A Whole New Mind: Why Right-Brainers Will Rule the Future by Daniel H. Pink Page A

telling a story. And your doctor will interrupt you. Twenty years ago, when researchers videotaped doctor-patient encounters in an exam room, they found that doctors interrupted their patients after an average of twenty-one seconds. When another set of researchers repeated the study more recently, doctors had improved. They now waited an average of twenty-three seconds before butting in.
    But that rushed just-the-facts approach to patient care may be changing, thanks in large part to the work of Dr. Rita Charon, a Columbia University Medical School professor who is attempting to place story at the heart of diagnosis and healing. When Charon was a young internist doing rounds at a hospital, she made a startling discovery: much of what she did as a doctor revolved around stories. Patients explained their ailments in narratives. Doctors repeated stories of their own. Illness itself unfolded as a narrative. Narrative was everywhere. Everywhere—except in the medical school curriculum or the consciousness of students and teachers. So Charon picked up a PhD in English to go with her MD—and then set about reforming medical education. She launched the narrative medicine movement in a 2001 article in the Journal of the American Medical Association that called for a whole-minded approach to medical care:
“Stories—that’s how people make sense of what’s happening to them when they get sick. They tell stories about themselves. Our ability as doctors to treat and heal is bound up in our ability to accurately perceive a patient’s story. If you can’t do that, you’re working with one hand tied behind your back.”
— DR. HOWARD BRODY,
family practice
physician
A scientifically competent medicine alone cannot help a patient grapple with the loss of health or find meaning in suffering. Along with scientific ability, physicians need the ability to listen to the narratives of the patient, grasp and honor their meanings, and be moved to act on the patient’s behalf. 8
    Today, at Columbia, all second-year medical students take a seminar in narrative medicine in addition to their hard-core science classes. There they learn to listen more empathically to the stories their patients tell and to “read” those stories with greater acuity. Instead of asking a list of computerlike diagnostic questions, these young doctors broaden their inquiry. “Tell me where it hurts” becomes “Tell me about your life.” The goal is empathy, which studies have shown declines in students with every year they spend in medical school. And the result is both high touch and high concept. Studying narrative helps a young doctor relate better to patients and to assess a patient’s current condition in the context of that person’s full life story. Being a good doctor, Charon says, requires narrative competence—“the competence that human beings use to absorb, interpret, and respond to stories.” 9
    Narrative medicine is part of a wider trend to incorporate an R-Directed approach into what has long been a bastion of L-Directed muscle-flexing. Fifteen years ago, about one out of three American medical schools offered humanities courses. Today, three out of four do. 10 Bellevue, the legendary New York City public hospital, publishes its own journal—the Bellevue Literary Review. (Literary journals have also popped up at medical schools at Columbia, Penn State University, and the University of New Mexico.) The editor in chief of the Bellevue journal, Dr. Danielle Ofri, who teaches med students, requires her young charges to write up at least one of their patient histories as a narrative—to tell the patient’s story from the patient’s point of view. “That’s not different from what the novelist wants to do,” Ofri says. “I think we can take people who are basically empathetic and well-meaning and give them better skills to connect with their patients.” 11
    Of course, narrative competence cannot replace technical expertise. A doctor who