Croatian Journal For Public Health

Croatian Journal for Public Health, has a regular feature on „Literature and Health.“ Our Journal is on Internet, open to everyone, including Dr Chen and YOU (Google: hcjz), in line with our beleif in a global moral community, health for all and averyone. We promote the idea that global connection should inclede health, that every country should have a health journal, and health should link to literature as well as to science. We have already published beautiful works on peace tolerance, facing poverty and other works. We support, practice and invite cooperation in work on health and literature, health and challenge of goodness in this one world, of many countries and billions of homes and wonderful people. — Dr Slobodan Lang  21. October 24, 2008 12:54 am  . October 23, 2008 10:13 pmLink Thank you for Dr.Chen’s article and the chance to comment. As an oncologist and a writer I have found that the opportunity to write about my experiences, even if only for myself, but when possible shared through publication and story telling, has greatly enriched my work as a physician. Sometimes immediately, sometimes from a great distance in time, I can relive incredibly poignant moments and comprehend their meaning in much more profound ways than is allowed in my average too busy day. Seeing and reviewing my own description of what happened takes me to a deeper level of understanding when I did a good job and when I failed. Being a writer and a reader unquestionably makes me a better doctor and teacher in the training hospital where I work. — Kathleen Ogle, MD  16. October 23, 2008 11:44 pm Link Each patient has a unique story. Each patient want to tell that story. Doctors are privileged in that they are allowed to ask for those stories. But rarely do they ask - because of time constraints. Many writers have been physicians. What connects these two professions is the human story. We all want to hear that story, and we all want to tell our story. Alexa Fleckenstein M.D., physician, author. — Alexa Fleckenstein M.D.  17. October 23, 2008 11:57 pm Link Great piece. I love seeing Rachel Remen’s “Kitchen Table Wisdom” in the photos. My wife and I participated in a faculty seminar led by Dr. Remen on teaching a course she started at UCSF called “The Healer’s Art,” now taught at more than 60 medical schools worldwide. Her own narrative is compelling; the way she captures the stories of her patients and their families is a blessing.

Her life and work would be a great topic for a profile in Health. — John Schumann, MD  18. October 24, 2008 12:01 am Link As an ER doc and writer, Instructor in Narrative Medicine at Columbia with Rita Charon, I have found that being able to write down even a snippet or two of the never ending stories that unfold before me in the ER (and that, obviously, I become totally involved in as the physician taking care of the patient) has helped me tremendously in dealing with the intense emotional highs and lows that are so much a part of the job. As Rita says, when you write about something it allows you to subsequently stand outside the experience, walk around it, see it from many other points of view. Being involved in Narrative Medicine has given me tremendous compassion for my patients and has, whenever I can wrench a few free minutes to just talk and interact with them, allowed me to learn so much more about them, understand how they see themselves and how they see their illness in terms of their self-told life stories. In terms of the issue of who is best qualified to teach this: I must say that working in a group with Rita, as we all read our stories and poems, to be able to have the insights of her literary expertise, is astonishing. The more experienced the literary (and medical) background of one who runs a program in Narrative Medicine the richer and more nuanced the connections all involved will make, whether they be psychic, medical, creative. The places a group can go are endless. — Ken W  19. October 24, 2008 12:13 am Link I couldn’t help but wonder about the photograph illustrating the article. How did the patient, surrounded by a crowd of observing physicians, one of them reading to her, feel? Did she feel cared for as a person or placed in the role of a theatrical prop? — Eben Spinoza  20. October 24, 2008 12:31 am Link Croatian Journal for Public Health, has a regular feature on „Literature and Health.“ Our Journal is on Internet, open to everyone, including Dr Chen and YOU (Google: hcjz), in line with our beleif in a global moral community, health for all and averyone. We promote the idea that global connection should inclede health, that every country should have a health journal, and health should link to literature as well as to science. We have already published beautiful works on peace tolerance, facing poverty and other works. We support, practice and invite cooperation in work on health and literature, health and challenge of goodness in this one world, of many countries and billions of homes and wonderful people. — Dr Slobodan Lang  21. October 24, 2008 12:54 am Link This approach fascinates me, because I have witnessed the power of the written word to reach the human heart.

My mother was a legendary high school English teacher in my hometown, and then a legendary literature and creative writing professor in a nearby University town. I remember countless occasions when, while eating in a restaurant or stopping to fill up on gas, someone approached her and said something like, “You probably don’t remember me, but you changed my life forever.” These revelations didn’t necessarily come from budding scholars and future writers, but rather from her less likely fans, who discovered the transformative emotional value of great literature and creative self-expression. But here’s the rub. It may not be so easy to transfer the emotions touched by academic exercises, to the grueling routine of cranking patients in and out of the office. Again, recalling my wonder at my mother’s academic life, I was often flabbergasted at the callousness of her colleagues and the great writers who came through the campus on seminars. I remember pondering , “How could someone, who must be so sensitive, be so cruel?” It’s not so much a doubt as it is a question, because I’m excited about the idea. I enjoy Dr. Chen’s articles on the subject of empathy in medicine, and I hope they keep coming. It’s a subject vital for health care, and also, vital for our society. How do we go from a country where “liberal” is the “L” word, to one in which we care as much about the elderly, the homeless, and the people with no health insurance, as we do about people (ourselves?) who can’t afford luxuries in a bad economy? We all need more compassion. Let’s discover how to find it, and then how to use it. — Wesley  22. October 24, 2008 1:48 am Link I was always thankful that I did my psychiatry clerkship at one of the community hospitals rather than the lofty medical center. One of the better aspects of the community program was a seminar that was purely from the literary standpoint. We read and discussed short stories, passages, poems written by those in the throes of various psychiatric states - severe depression, psychosis, mania, others. That probably brought home much more so than any patient exposure that could be otherwise garnered during that limited time span. That seminar series likely played a great role in my ability to express empathy and nonjudgment regardless of a person’s condition. (I’m an internist.) This era of EMRs and documenting to bullet points has eroded the humanity of medicine. I recall attendings who lamented at the coldness of the presentations - “45 year old white male presenting with….” as opposed to “45 year old unlicensed plumber, single father of 2 who noted …” — susan  23. October 24, 2008 2:37 am Link

For several years I participated in a fiction writing program that deeply affected me. The instructor was an amazing professor at Northwestern. Through his guidance in terms of how we both read and wrote stories, I learned to curb my impatience and judgments, slow down, and pay attention to what people were doing and saying, and then think about what it all meant. When studying literature, you are studying people. Not a bad skill for a doctor to develop. I am sure I know which Lorrie Moore story was likely studied when mentioned above–she wrote a brilliant one about a child with leukemia called “People Like That Are the Only People Here.” With the classic phrase, “Peed Onk” (for pediatric oncology). And these lines, which still give me a painful smile: “The oncologist shrugs. What casual gestures these doctors are permitted!” — Francois  24. October 24, 2008 3:02 am Link “gently touching their patients…” I hate that. I have my boundaries, you know. Being a patient equals a million indignities; I don’t want more of the same. Be gentle when you insert that thing into my vein, otherwise, hands off! I agree that the courses shold be taught by specialists in the field. The people who imagine a Literature professional would do something worse than a lay person do not have a clear understanding of what literary analysis entails. It never fails to amuse me when people of limited scope discover the wonders of Literature. Duh! This article reminds me of another on Urban Literature (code for black pulp). Maybe medical narrative will get physicians to read, who knows? Still in medieaval times, universities required that every student first take Liberal Arts, to provide them with the necessary fundaments. Today, we have university graduates who may be apt in their profession, but I would hesitate to call them educated. — Susanna  25. October 24, 2008 4:16 am Link We read Dr. Chen’s article, “Stories in Service of Making a Better Doctor,” and this comments section, “Combining Literature and Medicine,” with interest and enthusiasm. At University of Alaska Anchorage we are developing a community outreach Web resource— LitSite Alaska . One of the areas of focus is Narrative and Healing. < http://www.litsite.org/index.cfmsection=Narrative-and-Healing >. We invite physicians to contribute their personal narratives.