Narrative Medicine: more humane practices

How many times have you heard of a doctor or a nurse refer to a patient by the name of an organ followed by a bed number? Narrative medicine is the exact opposite. It is a treatment strategy that unites the existential journeys of the physician and the patient by showing attention, interest, care and concern for the other.

Dialogue, not monologue

After analyzing 1,500 videos, psychologist Egidio Moja determined that a doctor tends to interrupt a patient just 18 seconds after the appointment begins. This alarming fact shows just how one-way the doctor-patient relationship is. A therapeutic relationship, however, is not a monologue, but a dialogue. Just like a patient is not an organ, the doctor is not a prescription, but a human being with emotional baggage. It is not without reason that we often speak about a lack of adherence to treatment, which is mainly due to a lack of trust and communication between the doctor and the patient.

Narrative Medicine proposes a change of direction through the application of a personalized “narrative” approach to treatment.  Information is gathered about a patient’s medical history with the objective of developing a personalized, therapeutic course of treatment that can relieve suffering and promote mutual trust in the physician-patient relationship.

The following factors are essential in the application of narrative medicine:

  • training
  • anthropological knowledge
  • awareness

Rita Charon of Columbia University Medical Center explains the concept: “Sick people need physicians [and nurses] who can understand their diseases, treat their medical problems and accompany them through their illnesses… we can call it patient-centered medicine, yet which also enables the physician to reflect on the meaning of medical practice.”

In the wake of narrative medicine, other communication forms have been developed that combine medicine and art, such as graphic medicine.

Different narratives for different objectives

Today, digital technologies -particularly social instruments- provide many ways for sick people to narrate their disease, even though the various channels available have different objectives. Forums, for example, are effective instruments for seeking out advice and solutions while Facebook groups are useful in finding support and sharing stories. Narrations produced through a medical approach, instead, aim at personalizing a course of treatment and developing a series of treatments that are shared with caregivers.  In order to achieve this, the narration needs to be developed in a way that allows the patient to deal with, metabolize, and, in the best case scenario, overcome eventual therapeutic difficulties. It is a complex procedure. In fact, organizations that work in this sector, such as SIMEN (Italian Society of Narrative Medicine) and the ISTUD Foundation, organize and promote master’s degrees in Narrative Medicine.

Narrative medicine and digital medicine

One of the greatest obstacles in the application of narrative medicine is that physicians do not often have much time to listen. It is also not easy for a doctor to create an intimate relationship with a patient and remain objective in terms of treatment. This is where digitalization plays a key role. Gathering information from a patient’s medical history through digital instruments is advantageous both for the doctor, who can become involved in the patient’s story without becoming too close, and for the patient, who feels free to tell his or her story without constraint. Digital medicine also has other practical advantages, such as eliminating transcription times and making the physician’s work easier and more functional, allowing the physician to concentrate on the interpretation of a patient’s story, even listening to it multiple times without the patient being present.

© Domedica s.r.l.

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