Narrative Rounds

The program's monthly Narrative Medicine Rounds provide a forum for health professionals, patients, literary scholars, and narrativists of all stripes to tell and hear of research, teaching, and clinical work at the boundaries of medicine and narrative. On the first Thursday of each month, join us to hear news from the frontiers of narrative medicine. Rounds are usually held in the Faculty Club, 446 P&S Building, 630 West 168th Street (between Broadway & Fort Washington Avenue) in Washington Heights, New York City. For more information, and for an upcoming schedule, see our narrative medicine rounds page.

Literature@Work

Years ago, a medical chief resident suggested that we start a medical center reading group. What started as a handful of residents reading a short story once a month has developed into a graduate-level literature seminar that meets twice a month for the serious study of literature. Pediatricians, nurses, internists, social workers, medical students, hospital administrators, pathologists, dentists, informatics faculty, psychiatrists and graduate students in English are some of the participants in Literature at Work. We are occasionally led by faculty in English from Columbia and elsewhere: Edward Mendelson led a discussion of Virginia Woolf, Andrew Delbanco chaired the talk on Melville's Billy Budd, Maura Spiegel discussed Faulkner's Light in August, Jeffrey Berman from SUNY-Albany spoke on Conrad's Lord Jim, and Michael Rowe from Yale discussed Kafka's "The Metamorphosis."

Our group is dedicated to the memory of Dr. Robert Braham, who—until his sudden pasing on Tuesday, November 12th, 2002—was a powerful force in American medicine, having led the development of primary care medicine training at Cornell, Einstein, and Columbia. Working within New York politics, internal medicine professional societies, and national advocacy groups, he moved us all the closer to universal health coverage and to justice for the sick. Dr. Braham was also a core member of the Literature at Work discussion group, attending the meetings as often as his busy work schedule allowed, and devoting himself to careful consideration of the texts. During our study of Keats this summer, he brought his wife Susanne and his son Howard to one of the sessions, an example of his commitment to literature as something that had a real connection to his relationships and his work. Bob forged strong bonds with students, colleagues and friends alike, and is admired and respected by all who have known him and benefited from his gifts.

The group is now focusing on the oeuvre of Henry James. We meet on the first and third Wednesdays of every month, from noon to 1:30pm, in the Irving Center conference room, PH10-CTR.

Humanities Workshops for Healthcare Professionals

The study, funded by the National Endowment for the Humanities, will attempt to clarify the conceptual underpinnings of humanities teaching in medical settings and then to rely on that conceptual framework to design a narrative training program for health professionals. Project faculty with degrees in English, history, philosophy, creative writing, internal medicine, pediatrics, and psychiatry will articulate the theory, goals and potential (and evaluable) outcomes of humanities teaching in health care. Through rigorous pilot-testing of the curriculum throughout the design process, the project group will not only assert but also demonstrate the narrative road toward empathy, reflection, and clinical courage.

Seminars for Medical Students

All second-year medical students at Columbia are required to complete an intensive 1⁄2 semester seminar in humanities. Each year, all second-year medical students select among the 12-14 concurrent humanities seminars offered. Typically, the catalogue includes seminars in literary studies, narrative writing, history of medicine, ethics, visual arts, religious studies, and alternative medicine.

Narrative Oncology

Doctors, nurses, and social workers on the oncology unit of Columbia-Presbyterian Hospital gather bimonthly to read to one another what they have written about their day-to-day clinical experiences in a project funded by the Kennth B. Schwartz Center in Boston, MA. After the pilot year, the participants are deeply committed to this collaborative practice of reflection, and its investigators are seeking funding to mount a major clinical outcomes research project to study its consequences. Project participants will pilot teaching methods with this group.

Clinical Witnessing

Dr. Charon writes in Narrative Inquiry: I have started a witnessing project in my practice. I invite non-clinically trained colleagues to join me in my office to help me attend to what happens. These are pre-medical students, health advocates, various trainees and fellows who are not doctors or nurses but persons interested in narrative medicine. As such, they are not hampered by my professional blinders. If the patient permits, the witness sits in with me during the whole visit. I ask the witness to keep field notes, more like an anthropologist than anything else. I want the witness to register the mysterious rituals of this complex subculture of illness. I want to defamiliarize my office routines so that I can see them fresh, and the best way to do that is to have it seen by someone unfamiliar with it.

For further discussion: "The Self-Telling Body" p.196-97.

Parallel Charts

Program faculty and staff have accomplished a major outcomes study, funded by the Fan Fox and Leslie R. Samuels Foundation of New York, NY, documenting the consequences of narrative writing in medical education. Structured narrative writing about individual patients was incorporated into the third-year internal medicine clerkship at Columbia-Presbyterian Hospital. Students wrote in ordinary language about patients under their care and then read to one another-in a small group teaching session-what they had written. The practice of writing and reading led to frank and helpful discussions about the emotional, ethical, and personal levels of care.

In the context of a wide-ranging examination of many aspects of the third-year clerkship, we were interested to know whether students who participated in the writing exercises differed from students who did not. Preliminary findings reveal that, indeed, students who wrote were found by their faculty to develop better therapeutic relationships with patients and to be more effective as medical interviewers. Students who wrote evaluated themselves as more confident than those who did not in such clinical capacities as caring for dying patients and giving bad news. We continue to analyze both quantitative and qualitative results of this educational practice and will be publishing findings as they emerge. You are encouraged to reach Dr. Charon for more information on the Parallel Chart study.

Faculty Seminars

The program has initiated a NIH-sponsored curriculum development project to enhance the teaching of social and behavioral science in medical school. At Columbia's College of Physicians & Surgeons, the grant ("Human Experience and Behavior in Health and Illness", NIH-K07) supports an intensive faculty development seminar for teachers of the Clinical Practice course required of all first-year medical students.

The Arts in Medicine Project

The Arts in Medicine Project explores the principles of visual arts to enhance medical skills, through observation, description, and introspection. Courses offered include life drawing, museum focused study, and the acquisition of technical skills. The Project also involves the use of art in recovery and acceptance of illness and disability.

Faculty Seminars in Narrative Genetics