Culture, Medicine, and Psychiatry

, Volume 37, Issue 4, pp 670–680 | Cite as

The Practical Application of Narrative Medicine at Mayo Clinic: Imagining the Scaffold of a Worthy House

  • Johanna RianEmail author
  • Rachel Hammer
Original Paper


American health care institutions increasingly recognize narrative medicine as a means to developing quality patient care. More commonly applied in health care professional development settings, narrative medicine is less overtly employed with patient populations. In this article, we describe the application of various narrative practices in the patient care and medical education programs of a major health care center in Minnesota. We discuss the impact of these programs on their participants in relation to the evidence based in current scholarship. Further, we examine narrative externalization of illness in Katherine Butler Hathaway’s disability memoir “The Little Locksmith,” a text which implicates the work of metaphor-making as a transformative step in healing. While several reports demonstrate that patients can find creative writing during times of illness to be therapeutic, there are many for whom the practice is problematic or unattractive, obstacles to practice implementation that the authors discuss. However, based on the experience of our institution, for health care institutions seeking to build a legacy of leadership in empathic patient care, narrative—employed in mentoring physicians in training and in establishing strong, dialogic relationships with patients and colleagues—should serve as a central strategy, or scaffold.


Narrative medicine Disability Patient care Intersubjectivity Empathy 


  1. Arts in Medicine 2013 University of Florida Health Arts in Medicine University of Florida Health, Accessed 28 Apr 2013.
  2. Bauby, Jean Dominique (1998) The Diving Bell and the Butterfly: A Memoir of Life in Death. New York: Knopf Doubleday Publishing Group.Google Scholar
  3. Bolton, Gillie (2008) “Writing is a Way of Saying Things I Can’t Say”—Therapeutic Creative Writing: A Qualitative Study of its Value to People with Cancer Cared for in Cancer and Palliative Healthcare. Medical Humanities 34(1):40–46.CrossRefGoogle Scholar
  4. Bray, Melissa, Theodore L., S. Patwa, Margiano S., J. Alric, and H. Peck (2003) Written Emotional Expression as an Intervention for Asthma. Psychology in the Schools 40(2):193–207.CrossRefGoogle Scholar
  5. Brooker, Dawn.J. and L. Duce (2000) Well-Being and Activity in Dementia: A Comparison of Group Reminiscence Therapy, Structured Goal-Directed Activity, and Unstructured Time. Aging and Mental Health 4(4):354–358.CrossRefGoogle Scholar
  6. Broyard, Anatole (1992) Intoxicated by My Illness: And Other Writings on Life and Death. New York: Clarkson N. Potter, Inc.Google Scholar
  7. Charon, Rita (2001) The patient–physician relationship. Narrative medicine: A model for empathy, reflection, profession, and trust. The Journal of the American Medical Association 286(15):1897–1902.CrossRefGoogle Scholar
  8. Doty, Mark (2002) Still Life with Oysters and Lemon: On Objects and Intimacy. New York: Beacon Press.Google Scholar
  9. Freeman, Mark (1991) Therapeutic Use of Storytelling for Older Children Who are Critically Ill. Children’s Health Care 20(4):208–215.CrossRefGoogle Scholar
  10. Hammer, Rachel R., J.D. Rian, J.K. Gregory, J.M. Bostwick, C.B. Birk, L. Chalfant, and D.K. Hall-Flavin 2011a Telling the Patient’s Story: Using Theatre Training to Improve Case Presentation Skills. Medical Humanities 37(1):18–22.Google Scholar
  11. Hammer, Rachel, Christine Spampinato, and Lauren Jansons 2011b Submissions in white coat collection: Reflections by medical students on becoming a doctor. Therese Zink, ed. Minneapolis: Minnesota Medical Association Foundation.Google Scholar
  12. Hammer, Rachel (2012) The God Complex. Academic Medicine 87(6):775.CrossRefGoogle Scholar
  13. Hampl, Patricia (2007) Blue Arabesque: A Search for the Sublime. New York: Harcourt Trade Publishers.Google Scholar
  14. Hathaway, Katherine Butler (2000) The Little Locksmith: A Memoir. New York: Feminist Press at CUNY.Google Scholar
  15. Health Arts Network at Duke 2010 Health Arts Network at Duke. Durham: Duke University, Accessed 15 Apr 2013.
  16. Jones, Anne Hudson 1999 Narrative Based Medicine: Narrative in Medical Ethics. British Medical Journal 318(7178):253–256.CrossRefGoogle Scholar
  17. Kling, Kevin 2010 Personal Interview.Google Scholar
  18. Kuper, Ayelot (2007) The Intersubjective and the Intrasubjective in the Patient Physician Dyad: Implications for Medical Humanities Education. Medical Humanities 33(2):75–80.CrossRefGoogle Scholar
  19. Lamott, Anne (1994) Bird by Bird: Some Instructions on Life and Faith. New York: Random House.Google Scholar
  20. Morgan, N. P., K.D.Graves, Poggi E.A., and B.D. Cheson (2008) Implementing an Expressive Writing Study in a Cancer Clinic. Oncologist 13(2):196–204.CrossRefGoogle Scholar
  21. Pennebaker, James W. (2002) Writing About Emotional Events: From Past to Future. In The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being. Stephen J. Lepore and Joshua M. Smyth, eds., pp. 281–291. Washington, DC: American Psychological Association.Google Scholar
  22. Pennebaker, James W. (2004) Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval. Oakland, CA: New Harbinger Publications, Inc.Google Scholar
  23. Shapiro, Johanna. (2011) Illness Narratives: Reliability, Authenticity and the Empathic Witness. Medical Humanities 37(2):68–72.CrossRefGoogle Scholar
  24. Sontag, Susan (1979) Illness as Metaphor. London: Macmillan Publishing.Google Scholar
  25. State of the Field Committee 2009 State of the Field Report: Arts in Healthcare 2009. Washington, DC: Society for the Arts in Healthcare.Google Scholar
  26. Tran, Christine 2012 The Practice of Narrative Medicine Reflective Essay.Google Scholar
  27. White, Michael 2005 Michael White Workshop Notes, Accessed 28 Apr 2013.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Mayo Clinic Center for Humanities in MedicineRochesterUSA
  2. 2.Mayo Clinic College of MedicineSeattle Pacific UniversitySeattleUSA

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