Narrative Medicine in Palliative Care
“Palliative care is not hospice. It’s about living your best life despite having an illness.”
- Dr. Rachel Ombres, Palliative Care Physician & Geriatric Medicine Specialist
What does it mean to have a so-called ‘good’ death?
How can one’s death be considered good when mortality brings bereavement, hopelessness, and emotional pain?
There is much speculation around this, as not every person reaching their demise will be satisfied with the life they lived, and may fall into pits of despair. However, despite these perceptions we have of ourselves, we all have a story to tell, a life to reflect on, and opportunities to maintain communal connections to preserve what we already have. Rather than viewing the end of life as a dark void, we can shift our mindsets to remind ourselves that our life trajectories have shaped who we are in incredulous ways.
A ‘good’ death, one where the sufferer is satisfied with all life has to offer and is able to come to terms with the reality of their passing, is facilitated by narrative medicine. Recall that narrative medicine is “a practice informed by the theory of practice of reading, writing, telling and receiving stories” (Charon, 2006, p.4, as cited in Stanley & Hurst, 2011).
Its multidisciplinary approach “promotes health and medical care that values witnessing and that invites one to be moved by stories of illness” (Stanley & Hurst, 2011). In other words, narrative medicine is a holistic, humanistic way to avoid equating the patient to their diagnosis.
Read this quick personal piece on how a student found meaning in his father’s experiences and stories, enabling healthcare workers to better treat his illness.
In the context of palliative care, we do not view the patient as ‘dying’ but rather thriving through the telling of personal accounts to gauge a deeper interpersonal understanding of their unique experiences that have ultimately shaped who they are. Communication is crucial because there are exceptionally challenging ways in which the elderly and the dying are misconstrued and overlooked.
The healthcare field nowadays tends to be strained with severe job burnout, ultimately leading caregivers and other healthcare workers to behave nonchalantly toward their patients. It does not come from a place of hostility or disdain, but rather from a place of anxiety and fearfulness when coming face-to-face with mortality. Although there is an instinctual drive to employ denial as a defense mechanism against the notion of death, narrative medicine allows caregivers to exercise empathy and compassion (Stanley & Hurst, 2011). Clinicians develop a new lens and outlook on life, cherishing it through the patient’s rich stories. It is not to sugarcoat the situation but to be made personally and socially aware of one’s suffering, considering what course of action is appropriate to make the patient as comfortable as possible. The patient, consequently, feels heard serving as a reminder that their voice will not be silenced even when it seems hope is lost.
There is still a long way to go before narrative medicine fully ingrains itself into all aspects of healthcare, but educating clinicians and other staff on its benefits ultimately puts healthcare on a path to inclusivity and interdependency.
By Saray Membreno (She/Her) | Marketing Committee Member
