Dr. Rita Charon: Innovative Pioneer in Narrative Medicine
Approximately 50 years ago the English physicist and novelist C.P. Snow coined the catchy phrase “the two cultures,” describing what he saw as an intellectual divide and challenging professionals in the Humanities and Sciences to understand each other’s areas in order to solve the world’s problems. What followed in universities and colleges were often fragmented and superficial attempts at interdisciplinary and multidisciplinary studies which largely turned out to be watered-down attempts to bring together diverse disciplines and subject matter rather than integrated and reciprocal study of cognitive thinking in the sciences and the liberal arts. Snow himself was aware of the imbalance and inadequacy of the challenge: there were more professionals in the sciences able to appreciate Shakespeare than there were specialists in the humanities able to describe the Second Law of Thermodynamics or understand its mathematical underpinnings. Long since modified, the idea of bridging the gap between the two cultures nonetheless informed curricula, especially with the growth of technology which has become a common ground of academic life. Still, it’s relatively rare to find scholars and researchers who move with confidence and expertise across the divide.
Dr. Rita Charon, Professor of Medicine and Director of the Program in Narrative Medicine at the Columbia University College of Physicians and Surgeons, is that rare individual, a medical doctor and a Ph.D. who not only conceived and instituted a communications program that brings together literature and medicine but crossed the divide herself. She earned a doctorate in English from Columbia (with a thesis on Henry James, “my beloved author”) at the same time she continued and continues to be an internist with a primary care practice at Presbyterian Hospital. She is also someone who has recently embarked on assessing and enhancing her nine-year-old program by heading up a team of specialists to provide theory for further qualitative research and to ensure that Standards of Practice are established so that schools adapting her program do so as she and her team describe it.
To that end, she is readying for press a forthcoming textbook entitled Principles and Practice of Narrative Medicine, whose co-authors include doctors and literary scholar, a novelist, a phenomenologist, and an anthropologist. The goal is what it has always been for her: to humanize the medical field by helping doctors and other health care professionals learn how to talk to their patients and thereby “increase empathy and reflection in health professionals and students.”
Dr. Charon’s resume keeps expanding as she wins award after award and takes on more responsibility to ensure that the program she started and that has inspired others across the country – and over the world - is being pursued with rigor and faithfulness. Her work has been recognized by the Association of American Medical Colleges, the American College of Physicians, the Society for Health and Human Values, and the Society of General Internal Medicine. The former editor-in-chief of the journal Literature and Medicine, she is the author of Narrative Medicine: Honoring the Stories of Illness and co-editor of Psychoanalysis and Narrative Medicine and of Stories Matter: The Role of Narrative in Medical Ethics. After 34 years, she just recently closed her clinical practice and has accepted a Guggenheim and Bellagio residence from Rockefeller University. A frequent guest at various conferences and symposia, her 18-minute TED talk in Atlanta on September 13, 2011 particularly shows her humility, intelligence and thoughtfulness, not to mention sly humor, in discussing how her program works, especially when a patient is terminal or succumbs to the unexpected recurrence of a serious disease.
A life-long reader and the child of a physician father, Dr. Charon was graduated with a B.A. in biology and child education from the Experimental College of Fordham University in 1970, and after working as a teacher and peace activist, attended Harvard University Medical School. Listening to her talk about her work, it’s impossible not to conclude that she is, as they say, The Real Deal. She knows, she volunteers, that she is not the first one to try to link literary studies and medicine, but as a doctor, first, she felt that her “sleeves were more rolled up” in knowing what she wanted to effect in the clinical training of new doctors. Studying literature, learning about reading and writing stories, “transformed” her, her teaching and her practice. She learned how to interview better, refining her sense of observation [who better, than Henry James!], as she listened to what patients said about their illnesses and emotional conditions. She paid more attention to their words, their silences, watched body movements, noted what others said about them – accounts that often bore contradictions but which were her job to make cohere. “I will be your doctor, so I need to know about you,” she will typically begin. It’s an invitation to a conversation, not a cold review of a medical record. In turn, patients reported being “thirsty” to talk about themselves this way, never having been invited to do so before. C. P. Snow would have been impressed. #