Physicians are generally adept at diagnosing and treating illness, but not always skilled at listening to and understanding their patients, says Rita Charon, a general internist and associate professor of clinical medicine at Columbia University.
But physicians can better understand the people for whom they are caring simply by putting themselves in the patients’ shoes, Charon says. And there’s no better way to do this, she says, than to write in a patient’s narrative voice.
“It prompts doctors to see the world from the point of view of the patient, to leave behind their points of view for just a minute,” Charon says. “It takes courage and skill to take that imaginative leap.”
Charon will discuss her ideas as guest speaker at this year’s annual Lorin Stephens Visiting Lectureship, which takes place April 22 in the Louis B. Mayer Auditorium. She will present a lecture, “The Narrative Road to Empathy” and a workshop, “The Clinical Imagination: Reading, Writing and Doctoring.”
The lecture begins at 9:30 a.m. All first and second year medical students are required to attend, and anyone else is welcome to sit in, said Pamela Schaff, director of the Introduction to Clinical Medicine Program.
Stephens was an orthopedic surgeon at the School of Medicine who was instrumental in establishing the Introduction to Clinical Medicine program. The program was one of the first of its kind in the country.
Stephens was especially concerned about medical students’ vulnerability as they encounter illness and death. The lectureship endowment was started in his memory to expose young and established physicians to human values in medicine.
Schaff said she invited Charon to be the guest speaker because her beliefs parallel those of Stephens.
Charon became interested in the doctor-patient relationship during her internship and residency and first couple of years of practice.
“I realized I was being paid to understand what these patients were telling me – some of it in words, some in gestures, some in silence,” Charon says. “That’s the part that most appealed to me – the challenge and great pleasure of listening and hearing and understanding what people are saying.”
Young and older physicians need to be trained to better listen to their patients. And more and more medical schools are training students in this area using literature and writing, Charon said.
In 1995, 33 percent of medical schools required students to take some reading and writing courses, she says. By 1998, the figure was 79 percent.
“There is definitely an increased and serious attention to how one establishes a therapeutic relationship,” she says.
Charon directs Columbia University’s Program in Humanities and Medicine, its Clinical Skills Assessment Program and required courses in medical interviewing.