dead) and learned from them as best I could. I started to write for my own edification—to put things into perspective, to learn from my mistakes, to identify what was important in caring for my patients. I published pieces to share what I learned with others, who likewise were searching for fulfillment in their roles as healers.  All of this I did with no expectation of monetary reward—I did it for the love of it, and an amateur I remain.

Now that narrative medicine has become the “in thing,” entrepreneur types are capitalizing on it, generating big bucks through workshops and programs like Dr. Charon’s at Columbia.  Eventually, it will become tainted. (As Mark Twain said, ‘Taint yours and ‘taint mine.)

But for the time being, those of us who work in the field, listening to the stories of our patients every day, can continue to ride the common waves for as long as the surf’s up.

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4 comments on “The Emerging Science of Narrative Medicine

  1. Art says:

    In regards to what your father said , just look how legislators have destroyed public education because they know what is best for children. Heaven forbid they should ask teachers. Our school superintendent just won Superintendent of the Year for PA. She never even taught in the classroom. She was a guidance counselor when she worked in the schools. Enough. Speaking of tainted….

  2. ~ t says:

    Life’s a crap shoot; sometimes you get good teachers, physicians, repairmen, etc. other times not. I had better instruction in high school than college, yet my cabinet making instructor won awards, while mostly ignoring or belittling his students. It’s long been “the American Way” to huckster what’s popular for big bucks.
    After a while, the lipstick on the pig wears off, and you’ve got only a sow’s ear to show for your investment.

  3. Donna Laluya says:

    Hello,

    I am a LCSW and I live in the Chicago area. I am very interested in gaining some skills and training in Narrative medicine. I have a family and can not relocate to New York for a year. Please help me understand how to best gain skills in education and training in Narrative Medicine outside of New York. Online would be fine. I am hoping to work with elderly and ill clients in a hospital setting as a social worker.
    Thank you
    Donna Laluya

    • Brian says:

      Hats off to you, Donna, for your interest in narrative medicine and the medical humanities! With your training as a social worker, you no doubt already possess the most important skill for success: knowing how to listen to the patient. A second requirement that I would add: a heartfelt interest in the lives of others. Finally, broaden your base by reading the classics of narrative medicine, many of which you can find on this document.

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