What do internists, especially ones practicing narrative medicine, have to tell law students and lawyers? Quite a lot. And all it will take is 39 minutes of your time.
Rita Charon, MD, PhD. a nationally renown physician, writer and educator as well as Executive Director/Founder, Program in Narrative Medicine College of Physicians and Surgeons, Columbia University is at the top of the game of Narrative Medicine.
Click here to attend the Department of Medicine Division of Medical Humanities presentation "Narrative Medicine: Accuracy, Evidence, Allegiance, Joy" as Dr. Charon discusses the importance of the medical narrative as a tool for physicians to better understand their patients and themselves, and it's role in training a new generation of doctors.
What is so fascinating to this former pediatric nurse, life-long storyteller and litigation consultant is the cross-over between Dr. Charon's ideas on the dividends of narrative medicine and those that can be reaped in law schools and law practices.
Highlights with my comments in [brackets]:
* Medicine must go beyond the bounds of knowledge with differential diagnostic brains. That kind of fact-based thinking is inadequate to the task. [Likewise, our reliance on "the facts and only the facts" gives us a distorted view of what happened to our clients and what matters to them.]
* Illness unfolds in stories. The thing that is amiss in the body tells the self that there is something the matter and eventually that story comes to the attention of the healthcare provider who will turn around and tell it to a colleague. The idea being that the telling and retelling should lead one to know what to do. [How do you see yourself in the internist's shoes?]
* Medical stories are a matter of ongoingness. A doctor's duty is to develop a sense of story that takes into account devastation, loss, grief, magnitude of hurt and pain. [Our clients are in the same boat - and we are there with them.]
* The big question: Are you available to receive the story, to “co-hear” the narratives of illness, to train yourself to know accurately and fully what the patient expresses to be more effective in care? [For lawyers, are we available to hold the space for the client so we develop different skills interviewing our clients, determining what the problem is and how to remedy it?]
* You must learn to heed the story, learn from the story, learn the skills to recognize it, stand in the gathering of the story and work with the patient and family - to experience what the patient and family go through and for the patient to learn what the healthcare people experience. [Who here has often desired that ability to co-hear with our clients and our clients families? We are walking parallel roads with these internists.]
* What are the dividends? We find this practice helps improve cohesion of healthcare teams, minimize burn-out, increase empathy, encourage taking on the perspective of another person, feeling a growth in affiliation with their colleagues and others, listening attentively and less defensively, recognizing the unique dimensions of colleagues, using parts of the brain that had gone fallow, and recognizing that stories are total storms rather than the typical pattern of beginning, middle and end. [What would you give for similar practical and human dividends in your practice?]
* Narrative medicine helps medical students and doctors stop squandering evidence by learning to retrieve it in narrative, grasping the patent's story in words and learning to plumb the meaning of the evidence. [For lawyers that meaning will carry over to the trier of fact.]
* When doctors are fortified with the competencies of listening, curiosity, empathy, imagination their practice changes, they make authentic contact with the patient cleared of biases and other fsact-gathering screens. [All anyone wants is to be heard, even for a moment. After you have given the client the chance t tell their story you can go back and collect the data you need for the lawsuit.]
Dr. Charon's makes this introduction to every patient: " As your doctor I face you so you can express to me what you are going through in words - please tell me what you think I should know about your situation." She sits with her hands in her lap and absorbs what happens. By inviting the account she can learn without shoe-horning the patient into her own fact list. [Beginning with law school we can encourage the development of attentive listening. It wil flow over to practice. Imagine th transformations.]
I invite you to spend 39 minutes and change your practice with practical and human dividends.
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