Literary genres used in medicine are multiple and versatile, there are also various methods of using literature.
Genres:
- Autobiographies and memoirs by patients, carers, family and physicians
- Self-help books
- Poetry
- Fiction
- Research works about applications and effectiveness of literature in medicine
Methods
- Books sought out autonomously
- Through physician’s recommendation, coupled with reflective discussions (McCullis, 2012)
- Literature electives incorporated into medical curriculum
- Reading groups and workshops (Longden et al, 2015) (Ratcliffe, 2016)
- Apart from reading literature, people also use creative writing to illuminate the patient experience (Aronson, 2000). This does not exclude writing about other forms of art (O’Neill, 2010) (Harris, 2002-2004)
Benefits
- For patients: Can be autonomous in managing their problems. (McCullis, 2012) (HSE, 2017)
- For doctors: Act as a tool for reflective practice and clinical empathy-contemplate role and implications of medicine, understand the social interactions between doctors and society. (Oyebode, 2010) (Charon, 2001)
- All readers: personal development and wellbeing. (McCullis, 2012)
- Gain insight into the experiences of others, the stress of the physician, the frustrations of the patient, the isolation of carers and families etc…(Oyebode, 2010) (Billington, 2016)
As we all know, many authors have described the use of literature in reflection about self, the practice of medicine, the patient experience and the therapeutic use of literature. Many efforts were put into identifying useful texts for busy clinicians. There are several genres of literature used in medicine. One approach may be the use of self-help books which are either recommended by doctors or independently sought out by patients. Other approaches may include autobiographies of the illness experience, which help readers, physicians and patients alike, to gain insight into subjective nature of the illness experience. Apart from reading literature, people also use creative writing and literature to illuminate the patient experience; the list about applications of literature can go on and on…There is also research around the effectiveness and different applications of literature in medicine.
Narrative medicine was introduced as a humane model for medical practice which requires narrative competence: “the ability to acknowledge, absorb, interpret, and act on stories and plights of others”. One of the methods to achieve narrative competence is through close reading of literature. This form of practice seeks to build a more empathic engagement between patient and physician, hence achieving a more productive therapeutic interaction (Charon, 2001). Not only that, reading literature can spur critical and creative thinking about the role medicine can play in contemporary culture (Oyebode, 2010)
Reading autobiographical accounts of the illness experience reminds physician readers about the unique individuality of the patient amidst the waves of objective biomedical reports (Oyebode, 2001)(Aronson, 2017). Reading these autobiographies allows readers to gain insight into the experience from the author’s point of view; in other words, to gain experiences without living through them. Consequently, this knowledge allows readers to have a greater capacity for empathy towards the people involved, patients and doctors alike, as well as being informed about how to behave appropriately around them. Apart from autobiographies, fiction also plays a role in reflective practice. It gives readers the unique opportunity to contemplate unconventional ideas, explore unusual scenarios and implications in medicine (McFarlane, 2017).
Close reading of literature can be done individually and autonomously by both patient and physician readers. In addition, patients who are prescribed bibliotherapy are encouraged to discuss about the reading experience with the physician.
Additionally, literature workshops have been used with healthcare professionals where the group does close reading of specific texts and engage in reflective discussions. In addition, literary studies are also integrated into medical education programmes; such as poetry courses in University of Birmingham, and medical humanities subject electives in Trinity College Dublin.
In conclusion, literature has an invaluable capacity to enrich medical education, clinical practice, and personal wellbeing. The field of using literature in health is a diverse area and as a clinician it can be hard to know where to start.
As starting points, participants in the project identified some of the text below about how people use literature
- Josie Billington, Is Literature Healthy? -the first book of the Literary Agenda series. The author provides an introduction of the medical humanities, explores the definitions of illness from various perspectives, and then contemplates models of literary reading.
- Borys Surawicz, Beverly Jacobson, Doctors in Fiction: Lessons from Literature -This book is a compilation of reflective notes by multiple physicians from reading specific literature, contemplating how people view the medical profession
- Femi Oyebode, Mindreadings: Literature and Psychiatry -This book explains what literature can do for medical education and practice, with a focus on psychiatry.
- Art and Images of Psychiatry -A webpage featuring a compilation of essays written by a Professor of Psychiatry and published in JAMA Psychiatry between 2002 and 2014. The author refers to specific visual arts pieces in each of his essays where he explores the role of creative art in representing health issues.
- Charon, R., Banks, J., Connelly, J., Hawkins, A., Hunter, K., Jones, A., Montello, M. and Shapiro, P., Literature and medicine: contributions to clinical practice (1995) -a review about incorporating literary studies in medical education
- Seamus O'Mahony, Against Narrative Medicine (2013) “This essay aims to provoke debate on how and what the medical humanities should teach. It argues that the field has been dominated (to its detriment) by two misguided movements, postmodernism and narrative medicine, and that it should be redirected from utilitarian aims towards the goal of exposing medical students to a climate of thought and reflection.”-abstract
This online toolkit is a collection of resources about using literature to support mental well-being. It is particularly aimed at clinicians and medical students keen to incorporate the use of literature in clinical and reflective practice but may be of interest to a range of interested readers, academics and of course to those experiencing illness. We are keen to collaborate further in developing this resource with other organisations.