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Sarah West: Film Review ‘Alive Inside’

26 May, 15 | by Ayesha Ahmad

It is because we live in a society where we tend to commit vulnerable members such as people with dementia to care institutions that we need documentaries like “Alive inside”. This very moving film, winner of the “Audience Award” at the Sundance Film Festival, 2014, follows a New York based social worker Dan Cohen as he volunteers in a nursing home, takes music to the isolated residents suffering from dementia, and in the process brings them alive before our very eyes. Sharing music with nursing home residents is a relatively easy task with the undeniable power of music to stir emotions and lift mood. The novel and creative use of iPods and MP3 players with personalised playlists proves to be an effective therapy for people with dementia who have lost their identity and connection with their loved ones.

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The Reading Room: The Birkbeck Medical Humanities Reading Group

19 May, 15 | by cquigley

 

The Birkbeck Medical Humanities reading group aims to create a space in which academics, clinicians and students can come together to explore key readings, ideas and materials in the field of medical humanities. Our endeavour is to find ways of talking across the different disciplines of the humanities and medicine, and we welcome participation from colleagues interested and engaged in these areas.

Our next meeting will be on Wednesday, 27 May 2015, where we will continue to explore the theme of narrativity in the medical humanities, with a special focus on verbalising illness.

We will meet in the Keynes Library, 43 Gordon Square, between 3.30-5pm. 

Set texts:

  • Lucy Bending, ‘Approximation, Suggestion, and Analogy: Translating Pain into Language’, The Yearbook of English Studies, 36:1, Translation  (2006), 131-137
    Stable URL:  http://www.jstor.org/stable/3508741
  • Joanna Bourke, ‘Metaphor’, in The Story of Pain: From Pain to Painkillers (Oxford: Oxford University Press, 2014)
  • Extracts from Alphonse Daudet, In the Land of Pain, trans. By Juilan Barnes (New York, 2002)
  • Extracts from Eula Bliss, On Immunity: An Inoculation (2014)

For further details, and copies of the set texts, please contact Heather Tilley, h.tilley@bbk.ac.uk.

Colleagues may also be interested in listening to this Radio 4 programme on the Language of Pain, aired on 2 May, on the BBC iPlayer (http://www.bbc.co.uk/programmes/b05spk3q) (blurb below).


Virginia Woolf claimed that English has no words to express what it feels like to be in pain. Professor Joanna Bourke from the Birkbeck Pain Project sets out to challenge this notion, exploring archives from the last two centuries to illustrate the rich metaphorical language people have used to express pain, and demonstrate why doctors need to pay attention to what their patients say. This one-hour programme includes contributions from social, cultural and music historians Dr Louise Hide, Dr Lucy Bending, Dr Simon Heighes, Professor Javier Moscoso and Dr Ana Carden-Coyne, as well as pain clinicians Professor Rita Charon and Dr Joanna Zakrzewska, and artist Dr Deborah Padfield. It has been produced by Isabel Sutton for Just Radio.

Next Reading Group

Our last meeting of the term will be held on Wednesday 24 June, 3.30-5.00 (again in the Keynes library), and will focus on graphic medicine, with selections from Ian Williams, Daryl Cunningham, and some short animated videos.

More information on the group is available on our webpage, along with details of past reading.

Jo Winning (Director), Heather Tilley and Suzannah Biernoff.

 

The Reading Room: Upcoming workshop on ageing

12 May, 15 | by cquigley

 

Medical Humanities and Ageing, 29/06/2015

 

An initiative of the CHCI Medical Humanities Network Program, funded by the Andrew W. Mellon Foundation through the Consortium of Humanities Centers and Institutes (CHCI)


Location:
Old Committee Room, King’s Building, King’s College London, Strand Campus, Strand, London WC2R 2LSDate: Monday 29th June 2015

The Centre for the Humanities and Health, King’s College London, would like to invite you to our second workshop on medical humanities and ageing. We are one of the six CHCI member centres and institutes working on a project to further the development of medical humanities as a subject of study: each partnering centre conducts specific research on ageing, undergirded by collaborative reflection on issues of evidence, value, and evaluation.

Programme:

10:00 – 10.30: Welcome

10:30 – 11:30: Panel: Reflections on Old Age

Dr Claire Hilton, Sauerkraut and African Violets: the Art of Old Age Psychiatry

Dr Elizabeth Barry, ‘Narrower and Narrower would her Bed Be': Woolf, Beauvoir and the Change of Life

11:30 – 12:00: Coffee break

12:00 – 13:00: Panel: Stories from the End of Life

Dr Columba Quigley, How We Die: Palliative Care and an Ageing Society

Dr Maria Vaccarella, Narrating Decay

13:00 – 13:30: Concluding remarks

Seating is limited, so if you would like to attend, please contact Dr Maria Vaccarella (maria.vaccarella@kcl.ac.uk) by Monday 15th June 2015

 

The Reading Room: A review of ‘Health Humanities’

5 May, 15 | by cquigley

 

Health Humanities Paul Crawford, Brian Brown, Charley Baker, Victoria Tischler and Brian Abrams (London: Palgrave, 2015)

Reviewed by Dr Maria Vaccarella, Postdoctoral Research Fellow in Medical Humanities, Centre for the Humanities and Health, King’s College London

9781137282590

In her foundational study Manifestoes: Provocations of the Modern (1999), Janet Lyon explains that “the manifesto both generates and marks a break in history: it is both a trace and a tool of change” (16). In drafting this manifesto for the health humanities, Paul Crawford, Brian Brown, Charley Baker, Victoria Tischler and Brian Adams provide exactly this combination for change: Health Humanities (2015) traces the long-standing interplay of arts, humanities and healthcare, as well as advocating a reconceptualization of this very interaction. Scholars and practitioners in the field will be familiar with Crawford’s argument for an expansion of the medical humanities to include non-medical carers involved in the provision of health and wellbeing. What emerges more clearly from this book is a stance against “medicalised humanities”: as paradoxical as it sounds, humanists can end up privileging medical understandings of health and wellbeing issues, especially when constantly pressurized to justify their own research topics and methods, according to well-established research patterns, originated in the biomedical sciences.

This reflection on what counts as reliable research and interventions in humanities-based healthcare activities (chapter 7) is by far the most valuable contribution of this book to existing scholarship. The authors move from a careful examination of the shortcomings of evidence based medicine – unfortunately sometimes still showcased as the golden standard of health-related research – to an exploration of practice-based evidence, a helpful framework for bringing into play the positive results of recent challenges to traditional research, e.g. action research, patient advocacy, etc. This bottom-up shift in perspective will be most helpful in redressing the benefits of humanistic approaches to health-related issues, as well as dismantling the power imbalance between researchers and participants. The notion of evidence is not naively dismissed as inapplicable in the humanities; rather, it is presented as a much more nuanced concept than what is usually encountered in the biomedical sciences. As a consequence, if we want to collate results of humanities-based healthcare activities with a view of improving healthcare provision and policy, then we should reflect on an adequate methodology, given the limitations of systematic reviews and meta-analyses in this area. Crawford and colleagues suggest metasynthesis as a better way of making sense of the diverse inputs that the arts and humanities are likely to engender. Engaging in metasyntheses could also facilitate the emergence of a new, more cogent role for humanities academics interested in health-related issues, whom the authors describe as often wary of pushing their ideas into practice. A further advantage of a stronger engagement with creative practice is a resulting sense of mutual (one would be tempted to add, non-medicalised) recovery and community-building: to quote from the book, “there is a need to bring together diverse academic and community partners to share insights, approaches, methods and analytic tools in order to mobilise the concept and develop creative practice as mutual recovery to better connect communities for physical and mental health and well-being.” (142)

This invitation to fully embrace creativity is offered at the end of a survey of previous, more or less deliberate, preparatory work in a range of disciplines, from anthropology and the study of culture (chapter 2), through applied literature (chapter 3), narrative and applied linguistics (chapter 4), to performing and visual arts (chapters 5 and 6, respectively). The authors provide an introduction to the field under scrutiny in each chapter and then list a wide-ranging selection of its applications in health-related settings. There are nonetheless some inexplicably neglected areas, e.g. the role of performing arts in bringing about Patient Educators and Medical Readers’ Theatre (the benefits of which reach far beyond medical schools), or patients’ and carers’ graphic memoirs as a vivid example of the transformative, if not strictly therapeutic, potential of the visual arts. The internal organization of these chapters is also regrettably uneven. By way of an example, the chapter on anthropology ends with a most helpful set of questions, inspired by Arthur Kleinman’s exploratory models, to assist health humanities practitioners in taking stock of results from a cognate discipline to improve their own approach to patients. However, if readers expect a similarly pragmatic conclusion to all other chapters, they are bound to be disappointed. Of course, reducing innovative concepts to a list of questions could be regarded as a tedious exercise; but at least some of the disciplinary fields reviewed here (e.g. narrative medicine) would have easily yielded practical guidelines, a surely welcome gesture towards those informal carers that the authors make a point of engaging with to a greater extent. In this regard, the concise case studies boxes distributed throughout the text precisely perform this function of providing snapshots of interventions, informed by the theoretical debates surveyed in the chapters. They are so effective in showcasing the potential of the health humanities approach that one regrets that they have not been used more consistently throughout the volume.

The central tenet of Health Humanities that “the majority of healthcare and the generation of health and well-being is non-medical” (153) is indeed fascinating, especially because it could potentially evoke completely different scenarios in the context of global health. This looks like the ultimate challenge to the authors of this volume and all other practitioners of the health humanities: how can their promise of inclusiveness and internationalisation be predicated on a global scale, so that their envisioned maximisation of benefits to practitioners, informal carers and patients/carers responds to worldwide health-related needs? The manifesto has been produced; we now look forward to the change.

Mark Making: An Experience of Dementia and the Arts by Hannah Zeilig

28 Apr, 15 | by BMJ

Rose sensed that I was nervous. My façade of confidence was not convincing, I was holding my papers a little too defensively across my chest and my shoulders were tense. I stood awkwardly at the edge of the circle of people, feeling outside their camaraderie. It was strange but also salutary to feel an outsider amidst a group of people with dementia. Instinctively, I wanted to make a note about this. However, the point of the day was that I should participate so reluctantly and feeling slightly naked I put my notebook down. I wondered how I could remember without notes. If we are our memories, then I am contained in small black notebooks. Then Rose made her well timed move. Loudly pushing her chair away she stood up and came to embrace me. ‘Enjoy the day’ she exhorted me loudly in a rich Jamaican voice. Rose’s warmth dissolved my hesitations. I began to understand that I might not need my notebooks here and that I would remember ‘feelingly’ to borrow a phrase from King Lear.

 

From this point onwards, I joined the music making, art viewing or tea drinking: all activities that were integral to the participative arts projects that I worked with during Mark Making. This AHRC funded project was an exploration of the participative arts for people with dementia. In the last decade, arts activities for people living with dementia have flourished; these include singing, drama, painting, photography and puppetry (to name a few). The context for this burgeoning interest in the arts and dementia includes a widespread awareness that in the absence of cures, interventions that emphasise quality of life are important [1]. Despite being a small-scale project Mark Making tackled some big, existential issues. These include what we mean when we refer to ‘dementia’, what we think the ‘arts’ are and can do and what value means in the context of the arts. Of course we do not have satisfactory answers and this was never our goal. However, it was through actively participating in arts projects that we came closest to asking the right sorts of questions.

 

Putting aside pens and digital recorders helped me shed my own assumptions and enter the moment creatively with others there. I was too occupied attempting to singing notes in harmony or exploring John Van Ruisdael’s Waterfall to do anything other than feel the presence of other participants intuitively. In a brief period, my identity as a researcher and reliance on analytical, cognitive skills to investigate how the arts ‘work’ disappeared. I noticed that other group members, the majority of whom were living with some form of dementia, were perceptive about my feelings and could sense when I felt hesitant about singing out my name or using a shaker. On one memorable occasion, during a session of music making Edith showed me how to use the shaker. She took it from me to demonstrate and said laughingly: ‘The shaker will be your best friend.’

 

Due to past experiences of working with people with dementia, I knew that when I engaged attentively with individuals I was able to learn a lot about their feelings and experiences. I have also spent time educating the dementia care workforce, students including medics and nurses and the general public in an effort to dispel the prejudices that continue to cloud our collective vision about dementia. Until I worked closely with the arts projects that I was also researching, I did not suspect that I still had my own prejudices concerning what people with dementia can do.

 

However, by becoming part of the sessions that I attended I began to understand the creative process in way that was embodied rather than solely intellectual. Along with other participants I experienced how the arts projects provided an opportunity to become part of an alternative group that was engaged in a structured activity distinct from the everyday routines that define normal life. Thus living with dementia became a social experience (as opposed to an isolated, singular experience).

 

During the focus group one participant eloquently articulated his sense that he was part of a group:

‘We became a little group within ourselves. …’

In addition, the security of being part of this new group was evident, as the same respondent noted:

‘It wasn’t only me, there were other people’.

The sense of collective identity that to some extent afforded participants (and myself when I was there) a sense of camaraderie mirrors observations by other researchers that supportive social contexts can promote identity adjustment.

However, attending a public concert in the Wigmore Hall with the group of participants from Music for Thought really challenged my preconceptions. Despite my lively imagination I could not quite predict how the diverse group of individuals would experience the concert. There were practical issues including how we would physically access the concert hall with our group, some of whom walked with several canes, others who were without language but prone to making unexpected sounds and others who needed the toilet at regular intervals. The pre-concert meeting with tea proved essential. This allowed us all to gather and reconfigure ourselves as a ‘group’. I spent time with Harold who treated me as both a co-conspirator and later as his date. He called me his gal. I felt delighted as he held my arm proprietorially in the concert hall.

 

There was some anxiety about ensuring that everyone was able to get upstairs into the main concert hall and find their seats before the concert began. The concert was a formal event, performers were in suits and ball gowns and it consisted of a song cycle based on Goethe’s poetry set to music. To my surprise and delight the group seemed able to concentrate throughout the performance (in some cases better than myself); there was a tacit understanding about how to behave in this environment.

 

This event demonstrated the ability that some people with dementia have for participating in cultural events, even those living with a fairly advanced dementia. The grandeur of the setting, the emotions expressed by the performers, the vibrations of the music which could be felt physically as well as aurally, combined to create a space in which the condition dementia was less relevant than the sense of being present in the musical moment. Even if there were moments when those with dementia were not fully engaged it seemed a more appropriate activity than, for example, watching TV. This is because it was a form of living communication that was facilitated by the immediacy of the performance. In addition, the equality of simply being part of a concert-going audience was noticeable.

 

Concluding thoughts

Mark Making demonstrated that the participative arts groups stimulated a distinct social experience, one that was partly connected with a shared identity but that was also characterised by an ability to transcend the habitual constraints that define life with a dementia. I felt lucky to be able to learn from those people with dementia that I worked with and humbled by how much I am also hampered by judgements and assumptions. However, I am heartened by the ability of the arts to dispel stigma by uniting groups of people who are otherwise disparate in generation, gender, occupation and physical or mental health. After all, the arts rely on taking a broad, imaginative view – appreciating context and privileging feelings rather than relying on certitudes. Living with uncertainty is something we should all aspire to, as it is a fundamental part of life whether you have dementia or not.

Reference:

  1. Zeilig, H., J. Killick and C. Fox (2014). “The participative arts for people living with a dementia: a critical review.” International Journal of Ageing and Later Life: 1-28.

Further Information: http://markmaking.arts.ac.uk

Correspondence:

Dr Hannah Zeilig

University of the Arts, London

h.zeilig@fashion.arts.ac.uk

 

 

 

The Forgiveness Project: Stories for a Vengeful Age

26 Apr, 15 | by Deborah Bowman

Images of Eva Kor embracing former SS guard, Oskar Groening, at his trial in Lueneberg this week have been shared on social media and in newspapers worldwide. These images, and the responses to them, reveal much about the complex, surprising, inspiring and challenging, sometimes even threatening, nature of forgiveness. Our relationship with forgiveness, collective and individual, is always nuanced and often ambivalent. It is a slippery, shape-shifting concept that rarely exists without an undercurrent of emotion. Forgiveness can be experienced as both restorative and undermining. It may be perceived as noble and a betrayal. We may aspire to it even as we fear it. Forgiveness is a force that may be resisted or harnessed or, perhaps more often than we acknowledge, both.

 

Few have thought more about forgiveness than Maina Cantacuzino. Ten years ago she founded The Forgiveness Project. Last year, saw a series of outstanding events to celebrate a decade of its work culminating in the publication of a book – The Forgiveness Project: Stories for a Vengeful Age. It is a remarkable text that manages in a slim volume to capture the significance and unique approach of The Forgiveness Project and, in doing so, captures why its work matters more than ever.

 

Central to the book and to the work of The Forgiveness Project are stories. Those stories offer an unmediated insight into this demanding, elusive, inspiring and troubling thing we call ‘forgiveness’. It provides space, without judgement or commentary, for people to reflect on and to share what forgiveness means for them.

 

It is these narratives that form the basis of the book, although Marina Cantacuzino’s introductory essay – “As Mysterious as Love” – is an outstandingly thoughtful, and thought-provoking, exploration of forgiveness and her own personal and professional relationship with it. The book also carries two rich and insightful forewords from Desmond Tutu and Alexander McCall Smith. Yet, it is the forty individual stories that follow the introduction and forewords that form the essence of this unique work.

 

Some of those who come to The Forgiveness Project are well-known people whose capacity for compassion and empathy towards those who have caused devastation has prompted fascinated media attention across the world. Others are less familiar names but their stories are equally urgent and compelling. There is neither formula nor any sentimentality to be found. Anyone seeking sentimental salve will be disappointed. Nor do tropes of heroism or survival occur often. What is offered instead is much harder and ultimately more rewarding. These are accounts that are authentic, sometimes painful, often surprising and always affecting.

 

It is not merely the content of these stories that is noteworthy. The form reflects the discomforting and urgent nature of the tales told. All the individual contributions are short, few extend beyond five pages and the language is direct, plain and unflinching. There is force in the form. It propels the narrative, unadorned and untamed, searing each account in our memories and unsettling our own perceptions of forgiveness. The stories are presented with little in the way of preamble and often begin at points of loss, crisis and despair. The ways in which each of these accounts breaches the reader’s consciousness reflects the nature of the experiences described. These stories, like the events they relate, arrive unbidden and unexpectedly, without warning or invitation. They interrupt and disrupt. The language is spare, sometimes even brutal, and simple belying their daunting legacies. These are collisions with strangers that can change the direction of a life, or at the least, the beliefs one holds about a life.

 

These stories reveal that the force of forgiveness is often experienced viscerally. Its charge is both negative and positive. Within the book, there are no homilies or sermons about its normative value or otherwise. It is simply there: unfiltered and demanding our attention. Whether it is resisted, embraced, explored or ignored, its force cannot be avoided. A number of contributors note that it may be easier to define forgiveness by what it is not and, in so doing, they challenge much of the received wisdom about what constitutes forgiveness and why it matters. Others are less interested in definitions and the boundaries of the concept. All those who have contributed to the book attend to meaning in all its infinite variety. These are fluid explorations for alongside the meditations on forgiveness, are reflections on what it means to have hope, to be loyal, to restore dignity and ultimately to be human. That these ideas emerge from the rubble of lives shattered by loss, cruelty and destruction is not only intensely moving, but serves as testament to Marina Cantacuzino’s transformative work both in creating this book and leading The Forgiveness Project.

Prof. Deborah Bowman

Editor, Medical Humanities

St George’s, University of London

Email: dbowman@sgul.ac.uk

Twitter: @deborahbowman

 

Sarah West: Film Review ‘Wild Tales’

13 Apr, 15 | by Ayesha Ahmad

What separates us from living like animals? And what calamity or force does it take to unleash our primal instincts?

 

“Wild Tales” is a compendium of satirical short stories about the pain and pressure points of modern 21st Century life and specifically what happens to the Latin spirit under duress. What delirious lengths do we go to when the pressure of injustice reaches boiling point and something inside us snaps, when all social constraints are abandoned and our spirits are liberated to express our hidden rage and seek bloody revenge. It is a wild ride, visually exciting, full of imaginative twists, and not a breath of the script is wasted.

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Franco Ferrarini: Film Review ‘Still Alice’

13 Apr, 15 | by Ayesha Ahmad

Alice Howland (Julianne Moore) is a good-looking fifty-year-old successful professor of linguistics; her loving husband (Alec Baldwin) is a brilliant research physician, she has three beautiful children, a brownstone in the Upper West side and a house at the Hamptons. This is the perfect stage for an impending disaster; in fact after some episodes of forgetfulness, a medical work-up gives the disaster a name: early-onset familial Alzheimer’s disease. From then on directors Richard Glatzer and Wash Westmoreland depict the relentless downhill course of the disease, sparing the viewer only its excruciating terminal stages.

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Ayesha Ahmad: Maslaha Workshop for Medical Students: Practical implications of working with diverse communities

1 Apr, 15 | by Ayesha Ahmad

Narrative is an increasingly potent concept for medical educators; developed as a tool to un-cover the patient experience as well as to illustrate the nuances where empathy has a place to fill the gap between the patient and their doctor.

Medical humanities, then, has an integral role for students learning how to become a doctor; and not just merely a doctor; but ‘Tomorrow’s Doctor’ as envisioned by the General Medical Council.

Narratives require that there is space especially within the clinical encounter to be expressed and received. Of course, medical practice elicits narratives containing some of the most significant elements of the human condition. As well as the narratives being diverse encompassing different beliefs surrounding the meaning of life, death, illness, and health, then, so are the narrators. This means that it is necessary for doctors to be trained in perceiving and receiving another person’s story. This is a moral endeavour and also one of justice in the context of a healthcare system that is based on equality and non-discrimination.

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The Reading Room: A review of ‘The Development of Narrative Practices in Medicine c.1960-2000′

1 Apr, 15 | by cquigley

 

The Development of Narrative Practices in Medicine c.1960-2000

Jones E M, Tansey E M. (eds) (2015) Wellcome Witnesses to Contemporary Medicine, vol. 52. London: Queen Mary University of London.

 

Reviewed by Ben Chisnall, Medical Student, King’s College London, UK

 

“Narrative medicine” is a term used to refer to a number of analytical and interpretative approaches towards medical practice and interactions between patients and doctors. Its remit is broad, and encompassed within its boundaries are examinations of the personal and professional stories of doctors and patients, the sense-making processes of medical discourse, literary representations of medicine and its practitioners, and the scrutiny of medical forms of writing. Yet it remains a nebulous term, and this book – a transcript of the Wellcome Witness Seminar held at Queen Mary, University of London in June 2013 – brings together many of the individuals who have driven the development of narrative medicine studies in the UK, USA and Europe to provide insight into the scholarly currents which have shaped the field as it stands today.

The book takes the form of a discussion in which a series of narrative accounts are provided by academics and clinicians, many of whom can be regarded as protagonists of the narrative medicine movement. These narratives chart the chronological development of narrative medical studies and the reasons behind its integration into universities and medical schools. What comes across as a major concern of those involved is the desire to better hear the voice of the patient, and to incorporate the patient’s perspective into the thought processes of doctors.

The discussion begins in the 1960s and 1970s, with the introduction of humanities academics into US medical schools. The two main reasons for this, the book suggests, were the desire to provide a more balanced education for medical students, and – as Professor Kathryn Montgomery explains – to “keep [students] interested in patients as they went through the great grinder.”

What is hinted at but not answered in the discussion is whether the interest in what is now referred to as “patient-centred care” within the medical profession prompted a reaching out towards the humanities, or whether the development of narrative medicine and medical humanities departments drove the medical interest in understanding the patient’s perspective. One suspects that these explanations are both correct, and that a gradual alignment of interests between clinicians and humanities academics led to a shared interest in narrative practice in medicine.

The book also touches on larger social trends which may have driven and been driven by increasing interest in narrative medicine. The growth in popularity of celebrity illness memoirs – examples given in the text by Professor Arthur Frank include the Newsweek journalist Stewart Alsop’s column about his leukaemia, and the personal accounts of breast cancer by journalist Betty Rollin and First Lady Betty Ford – indicate a growing desire to hear the voice of a patient and their experiences and interpretations of their own disease and interactions with the medical profession. A recent and useful regular addition to the British Medical Journal entitled “What your patient is really thinking” is a good illustration of how patient voices have come to be valued and their experiences seen as enlightening both for doctors and for lay readers and listeners.

Alongside the development of narrative medicine has been the establishment of medical ethics as a field of study in its own right, which the book identifies as a parallel and reinforcing influence on narrative medicine. Literature and narrative can be used to apply ethical concepts in practical situations, and stories can provide the shift in perspective needed to understand complex ethical dilemmas. Yet as Arthur Frank highlights in the discussion, medical ethics as a discipline does not capture the element of suffering inherent in narratives of illness; this is where narrative medicine can act as an influential force on ethics.

Whilst these developments were happening in the English-speaking academy, narrative medicine in mainland Europe – as described here by Professor Jens Brockmeier from the American University of Paris – looked more towards influences from psychiatry, psychoanalysis and Freud. What emerges is the sense of the ideas behind psychoanalysis working their way into the medical academy through the growth of psychiatry as a scientific discipline during the 20th Century. So too is the study of hermeneutics, which runs through much European analytical literature, applied to the process of medical interpretation: of texts, tests and tales of patients.

The discussion in the book is far-ranging in theme and chronology, and contributions are well marshalled by Professor Brian Hurwitz in the chair. It provides valuable and thought-provoking insights into the beginnings of the narrative medicine movement, and the various and geographically diverse voices captured in the text give a heterogenous feel befitting the nature of the subject under consideration. Although narrative medicine is currently a specialised area of study, the topics under discussion in the text are accessible and applicable for those unfamiliar with the field.

Reading the book brought to mind the influence of those principles at the heart of narrative medicine on the reporting of and reactions to two scandals in the NHS which have been in the public consciousness recently – the Francis Report into the standards of care at the Mid Staffordshire NHS Trust, and the revelations of abuse at a number of NHS hospitals by Jimmy Saville in the 1960s and 1970s. Mention is made in the discussion of a “crisis of compassion” in the modern NHS, and the poor standards of care at Mid Staffs were uncovered when patient voices – many of whom were elderly, and therefore less likely to command attention – were listened to and acted upon. Similarly, the rise to prominence of the voice of patients after years of dismissal led to an investigation into Saville’s abuse. These are prime illustrations of not only the impact that narrative can have on modern healthcare, but also on how the ideas behind narrative medicine delineated in this book have become widespread and valued.

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