NARRATIVE AND MEDICINE 2012

The Self-Telling Body, or How Narrative Practices Illuminate the Care of the Sick
Rita Charon

Giving and receiving accounts of self are the central events of health care. A sick person will tell—using words, gestures, silences, or the physiologic signs measured in the blood or flesh—about his or her predicament. The doctor or nurse or social worker receives all that is emitted by the patient, trying to cohere the heard and seen into a diagnostic impression firm enough to support therapeutic action.

The incursion of narrative theory and practices into clinical work fortifies what we doctors and nurses and therapists do with or for patients. As a close reader, I have improved my skill in absorbing and decoding and being moved by what my patients tell me. As a respectable writer, I can represent the complex situation of a patient in words, the reading back of which always teaches me something I did not know about the patient before the writing act.

In this talk, I will spell out some of the narrative theories that form a basis for our clinical practice of narrative medicine and will give an account of two clinical cases that seemed to me and to the patient to pivot on the narrative work we did together. I will propose some ways of thinking about what happens at the membranes between clinician and patient that give us the means to assure meaningful and therapeutically significant contact in the care of the sick.


Rita Charon, biosketch

Rita Charon is a general internist and literary scholar at Columbia University in New York, NY, USA. She has a small general practice in a poor immigrant neighborhood of Manhattan. She teaches medical students about the language of medicine, how to build helpful relationships with patients, and how to use the imagination in the care of the sick. By creating the Program in Narrative Medicine at Columbia in 2000, Dr. Charon brought together scholars from the humanities and social sciences with doctors, nurses, social workers, psychoanalysts to think, together, about how the use of stories improves health care.

The Program, under Dr. Charon’s directorship, provides a robust educational program for clinicians and trainees of many disciplines and many levels of training. The Program has an active research agenda, collecting evidence of the consequences of narrative training for clinicians. In 2009, the Master of Science in Narrative Medicine was launched at Columbia, attracting clinicians at all stages of their careers along with writers, poets, literary scholars, journalists, and young students on their way into one or another of these fields. Dr. Charon has been honored with a Guggenheim Fellowship, a Rockefeller Foundation residence at Bellagio, and many achievement awards from medical and literary societies. She lectures and publishes extensively on narrative medicine topics. She is the author of Narrative Medicine: Honoring the Stories of Illness and co-editor of Psychoanalysis and Narrative Medicine and Stories Matter: The Role of Narrative in Medical Ethics. She is working on a book on Henry James.