Building Connection, Community and Resilience Through Writing and Reflection

It is 5:15 p.m. on a Monday evening and instead of heading home after a day in clinic and meetings, I make my way to a small room in the hospital’s Main Building. It is that special Monday … when we meet for a monthly narrative medicine session. I am eager to see those who come regularly and those who drop in sometimes, colleagues whom I did not know before but now count as friends at work. They are social workers, chaplains, researchers, physicians, fellows, and residents and even physicians from HUP.

An hour passes by as we read a poem, discuss its many meanings, quietly write for a few minutes and share our stories—about our patients, our work and life, our families, ourselves. We listen to mainly understand without the need to respond. Sometimes we know the patients and families that others write about and we see them anew. At other times, unknowingly, our writings are about the exact same sentiment on a prompt that can go a million ways.

As I leave the room at 6:30 p.m., there is a feeling of repose. Some words from the evening stay with me as I drive home. I am surprised by what I wrote and often wonder why that is, as do other participants. Words from a poem or from the discussion bring it out something hidden in the deep recesses of my mind. A patient or event I thought I had forgotten comes alive in the writing when there is a space for reflection. I reflect more on my reflection!

The glow of that evening stays with me for several days. A week later I see one of my friends from the group on the unit and we hug. Our connection is deep and different due to what we share on those Monday evenings. I don’t meet most members except on those evenings; our paths do not cross at work. Yet I feel I know them better than colleagues I see every day. I have heard some poignant and eloquent tales. The space is safe and welcoming. Reflection and sharing needs that safe setting.

It has been 6 years since this group was started after I attended a Narrative Medicine workshop at Columbia University. Rita Charon, an internist and literary scholar at Columbia University, has pioneered Narrative Medicine. She describes it as “an interdisciplinary field that brings powerful narrative skills of radical listening and creativity from the humanities and the arts to address the needs of all who seek and deliver healthcare. Narrative medicine enables patients and caregivers to voice their experience, to be heard, to be recognized, and to be valued, improving the delivery of healthcare.” Columbia University has a well-known Program in Narrative Medicine with a Masters in Science in Narrative Medicine and a Certification of Professional Achievement in Narrative Medicine. Several institutions have similar programs that bring the humanities into medicine.

What is central to all these efforts is the importance of stories in medicine. As healthcare professionals, we listen to stories every day; we tell those stories to others every day. How we hear, understand, interpret, and relate to those stories determines how effective we are in our work. Some stories are forgotten or rather stored somewhere deep in our minds until we sit down to reflect and write about them. The act of reflection and writing quietly even for 5 minutes evokes memories and emotions of which we are often unaware. The act of sharing those memories and feelings builds a connection with colleagues and helps us find meaning in our work and decrease burn out.

Anywhere from 5 to 15 of us have met once a month for more than five years and built deep connections with each other. We start with a poem or a short excerpt from a book or article and discuss it briefly. We then write for about 7 minutes on a prompt related to what we have read. Some volunteer to share their writing. The emphasis is on voicing our experience and feelings. What surprises me every time is where the prompt takes each person. The prompt is deliberately general and open to interpretation. Through our writing we explore our connection to our work, patients, colleagues, and also to our families and friends.

To mark the group’s 5-year anniversary, some regular participants shared what they value about the group. Here’s what they shared:

Sheila Quinn, DO, Adolescent Medicine

When I first got to CHOP and Penn, I was overwhelmed by the size. What I love most about the Narrative Medicine group at CHOP is that is shrinks down this massive institution for me—it brings together a group of like-minded people who want to read and write something outside of the scientific literature and medical records in which we are all immersed constantly. It's enlightening to realize that people in all different roles throughout the health system are hearing and processing and making sense of stories all day long—stories of our patients, their families, and of ourselves and colleagues. I also love how it levels the ground in a field that tends be quite hierarchical. I feel really lucky to have this community.- Sheila Quinn, DO

Wynne Morrison, MD, MBE, Critical Care and Palliative Care

I was an English literature major, so I always knew I wanted to somehow have the humanities continue to be a part of my life. The narrative medicine group was therefore a perfect fit for me, and I have been thrilled to find a group of like-minded individuals who find that writing can help them preserve what matters most to us in patient care, whether that is the awareness of the patient as an individual or the acknowledgement that we can also be affected by what we witness. Our group also reminds me of the countless untold stories—of our patients, their families, or our colleagues—that are around us every day. Everyone brings a real piece of themselves to the group. I believe sharing our narratives helps us grow and sustain ourselves from these experiences, rather than wearing down. -Wynne Morrison, MD, MBE