Well fellow surgeons, here is part of my first foray into tracking down more information on Narrative Medicine.Book Reviews

Stories Matter: The Role of Narrative in Medical Ethics
Reviewed by: Beverly Steinman, MD
Medscape General Medicine 5(1), 2003. © 2003 Medscape
Posted 01/24/2003
Edited by Rita Charon and Martha Montello
Routledge
Copyright 2002
242 pages
ISBN: 0-415-92838-9
$24.95 paperback
Medical ethics is more than a theoretical abstract to be discussed in committees and academic environments. Every human life is at some time affected by this discipline. The collection of essays presented in Stories Matter: The Role of Narrative in Medical Ethics, skillfully edited by Rita Charon, MD, PhD, and Martha Montello, PhD, broadens and deepens the understanding of how medical ethics is interwoven into our lives, through an illustration of the role of narrative in medical care. Readers from all fields -- clinicians, ethicists, and anyone associated with providing healthcare -- will benefit from this book. Those with no previous experience in medical ethics may also find the text stimulating, although its concepts may be challenging for those without literary and/or clinical background.
Both Charon and Montello are at the forefront of the narrative medicine movement, which advocates that physicians must learn to become close readers of their patients' stories (or histories) in order to identify and respond effectively to moral and clinical questions posed. Charon, Editor-in-Chief of the journal Literature in Medicine, and Montello, a Professor of History and Philosophy of Medicine at the University of Kansas, bring together 23 bioethicists and literary theorists, such as Howard Brody, MD (Stories of Sickness), and critic Wayne C. Booth, PhD (The Rhetoric of Fiction), each individually recognized as an expert in their area of focus.
By linking their essays in a logical and iilluminating sequence, the editors have produced a text that educates and inspires. While each author makes a unique contribution, they collectively make the case for the importance of the narrative approach to bioethics.
The editors accomplish their goal of guiding readers "toward a cognitive, practical, emotional, and aesthetic familiarity with the conceptual frameworks, methods, and powers of narrative ethics." (p. x) While the average clinician may find some of the terminology (such as reliability, intersubjectivity, and textuality) and citations unfamiliar, it is well worth the effort to immerse oneself in new territory throughout this text. Many ideas and perspectives are presented that, when incorporated into everyday clinical practice, can change us and our ability to ethically care for patients.
For example, case studies using the narrative ethics approach are presented, aptly illustrating how the concepts work to accomplish the goal of a more complete and accurate consultation. Richard Martinez states, "Narrative methods help us to listen and see with intensified accuracy and reach -- a hermeneutic stethoscope of a sort." (p. 131) This comparison to a common diagnostic tool provides a powerful visual linkage, likely to be understood by all clinicians.
Some of the material is assimilate, such as a section introducing the importance of context, voice, time, character, plot, and reader response in the narrative approach to bioethics. This simple comparison to the basic components of stories is very effective in providing a manageable framework by which we can expand our view and methodology in the consultation process.
It was quite refreshing to find frank and straightforward observations from the authors of Stories Matter, especially dealing with the reality of the current medical world. For example, the authors noted that, currently, a few "experts" often dominate the ethical consultative process in an organization. They suggest that a narrative approach causes a change to a more democratic process, as each person's perspective is valued.
In addition, very practical advice is given on how to train practitioners on the use of narrative ethics, including the range of educational opportunities available. A listing of the specific competences for narrative medical ethics is suggested and is compared to the original competences for ethics committees. Realizing that the work in narrative bioethics has been in progress for 25 years helps the reader to both understand the dedication of those involved and prepare for what is most likely to be a slow transition in one's own organization.
The ever-present issue of time will undoubtedly be one of the greatest challenges. The comprehensive narrative approach involving multiple perspectives will take longer than a "sidewalk" consult or a 1- or 2-sided presentation at an ethics committee meeting. It would have been helpful to have this dilemma addressed more fully.
The book ends appropriately with a look at the future of narrative medical ethics. By reviewing the additional case stories, healthcare data, and concepts presented, the reader will be further convinced that this approach is essential to the provision of quality ethical care. In the last chapter, Joanne Trautmann Banks states it well: "...narrative is fundamental to our bodies, minds, communities, and souls." (p 219)
Through the authors' passionate, logical, and credible sharing of their knowledge and experience, readers will gain the ability to understand and participate in an improved approach to medical ethics, both in their own practices and within their organizations. Incorporating multiple perspectives, understanding "stories" in all their complexity, becoming more aware of what each individual brings to the situation, and managing this challenging methodology in a systematic, thoughtful way, will take medical ethics to a new, more proficient and complete level.
The authors are clear that the previous or current methodology used in medical ethics, usually the principlist approach, is not necessarily to be abandoned, but most likely will be complementary to the narrative approach. Hence, we will be building on the past as we strive toward a future that will be guided by the concepts shared in this book.
Beverly Steinman, MD, consultant and educator in healthcare communication with the Northwest Center for Physician-Patient Communication