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In: The European legacy: the official journal of the International Society for the Study of European Ideas (ISSEI), Band 16, Heft 3, S. 385-387
ISSN: 1470-1316
In: The world of music: a journal of the Department of Musicology of the Georg August University Göttingen, Band 12, Heft 1
ISSN: 2941-3680
In-person interactions were drastically altered in the unincorporated territory island of Guåhan (Guam) and the Commonwealth of the Northern Mariana Islands during the height of the COVID-19 pandemic in 2020. This article seeks to investigate how lålai (CHamoru chant) and music making are resurgent forms of sound-based cultural practices that can be understood as "narrative medicine." The latter has the potential to be a model for musical sensemaking, whereby Indigenous storytelling maintains connections among kin and heals from colonial trauma. Critically reflecting on a community grant film project entitled, "Tåhdong Marianas: Storytelling Across the Marianas," I explore how a young group of Indigenous CHamorus use the medium of film to adapt to the situation of COVID-19 while calling into question conventional parameters of fieldwork. I analyze how the privileging of work done by and for Indigenous people actively foregrounds the sonic potential of narrative medicine by focusing on the sensory experiences of island peoples to music in ways that undo the epistemic violence of Indigenous knowledge erasure and extraction.
In: Social change review: SCR, Band 15, Heft 1-2, S. 105-128
ISSN: 2068-8016
AbstractThe present paper aims at presenting a non-exhaustive list of methodology instruments for narrative analysis in medical communication. Patient narratives became of more and more importance while evidence-based medicine has created a gap between patients, their illness and their doctors. While being investigated through high-technology instruments used in medicine, the patient vanishes behind the computer screen where his body is analysed based on the biomedical factors. Narrative medicine is defined by one of its founders as the interaction between a health practitioner who doesn't simply look at diseases, but treats the person who's suffering from an illness by listening closely to his story (Charon 2001). Therefore, as mentioned by Rita Charon in her works, the doctor-patient interactions are measured considering the effectiveness of medical care. The patient is empowered with medical knowledge related to his illness, transposed into an accessible language. On the other side of the communication spectrum, the doctor reconnects with his patient, manifesting interest on how the patient's life is affected by illness, not only on how it can be effectively treated. 'Now, in recent years medical narrative is changing—from the stories about patients and their illnesses, patient narratives and the unfolding and interwoven story between healthcare professionals and patients are both gaining momentum, leading to the creation or defining of narrative-based medicine (NBM).' (Kalitzkus and Matthiessen 2009). Narrative based medicine is presented to counteract the pitfalls of evidence-based medicine (EBM). NBM can foster a better care while taking into account the patient's story on the way illness is affecting the quality of his everyday life. The final objective of effective medical care is to alleviate, if not to dismiss completely the illness and the suffering of the patients.
BACKGROUND: Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. OBJECTIVE: To document how CHWs apply specific NM concepts in Brazil's Family Health Strategy (FHS), the key component of Brazil's Unified Health System. DESIGN: We used a semi-structured interview, grounded in Charon's (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. KEY RESULTS: Sample: 18 females; 13 White, 12 "Pardo" (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. CONCLUSION: This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs' roles is needed to enhance the ...
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Preface -- Contents -- About the Authors -- Chapter 1: Introduction: Narratives, Local Knowledge, and World Entry -- Why Local Knowledge? -- World Entry -- End of Dualism -- Narratives Are Everywhere -- Conclusion -- References -- Chapter 2: Community and Narratives -- The Linguistic Turn -- No Message with Indicators -- The Elusive Community -- Narratives and Public Health Care -- Local Control -- Conclusion -- References -- Chapter 3: What Is Dialogue? -- Striving for Transparency -- Courting Intimacy -- Becoming Patient-Centered -- Elements of Dialogue -- Professionals and Dialogue -- Conclusion -- References -- Chapter 4: Storylines, Causes, and the Locus of Interventions -- A Causal Sequence -- A Narrative Framework -- Storylines and Interventions -- Conclusion -- References -- Chapter 5: Narratives, Methods, and World Entry -- The Standard Aim -- Thrown into the World -- Styles of Investigation -- Ways of Engaging Storylines -- Conclusion -- References -- Chapter 6: Community Mapping Tells a Story -- What Does a Typical Map Do? -- Traditional Disembodied Dimensions -- Embodied Dimensions -- Community Entrée -- Conclusion -- References -- Chapter 7: The Politics of Storytelling -- Questions About Dialogue -- Medicine and Realism -- The Road to Democratization -- Conclusion -- References -- Chapter 8: Conclusion: A Community-Based Strategy -- Why Community-Based? -- Becoming Community-Based Through Narratives -- Narratives and Change -- Final Thoughts -- References -- Bibliography -- Author Index -- Subject Index
Intro -- Foreword -- Preface -- Acknowledgements -- Contents -- About the Author -- 1: Evidence-Based Medicine and Narrative Medicine: A Harmonic Couple -- Evidence-Based Medicine: Where It Started and Where It Stands Today -- The Reasons for Narrative Medicine -- References -- 2: Bridging from Mythology to Contemporary Care: The Art of Listening -- The Purpose for Narrative -- Non Narrative: Another Way of Living? -- References -- 3: Bridging from Oral Tradition to Writing: The Art of Empathy -- Empathy, at the Basis of Humanities -- The Devil in the Third Year of Medical School -- The Fight Against the Devil -- References -- 4: The Tower of Babel: The Language of Physicians, Patients, and Providers of Care -- Contrasting Communication Styles -- Genres in Narrative Medicine -- Patient Stories: Classic Illness Narratives -- Physicians´ Stories -- Narratives About Physician-Patient Encounters -- Grand Stories-Metanarratives -- One More Genre -- References -- 5: Patient´s Narrative as a Probe for Successful Coping -- How Does All this Fit with Narrative Medicine? -- Love, as a Fuel for Coping -- Ode to Joy: An die Freude, Towards Optimism -- The Probe of Narrative Medicine -- References -- 6: The Muted Desire for Well-Being and the Abuse of the Word ``Normality´´ in Medicine -- Beginning this Tour from the History of Normality and Diversity -- In the Middle of the Tour Around the Contemporary Concept of the Word Normality -- The Progression of the Explanation on Normality in Disease and Wellbeing -- The Follow-up to the Contemporary View of the Word Normality, up to the Denial of Feelings -- The End, the Human Desire of Being Normal -- Beyond the Lines, a New Frontier to Define the Concept of Normality -- References -- 7: Bridging the Gap Between Personalization of Care and Research -- The Case of the CRESCERE Project -- Analysis of Stories.
In: Social philosophy today: an annual journal from the North American Society for Social Philosophy, Band 37, S. 197-205
ISSN: 2153-9448
In "Communication Breakdown: Probing the Limits of Narrative Medicine and its Discontents" (2019), David J. Leichter engages practical experience teaching medical ethics in the college classroom to explore opportunities—and limits—of narrative engagement within medical ethics and clinical practice. Leichter raises concerns regarding potential epistemic harms, both testimonial and hermeneutical, when individuals, or their pain, cannot be adequately recognized through expressive modes traditionally understood as "narrative." While I largely agree with Leichter's worries about narrative authority and limits, I challenge his characterization of "narrative medicine." In response, I suggest that "narrative medicine" is more than merely narrative engagement in medicine. As theorized by Rita Charon (2001, 2006), "narrative medicine" involves an inclusive approach to what narrative is, and more than mere mastery of "narrative competency." I argue that at least one way to conceptualize "narrative medicine" is as a technical term, which refers to the process of attention, representation, and affiliation Charon develops as the achievement of narrative medicine. When understood in this technical way, narrative medicine can both resist and respond to the kinds of epistemic harms about which Leichter is rightfully worried.
In: Social philosophy today: an annual journal from the North American Society for Social Philosophy, Band 35, S. 59-73
ISSN: 2153-9448
The turn to narrative in biomedicine has been one of the most important alternatives to traditional approaches to bioethics. Rather than using ethical theories and principles to guide behavior, narrative ethics uses the moral imagination to cultivate and expand one's capacities for empathy. This paper argues that by themselves narratives do not, and cannot, fully capture the range of the illness experience. But more than that, the emphasis on narrative often obscures how dominant forms of narrative discourse often operate to marginalize those whose narratives fall outside the parameters of traditional narrative forms or whose stories are occluded by structural violence and oppression. Rather, by focusing on forms of embodiment that are irreducible to narrative discursivity, this paper highlights forms of selfhood that exist outside of the narrative self.
In: European research studies, Band XXIV, Heft 3, S. 949-956
ISSN: 1108-2976
In: Humboldt Journal of Social Relations, Band 1, Heft 45, S. 136-151
ISSN: 0160-4341
In: The European legacy: the official journal of the International Society for the Study of European Ideas (ISSEI), Band 16, Heft 3, S. 389-391
ISSN: 1470-1316
In: Open library of humanities: OLH, Band 8, Heft 2
ISSN: 2056-6700
In critical dialogue with contemporary 'narrative medicine', a concept popularised by Rita Charon, this article re-examines representations of mental illness in the short prose of the German Expressionist writers and doctors Alfred Döblin (1878–1957) and Gottfried Benn (1886–1956). Taking as my focus Döblin's story, 'The Murder of a Buttercup' ['Die Ermordung einer Butterblume'] (1912), and Benn's cycle of 'Rönne novellas' (1916), I argue that their protagonists embody a form of 'narrative modality': a futile attempt to fashion entangled and chaotic mind-body relationships into self-controlled and socially sanctioned subjectivities. Michael Fischer's hallucinations have often been read as the symptom of nature's mythic revenge on the alienated modern subject, and they have also been associated with various specific psychopathologies. By considering the story's resonances with contemporary biopolitical discourses, Döblin's own psychiatric research, and Oliver Sacks' neurological case studies, I read our inability to 'pin Fischer down' both as the mirror image of his inability to control a wayward body and mind, and as the marker of his broken yet irreducible humanness. Benn's autobiographically inflected 'novellas'—as he termed his experimental pieces—trace the repeated collapse of Dr Werff Rönne's attempts to re-establish a stable sense of self. This collapse sounds the death knell for those endeavours and, at the same time, it opens radically new possibilities for both thinking and being. My article shows how these authors probe the very limits of literary narrative in its capacity for doing justice to the strange and singular lived experiences of mental illness.Featured image: A Detail from Egon Schiele, Der Tod und das Mädchen [Death and the Maiden], 1915. Public domain, via Wikimedia Commons {{US-PD}}.
In: Humanities and Social Sciences Communications, Band 11, Heft 1
ISSN: 2662-9992
AbstractNarrative medicine has become a meaningful solution to promote medical students' professional and personal growth. However, there is a lack of study on how students benefit from the narrative medicine approach when developing identities. This study aimed to establish and implement an integrated English reading and writing curriculum based on collaborative reflection and discussion using the narrative medicine approach, exploring how students presented and constructed physician identities by performing speech acts. First-year undergraduate students majoring in clinical medicine were recruited. Collaborative reflection and discussion were conducted in the integrated course involving 14 pieces of medical-related narrative works, along with essential elements that guided the students to engage in classroom activities. In the following analysis, the qualitative analysis software NVivo was used to identify the main speech acts and their frequency to analyze students' perception and recognition of different physician identities. Our analysis presented 33 major speech acts and revealed their frequency and characteristics, which we summarize in five interrelated physician identities. The fine-grained analysis showed how these identities were influenced by the narrative medicine approach, which provides enlightenment for supporting students to develop their professional identities. Another unique contribution of this study was to present the teaching basis and essential elements in an integrated humanistic curriculum. The results helped clarify the relationship between speech acts and physician identity and suggested that collaborative reflection and discussion using the narrative medicine approach improved the humanistic component that was in short supply in medical education through its interdisciplinary advantages, thus promoting professional identity development that can lead to higher-quality medical and emotional care.
In: Intervention, Band 15, Heft 2, S. 106-119