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