Medical and Health Humanities

Scientific, evidence-based medicine is increasingly seen as fundamental to providing effective healthcare, but narrative-based medicine sheds light on social and interpersonal aspects of the practitioner-patient interaction which can also greatly affect healthcare outcomes. The philosophies underlying these two approaches seem to contrast, yet those who can integrate both into their practice are among the most successful medical professionals. Integrating Narrative Medicine and Evidence-based Medicine provides answers to the key question of how medical practitioners can best put both approaches into practice. It anticipates a future where evidence-based practice will be expected of all medical professionals, but contends that the integration of a narrative-based approach will also be crucial, presenting a unique perspective on structuring the patient-professional encounter for optimum results. It develops a cultural analysis and socio-cultural theory of the science of healing, and describes an efficient method by which medical practitioners can find and use medical research at the point of care with current technology and skills. This addresses the need for translational science - moving research into practice - identified by the National Institutes of Health. This book will be essential reading for educators of medical students and postgraduate trainees, behavioral scientists, psychologists, social scientists working in medical settings, and health managers and administrators. Medical students and postgraduate trainees will also find it useful in their learning.

This is a workbook for health professionals working with diabetic patients. It is based on the experiences of one group of health care workers in an inner city area. It illustrates how using individual patients' stories can inform and help health care workers to understand and manage their patients' difficulties better. In this way it has similar aims to the narrative based medicine books. It also provides the interactive learning element with suggested learning objectives, assignments and further reading in each unit.

Seeks to restore the pivotal role of the patient's own story in the healing process * Shows how conventional medicine tends to ignore the account of the patient * Presents case histories where disease is addressed and healed through the narrative process * Proposes a reinvention of medicine to include the indigenous healing methods that for thousands of years have drawn their effectiveness from telling and listening Modern medicine, with its high-tech and managed-care approach, has eliminated much of what constitutes the art of healing: those elements of doctoring that go beyond the medications prescribed. The typically brief office visit leaves little time for doctors to listen to their patients, though it is in these narratives that disease is both revealed and perpetuated--and can be released and treated. Lewis Mehl-Madrona's Narrative Medicine examines the foundations of the indigenous use of story as a healing modality. Citing numerous case histories that demonstrate the profound power of narrative in healing, the author shows how when we learn to dialogue with disease, we come to understand the power of the "story" we tell about our illness and our possibilities for better health. He shows how this approach also includes examining our relationships to our extended community to find any underlying disharmony that may need healing. Mehl-Madrona points the way to a new model of medicine--a health care system that draws its effectiveness from listening to the healing wisdom of the past and also to the present-day voices of its patients.

This book examines all aspects of narrative medicine and its value in ensuring that, in an age of evidence-based medicine defined by clinical trials, numbers, and probabilities, clinical science is firmly embedded in the medical humanities in order to foster the understanding of clinical cases and the delivery of excellent patient care. The medical humanities address what happens to us when we are affected by a disease and narrative medicine is an interdisciplinary approach that emphasizes the importance of patient narratives in bridging various divides, including those between health care professionals and patients. The book covers the genesis of the medical humanities and of narrative medicine and explores all aspects of their role in improving healthcare. It describes how narrative medicine is therapeutic for the patient, enhances the patient-doctor relationship, and allows the identification, via patients' stories, of the feelings and experiences that are characteristic for each disease. Furthermore, it explains how to use narrative medicine as a real scientific tool. Narrative Medicine will be of value for all caregivers: physicians, nurses, healthcare managers, psychotherapists, counselors, and social workers. "Maria Giulia Marini takes a unique and innovative approach to narrative medicine. She sees it as offering a bridge - indeed a variety of different bridges - between clinical care and 'humanitas'. With a sensitive use of mythology, literature and metaphor on the one hand, and scientific studies on the other, she shows how the guiding concept of narrative might bring together the fragmented parts of the medical enterprise". John Launer, Honorary Consultant, Tavistock Clinic, London UK

Narrative medicine is a fresh discipline of health care that helps patients and health professionals to tell and listen to the complex and unique stories of illness. The Principles and Practice of Narrative Medicine expresses the collective experience and discoveries of the originators of thefield. Arising at Columbia University in 2000 from roots in the humanities and patient-centered care, narrative medicine draws patients, doctors, nurses, therapists, and health activists together to re-imagine a health care based on trust and trustworthiness, humility, and mutual recognition.Over a decade of education and research has crystallized the goals and methods of narrative medicine, leading to increasingly powerful means to improve the care that patients receive. The methods described in this book harness creativity and insight to help the professionals in being with patients,not just to diagnose and treat them but to bear witness to what they undergo. Narrative medicine training in literary theory, philosophy, narrative ethics, and the creative arts increases clinicians' capacity to perceive the turmoil and suffering borne by patients and to help them to cohere orendure the chaos of illness.Narrative medicine has achieved an international reputation and reach. Many health care settings adopt methods of narrative medicine in teaching and practice. Through the Master of Science in Narrative Medicine graduate program and health professions school curricula at Columbia University, more andmore clinicians and scholars have obtained the rigorous training necessary to practice and teach narrative medicine. This text is offered to all who seek the opportunity for disciplined training in narrative medicine. By clearly articulating our principles and practice, this book provides thestandards of the field for those who want to join us in seeking authenticity, recognition, affiliation, and justice in a narrative health care.

The field of the medical humanities is developing rapidly, however, there has also been parallel concern from sceptics that the value of medical humanities educational interventions should be open to scrutiny and evidence. Just what is the impact of medical humanities provision upon the education of medical students? In an era of limited resources, is such provision worth the investment? This innovative text addresses these pressing questions, describes the contemporary territory comprising the medical humanities in medical education, and explains how this field may be developed as a key medical education component for the future. Bleakley, a driving force of the international movement to establish the medical humanities as a core and integrated provision in the medical curriculum, proposes a model that requires collaboration between patients, artists, humanities scholars, doctors and other health professionals, in developing medical students' sensibility(clinical acumen based on close noticing) and sensitivity(ethical, professional and humane practice). In particular, this text focuses upon how medical humanities input into the curriculum can help to shape the identities of medical students as future doctors who are humane, caring, expressive and creative - whose work will be technically sound but considerably enhanced by their abilities to communicate well with patients and colleagues, to empathise, to be adaptive and innovative, and to act as 'medical citizens' in shaping a future medical culture as a model democracy where social justice is a key aspect of medicine. Making sense of the new wave of medical humanities in medical education scholarship that calls for a 'critical medical humanities', Medical Humanities and Medical Education incorporates a range of case studies and illustrative and practical examples to aid integrating medical humanities into the medical curriculum. It will be important reading for medical educators and others working with the medical education community, and all those interested in the medical humanities.