The Story of Illness: Narrative Medicine

Anyone who has ever taken the time to talk to an ill person (pretty much all of us), know that the person never says the things that are written about them in medical charts. They describe their symptoms, their disease progression, and their outlook in terms of analogy and simile. In essence: they tell the tale of how they became ill, what happened in the months leading up to their becoming ill, how they came to get diagnosed and helped, what troubles they are encountering in getting treatment, and what they feel that their prognosis will be.

Narrative competence has been described as the ability of a doctor to recognize, absorb, interpret, and act on their patients’ stories of illness and strife. Narrative medicine is the interplay between narrative storytelling and science. Quickly gaining traction in America, 75% of medical schools offer coursework on narrative competence and 40% require narrative medicine coursework. These studies are thought to help medical students develop critical thinking skills and challenge false assumptions. Every day, Schwartz Center Rounds are held in hundreds of hospitals in the U.S, wherein the human aspects of a difficult medical case are discussed and reflected upon. When a medical professional allows a patient to tell their story and describe their illness in their own terms, they are practicing mindfulness and being present in the moment, while actively listening to and observing the patient as a person rather than a medical record number.

Why is this philosophy suddenly gaining traction in the United States? It could be because we have effectively fragmented the modern healthcare system to the point where medical providers spend much more time staring at a computer or phone screen than they do actually looking at or talking to patients. Nor do they have much time to share their experiences with their colleagues. What has this cost us? The loss of empathy for the patient’s unique situation and a decrease in the amount of time expended advocating for the patient. All of this results in cynicism, fatigue, and isolation that ultimately puts all of us at risk should we require medical care.

Sharing these stories with others is believed to help them cope with illness and develop resilience. The stories that we tell ourselves shape how we understand our personal lives, identities, and bodies. They illustrate how our emotional experiences and beliefs affect our physical wellness and ability to recover from illness or injury. Once you start to see the world in terms of a story that you can tell and in relation to stories that you have previously heard, it’s not something that you can easily turn off again, because everything quickly becomes an opportunity for another story. Life is so much more engaging in this light, and wouldn’t you like your doctor to be engaged?