I started sharing my stories through a blog online. The creative parts of our brains shouldn’t wilt away just because we have become experts in scientific method. But it also gives me a way to share the sorrow, suffering, and joy of street medicine with many hands. It allows me to share some of these riches with others in a way that l hope brings honor to the patients and the stories they have trusted me with. Narrative medicine has given me a way to bring honor to the beautiful, and sometimes raw, stories that have been shared and witnessed on the street. Putting further structure around the stories requires knowing who is the audience? Whose perspective is leading the story? Are you expanding on a moment during an encounter (like a great love song) or are you taking the listener or reader on a journey across time? All of these questions (and many more) help to shape the story that is ultimately told. If you search your mind for a story that either enraged or enthralled you, I am certain you will find it centers around 1 of these 4 relationships. Stick figures, the great equalizer of artistic ability, followed by storytelling and listening serves as a gateway to the liberation of narrative medicine.įundamentally, narrative medicine asks us to think about 4 central relationships that need to be explored through our action of storytelling: In fact, when I teach introduction to narrative medicine workshops, I always start with a comic strip drawing activity where participants are asked to depict a positive or negative experience in health care using only stick figures. While narrative medicine is often tangibly carried out in the form of written narratives, it can also be through poetry, spoken word, and song lyrics.
1 Founded by Rita Charon, MD, PhD, of Columbia University, narrative medicine challenges us to expand our ability to empathize with our patients by learning how to listen to what is really being said and sharing it with others in a meaningful way that richly represents the diverse perspectives that interplay to create a patient’s illness experience. Narrative medicine is medicine that is practiced with narrative competence that asks clinicians to recognize first when a story is being told to you, to absorb and interpret the story, and to be moved by what was heard. I didn’t know it at the time, but what I was searching for was narrative medicine. I had made the mistake of trying to bear their sorrows, injustices, and burdens as my own instead of holding the burdens with my patients in an act of solidarity. Second, I realized how heavy the stories were. I wanted to do the stories justice, but I didn’t know how and so I shared just a snippet and then put it away for another time. Only taking a story out of storage judiciously, sharing their riches in vague stories I would tell my parents or PA students during lectures. First, I started to feel like the dragon Smaug from the Hobbit (minus the fire breathing, though my kids might disagree), sitting selfishly on my heaps of golden treasure, guarding their secrets. In the practice of street medicine, which is the direct delivery of primary care to people experiencing homelessness living in parks, underpasses, and abandoned buildings, we have the privilege of witnessing those lives lived as society casually passes by, seemingly blinded to the suffering happening at their feet.īut then, it wasn’t enough. Witnessing an individual’s journey of life and illness, with its bending and weaving trajectory, is part of the sacred privilege given to us through the practice of medicine and grants us wisdom through the observation of hundreds of lives. But on that day, between the soft sighs of this new life, I realized that the stories that I had tucked away in my mind like dust bunnies in the glorious nooks and crannies of a Swiffer duster needed to find their way out. A mom, a volunteer health care clinician working in street medicine, and a PA working in trauma, HIV medicine, and primary care have made for rich but busy and long days. And what else is life from the time you were born but a struggle to matter, at least to someone?” - Elliot PerlmanĪt home on maternity leave with my third child, I sat down on the couch rocking my newborn to sleep when I felt I could actually hear myself think for the first time in 9 years.
“Wouldn’t you want someone to tell your story? Ultimately, it’s the best proof that we mattered.