Narrativemedicine (NM), or reflective writing in medicine, recognizes the value of thepatient’s story in clinical practice, medical education and research. The ideaof combining story-telling with medicine has played a part in medical educationfor over 40 years, with studies repeatedly showing that a literary flavor ofthis sort can strengthen and support the compassionate instincts of doctors. Writingabout patients and patient encounters, thus, not just creates a unique learningand teaching experience, but also allows for the processing of one’s thoughts,feelings and emotions. This very processing, in turn, allows for empathy andcompassion to be bred, acknowledged, nurtured…and then shared in the most fluidof transactions.
With this idea in mind camethe concept of NM at the Aga Khan University (AKU), with Dr. Asad Mian leadingyet another effort under the banner of CriticalCreative Innovative Thinking. The effort soon translated into aworkshop on January 20th, 2016, with Drs. Murad M. Khan and AyeshaMian co-facilitating the process. Guest Speaker Dr. Simi Rahman, AKU MBBS classof 1997, currently a medical narrativist and physician-educator at the KeckSchool of Medicine in Los Angeles, California, provided a refreshing,insightful take on the subject.
The workshop was well-received.A total of 30 people participated, with the activities spanning the first halfof the day. In a somewhat ‘flipped classroom’ approach, there were didactic sessionsand group activities, with the latter requiring participants to read aloudtheir own works, and have the group reflect and critique on them. Held at theJuma Building, the workshop brought together individuals from different walks oflife (Emergency Medicine, Psychiatry; medical and non-medical professionals,residents and students) in an atmosphere that served a pleasant break fromroutine. The initiative not just gave participants a better understanding ofthe importance of NM, and the ethical boundaries enmeshed within it, but alsogave reluctant writers and listeners a sense of liberation. In this regard, itwas an effort aimed at nudging them into starting their own blog, getting theirpieces published in biomedical journals or newspapers - or even penning down theirvery first book.
In the short-term, though,it led to the formation of the Writers’ Guild (WG) – an online editorial boardthat houses medical narratives from anyone interested in the fledgling effort. Aninterest group in its own being, WG has been pivotal in bringing togetheramateur writers, editors, artists/photographers and blog developers - friends,colleagues and strangers, connected uniquely by the will to let patient storiesflow from one heart to the next.
The journey of WG beganwith Dr. Asad Mian publishing a narrative medicine piece titled ‘Letting Ali Die’ in the Express Tribune newspaper – the link then found its way into hisblog and other portals of social media, and reached a like-minded cohort of readers.One by one, physicians, nurses, students, as well as non-medical professionals,followed suit, putting their heads and hearts to work, and letting more narrativessweep their way into the ‘NM blog’. Relevant to the field of surgery inparticular, Drs. Shahzad Shamim and Anila Darbar put the local myth ‘surgeonsdon’t have the time or will to write’ to rest, with Dr. Darbar also assistingthe first-ever WG workshop at Liberty Books as both a facilitator and reviewer.
It didn’t matter if thewriter was young or old, or half- or full-baked – appreciation and encouragementautomatically filed in. Comments and discussion flowed, and new acquaintancesmade under the said exchange of perspectives. Perhaps the effort had turnedinto a small community of sorts…
Todate, a total of 11 doctors, four students and two non-medical professionalshave become part of the NM pool of writers, with a separate student-doctor‘league’ involved in the behind-the-scenes work: namely reviewing / editing,illustrating / photographing and blog developing. Much like the shoemaker’selves, the tasks undertaken by the ‘league’ are voluntary - borne out of thesheer labor of love – with the contributions being collected, posted and sharedon a rolling basis.
Although a new concept at our university, NM isn’t an alienphenomenon at all: Columbia University’s College of Physicians and Surgeons hasone such program, for example, which offers doctors training in NM, as well asthe opportunities to practice empathy as a skill. According to work by NM pioneerDr. Rita Charon, medical personnel exposed to literary works are more willingto adopt another person’s perspective, even after as few as three or fourone-hour workshops - and that was a notable achievement.
Pulsating, international dynamics like these underscore theimportance of NM, which then becomes a positive culture. But even if thathadn’t been the case, introducing NM at AKU would still have been a great idea,for reasons more than one: NM provides a framework for those who wish to listento that which is not said, and helps them bask in the realization that they arenot alone in feeling a certain way. It acknowledges teamwork, cultivateshumanism, adds creative dimensions to the patient-physician relationship, andshows that empathy is more than just a term localized to the undergraduatecurriculum; it is for real.
[fromNarrative Medicine]
About the Author: Huma Baqir, AKU MBBS Class of 2017, is interested in pursuing a career inpsychiatry.
About the Reviewer / Editor: Asad I. Mian MD, PhD, is an Associate Prof., Dept. of EmergencyMedicine, AKU.
Editorial Note:Copyright belongs to the author.This is from a series collected as part of theNarrative MedicineWorkshop at AKU on January 20th, 2016. Theeditorial work was performed bythe Writers’ Guild, an interestgroup at AKU, with the purpose to promote love of reflective reading andwriting, within and outside of AKU.
