Tag Archives: health

Week 3: Diagnosing Illness Narratives

*Part III Chapter 6: Close Reading from Rita Charon, Narrative Medicine (pgs 107-130)

*Arthur Frank, The Wounded Storyteller (pgs xi-xiii, 75-84, 97-102, 115-119)

How do Frank’s 3 types of illness narratives help us and in what ways might this framework limit our understanding of illness narratives? What stories do people tell through social media about illness and how does society receive these stories? Give an example of what common responses to illness narratives might suggest about societal understandings of health inequity. OR Create a narrative about illness that uses common elements outlined in Frank’s illness narrative categories.

Our class began discussing questions posed by Ann Jurecic: “Where did [illness narratives] come from? Why are we so interested in reading them now? Why are so many people interested in writing them now?” In groups, we tackled the illness narrative worksheet, each group focusing on a single category of Frank’s types of illness narrative. I asked for students to focus on examples in popular media, ie. film and art. We then discussed the benefits of this narrative typology and the limitations of this framework, unraveling some of the caveats that must be kept in mind when thinking about these categories. I shared brief slides about the evolution of medicine and narrative, patient- and family-centered care, and examples of using illness narrative types to inform communication strategies and in research.

Some highlights of our conversation include:

-Categorizing types of illness narrative is most helpful for the listener. Importantly, Frank’s illness narrative types are not distinct categories but rather can overlap. How people narrate illness is a dynamic process and different illness narrative types can be expressed at any given moment.

-Understanding how people narrate their experiences with illness can help us to better meet them where they are and provide patient- and family-centered care.

We explored the question of whether “survivor” falls under a restitution narrative vs. a quest narrative (answer: lots of caveats to consider!). The idea of knowing how to respond when a narrative contains elements of chaos and restitution/quest was explored, and the idea of how to best meet patients where they are with how we communicate. We also talked about how knowledge of these narrative types could impact clinical care. Class ended with an engaging creative writing prompt about personifying disease!

My Week 3 lesson plan, worksheet, and slides are included below:

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Filed under Narrative Medicine and Health Inequity

Jessica Beels Design: The Dimensions of Disease

Disease exists in three-dimensional space. Sculptures allow our depictions of pathology to inhabit the world as such. With metal and broken shards of glass, Jessica Beels brings disease to life. From the microscopic HPV virus to blood clots and galaxies of neurons, Beels crafts the symbolic works of art with an understanding of their scientific significance.

These works were designed specifically for an exhibit called Pulse: Art and Medicine, “a multi media investigation of medicine as an inspiration for art, and the inherent artistry involved in the medical sciences.”

What I love about Beels’ creations is that they embody all aspects of this mission. The multiplicity of medium, incorporating  ordinary tools of art alongside the extraordinary. Understanding how medicine, the springy resilience of blood cells or the withering effects of Alzheimer’s on neurons, are influence  these creations. And, at the same time, how this art reflects the natural and unnatural of the human body.

It is the thought and care behind these works that empowers them. Beels outlines the flow of her ideas, inviting the viewer to understand the decisions she made in shaping each creation. She clearly respected this feat of stepping into the world of science and drawing upon art to explore. Beels seems to devote herself to each of these works, allowing each component to bring its scientific merit into art.

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Filed under Visualizing Illness

Catalyzing Change With Narrative

Standing before us were four individuals: a public health professor, a director, an actor, an artist. But each of these individuals held so much more than just one profession; they each dabbled into a variety of other realms, but they were all here for one reason. Today, they were here to promote the power of narrative.

Tell Me A Story: Designing Narratives for Health Behavior Change was an extraordinarily compelling and fascinating symposium organized by the School of Public Health.

Tell Me A Story

With three prominent guest speakers each contributing their insight about a different facet of the narrative, this symposium explored essence of the narrative and the potential potency of its role in instigating change.

To begin with, Monte Montgomery showed the audience what makes a story. 4 purposes, often accomplished by a 3 act structure. Engaging, understandable, and memorable all lead to the fourth purpose: actionable. The 3 act structure, as illustrated below.

3 Act Structure

Although this 3 act structure seems to be relatively pervasive in our society, I found it interesting that illness narratives represent one of the few genres that often defy this standard. Just as disease pushes against the normal functioning of the body, illness is defined by a deviation from the norm. And since illness narratives are created to mirror the illness experience, illness narratives resists the 3 act structure.

So what are the effects of this resistance? The most powerful deviation in my mind was that while 3 act narratives imply that conflict allows for an individual to achieve greater stability. This in many ways embodies the triumph narrative, which Conway so persistently cautioned us about. The 3 act structure suggests that the restitution narrative allows for not only a restoration but a progression, where an individual becomes better off than they were in the past. Illness narratives that break free from the model of the triumphant overcome of illness, then, also escape the confinement of the 3 act structure.

After Montgomery had established a basic understanding of narrative and explored the individual change that narratives can inspire, Mike Mosallam discussed the social changes that can arise from narratives. Leading with the powerful question “What is my story?,” Mosallam gave us a glimpse of his own narrative and introduced us to his reality TV show All American Muslim to show how theater can instigate social change by creating dialogue, building bridges, and humanizing groups of people such as Arabs/Muslims.

One story that particularly struck me was Mosallam’s anecdote about acting as a patient for medical school students. Mosallam described how a key part of using narrative revolves around preserving the “authenticity of stories.” There were some medical students who he said he would never want to have as his doctor. “You can’t guide and manipulate,” he explained. “Let the subject direct the narrative.”

Taking a step away from the commonly linguistic nature of narrative, Kody Chamberlain walked us through the process and the power of incorporating art into narrative. He opened my mind to thinking more about what is entailed by the creative process, which is really an interdisciplinary challenge that shares many similarities between different realms. It was fascinating to think about the impact of images, especially in the spaces between words or as replacements to words. Chamberlain’s advice about the creative process, the persistence and the depth involved in works of art, was extremely interesting, and I felt like he dispelled many common stereotypes of art with ideas such as “inspiration is a placebo.”

These three speakers left us all with a challenge:

What do you want to do? How do you want to do it?

And how can you incorporate the power of narrative?

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Filed under Miscellaneous Musings