NMED PS5020. Giving and Receiving Accounts of Self. 4 pts.
What are the clinical applications of literary knowledge? How are illnesses plotted represented? Does suffering belong to a genre? Can a medical history be co-narrated in order to redistribute ownership and authority? What does Geoffrey Hartman mean by the term “story cure?” The objectives of this course include advancing the instrumental value of literary practice in medical practice. At the center of this project are medical encounters in which one person gives an account of himself or herself and another person is expected to receive it. In examining the complexities of this exchange, to help clinicians to fulfill their “receiving” duties more effectively, we turn to narrative theory, performance theory, autobiographical theory, psychoanalytic theory, and the nexus of narrative/identity. Readings include works by, Henry James, W. G. Sebald, Kazuo Ishiguro, Judith Butler, Adriana Cavarero, Hannah Arendt, Arthur Frank, as well as illness narratives, trauma scholarship, and witnessing literature. The clinical component of the seminar take place in Dr. Charon’s internal medicine practice at New York-Presbyterian Hospital, where graduate students will have the opportunity to function as witness, observing and representing what occurs in the office or on rounds as a way to help both patient and doctor to take full measure of what they do together.
Recent decades have witnessed the emergence of illness and disability autobiographies as a unique field of literary and sociological study. Autobiographies written by individuals experiencing illness bring to the fore issues of subjectivity and embodiment, while simultaneously reflecting larger social, political, and cultural realities. This course the field of illness and disability autobiography as well as prominent scholarship in this field. The primary goal of the course is to examine issues of embodiment and voice in illness narratives. The course will examine the relationship between illness and disability narratives and their familial, social, and institutional contexts. Finally, this course addresses the issue of “personal to political” narratives—illness and disability narratives as they relate to broader advocacy and activism. As narrative is both analytical and practical, this course combines theoretical articles with a variety of illness autobiographies and illness narratives. The course incorporates short weekly narratives based on a personal illness experience of a student’s own or that of a close family member or friend.
Who is the Other? What is the nature of the relationship between oneself and the Other—the intersubjective relationship? Is this relationship immediate or mediated? If mediated, by what? Can I ever truly know the Other? If so, how? What does “knowing” the Other mean? What is the role of language in the intersubjective relationship? This class explores “intersubjectivity” and the “Other” as terms central to the study of Narrative Medicine. Students examine various ways of conceptualizing these terms, from Cartesianism, Hegelianism, Phenomenology, Psychoanalysis, Feminism, and other traditions. Through this exploration of intersubjectivity and Otherness, the class challenges our assumptions about the nature of the clinical encounter, with a view toward better understanding the ways that Narrative Medicine might foster authentic intersubjective, empathetic relationships between clinicians and patients.
This course details and models the skills required for the practice of narrative medicine. Although there are many forms of practice in this field, the close reading and reflective writing skills that this course teaches are the foundational skills for our pedagogy, scholarship, and clinical work. From the classic “hermeneutic circle” (from part to whole) to Arthur Frank’s approach of “reading with” stories to Michael White’s theories of narrative-based therapy, the class examines different ways to effectively combine close reading with timed reflective writing exercises. As many students will be returning to medical institutions as narrative medicine administrators or facilitators, this course focuses on developing methods for teaching and facilitating discussion and on developing and responding to writing exercises with health care professionals. Literary theory offers the foundation for understanding and knowing what to do with stories, while literary texts offer a broad range of genres, voices, narrative strategies, and techniques from which to teach. Students in this course will be introduced to a large bank of texts for learning and teaching, including short stories, prose poems, memoirs, novels, and a few films. At the same time that this course demonstrates the theories and methods in seminar, students will be putting these skills into practice in teaching practicums arranged in tandem with the seminar learning. Thoughts and methods will flow among the seminar, full-day intensive sessions, and the practicum. The seminar and full-day sessions will focus on practical questions, such as as what makes a good writing prompt, what is the proper length story to assign to clinical trainees, and does the teacher respond orally or in writing to the writing of a learner. The aim of the course is to equip students with the knowledge to approach and inhabit stories and the skills to impart this knowledge to others.
What is the meaning of embodiment? For most of us, it seems this is a question we only confront when our bodies “break down,” “fail,” or “betray” us. In truth, however, it is a question we are answering with every intentional movement, feeling, impulse and desire of our conscious life. In this course, we will explore various approaches to embodiment from contemporary thinkers. We will ask what these approaches might tell us about the experience of illness and how they might inform our understanding of care, both of ourselves and others.
Narratives of illness, until recently, were conceptualized as textual—illness memoirs, hospital charts, doctors’ stories, and patients’ verbal accounts of sickness. During the past decade or so, visual representations of illness have come to the fore to complement language-based narratives. The fields of narrative medicine and arts and medicine are now attuned to the power of visual art—paintings, photography, sculpture, movies, graphic novels—to convey that which even language cannot convey about suffering and healing. The Master of Science in Narrative Medicine has a responsibility to equip its candidates with the skills in visual perception and interpretation necessary to not only behold but also understand the situations of patients as telegraphed by their bodies. The course is designed for all who hope to enrich their ability to witness suffering—to recognize, interpret and be moved to action by the embodied stories of others—with a view toward enhancing the provision of quality health care as teachers and/or practitioners of Narrative Medicine. Specifically, the course will strengthen the skill of students to observe and interpret the bodily states of patients so as to improve their clinical capacities. Readings for the seminar will include works of theory, criticism, connoisseurship and the writings of artists themselves. We will examine such questions as: Is there such a thing as an artistic personality? To what extent and in what ways can art be taught? Is there a relationship between art-making and mental illness? And why do so many artists allude to suffering, both mental and physical?
From Frankenstein to AI, from Brave New World to Gattaca—this course draws upon literature, film and criticism to explore the ways in which popular culture both reflects and informs our understanding of bioethics. We will investigate the reciprocity between narrative—understood as the form and means of storytelling—and ethics, particularly in the domain of illness, bioethics, and medical practice. Topics include superheroes and disability studies; the Outbreak narrative in literature, film, and current events; the ethics of clinician writing, and the thematic connections between contemporary debates concerning vaccination and the story of Dracula
Narrative medicine, its practice and scholarship, is necessarily concerned with issues of trauma, body, memory, voice, and inter-subjectivity. However, to grapple with these issues, we must locate them in their social, cultural, political, and historical contexts. Narrative understanding helps unpack the complex power relations between North and South, state and worker, disabled body and able body, bread-earner and child-bearer, as well as self and the other (or, even, selves and others). If disease, violence, terror, war, poverty, and oppression manifest themselves narratively, then resistance, justice, healing, activism, and collectivity can equally be products of a narrative-based approach to ourselves and the world. This course explores the connections between narrative, health, and social justice. In doing so, it broadens the mandate of narrative medicine, challenging each of us to bring a critical, self-reflective eye to our scholarship, teaching, practice, and organizing. How are the stories we tell, and are told, manifestations of social injustice? How can we transform such stories into narratives of justice, health, and change?
This course is an in-depth exploration of the way in which narratives are co-constructed, negotiated, and performed. The reciprocal relationship between storytelling and listening is an additional focus of the course. Students apply current and previous experience to the presentation of a co-constructed narrative. The course is structured in three interrelated phases: The first phase addresses theoretical foundations and philosophical issues of narrative approaches, dialogue, and negotiation; the second phase focuses on practical components, including creating safe spaces for storytelling, uncovering the obstacles to listening, and elucidating the basic elements of storytelling; and the final phase includes the presentation and in-depth analyses of student co-constructed narratives. To facilitate the application of knowledge accrued about the co-construction of narratives, students examine and analyze a series of illustrative examples over the course of the semester, including documentary films, published articles, and live performances.
Death and dying, like birth and birthing, are medical events in modern society. Most of us end life as we began it—in the hospital, with “strangers at the bedside,” as David Rothman writes, and often as cyborgs imbedded with machinery that externalizes even as it embodies life itself. Is it indeed possible to be part of this medicalization process and yet understand and connect with dying and death from within the experience of the person? The intention of the course is to bring students to a deeper understanding of their own connection to death and dying, to a stronger connection to the experience of dying for dying people, and to a more caring sensitivity to those who care for others at the end of life. While we live we are the subject: our lives unfold in stories and are connected to others through narrative. By using narrative to better understand our own feelings toward death and dying, as well as connecting to the experience of others, we become better clinicians and more effective caregivers. The course explores the meaning of death and its cultural construction in western and non-western societies; the definitions of death and the place of the individual at the intersection of physiological, technological, legal, and philosophical interpretations; and the experience of death in the personal and in the public spheres. We use narratives by patients, families, caregivers, and clinicians in different media to explore these dimensions, as well as using secondary sources built on narrative and narrative analysis.
As students create and implement narrative programs, research methods become essential tools in assessing their impact. The nature of most narrative work – group process around writing, sharing and responding to text – lends itself to descriptive study. Thus, this course will focus primarily on qualitative methods of inquiry and analysis, including participant observation, interviews and focus groups, with a brief foray into commonly used, basic quantitative tools that serve to supplement qualitative data. Students will read and discuss examples of qualitative studies, learn the methods in class, engage in fieldwork in order to practice the methods, and analyze the data collected in the field.
This course is a follow-up to the prerequisite Applied Writing in the Narrative Medicine Context and Beyond (NMED PS5990) and will serve as an elective for those students who wish to develop creative projects and to further cement their facility with the language of craft and modes of storytelling. We will focus intensely on the student work—bringing in outside texts only as they relate to individual student projects—and will push students not only to further their own writing but to meaningfully engage with their classmates’ projects and develop their capacity as thinkers and responders to the craft of stories.
Literary and cultural understandings of colonialism, borderlands, diaspora, identity and home deepen health and humanities scholarship. Indeed, theorists such as Arthur Frank have argued that it is the liminal, in-between-ness of the illness experience that make meaningless previously held senses of time and space. Illness, disability, indeed, any host of embodied changes demand a new story, a new destination and map to life’s journey. Illness, disabilities and other identities at the embodied borderlands, then, are akin to a new sort of diaspora, a sort of belonging to nowhere and everywhere that brings with it a unique insight into the human experience. In the words of Marcel Proust, “the real voyage of discovery consists not of seeing new landscapes, but in having new eyes.” This seminar will explore the relationship between embodied borderlands and Narrative Medicine by reading (and viewing) diasporic fictions concerned with health and illness, witnessing and memory, identity and intersubjectivity, the real and the uncanny. In addition, we will examine the intersections between cultural theory, queer theory, postcolonial theory, disability theory, and critical race feminist theory to understand how these fields deepen the work of narrative medicine..
Each student has the option of completing a clinical practicum, a capstone project, or a thesis. The type of practicum or independent study, the placement, and the topic are subject to the approval of the program adviser in consultation with other faculty. On the basis of this decision, each student will be assigned a practicum/independent study adviser.
Students are expected to choose a practicum or independent study based on their past experience and future professional or academic goals. Examples include: clinical placements; curriculum, program design, or program evaluation projects; master’s theses; or publishable articles.
In this class we will explore the act of writing: how it is done, what it is for, how it works on our minds and bodies, and how it can be used to engender meaningful change in the clinical context. What really happens to one in the act and wake of writing? We will examine this question through the explorations of writers and thinkers as well as through our own practice and close study of the craft. At the end of the course students should have, in addition to a better understanding of their own strengths, weaknesses, and instincts as writers, a working knowledge of how and why to write with others in a clinical context.
The independent study in narrative medicine may be taken for between one and three points per semester depending on the work involved as determined by the instructor.