Tag Archives: storytelling

Week 11: Canonical Babbling in Peed Onk: Childhood Cancer and Death Stories

*Lorrie Moore, People Like That Are the Only People Here
*Raymond Carter, A Small, Good, Thing
**Proposal for Final Project due

Your reflection this week can be brief, but please still post and comment on another post about the impact and effectiveness on these fictional short stories.

We opened class with our guest speaker, Dr. Joy Brooke Fairfield, Assistant Professor of Media Studies at Rhodes College. She led us through several improv exercises that touched upon the fun of making mistakes, creating a safe space by consenting to improv, hilariously breaking bad news (ie. a superhero firing their sidekick), and breaking bad news like in A Small, Good Thing. It was a playful hour full of laughter and observation that encouraged students to stretch themselves outside of their comfort zone.

After reflecting on our experiences with medical improv, we wrote in the style of People Like That Are the Only People Here. During our class readings this week, we explored two different short stories that touched upon pediatrics: A Small, Good Thing by Raymond Carver and People Like That Are the Only People Here by Lorrie Moore. Even though we have talked throughout the semester about the value of first person narrative and insight, these stories exemplified how impactful and truthful fiction has the potential to be.

We then spent some time encountering first hand narratives from children and adolescents with cancer, as featured in my book Chronicling Childhood Cancer: A Collection of Personal Stories by Children and Teens with Cancer. It was refreshing to encounter these stories again for the first time since I have been an oncologist. Memories of my time with each of these young authors flooded back to me. I remembered kneeling in infusion centers, perching at the center table in the playroom, or pulling up an armchair to sit at the bedside inpatient. I remembered how so many of these kids were excited to participate in this activity (and some terrified by the idea), one telling my frankly that he didn’t think he had ever really spoken about his cancer this much. That idea still stuns me, that many children and adolescents with cancer might not have the space to tell their stories. Even though it was a decade ago, I remembered it as though it were yesterday.

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Week 9: Ethics of Narrative in Medicine

*Part II Chapter 7: Attention, Representation, and Affiliation from Rita Charon, Narrative Medicine (pgs 107-130)

*Part IV Chapter 9: Bearing Witness and 10 Bioethics from Rita Charon, Narrative Medicine: Honoring the Stories of Illness (pgs 177-218)

*Healing Narrative: Ethics and Writing about Patients, AMA Journal of Ethics

Reflecting on what you have learned about narrative medicine so far this semester, what ethical considerations must be made when we think of narrative medicine? Some examples of ideas to reflect on include: 

-ethics of practicing narrative medicine clinically with patients (i.e. how to do so equitably)

-ethics of sharing the stories of our patients and/or colleagues and/or loved ones (i.e. issues of attention, representation)

-ethics of how society tends to share certain narratives and silence others, and why this occurs

-ethics of how healthcare systems use patient narratives (i.e. for marketing, for donors)

Are there narratives that we have encountered this semester that feel less ethical than others? If so, why?

This week, we took a step back to reflect on the ethics of narrative medicine. We began with a writing prompt: Write a story about a healthcare experience that isn’t yours to tell. We talked about what makes a story yours to tell, and different writing techniques for writing a story that isn’t yours to tell.

After briefly discussing Beauchamp and Childress’ 4 Biomedical Principles of Ethics, we launched into 3 work groups to define our own policies about Consent, Patient Care, and Marketing/Fundraising. We unpacked what best practices of using stories in these different spaces might look like and created our own standard practices for ethically using stories. Topics included de-identification in narrative and the importance of obtaining patient permission, reframing stories propagated amongst healthcare professionals, and imagining patient-centered approaches to storytelling for marketing/fundraising purposes.

We returned to the same story we wrote about earlier and wrote again: Write about the same healthcare experience as a story that is yours to tell. We reflected on how different this experience felt, and how different the stories were that emerged.

After our break, we began an informal debate to illuminate different perspectives to consider with the ethics of storytelling in medicine. Students were each assigned as patients, families, clinicians, or hospitals. We discussed stories that emerged earlier in class or scenarios that people wrote about in response to the writing purpose.

I concluded class by sharing my own imperfect framework for considering the ethics of narrative medicine:

Who- who is telling the story? Who is receiving the story?

What- what is the story being told?

When- at what time is the story being told?

Where- location of storytelling, i.e. at the bedside, in elevators and stairwells, social media

How- rhetoric, tone, language used to tell story, making space for storytelling?

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