Impossible to talk about narrative medicine without hearing its name pronounced. At the origin of the development of this concept in France, there is an American professor, Rita Charon, 73 years old today. It was she who, in 2000, created the first chair on the subject, at the prestigious Columbia University in New York.
Patients with complicated stories
The click: his installation as a doctor in a New York hospital. The“I began to know people who were strangers to me until now, and were going to become my patients for more than twenty years”, she says in her founding book, Narrative Medicine, Honoring Illness Stories (published in France in 2015, by Sipayat editions). “Most were poor, sick, women of color, from the Dominican Republic, Puerto Rico, Central America, South America. I realized, little by little, that my job was to develop skills to listen more attentively to the complicated and contradictory stories of their illnesses…”
→ TO ANALYSE. Narrative medicine, listening better to treat better
Rita Charon combines her vocation as a doctor with a passion for literature nurtured since childhood (she will earn a doctorate on the British writer Henry James, in 1999). “I realized that what I was doing as a reader, I wanted to do with my patients,” she writes again. To know : “Be a good reader. » Reading a patient, she says, requires an ability to “to recognize, absorb, interpret and transpose the history of the disease”. An ambition in tune with the times of 1970s America, where part of the medical world, particularly in New York, intends to give more power to the sick, in response to medicine and doctors deemed paternalistic.
A patient as a whole
It was at this time that she began to forge the main principles of narrative medicine. Which holds in a famous triptych, taken since around the world: the attentive reading, the creative writing and the sharing of its texts. The relationship with medicine? “Reading a book is like examining a patientestimate Rita Charon. You have to observe the context in which the text was written, its form, the time in which it takes place, the plot it tells. » The substance cannot be separated from the form. To her patients, she often launches: “Tell me what I should know about your situation!” » The patient transmits information through his body, through his words, but also through his silences, his unspoken words. In summary, it should be taken as a whole and not just a collection of symptoms.
→ DEBATE. Are doctors showing enough empathy?
Today, narrative medicine is taught in 80% of American medical schools, according to the New York Times. A concept that has also been exported to the United Kingdom, Spain, Denmark, Italy…