What can we learn from this book? If you’re seeing a primary doctor for the first time, and they don’t let you tell your story about what’s wrong, find a new doctor. The patient-doctor connection needs to be a relationship, not a transaction.
In her preface, Dr. Rita Charon lays out what her book, Narrative Medicine: Honoring the Stories of Illness (2006), is about: “narrative medicine [is] defined as medicine practiced with the narrative competence to recognize, absorb, interpret, and be moved by the stories of illness.” She goes on to say that it provides “health care professionals with practical wisdom in comprehending what patients endure in illness and what they themselves undergo in the care of the sick.”
That’s narrative medicine in a nutshell by the person who founded the subgenre. Well, two nutshells. Know and care how your patients are feeling, and be aware of how you are coping with the ongoing stress and the emotional impact of being unable to save everyone who has cancer.
To know how patients are feeling “requires that doctors enter the worlds of their patients … [and] see … from the patients’ point of view.” In other words, doctors have to listen to their patients’ stories, not just the facts of their symptoms. Patients don’t know what specific facts or symptoms their doctors are looking for, but sharing their stories conveys this information, as well as other problems the doctor doesn’t know about.
The process begins by taking a narrative life history so that doctors, nurses, and therapists hear patients tell their stories of suffering. Rita asks new patients to say why they have come to see her. Then she listens without interrupting, and without writing anything down, because she wants to get a sense of who this person is outside of the illness. Dr. George Beauregard noted in his book on his son’s colon cancer that a study showed doctors waited an average of 11 seconds before interrupting patients. Rita doesn’t want this to happen and waits until her patients have finished talking before she asks any questions.
In her practice as a doctor, she also shows her patients what she writes about them, and encourages them to write about what they are experiencing during their treatments as a way of helping both of them understand each other.
In the first section of the book, Rita says that although there have been impressive developments in medical technology and treatment options, “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 toward recovery, with chronic illness, or in facing death.” She adds “nurses and social workers have mastered these skills more fully than have physicians….”
Part of the cause of physician distancing has been that personal mentorship in medical schools and the empathetic care of patients have “been eroded by “time and money pressures.”
She notes that patients telling their stories of illness is therapeutic for them because once they are shared, their “suffering is lessened.” Stories also help patients in their search for meaning in the face of the trauma they are enduring.
Rita says: “What masseuses and acupuncturists and holistic healers provide that doctors do not is attention and regard, and their lack of scientific rigor is overlooked for the dividends of their caring.”
These insights are from Part One of her book. In the rest of her book, she discusses narratives of illness, developing narrative competence, and the dividends of narrative medicine, including bioethics and a vision for health care. I will share more in future posts.
Related reading – Dr. Laura Vater on my June 13 post.
© 2026 Mark Liebenow
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