Painted Nails and Personal Narratives - Thompson Writing Program

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ecome automatically activated (Abraham 4). Simply put, the individual in the story seems real because she reminds one of oneself. If this merging of the self-and-other sounds distinctly like Dr. Schafer’s definition of empathy — that of “feel[ing] yourself into the subjective experience of another” — that’s because it is; hearing about real people causes us to see them as more relevant to ourselves. Their ex - periences bring to mind our experiences, and together, identities intertwine. Thus, reading creative nonfiction allows a physician to practice relating foreign experiences to personal ones; it nurtures a habit of seeing the world through another’s eyes and encourages exactly the sort of empathy hospital wards need. The ability to empathize, however, is not the only otherwise elusive skill that creative nonfiction nurtures. Reading personal writing also teaches aspiring doctors what we all failed to learn in kindergarten: how to listen. According to Dr. J. Vannatta of the University of Oklahoma, doctors can find about eighty to eighty-five percent of the information necessary for diagnosis in patient narratives (qtd. in Smith 55). Yet the medical interview often acts as an interrogation; the doctor fires off a list of questions about cough frequency, sleep fluctuations and the intensity of a running nose on a scale from one to ten. Although such rapid-fire run-downs may diagnose common conditions, Dr. Rita Charon argues that more complicated conditions require a patient to tell his story in full. As Charon listens, she must “identify metaphors or images, tolerate ambiguity and uncertainty…identify the unspoken subtexts, and hear one story in light of others told by [the] teller” (Charon 4). The doctor must remain sensitive to nuances of the patient’s story that no check-mark list can capture. This sort of intense attention may sound superhuman, but quite frankly, it isn’t — English professors have taught it for years. The art of interpretation lies in the domain of literary scholars, but such exclusivity need not be the case. Charon argues that such “narrative knowledge” finds apt application in healthcare, for doctors exposed to the literary arts cultivate skills of careful reading that translate into skills of careful listening (10). Readers cannot interrupt an author in the midst of her essay, and a doctor cannot interject to ask if the pain was mild, moderate, or intense. Instead, the listener, like the reader, must wait, collect evidence, and un - derstand the patient’s story from the patient’s viewpoint, not her own. What does this sort of interaction look like? It’s not a specialized set of knowledge or a radically new mode of treatment—it’s a subtle kind of attention to detail that we already practice when we open a book. The difference, though, is that instead of reading an essay, we’re reading a patient. Dr. Charon tells us the story of a man who came into her office complaining of crippling abdominal cramps. Charon, however, looked beyond the textbook list of ailments. She noted the pressured way her patient spoke, saw the tension with which he gripped the examination table, and remembered his words when he said that he had endured the pain for a decade or so without once stepping into a hospital. These small signs signaled to Charon that her pa tient harbored a long-standing fear of the medical Hearing about real people causes us to see them as more relevant to ourselves. establishment—one that had compromised his health for years. With this knowledge in mind, she treated him with extra gentleness to ensure that her examination was “not an assault but an effort to help” (Charon 12). This is what listening to the patient means; by absorbing the man as a person with a past rather than as a hodgepodge of symptoms, she cared for his health—not only as it pertained to his immediate condition, but also as it related to his relationship with medicine as a whole. Careful listening, however, requires even more than picking up details and piecing 57
58 together plotlines, which again explains why creative nonfiction offers more to a physician than novels. Here too the key lies in creative nonfiction’s relationship to reality. An individual’s story is an account of subjective emotions and experiences, not a list of facts. The teller of the story lays a narrative framework over an ever-shifting collage of impressions An illness narrative, just like any narrative, cannot be objectively “True.” Those who read personal essays must sift through a complex portrayal of reality and understand the author not through just what she says, but also how she says it. and ideas; there are a thousand ways to communicate the same events, the same symptoms, and each one gives a slightly different picture. By its very nature, then, an illness narrative, just like any narrative, cannot be objectively “True.” Those who read personal essays must sift through a complex portrayal of reality and understand the author not through just what she says, but also how she says it. Reading creative nonfiction therefore uniquely equips doctors to deal with the everuncertain nature of truth in patient narratives. Both the essayist and patient present an understanding of their experiences subject to re-interpretation and revision; there is as much meaning in what they don’t mention as there is in what they do. Falsehoods and half-truths remain just as frustrating in the medical realm as they do in the literary one; a fair share of James Freys step into our hospitals. Yet the teenager who refuses to disclose his sexual history, the woman who lies about her alcohol usage, and the man who exaggerates his symptoms to get a bottle of pills can’t be dealt with as easily as A Million Little Pieces. We can’t move their narratives from the Autobiography to the Fiction section of the bookstore and be done with them, for no matter how misleading their stories, they still need care. How, then, can a doctor provide treatment when the truth of a patient’s condition remains shifting and uncertain? Reading creative nonfiction gives otherwise floundering doctors the skills to make sense of intensely layered information, for the stories both essayists and patients tell are in themselves telling, no matter the veracity of their claims. As oral historian Alessandro Portelli puts it, the “psychological truth” may indeed be just as important as the factual truth (qtd. in DasGupta 450). Take, for example, medical student Yo-El Ju, whose patient lied about his symptoms and downplayed his ailments. Tests revealed prostate cancer, but when Ju confronted her patient with the diagnosis, he stormed out of the hospital denying it. Had Ju considered the psychological implications of the patient’s deception, she might have sensed that fear of disease fueled his defensive denial and may have broken the news with more tact (Smith 56). Yet she had not practiced such nuanced interpretation, and a cancer victim left the hospital untreated. Ability to understand a patient’s story — his whole story, including what he leaves unsaid—thus carries real weight in medicine. When it comes to deciphering the meaning of an illness narrative, doctors exposed to personal essays will have an advantage over those who have read only charts and spread sheets, which are understood to be purely factual, and even over those who have read only novels, which are understood to be purely fictional. So, creative nonfiction’s inherent blending of truth and artistic liberty mirrors the nature of the patient’s story. From more honest self-reflection to more genuine compassion to more nuanced listening, those in medicine stand to gain a great deal from the study and creation of personal essays. As a pre-med English major, it’s not hard to imagine why I want to argue this point—linking writing and reading to healing
Page 1 and 2: 54 The idea behind this essay actua
Page 3: 56 might sound like psychoanalyst t
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