[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.238.190.122. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
1.
Morris DM. Illness and Culture in the Postmodern Age. Berkeley: University of California Press; 1998.
2.
Konner M. Medicine at the Crossroads: The Crisis in Health Care. New York, NY: Pantheon Books; 1993.
3.
Charon R. The narrative road to empathy. In: Spiro H, Curnen MGM, Peschel E, St. James D, eds. Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. New Haven, Conn: Yale University Press; 1993:147-159.
4.
Charon R. Narrative medicine: form, function, and ethics.  Ann Intern Med.2001;134:83-87.Google Scholar
5.
Engel GL. The need for a new medical model: a challenge for biomedicine.  Science.1977;196:129-136.Google Scholar
6.
Laine C, Davidoff F. Patient-centered medicine: a professional evolution.  JAMA.1996;275:152-156.Google Scholar
7.
Greenhalgh T, Hurwitz B. Narrative Based Medicine: Dialogue and Discourse in Clinical PracticeLondon, England: BMJ Books; 1998.
8.
Kleinman A. The Illness Narratives: Suffering, Healing and the Human Condition. New York, NY: Basic Books; 1988.
9.
Brody H. Stories of SicknessNew Haven, Conn: Yale University Press; 1987.
10.
Swenson MM, Sims SL. Toward a narrative-centered curriculum for nurse practitioners.  J Nurs Educ.2000;39:109-115.Google Scholar
11.
Polkinghorne DE. Narrative Knowing and the Human SciencesAlbany: State University of New York Press; 1988.
12.
Krieswirth M. Trusting the tale: the narrativist turn in the human sciences.  New Literary History.1992;23:629-657.Google Scholar
13.
Mishler EG. Research Interviewing: Context and NarrativeCambridge, Mass: Harvard University Press; 1986.
14.
Martin W. Recent Theories of NarrativeIthaca, NY: Cornell University Press; 1986.
15.
Brooks P. Reading for the Plot: Design and Intention in NarrativeNew York, NY: Vintage; 1985.
16.
Booth WC. The Rhetoric of Fiction2nd ed. Chicago, Ill: University of Chicago Press; 1983.
17.
Lewis RWB. The American Adam: Innocence, Tragedy and Tradition in the Nineteenth CenturyChicago, Ill: University of Chicago Press; 1955:3.
18.
Bruner J. Actual Minds, Possible Worlds. Cambridge, Mass: Harvard University Press; 1986.
19.
Paulos JA. Once Upon a Number: The Hidden Mathematical Logic of Stories. New York, NY: Basic Books; 1998.
20.
Smith BH. Narrative versions, narrative theories. In: Mitchell WJT, ed. On Narrative. Chicago, Ill: University of Chicago Press; 1981:228.
21.
James H. The Art of the Novel: Critical Prefaces. New York, NY: Charles Scribner's Sons; 1934.
22.
Barthes R. S/Z: An Essay. Miller R, trans. New York, NY: Hill & Wang; 1974.
23.
Kermode F. The Art of Telling: Essays on FictionCambridge, Mass: Harvard University Press; 1983.
24.
Iser W. The Act of Reading: A Theory of Aesthetic ResponseBaltimore, Md: Johns Hopkins University Press; 1978.
25.
Tompkins JP. Reader-Response Criticism: From Formalism to Post-StructuralismBaltimore, Md: Johns Hopkins University Press; 1980.
26.
James H. The novels of George Eliot. [First printed in Atlantic Monthly, 1866.] Reprinted in: Stang R, ed. Discussions of George Eliot. Boston, Mass: DC Heath & Co; 1960:5.
27.
Charon R. Literature and medicine: origins and destinies.  Acad Med.2000;75:23-27.Google Scholar
28.
Stolorow R, Brandchaft B, Atwood G. Psychoanalytic Treatment: An Intersubjective Approach. Hillsdale, NJ: Analytic Press; 1987.
29.
Lipkin M, Putnam S, Lazare A. The Medical Interview: Clinical Care, Education, and ResearchNew York, NY: Springer-Verlag; 1995.
30.
Society for Health and Human Values.  Special issue in humanities and medical education.  Acad Med.1995;70:755-813, 822-823.Google Scholar
31.
Cassell E. The nature of suffering and the goals of medicine.  N Engl J Med.1982;306:639-645.Google Scholar
32.
Hunter KM. Doctors' Stories: The Narrative Structure of Medical KnowledgePrinceton, NJ: Princeton University Press; 1993.
33.
Nelson HL. Stories and Their Limits: Narrative Approaches to Bioethics. New York, NY: Routledge; 1997.
34.
Jones AH. Literature and medicine: narrative ethics.  Lancet.1997;349:1243-1246.Google Scholar
35.
Anderson C. "Forty acres of cotton waiting to be picked": medical students, storytelling, and the rhetoric of healing.  Lit Med.1998;17:280-297.Google Scholar
36.
Hawkins AH. Reconstructing Illness: Studies in Pathography2nd ed. West Lafayette, Ind: Purdue University Press; 1999.
37.
Selzer R. Letters to a Young DoctorNew York, NY: Simon & Schuster; 1982.
38.
Zabarenko RN. The Doctor Tree: Developmental Stages in the Growth of PhysiciansPittsburgh, Pa: University of Pittsburgh Press; 1978.
39.
Genette G. Narrative Discourse: An Essay in Method. Lewin J, trans. Ithaca, NY: Cornell University Press; 1980.
40.
DeSalvo L. Writing as a Way of Healing: How Telling Our Stories Transforms Our Lives. San Francisco, Calif: Harper; 1999.
41.
Anderson CM. Writing and healing [special issue].  Lit Med.2000;19:1-132.Google Scholar
42.
Bolton G. The Therapeutic Potential of Creative Writing: Writing MyselfLondon, England: Jessica Kingsley Publishers; 1999.
43.
Anderson CM, MacCurdy MM. Writing and Healing: Toward an Informed Practice. Urbana, Ill: National Council of Teachers of English; 2000.
44.
Groopman J. The Measure of Our Days: A Spiritual Exploration of Illness. New York, NY: Penguin; 1998.
45.
Verghese A. My Own Country: A Doctor's Story. New York, NY: Vintage/Random House; 1995.
46.
Charon R. Medical interpretation: implications of literary theory of narrative for clinical work.  J Narrative Life History.1993;3:79-97.Google Scholar
47.
Weine SM. The witnessing imagination: social trauma, creative artists, and witnessing professionals.  Lit Med.1996;15:167-182.Google Scholar
48.
Feinstein A. Clinical JudgmentBaltimore, Md: Williams & Wilkins; 1967.
49.
Spiro HM, Curnen MGM, Peschel E, St. James D. Empathy and the Practice of Medicine: Beyond Pills and the Scalpel.  New Haven, Conn: Yale University Press; 1993.
50.
Toombs SK. The Meaning of Illness: A Phenomenological Account of the Different Perspectives of Physician and PatientDordrect, the Netherlands: Kluwer; 1993.
51.
Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician: personal awareness and effective patient care.  JAMA.1997;278:502-509.Google Scholar
52.
Miller SZ, Schmidt HJ. The habit of humanism: a framework for making humanistic care a reflexive clinical skill.  Acad Med.1999;74:800-803.Google Scholar
53.
Berger J, Mohr J. A Fortunate ManNew York, NY: Pantheon Books; 1967.
54.
Fox R, Lief H. Training for "detached concern." In: Lief H, ed. The Psychological Basis of Medical Practice. New York, NY: Harper & Row; 1963:12-35.
55.
Connelly J. Being in the present moment: developing the capacity for mindfulness in medicine.  Acad Med.1999;74:420-424.Google Scholar
56.
Halpern J. From Detached Concern to Empathy: Humanizing Medical Practice. New York, NY: Oxford University Press; 2001.
57.
Risdon C, Edey L. Human doctoring: bringing authenticity to our care.  Acad Med.1999;74:896-899.Google Scholar
58.
Hawkins AH, MacEntyre MC. Teaching Literature and Medicine. New York, NY: Modern Language Association; 2000.
59.
Charon R, Banks JT, Connelly JE.  et al.  Literature and medicine: contributions to clinical practice.  Ann Intern Med.1995;122:599-606.Google Scholar
60.
Coles R. The Call of Stories: Teaching and the Moral ImaginationBoston, Mass: Houghton Mifflin; 1989.
61.
Skelton JR, Macleod JAA, Thomas CP. Teaching literature and medicine to medical students, part II: why literature and medicine?  Lancet.2001;356:2001-2003.Google Scholar
62.
Charon R. Reading, writing, and doctoring: literature and medicine.  Am J Med Sci.2000;319:285-291.Google Scholar
63.
Sacks O. The Man Who Mistook His Wife for a Hat and Other Clinical TalesNew York, NY: Summit Books; 1985.
64.
Mates S. The Good DoctorIowa City: University of Iowa Press; 1994.
65.
Williams WC. The Doctor StoriesNew York, NY: WW Norton & Co; 1985.
66.
Charon R. Medicine, the novel, and the passage of time.  Ann Intern Med.2000;132:63-68.Google Scholar
67.
Toulmin S. The construal of reality: criticism in modern and postmodern science. In: Mitchell WTJ, ed. The Politics of Interpretation. Chicago, Ill: University of Chicago Press; 1983:99-117.
68.
Ludmerer K. Time to Heal: American Medical Education From the Turn of the Century to the Era of Managed Care. New York, NY: Oxford University Press; 1999.
69.
Bosk C. Forgive and Remember: Managing Medical Failure. Chicago, Ill: University of Chicago Press; 1979.
70.
Balint M. The Doctor, His Patient and the IllnessLondon, England: Tavistock Publications; 1957.
71.
Cruess RL, Cruess SR. Teaching medicine as a profession in the service of healing.  Acad Med.1997;72:941-952.Google Scholar
72.
Wynia MK, Latham SR, Kao AC, Berg JW, Emanuel LL. Medical professionalism in society.  N Engl J Med.1999;341:1612-1616.Google Scholar
73.
Reynolds PP. Reaffirming professionalism through the education community.  Ann Intern Med.1994;120:609-614.Google Scholar
74.
Rodwin MA. Medicine, Money, and Morals: Physicians' Conflicts of Interest. New York, NY: Oxford University Press; 1993.
75.
Spece R, Shumm D, Buchanan A. Conflicts of Interest in Clinical Practice and ResearchNew York, NY: Oxford University Press; 1996.
76.
Rothman D. Medical professionalism: focusing on the real issues.  N Engl J Med.2000;342:1284-1286.Google Scholar
77.
Anders G. Health Against Wealth: HMOs and the Breakdown of Medical TrustNew York, NY: Houghton Mifflin; 1996.
78.
Feldman DS, Novack DH, Gracelv E. Effects of managed care on physician-patient relationships, quality of care, and the ethical practice of medicine.  Arch Intern Med.1998;158:1626-1632.Google Scholar
79.
Morreim EH. Balancing Act: The New Medical Ethics of Medicine's New Economics. Washington, DC: Georgetown University Press; 1995.
80.
Hurwitz B. Narrative and the practice of medicine.  Lancet.2000;356:2086-2089.Google Scholar
81.
Harden J. Language, discourse and the chronotope: applying literary theory to the narratives in health care.  J Adv Nurs.2000;31:506-512.Google Scholar
82.
Heliker D. Transformation of story to practice: an innovative approach to long-term care.  Issues Ment Health Nurs.1999;20:513-515.Google Scholar
83.
Hunter KM, Charon R, Coulehan JL. The study of literature in medical education.  Acad Med.1995;70:787-794.Google Scholar
84.
Charon R. To render the lives of patients.  Lit Med.1986;5:58-74.Google Scholar
85.
Branch W, Pels RJ, Lawrence RS.  et al.  Critical incident reports from third-year medical students.  N Engl J Med.1993;329:1130-1132.Google Scholar
86.
Reifler DR. "I actually don't mind the bone saw": narratives of gross anatomy.  Lit Med.1996;15:183-199.Google Scholar
87.
Winckler M. The Case of Dr. Sachs. Asher L, trans. New York, NY: Seven Stories Press; 2000.
88.
Charon R, Montello M. The Practice of Narrative Ethics. New York, NY: Routledge. In press.
89.
Chambers T. The Fiction of Bioethics: Cases as Literary Texts. New York, NY: Routledge; 1999.
90.
Bauby JD. The Diving Bell and the ButterflyLeggatt J, trans. New York, NY: Vintage/Random; 1998.
91.
Mairs N. Waist-High in the World: A Life Among the Nondisabled. Boston, Mass: Beacon Press; 1996.
92.
Smyth JM, Stone AA, Hurewitz A, Kaell A. Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: a randomized trial.  JAMA.1999;281:1304-1309.Google Scholar
93.
Pennebacker JW. Telling stories: the health benefits of narrative.  Lit Med.2000;19:3-18.Google Scholar
The Patient-Physician Relationship
October 17, 2001

Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust

Author Affiliations

Author Affiliation: Division of General Medicine, College of Physicians and Surgeons of Columbia University, New York, NY.

 

The Patient-Physician Relationship Section Editor: Richard M. Glass, MD, Deputy Editor.

JAMA. 2001;286(15):1897-1902. doi:10.1001/jama.286.15.1897
Abstract

The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.

×