Next Generation is a BWH Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. This month, we feature a column originally published in March 2017 written by Ersilia M. DeFilippis, MD, who was a second-year resident in the Department of Medicine at that time. DeFilippis has completed her residency and is now a first year cardiovascular fellow at New York Presbyterian Hospital–Columbia University Medical Center.
As doctors, we tell stories. If you listen to rounds on the general medical floors of BWH, you hear young doctors presenting their patients to their attending physicians and the rest of the medical team.
“Mr. J. is a 60-year old man with hypertension, diabetes and heart failure with preserved ejection fraction who presents with new-onset left-lower extremity weakness.”
This is the typical “one-liner” formula that we, as medical students and resident trainees, are taught to convey the most pertinent medical data.
However, this sentence fails to communicate that Mr. J. has been homeless for months because he lost his job as a financial assistant. Or that he is concerned he will not be able to walk his daughter down the aisle at her wedding given this new weakness. All of these components of a patient’s life, his or her story, are important in different ways and serve different purposes.
Narrative medicine is a growing field within medicine that allows us as physicians and trainees to tell the lesser-told stories. It allows me to reflect on my relationships with my patients, the structures that influence clinical decision-making and how I can be a better clinician.
I first discovered my love for writing as a junior in college following the death of a close friend. He had committed suicide and, as part of a writing class, I decided I would write about it as a way to explore the feelings that I had been suppressing at the surface. It was a cathartic and therapeutic exercise.
Throughout medical school and my internal medicine residency, I continued to take notes about poignant moments and memorable stories – on pieces of paper, my iPhone or elsewhere. I yearned to remember each moment, concerned I would fail my patients if I forgot even the most minor details of their stories. Writing has inspired me to ask questions and to learn about my patients in the context of their life journeys.
Fortunately, I have been able to lead a writer’s workshop for internal medicine residents here at BWH alongside my co-resident William Feldman, MD, DPhil. The group meets monthly to discuss recently published pieces, as well as to workshop editorial and op-ed pieces written by residents in the program. Not only do these meetings sharpen our skills, but they also provide a time for reflection and rumination.
The group was started by now third-year internal medicine residents Ravi Parikh, MD, and Mohammad Dar, MD, with mentorship from BWH cardiologist Lisa Rosenbaum, MD, a correspondent for The New England Journal of Medicine, as well as Lisa Lehmann, MD, PhD, of the Department of Medicine. Together, our residents have published pieces in JAMA, The New York Times, Huffington Post, Washington Post and other venues.
In medicine, we experience our patients’ triumphs and their failures. We are privy to their secrets, their fears and their dreams. I tell stories to help my patients leave a legacy, to share their love and their bitter struggles. Their stories help us heal.