While much has changed in the world over time, story as a connector, creator of community, critical to health and healing, and conveyor of change and hope has not. As humans, we live in and through storytelling- it is how we communicate. The teller/listener dynamic is an agent of change that can transform the person telling as well as all of those who receive it.

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Storytelling is at the heart of healthcare and humanity.

 

What is in a story?

• essential “medicine” for our brain and health

• a way to build connection and community

• a vehicle to make sense of the world, understand others and self

• a dynamic educational tool for all healthcare professions

• an advocacy tool

• a roadmap for health, equity, justice and systems change

• a way to humanize health care and health profession education

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We live in a divided and distracted time. Stories swirl around us as posts, soundbites and EHR entries. Sometimes stories are told for or about us- but not by us. Often we lack the time, means or ability to enter a story, absorb, and be moved to act in response to a story.

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The Bluebird Way Foundation is committed to ensuring that stories are told by the voices of lived experience, are valued, and are the vehicles to help us join together in a U-turn away from divisions toward community, compassion and hope. 

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Narrative Medicine

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The tightening of time, space and humanity in the business of health care strips the ability to listen and respond to stories. Instead a person’s story is zipped up into an EHR summary, handoff, or referral from one specialist to another. While scientific advances in medicine and technology are impressive, they alone cannot build the relationships, communication, healing and compassion that patients, providers and families all need.

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Narrative Medicine is a discipline of health care that helps patients and health professionals to tell and listen to the complex and unique stories of illness.-- Rita Charon (1)

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What is Narrative Medicine? How do you do "it?"

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Narrative medicine is a discipline of health care that uses the arts and humanities  to improve health care. It offers principles and practices to equip one with “narrative competence:” the ability to acknowledge, absorb, interpret and act upon stories. Originally created to help clinicians develop skills to care for patients narrative medicine has expanded and offers ways for patients, families, and others to counteract the dehumanization of health care.

 

While some may approach the practice and seek to "master" a narrative as they may have been taught to become culturally competent (i.e.- learn all about a culture and competent in it) , "narrative humility" highlights that stories are in fact dynamic relationships. We can listen, explore, and interact with stories, but we may not be able to fully know or understand every aspect- or extract every detail or fact needed for a situation. Narrative humility requires you to be open to all that a story offers, including ambiguity and contradiction, and to be open to self-evaluation about issues such as your own role in the story as listener, your expectations of the story, your responsibilities to the story, and your ownership of the story.(2) 

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The practice of narrative medicine can take on a variety of forms. Typically, workshops uses these methods to work groups through the movements of narrative medicine:

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• Attention- engaging with works, such as a poem, painting or song, to develop skills through close reading and close listening

• Representation- writing reflectively to explore personal narratives

• Affiliation- share observations of close reading/listening and reflective writing with others to develop and strengthen relationships

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The Benefits of Narrative Medicine

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The evidence suggests that the core tenets of narrative medicine are proven tools to bridge divides, promote communication and activate compassion. Participation in narrative medicine workshops increases compassion and professional identity, decrease the negative effects of burnout, encourage team building, create community and improve communication. Participation in narrative medicine workshops has the ability to improve wellbeing while also improving the quality of care.

 

Narrative medicine, for patients and families in particular, also serves as a way to make sense of the challenging experiences in health care, supports exploration, discovery and expression of emotions around those experiences, and offers tools to approach difficult topics. Narrative practices have also been shown to improve physical and mental health, such as improve immune function, lower pain and medication use, and decrease levels of depression.

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1. Charon R. Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust. JAMA. 2001;286(15):1897–1902. doi:10.1001/jama.286.15.1897

2. DasGupta S. Narrative humility. Lancet. 2008 Mar 22;371(9617):980-1. doi: 10.1016/s0140-6736(08)60440-7. PMID: 18363204.