Category Archives: Narrative Medicine

Narrative Medicine and the Fine Art of Listening: A Memoir Moment

Posted by Kathleen Pooler/@kathypooler

 

“The greatest gift you can give another is the purity of your attention.” Richard Moss, MD

 

The field of Narrative Medicine has emerged gradually over time.

 

Dr Rita Charon, professor of medicine and executive director of Columbia University’s Narrative Medicine program defines narrative medicine as “medicine practiced with narrative competence to recognize, absorb, tell and be moved by the stories of illness.”

 

She is the author of Narrative Medicine: Honoring the Stories of Illness.

 

narrative-medicine-charon-rita-9780195340228
Narrative Medicine: Honoring the Stories of Illness by Dr Rita Charon

 

When I attended nursing school in 1964-67, we studied ‘interpersonal relationships and therapeutic communication.” It was a given that the nurse’s role was to consider the individual person in caring for the patient while the physician’s role was to concentrate on diagnosing and treating disease. We called it the nursing model and medical model. Together we would work as a team to deliver safe and compassionate care to our patients.

 

Listening to the stories of illness is at the heart of any compassionate, caring relationship. As Dr Charon cites in this article from the Journal of American Medical Association (JAMA),

 

“words nurse the wounds medicine cannot describe.”

 

It comes as a welcomed relief to me to see that the field of Narrative Medicine encourages a holistic approach for all healthcare providers.

 

I have been privileged to have served as a health care provider both as a registered nurse for forty-four years and as a family nurse practitioner for the last fifteen of those years.

 

Here is a story of a time I listened to a patient. It was 1974 and I was a staff RN in a busy emergency department of a 400-bed hospital:

 

Sacred Ground

 

50 year-old  male with crushing chest pain of three-hour duration. No known heart history. His wife is on her way,” the paramedic reported while whisking the ambulance stretcher past me on the way to the trauma room.

 

As I helped pull the man onto the exam table, his wide eyes and ashen color left no doubt about the urgency of his condition. We buzzed around him like a swarm of bees. While hooking him up to the monitor, starting an IV (intravenous), rattling off questions, I looked over at him and noticed his eyes searching. He clutched his chest and looked so scared.

 

“Mr Michaels, we’re giving you some medication in your veins to help the pain,” I said as I leaned in closer to his stretcher.

 

“Where’s Rachel? I need to see Rachel. Please go get her,” he pleaded, his salt and pepper hair now drenched with sweat. He had a look of terror in his eyes.

 

Sensing the desperation in his plea, I signaled to a co-worker to take my place and briefly left the room while the frenzied attempt to save his life continued.

 

A thin, scared young girl with long straight light brown hair and big brown eyes slowly inched her way around the corner when I called out for Rachel.

 

“Rachel, your dad wants to talk with you,” I said. When I bent down to put my hand on her shoulder, I wanted to wrap my arms around her frail, frightened body.

 

“Is my Daddy going to be OK?” she asked as she looked up at me and fiddled with the button on her dress. I sensed she knew he wasn’t.

 

“We’re doing everything we can, Rachel. Come with me,” I said as I took her hand and led her to the room.

 

I guided her to the head of her father’s bed through the maze of IV tubing, monitor wires, medical orders and staff rushing by.

 

Mr Michaels reached out his arm and pulled her head next to his, kissing her forehead.

 

“Take good care of your mother, Rachel. Daddy loves you very much.” He said. 

 

I love you too, Daddy.” She said and began sobbing.

 

He nodded, signaling me it was time to leave.

 

After ushering Rachel to the waiting room to the care of another nurse, I returned to the room. He was being resuscitated. As soon as I left the room with Rachel, he had gone into full cardiac arrest. After all attempts were deemed futile , he was pronounced dead.

 

Precious moments and sacred ground.

 

 I’m so glad I listened.”

 

 

I hope you will enjoy this YouTube video of a TED talk by Dr. Sayantani Das Gupta, professor in the Medical Humanities program at Columbia University. She talks about “Narrative Humility and the importance of reading and interpreting our patients’ stories.”

 

How about you? Have you experienced the healing aspect of storytelling and being listened to?

 

I’d love to hear from you. Please leave your comments below~

 

Next Week:

Monday, 3/31/14:  ” Finding My Way From Memoir to Fiction by Author Doreen Cox”

 

 

 

 

Narrative Medicine: A Guest Post by Memoirist Nancy Stephan

Posted by Kathleen Pooler/@kathypooler

 

“Kindness is more important than wisdom, and the recognition of this is the beginning of wisdom.” Theodore Isaac Ruben, MD  One to One.

 

I am very happy to feature  Memoir Author Nancy Stephan in this guest post on Narrative Medicine. We met online. Nancy is the author of  The Truth About Butterflies, a poignant story about the death of her beloved daughter, Nicole. My reviews are on Amazon and Goodreads. Nancy worked in health care as a nurse for 18 years before pursuing her degree in creative writing. 

 

Welcome , Nancy!

Memoir Author Nancy Stephan
Memoir Author Nancy Stephan

 

 

Narrative Medicine, defined as the intersection of medicine and the humanities, is not a new concept. Artists, writers, patients, physicians and caregivers have been combining literature and medicine for as long as people and the arts have existed.

Thanks to Dr. Rita Charon, the founder of narrative medicine, this intersection has been formalized. The roads have been paved, and street signs have been put up. It is no longer just an unmarked thoroughfare;

it has become a destination for caregivers wishing to improve their competency, for sick people wishing to improve their health, and for writers like me to share the stories that have helped us grow.

This is one of my stories from my nursing career:

 

Narrative Medicine:

A Tale of Two Men and a Four-letter Word

 

Nobody wanted to work on the 4th floor. That AIDS man was up there. It was the mid-1980s, and the greatest fear of every nursing student in our cohort was being assigned an AIDS patient. But, eventually, it happened. My fellow student Cleeta and I were both placed on the 4th floor. We were both assigned our customary one patient. Mine was an elderly lady with dementia who kept putting on the call light, looking for her feet; someone had stolen her feet. My friend Cleeta’s patient was the AIDS man at the end of the hall.

 

“I’m not taking that man,” Cleeta said. “I want to be reassigned!” But Mrs. Kluth, our clinical instructor, told Cleeta she would either take the patient she was assigned or she would be sent home. Grudgingly, Cleeta grabbed her things, and we headed to the 4th floor.

 

As the two student nurses working on the unit, we were taken to the room at the end of the hall and given a full demonstration on how to follow strict isolation protocol. There were gowns to be donned, and masks and gloves to be worn. There was a bleach solution to be mixed and cleaning guidelines to follow. I looked beyond the nurse and her droning voice and into the room where a skeleton of a man lay on the bed gaunt faced and wet with perspiration. The white sheet was pulled up to his waist, his nude, rib-barreled chest rising and falling with each breath.

 

As noon approached, we quickly passed out the lunch trays. The AIDS man’s tray was the last one left on the cart. Cleeta, having avoided it as long as she could, pulled the tray from the cart and walked with a quick pace toward the man’s room. “Here,” I said as I followed her, “I’ll hold the tray while you gown up.”

“You don’t need to,” she said.

And when we reached the room, Cleeta squatted in the doorway, put the tray on the floor, and slid it across the slick, shiny tile. “It’s not like he’s gonna eat it,” she said. “Look at him; he’s catatonic.” And she walked away leaving me standing there.

 

The man was lying on his side facing the door. His dark, sunken eyes were fixed on me. “Are you hungry, sir?” I asked from the doorway not knowing what else to do, but he didn’t respond. His eyes were stuporous, his naked body was wet with sweat, and his respirations were rapid and shallow. I donned a gown, mask, and gloves, and held my breath as I stepped in quickly to move the tray from the floor to the bedside table. I held my breath because I feared the AIDS virus might be swirling about in the air. The mask might not have been enough to protect me.

 

It had all been such a disaster, and I thought about it later that night as I lay in bed. I wasn’t prepared, I thought. It happened too quickly, and I didn’t have time to get my thoughts together. Besides, he wasn’t even my patient. I struggled, unsuccessfully, to justify the events of the afternoon, but the truth was inescapable. I should’ve behaved with more compassion. I should’ve walked into that room and touched him, not the touch that demands something, like a blood pressure or a pulse, not the rattling around of bed rails or the shifting of covers or the other busy work that our hands find to do, but the simple touch of one human being to another. I should’ve offered him a sip of water.

 

The truth was, even though I was a bit kinder, I was just as chickenshit as Cleeta. I wasn’t afraid of the AIDS man himself. I was afraid of what was killing him. I was barely 20 years old, and the only thing I was certain of was that I didn’t want to die.

 

Some years later while working for a home-health agency, I volunteered to care for another man who was dying of AIDS. His name was David. Thanks to medical research, we were a little wiser about the AIDS virus and its transmission, but people were still dying from the disease at alarming rates. As such, there were few caregivers lining up to care for people with AIDS.

 

David lived in a posh, midtown penthouse that was filled with beautiful furniture and exotic artifacts from his many travels. For the six weeks that I cared for him, we talked in great detail about life and death and the unknown. I sat on the side of his bed while he showed me pictures of his adventures in Africa and Europe and South America. I listened to his action-packed stories and outlandish tall tales. And every day we ate plump, juicy oranges that were delivered fresh from the farmer’s market. David insisted that I invest in a Walkman so that on restless nights when I found it difficult to sleep, I could listen to the sounds of nature, which is exactly what he was doing the night he slipped away.

 

These two men dwell in my memory as a jarring juxtaposition. Even though my experiences with them happened years apart, I view it as one event, one sacred lesson. When, for whatever reason, I miss an opportunity to lay loving hands on someone in need, the universe will provide me with a second chance to get it right.

 

It’s up to me to take advantage of that second chance and turn it into something beautiful.

 

Author’s Bio:

Nancy Stephan is the author of The Truth About Butterflies: A Memoir, which earned the Atlanta resident a 2012 Georgia Author of the Year Award. She holds a master’s degree in creative writing from Kennesaw State University and is the Writing Center supervisor at Georgia Perimeter College, Dunwoody. Her first collection of poetry, A Gary Girl’s Guide to Good, was published in 2012. She is currently working on a collection of essays entitled, 24th Opus.

 

Nancy’s Blog

Writer’s Bio

LinkedIn (Nancy Stephan)

Facebook

goodreads

Amazon

Memoirs Only Library

***

Thank you, Nancy for sharing your heart-wrenching story of caring for AIDS patients. It is reassuring to know that compassionate care has become the focus in health care  and that narrative medicine is helping both patients and caregivers  experience healing by sharing the stories that matter.

 

The Truth About Butterflies A Memoir by Nancy Stephan
The Truth About Butterflies A Memoir by Nancy Stephan

 

How About You? Has storytelling brought healing to you? Have you had any experience with Narrative Medicine?

 

We’d  love to hear from you. Please share your stories and comments  below~

 

Nancy will be giving away a copy of her memoir to a commenter whose name will be selected in a random drawing. She is also offering a 20% discount if you order The Truth About Butterflies here.

 

Announcement: Congratulations to Linda Thomas and Louise Carlini! Your names were selected in a random drawing of commenters: Linda won Slants of Light Anthology by Susan Weidener and the Women’s Writing Circle; Louise won Adopted Reality by Laura Dennis.

 

This week: I’m over at Nancy’s blog with a guest post, the  first in a series on narrative medicine: “Healing Each Other Through Storytelling: The New Face of  Narrative Medicine.”  I hope you’ll join us there,too.

 

On Thursday, 5/9/13: An interview with writer Sarah Freeman on ” Ghostwriting a Memoir.”