Narrative, Literature and the Experience of Illness, University of Pittsburgh

“Empathy isn’t just listening, it’s asking the questions whose answers need to be listened to. Empathy requires inquiry as much as imagination. Empathy requires knowing that you know nothing. Empathy means acknowledging a horizon of context that extends perpetually beyond what you can see.” —Leslie Jamison, The Empathy Exams “I think that reading and writing are, at their core, acts of empathy. If I were more engaged and practiced in the habit of empathizing, there’s no question that we’d be in a more compassionate place. Likewise, I believe that to write is to take part in the profound act of witness: the more people who try to write, who try to create a world out of twenty-six letters and their infinite combinations, the more likely we will be to see, for better or worse, what we’re capable of in terms of empathy and compassion...I think we read and write out of an unbounded curiosity about humanity. We’re looking for another soul on the page, and how satisfying and significant it is when the soul you find, whether reading or writing, is your own.” —Bret Anthony Johnston The English scholar and author Jonathan Gottschall argues that the defining characteristic of our humanity is not our large human brains, nor or upright posture, nor—even—the complexity of our languages and cultures. Rather, the feature of our species that most separates and elevates us among all creation is our affinity for, our facility with, our fundamental need to tell and to receive stories. Stories are how we humans make meaning and sense of the world. The field of narrative medicine applies this premise to teaching the clinical skills required of physicians. Rita Charon writes that narrative competence—that is, the development of skills necessary to construct and interpret narratives—sharpens our perception, engages our imaginations, and leads us to insights that would otherwise elude us. Indeed, the same skills that allow us to receive a patient’s story of illness, translate that account to produce a faithful narrative, and apply our data and experience to produce a meaningful assessment can also help us to navigate the complex moral questions that physicians encounter. Research confirms that students who had higher levels of exposure to the humanities prior to medical school tend to exhibit higher degrees of empathy, tolerance for ambiguity, self-efficacy, special skills, and decrease rates of burnout. The particular component of empathy on which narrative medicine focuses and which close reading of literature cultivates—the ability to view the world from another’s perspective—has been shown to reduce rates of burnout among clinicians, and has been correlated with higher patient satisfaction scores and improved clinical outcomes—from lower Hgb A1C and LDL-C levels to decreased disparities in pain management between white and Black patients. This elective provides the senior medical student with a unique opportunity to develop narrative competence through close reading, interpretation, discussion, and through a mentored creative writing experience. Along the way, we will examine existential questions that impact both doctors and patients through encounters with a diverse array of literary texts including poetry, fiction, essay, and novels. The class will meet 3-4 times per week over the span of 4 weeks and is facilitated by physicians with expertise in writing and in narrative medicine. This information has been collected for the Post-Discipline Online Syllabus Database. The database explores the use of literature by schools of professional education in North America. It forms part of a larger project titled Post-Discipline: Literature, Professionalism, and the Crisis of the Humanities, led by Dr Merve Emre with the assistance of Dr Hayley G. Toth. You can find more information about the project at https://postdiscipline.english.ox.ac.uk/. Data was collected and accurate in 2021/22.