In The Nicomachean Ethics Aristotle discusses what makes a good professional. For Aristotle the difference between the ordinary and the exceptional is his balance between reason and soul: “the function of man is an activity of the soul in accordance with or implying, a rational principle” (109a8-9). Aristotle specifically distinguished a harpist from a good harpist, a comparison applicable to the medical profession. Aristotle argued that a good harpist is someone who uses his ability to play the harp, his rational principle, alongside his passion for the harp, the activity of his soul. Likewise, a good doctor is one who uses his knowledge of medicine, his rational principle, alongside his love for humanity, the activity of his soul. Dr. Rita Charon, a general internist and professor at Colombia University, agrees with Aristotle’s idea of what makes a good physician. During Dr. Charon’s residency years, she noticed there was a gap in the relationship between patient and physician. In her book Narrative Medicine: Honoring the Stories of Illness she states, “But despite such impressive technical progress, doctors often lack the human capacities to recognize the plights of their patients, to extend empathy toward those who suffer, and to join honestly and courageously with patients in their struggles…” (Charon 3). Here, Dr. Charon addresses what lacks in the world of medicine, a physician with not merely technical but emotional skills.

As a solution to this problem, in 2000 Dr. Charon pioneered a new way to practice medicine. Narrative Medicine strives to teach physicians to practice medicine “with the narrative competence to recognize, interpret, and be moved to action by the predicaments of others” (Charon). In other words, Dr. Charon plans to create meaningful relationships between patients and physicians by training doctors to acknowledge the connection of body and soul. Dr. Charon aims to teach physicians that through the patient’s story they can better understand the patient which leads to a holistic diagnosis. Narrative medicine, also, “provide(s) health care professionals with practical wisdom in comprehending what … they themselves undergo in the care of the sick” (Charon vii). As part of narrative medicine, doctors write fictional stories about their patients, a practice known as the Parallel Chart (Charon 156). The goal of the Parallel Chart is to remind doctors that patients are fellow humans with emotions. At the same time, the Parallel Chart addresses the powerful impact patients have on doctors. With its holistic approach and emphasis in stories, narrative medicine is the bridge between medicine and humanities.

One of the issues in medicine is the lack of trust between a physician and a patient. Aristotle argues truth is one of the practical social virtues, which humans must practice (1108a9-14). From the social virtue of truth stems trust, trust that a patient will not hide information as well as trust that the doctor will give a straightforward diagnosis and prognosis. Narrative medicine upholds such virtue by creating a foundation for a truthful relationship between patient and doctor. For instance, Dr. Charon speaks of one of her patients, a young woman named Luz who briefly asked her for a disability form. Dr. Charon, having only treated Luz for headaches and unaware of what was going on in this woman’s life, resentfully gave Luz the disability form. This incident lingered on in Dr. Charon’s mind, and as a way of practicing narrative medicine, she wrote a fictional story about the reason for Luz’s request (Charon 5). In writing this story, Dr. Charon explains, “this narrative act helped me to get closer to the patient. My writing exercise invested me in learning of her true plight instead of blaming her or suspecting her of malingering” (Charon 6). In this instance, writing a fictional narrative forced Dr. Charon to consider the doctor-patient interaction from the patient’s perspective, and to realize that she had too readily dismissed Luz as a woman with a headache rather than engaging with her as a woman in need of help. Narrative medicine urged Dr. Charon to treat Luz in a holistic fashion by stimulating Dr. Charon to see Luz as more than a patient.

Once Dr. Charon began to write her fictional story about Luz, she realized that the only information she had to go on was the symptoms but not the reason behind Luz’s sudden need for a disability form. And so, when Dr. Charon next saw Luz, she inquired about her urgency in obtaining a disability form (Charon 6). Luz informed Dr. Charon that she was being sexually abused by her father, and at the age of 21 wanted to move away from home with her younger siblings to protect them but needed the disability form to make the move happen (Charon 6). Dr. Charon also mentions that after listening to Luz’s story, she spoke with a social worker and was able to get Luz and her siblings into an emergency shelter (Charon 5). After giving Luz the disability form, Dr. Charon had the option to forget about Luz, but, having written a fictional account, she felt driven to extend her hand not only as a physician but also as a support system. Dr. Charon uses narrative medicine to create a relationship built on trust. Luz trusted Dr. Charon to help her physically and emotionally while Dr. Charon trusted Luz enough to understand what Luz was struggling with.

One thing physicians tend to forget is that the actions in life can lead to symptoms that seem mild to the body but are detrimental to the soul. Luz’s story is an example of these patients; her headache was a mild reaction her body was having to the emotional toil her soul was going through. As philosopher Epicurus once stated in his Letter to Herodotus, the body and the soul are intertwined, one cannot carry on without the other (39). To Epicurus the soul is what experiences life through the five senses. When the soul is in the distress the body is in torment. Doctors validate this notion with narrative medicine by emphasizing to the patient that their life story matters to the health of their body. By doctors asking their patients’ stories, they build a relationship with the patient in such a way that each individual’s soul grows. A physician leaves an appointment a better man by treating the soul of the patient by listening to the patient’s story. In his treatise An Enquiry Concerning the Principles of Morals, Hume argues “humanity of one man is the humanity of everyone, and the same object touches the passion in all human creatures” (105). In other words, the humanity of the patient is that of the physician. By healing the soul and body of the patient, the physician simultaneously nurtures his own soul and body. Lastly, both parties are being touched by the equal passion of bettering the patient.

On the patient side of things, narrative medicine helps patients come to terms with their diagnosis, pain, and potential death. During a Ted Talk in Atlanta, Dr. Charon discussed a patient who had a hard time coming to terms with her diagnosis of breast cancer. Dr. Charon explains that after the patient underwent a mastectomy, she came to her office every other week with symptoms of a new lump and pain (Charon). Each time, Dr. Charon ran exams and came to the same conclusion that the patient was fine. One day, Dr. Charon explained to the patient that it was obvious she was afraid of death. By saying those words out loud, “we could accept [the glare of death] and—more than that—we made contact through it” (Charon). It is moments like this where the miracle of medicine intertwines with the simplicity of the humanities.

Moreover, through this shared moment, Dr. Charon and her patient came to “understand what medicine is for [and] what ordinary living is for” (Charon). In other words, through the combination of medicine and humanity, both women learned the purpose of living is to live through the pain in order to find ataraxia (absence of mental distress) and aponia (absence of physical pain). Both terms stem from Epicurus’ idea, discussed in Letter to Menoeceus, that pleasure is the “absence of pain in the body and of trouble in the soul” (44-45). According to Epicurus, the soul is the sensation of life and the soul and body are one; when the body dies so does the soul and the sense of life (38). For this reason, the goal of life is to not dwell on the pain and to live life through a serene soul.

It is human nature to interpret pain as bad, not realizing that some pains are needed to grow. In Letter to Menoeceus Epicurus points out this paradox: “by submitting to the pains for a long time, a greater pleasure results… not all pain is to be shunned” (44). In the case of Dr. Charon’s patient with breast cancer, when the patient shunned the pain of cancer she condemned herself to a limited life of suffering. However, the pain that she endured during the exams, and later the mastectomy, followed by her agony of fear of death led ultimately to a greater pleasure—her acceptance of her new life with breast cancer. This woman was able to reach such pleasure due to narrative medicine’s ability to see past the medicine and accept that the soul needs as much healing as the body. In the case of Luz, although her physical pain was less than that of someone with cancer, her internal pain was equally troubling. When Dr. Charon used narrative medicine she aided Luz in coming to terms with her suffering. When Luz was able to accept that her headaches were not solely in relation to her body, but it was more about the distress of her soul, Luz found ataraxia. In the case of the woman with cancer and Luz, both women were able to move forward in life once they embraced their physical and emotional pain.

Despite the fact that incorporating humanities with medicine is beneficial to patients and doctors, there are certain ideas that threaten the growth of narrative medicine. In the article “Mind-Body Dualism: A Critique from a Health Perspective”, Dr. Neeta Mehta argues, “Mind-body dualism is an example of a metaphysical stance that was once much needed to unshackle science and medicine from dogma, but which later had far reaching restrictive influence on the field of medicine” (Mehta). Dualism is a term coined by philosopher Descartes that states the mind and the body are two distinct things (Mehta). This notion still resides today and as Dr. Mehta points out, it threatens a fundamental view of narrative medicine. The view that the soul and body are indistinguishable, for “Not only is the body the exterior of the self—the shell for the kernel of the self—but the body is also the interior of the self, the dark and noisy beating of the heart…” (Charon 76). The idea of dualism blocks doctors from reaching their full potential as healers of the mind and body. When a doctor focuses on a patient as only a damaged organ, a faulty heart for example, they lack to understand the reason for that aching heart. Yet, when the doctor puts behind dualism, and uses narrative medicine, they see the physical symptoms of the damaged heart and the symptoms of a damaged soul which leads to a complete understanding of the illness.

Being a doctor is one of the hardest and yet most rewarding professions. It is a difficult profession due to the overwhelming years of training and the emotional implications of taking care of the ill. Still, being a physician is rewarding because doctors get the satisfaction of helping people. By practicing medicine, doctors practice benevolence, which according to Hume, is of the highest social virtues (98). As Hume stated in Of the Standard of Taste, critics “must place themselves in the same situation as the audience in order to form a true judgement” (89). Through narrative medicine, the physician, the critic of medicine, does in fact put themselves in the position of the patient. Hence, the doctor’s deep investment in finding a holistic treatment for the patient. The holistic treatment is grounded by the union of soul and body and the acceptance of pain intertwined with medical knowledge. All things considered, “With the narrative tools of description and diction and metaphor, we can represent—and therefore recognize and admire—singular individuals in contextualized situations…” (Charon 236). In other words, narrative medicine supplies an analytical tool with which doctors can establish a holistic view of the patient. Narrative medicine also enables physicians to create a personalized treatment for the patient since not everyone’s physical and mental distress will be the same. Since narrative medicine pairs the medical techniques with the fundamental ideas of humanity, this branch of medicine is the crossover between science and humanity.

Works Cited