Tapping Into the Left Side of the Brain

Lauren Edwards, MD

It is a bit unusual to read that a young faculty member has won an award from an entity called The Stanford Medicine & the Muse Program to create a narrative medicine group for internal medicine residents. Knowing nothing about narrative medicine, we approached Lauren Edwards, MD (clinical instructor, general medical disciplines), winner of the competitive award, to learn more.

What exactly is narrative medicine?

“Narrative medicine is the idea that understanding narrative (creative writing, fiction, literature, etc.) helps us physicians better understand the narratives of our patients: their life stories and how their illness fits into the context of those stories.”

How will the group work?

“What I hope to do with this group is provide a space and time for creative writing as a way for internal medicine residents to connect to that concept of narrative medicine. As part of my grant I am also going to be looking to see if being part of this group will help to improve two parameters: one is physician empathy and the other is combatting physician burnout. These are two important concepts, especially during residency when I think both can take a hit given the intensity of training and the work hours.

“We worked with the Residency Program to find a date and time for the first workshop, and it is scheduled for August 6 at 10:30am in the VA conference room. If this time works well for the residents we will likely have more at this time and location.”

Where did the idea for the narrative medicine group come from?

“I was a Philosophy major; I’ve always had a little bit of a balance of science and creativity, doing creative writing on my own, for instance. I did my medical school at Columbia where a pioneer of narrative medicine, Dr. Rita Charon, is located. She was the first person to show me that you can continue to have that balance, that not only was it beneficial for me as a physician, but it could also be beneficial to my patients. That was a concept that stuck with me and one that I wanted to bring to my residency program in San Diego.

“When I did it in San Diego, I was surprised by how many people joined who had never done writing before. I think it’s because we’re not given very many opportunities to reflect on difficult experiences or to do that in a community with other residents. Most importantly, it was a really nice time for the residents to get to be together, to have something be as medically-themed as they wanted, but to have opportunities for reflection and camaraderie in a different way.”

Will there be homework?

“It is going to be primarily writing, although we may have short pieces that they could read during the workshops. My goal is to have it not require any preparation work because the residents’ time is so valuable. This would just be in the moment, having opportunities to write to a writing prompt with a theme in mind.

“We’re also going to bring in some outsiders – some from the broader Stanford community and some from outside of Stanford -- for workshops. Residents in the group will get the opportunity to edit their pieces throughout the year, and we will create a journal of completed pieces that we can distribute to the Department of Medicine.”

How would a given workshop go? Would residents arrive, be given a theme, and just write?

“That’s pretty close. We give a writing prompt usually, and then for about a half hour or so they write, and then people read their pieces aloud if they want, or exchange pieces, and then people give feedback. It is a little bit like a real writers’ workshop where people bring in prepared pieces that they might have circulated in advance. But this will be more of an in-the-moment kind of thing given the residents’ limited time.

“I want it to be an environment that’s not intimidating, where anyone could come and try. That’s my hope.”

How will you define success?

“For me, success would be a positive experience for the residents. I am also going to be following the measures of empathy and burnout, and a more quantitative measure of success would be if we saw some improvement in those measures. There are validated measuring tools such as questionnaires that get at these measures. But a more important successful outcome would be if this is a positive experience that residents find additive to their busy schedules.”

For residents whose interest is piqued, how may they get additional information?

“Any internal medicine resident who is interested can contact me (laurened@stanford.edu) or chief medical resident Evan Hall (ethall@stanford.edu), who is helping to facilitate the group.”