Thursday Review: “Medical Humanities: Some Uses and Problems”

It’s been said that according to TV, there are only two interesting professions: law enforcement and medicine. Police dramas, mysteries, procedurals, and courtroom shows are nearly limitless. On the other hand, medical shows ranging from melodrama to comedy to documentary are easy to come by. The commercial success and wide range of even fictional stories about medicine points to an important discussion about the intersection of patient care and the humanities.
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Story-in-Place, April 11, 2020

Story-in-Place is a workshop to give healthcare providers a forum tell their stories during the COVID-19 crisis. The session will be online on April 11, 2020 at 2pm Pacific. Registration is free.

We’re living through a crisis and a profound shared experience. Healthcare providers and related fields are on the front lines. One of the ways that our connected world is dealing with the COVID-19 emergency is by seeking out, telling, and sharing stories.

If you’re a healthcare provider or work in a healthcare-adjacent profession, please join us. Maybe you want a space to share your story, or maybe you want a way to help process what’s going on.

In this workshop, we’ll briefly go over some fundamental elements of storytelling. Everyone will have a chance to reflect on their own stories and experiences from recent weeks. Those who would like to are invited to work through their own narratives with support from the other participants.

Thursday Review: “Taking Suffering Seriously: A New Role for the Medical Case History”

The first purpose of clinical medicine, Dr. William J. Donnelly quotes, is to relieve human suffering.1 Why, then, does the education and practice of mainstream medicine say almost nothing about patient suffering, other than pain relief?
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Thursday Review: “Soliciting the Patient’s Agenda: Have We Improved?”

What would a consultation look like if a patient were able to voice all of their concerns? Asked in a different way, how can we quantitatively demonstrate the benefits of a consultation where a patient is allowed to simply speak freely?

Writing in The Journal of the American Medical Association, Dr. M. Kim Marvel et al. give some rich detail and answers. They use a slightly different approach to “agenda” than Barry et al. did in their work on unexpressed patient agenda items. This paper, though, comes to the same general conclusion: that being intentional about hearing all that a patient has to say makes healthcare more effective, not less.

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Thursday Review: “Narrative Medicine and Decision-Making Capacity”

Greg Mahr’s article on using Narrative Medicine to evaluate the medical decision-making capacity of patients is a wonderful case study in the implementation of the medical humanities. Appearing in the Journal of Evaluation in Clinical Practice, the paper contains frequent, concise insights into the goals and possibilities of Narrative Medicine.

The article is well-written and presents the traditional model of assessing patients’ abilities, the issues inherent in it, Narrative Medicine’s viewpoint, and an alternative, narrative decision-making assessment. (The presentation is very much like a story!) Mahr says, and I agree, that Narrative medicine has been an effective and powerful tool in reshaping medical practice. It’s odd, then, that when contrasting the outcomes of the “traditional” assessment and the “narrative” assessment, narrative assessments should arrive at the same conclusions as traditional assessments, but without the ethical and philosophical difficulties embedded within the traditional assessment.

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