26 Oct, 12 | by BMJ Group
Medicine was the theme of this summer’s issue of Granta, the magazine of new writing. A gift for anyone with an interest in narrative medicine.
“What does that even mean, ‘Narrative Medicine’? I’m never totally sure what that means, but I think that’s part of the point, that it means different things to different people…” Chris Adrian’s opening story takes the form of a lecture or soliloquy delivered to junior doctors on the subject and uncertainties of narrative medicine. His stream of troubled consciousness soon appears to lose its way, his monologue becoming a rambling, but compelling recounting of his mother’s recent illness, of only marginal interest to his disaffected audience who mostly walk out of the lecture room, but enthralling to us, or me, the reader. It seems to offer part of an answer to the question, to demonstrate part of the point, one purpose of the endeavour: our need to tell stories.
Another part of the point is made by American physician Terrence Holt when he describes the “curious combination of high drama and burlesque” that is the hospital crash call or “code”:
“There is a great deal of mess in hospital medicine, literal and figurative and the code bunches it all into a dense mass that seems to represent everything wrong with the world. The haste, the turmoil, the anonymity, the smell, the futility: all of it brought to bear on a single body, as if to point to a moral that I would understand better if only I had time to stop and contemplate it. Which I don’t. Not today…”
Another purpose of the endeavour: our need to stop and contemplate.
Narratives by writers as patients suggest another point: intimate, honest, and often genuinely moving, they are the patients’ stories we rarely hear in medical histories; that we too rarely allow ourselves to hear at all. Novelist Maria Hyland writes for the first time about her illness, beginning: “A few weeks after I was diagnosed with multiple sclerosis, I made a pact with dying.” There follows suicide plans, anger, taxi rides for short distances, fatigue, broken crockery, but ultimately Maria finding and demonstrating a meaning in living. For Linda Davis, the crux of her diagnosis with Non-Hodgkins lymphoma (“the wrong kind”) is the impact that this will have for her adult autistic son who still lives at home: a story made all the more painfully poignant by her death just days after the magazine was published.
“Magazine” is maybe a little misleading. The pages are mostly black and white with single columns and sensible fonts, the thick A5 format makes Granta feel like a book, and the only photographs in this issue are a collection of vintage images (of death masks, shrunken heads, bottled foetuses, and yogic contortionists) accompanied by a thought provoking essay by AL Kennedy. It’s almost a book. You can buy it in bookshops. And online for e-readers. Issue 120 is a varied and brilliant collection by doctors, about doctors, and about experiences of health and illness. It’s a great reminder of what good writing can do, and of the point of a narrative approach to medicine.
Andrew Moscrop is a general practitioner.