Med-School Makeover; The new field of 'narrative medicine' is reintroducing doctors to listening.

Byline: Mary Carmichael

Dr. A. Scott Pearson's patient had a problem--two problems, actually, and only one of them seemed fixable by a surgeon. The patient, an elderly man, needed to have a tumor removed from his colon. He also didn't want to have the operation. Pearson, a surgical oncologist at Vanderbilt University, could have sent his reluctant patient home. Instead, he and his residents asked to hear the backstory. "He was the sole provider for his wife, who was an invalid," Pearson says. "He couldn't put her care in jeopardy while he got better." A team of doctors and social workers arranged temporary care for the patient's wife, and soon he lay recovering in a hospital bed.

Pearson may have exceptionally good instincts, but his technique is increasingly being taught in med schools. Known as narrative medicine, it's part of a new approach among physicians and medical educators to consider patients' personal stories as much as their test results in determining the course of treatment. Dr. Rita Charon of Columbia University, who coined the term and defined many of its tenets, says the practice has "really blossomed, sort of spontaneously." Her workshops have drawn doctors from Israel, England and Canada; more than 80 percent of med schools in the United States now offer courses with a narrative or literary bent. All of ...