Narrative Medicine

Here are some things to help create and run narrative medicine sessions. I welcome feedback, ideas, and resources.

Creating your own "close reading" session

This outline shows how to create a do-it-yourself 60 to 90 minute session. It follows the form that the Columbia University Narrative Medicine faculty use, and includes "close reading" suggestions. I use the modified approach where learners are not expected to read aloud what they have written.

Sample "close readings" and writing prompts

Close reading can explore any creative work, including graphics, painting, drawing, architecture, theater, photography, installations, dance, music, film, sculpture, and the written word. The work does not need to be medically oriented; in fact, it might be better to use non-medical writing for early learners and mixed audiences.

The Columbia Narrative Medicine program tends to use longer, complex pieces, for example, "Sonny's Blues" by James Baldwin, "Cathedral" by Raymond Carver, or "To Esme with Love and Squalor" by JD Sallinger. They generate some wonderful conversations and inspire great writing.

I tend to use shorter works. Below are sample close readings I have used with students, residents, practicing physicians, and community members in Narrative Medicine sessions. I like to use poetry because so few of us in medicine are comfortable with it and it lends itself to interpretation. These are simply ideas to get you started.

As a facilitator, you will create a simple, open-ended prompt by focusing on the theme or choosing a word or phrase from the piece. You might use the form of, "Write about a day when..." or "Write about a time when..." For example, if you choose "She Does Not Remember," your prompt might be, "Write about a time when you were cold." If you choose "Girl," your prompt might be, "Write how to be a 'good' medical student or resident." If you choose "Midsummer Rain," your prompt might be, "Write about a time when you wanted to follow." People can respond in whatever way they are inspired.

Poetry

For more ideas, poke around the Poetry Foundation website.

Prose

Examples of longer works (to be read ahead of a close reading session)

The Principles and Practice of Narrative Medicine

The definitive textbook in the field is The Principles and Practice of Narrative Medicine, edited by Rita Charon, Sayantani DasGupta, Nellie Hermann, Craig Irvine, Eric R. Marcus, Edgar Rivera Colon, Danielle Spencer, and Maura Spiegel. P&P is an erudite and spirited description of the basis and value of Narrative Medicine, including a wonderful description on the history and value of close reading, NM's "signature method."

The book was published by Oxford in 2016. Search PubMed to see the editors' extensive bibliographies.

Journal articles and resources that help understand the basis for Narrative Medicine

My own publications using narrative techniques

These papers describe the narrative approach I have used to help students create personal statements for their residency applications. My approach has evolved into a more NM approach as I completed the Columbia CPA program. They are behind paywalls.

Campbell BH, Havas N, Derse AR, Holloway R. Creating a Residency Application Personal Statement Writers Workshop: Fostering Narrative, Teamwork, and Insight at a Time of Stress. Academic Medicine (March 2016); 91(3):p 371-375. DOI: 10.1097/ACM.0000000000000863
Campbell BH, Treat R, Johnson B, Derse AR. Creating Reflective Space for Reflective and “Unreflective” Medical Students: Exploring Seminal Moments in a Large-Group Writing Session. Academic Medicine (June) 2020; 95(6):p 882-887. DOI: 10.1097/ACM.0000000000003241

My narrative essays in academic journals

All of these essays appear in my book, A Fullness of Uncertain Significance: Stories of Surgery, Clarity, & Grace, with permission of the journals.

Campbell BH. A Piece of My Mind: The Book. JAMA. 2007;298(14):1613–1614.
Campbell BH. A Piece of My Mind: Listening to Leviticus. JAMA. 2008;299(8):879–880.
Campbell BH, The Art of Oncology: The Sentinel. Journal of Clinical Oncology 2008; 26 (10): 1760-1761.
Campbell BH. A Piece of My Mind: The Code. JAMA. 2009;301(14):1415–1416.
Campbell BH. A Piece of My Mind: Determination. JAMA. 2017; 317(19):1953–1954.
Campbell BH. Whatever Happened to Local Otolaryngology Societies? JAMA Otolaryngol Head Neck Surg. 2019;145(2):107-108.

Principles and Practice of Narrative Medicine - Charon