Literature and Medicine and Narrative Medicine: A Distinction between Terms.

摘要

The terms literature and medicine and narrative medicine are often used interchangeably to describe story-based study in medicine and medical education. In this dissertation, I explore distinctions between literature and medicine and narrative medicine and assert that a conflation of these terms is inaccurate. I discuss the legacy of the medical humanities in medical education and examine literature and medicine as a sub-specialty. I then investigate narrative medicine as an outgrowth of literature and medicine, analyzing Rita Charon's coining of the term narrative medicine and her efforts to separate narrative medicine from literature and medicine. Evaluating the popularity of narrative medicine as well as the project's potential to surpass literature and medicine, I ultimately arrive at four conclusions: First, narrative medicine seeks an alignment with clinical practice in a way that literature and medicine does not. Second, narrative medicine, in core practice, focuses on the physician-writer. Literature and medicine, on the other hand, incorporates more diverse scholarship. Third, by encouraging the clinician as occasional-writer, the culture of narrative medicine does not adequately emphasize privacy concerns. Internet and social networking sites aiming to promote informal examples of narrative medicine also provide unchecked outlets for content that may violate patient confidentiality. Literature and medicine incorporates a peer-review process that ensures academic rigor but also leads to less democratic participation. And, finally, the clinical nomenclature of narrative medicine implies that its implementation may lead to measurable outcomes in a way that literature and medicine does not.