HU Credits: 1

Degree/Cycle: 1st degree (Bachelor)

Responsible Department: medicine - basic studies

Semester: 1st Semester

Teaching Languages: Hebrew

Campus: Ein Karem

Course/Module Coordinator: Einat Avrahami

Coordinator Email: avraein@gmail.com

Coordinator Office Hours: Monday 9:45-10:15

Teaching Staff:
Dr. Einat Avrahami

Course/Module description:
At the heart of medicine lies the ability to listen, to interpret, and to represent the patient's evolving story in medical terms. Narrative Medicine (NM), or medicine practiced with narrative skills, recognizes that the understanding and interpretation of disease cannot be separated from the understanding of the person. Therefore, the theory and practice of NM do not discard the patient's illness story once it is interpreted and can be represented by the doctor's story (e.g. the diagnosis). Rather than impose the medicalized illness story as objective and superior to the patient's illness story, physicians who practice MD call for an affiliation with, or the co-creation of, patient and doctor illness stories. This course will urge students to restore the human subject at the center by employing narrative as a consistent conceptual framework through which physicians can think of all levels of health care, including a self-reflexive interrogation of their own values and beliefs.

Course/Module aims:
The goal of the course is to answer the overwhelming challenge of understanding the patient's unique story and at the same time treating patients' diseases. Course participants will develop their sensibility to language by engaging in diverse discourses and genres. They will also learn about and experience innovative methods that integrate evidence-based medicine with the skills of active listening, close reading, narrative writing and effective conversation.

Learning outcomes - On successful completion of this module, students should be able to:
At the end of the course each student will be able to:
1) identify and discuss the rhetorical components and conditions of narrative and narration.
2) employ the skill of close reading as a basis for responding to the discourse of others.
3) write a narrative through the patient's voice and empoying his or her point of view.
4) write a self-reflexive journal.
5) conduct a narrative-based interview.
6) identify and be able to use circular questions in an interventive interview and in supervision.

Attendance requirements(%):
80 1 missed class only

Teaching arrangement and method of instruction: The course will be conducted in a flexible format, between graduate seminar and workshop. We will create a safe environment for relational learning that integrates in class writing, reading, and giving constructed feedback, thus enhancing participants' ability to practice professionalism and skilled communication. Students will engage in reflective writing,close reading, and excercises in narrative-based interview strateties in small groups of 2-4.
Each session will stem from and rely on the required theoretical and literary reading. Sessions will start with short presentations followed by a workshop in which participants are reuired to be active in discussion, in interviewing, and in writing.

Course/Module Content:
Major topics will include the rhetorical conditions and elements of narrative; re-vision(s) of disease and illness stories; disciplined and effective response to stories; caregivers’ and patients’ (re-) constructed roles as narrators; recognizing points of view as a prerequisite to empathy; healing stories; narrative-based interviews; the relational construction of testimony and beyond bioethics: narrative medical ethics.
.

Required Reading:
Required reading by the assigned order:
Launer, John. "Why Narrative?" Postgrad Med J 85 (2009): 167-188.
Shapiro, Johanna. "The Use of Narrative in the Doctor-Patient Encounter". Fam. Sys. Med 11.1: 1993. pp. 47-53.
Chambers, Tod. "Stores as Data." in The Fiction of Bioethics: cases as literary texts. New York: Routledge, 1999. pp. 1-20.
Eshet- Alkalai, Yoram. A Man Walks Home. Keter: Jerusalem, 2001 (excerpts).
Frank, Arthur.”Listening to the Ill.” in At the Will of the Body: Reflections on Illness. Boston: Houghton Miffin, 1991.pp. 123-128.
Brody, Howard."Chapter 1: Storytelling in Medicine." in Stories of Sickness. Oxford: Oxford Univ. Press, 2003. pp.5-20.
Neeman,Yael. "Barren" (AKARUT). in The Option. Keter: Jerusalem, 2013pp 7-32 (in Hebrew).

Williams, Carlos William. "The Use of Force" and "Face of Stone" in The Doctor Stories. 1932. Intro. Robert Coles. Afterword William Eric Williams. New York: New Directions, 1984. Pp 56-60, 78-87.
Remen, Rachel Naomi. Kitchen Table Wisdom. Riverhead Books: New York, 1994. selected stories.
My Grandfather's Blessings. Riverhead Books: New York, 2000. selected stories
DasGupta, Sayantani. "The Art of Medicine: On Humility." The Lancet 37: 2008, pp.981.
Shapiro,Johanna. "Narrative Medicine and Narrative Writing." Fam Med 44.5(2012): 309-11.
Coles,Robert. "Introduction: the moral education of medical students." in A Life in Medicine: a literary anthology. Eds., Robert Coles and Randy Testa. Norton: New York, 2002.
Matalon, Andre and Einat Avrahami, Eds. Doctors' Stories: Humanism in Family Medicine. Ramot - Tel-Aviv UP,2011,2012,2013 (4 stories)
Hartman, Geoffrey. "Narrative and Beyond." In Psychoanalysis and Narrative Medicine."
Eds Peter L. Rudnytsky and Rita Charon. New York: SUNY , 2008. pp 277-286.

Additional Reading Material:
Birk, Lara. "The Listening Room." In Stories of Illness and Healing: Women Write Their Bodies. Eds Sayantani Dasgupta and Marsha Hurst.Kent, Ohio,: Kent Univ. P, 35-38.
Booth, Wayne. “The Ethics of Medicine, as Revealed in Literature.” Stories Matter: The Role of Narrative in Medical Ethics. Eds. Rita Charon and Martha Montello. New York: Routledge, 2002. 10-20.
Broyard, Anatole. Intoxicated by My Illness and Other writings on Life and Death. New York: Ballantine Books, 1992.
Bruner, Jerom. Acts of Meaning. Cambridge, MA: Harvard UP, 1990
Bury, Mike. “Illness Narratives: Fact of Fiction?” Sociology of Health & Illness 3 (2001): 263-285.
Bauby, Dominique. The Diving-Bell and the Butterfly..
Charon, Rita. Narrative Medicine: Honoring the Stories of Illness. New York: Oxford University, 2006.
-- -- -- . “Reading, Writing, and Doctoring: Literature and Medicine.” The American Journal of the Medical Sciences 319.5 (2000): 285-291.
Chekhov, Anton. "Ward No. 6." 1892. In Chekhov's Doctors: A collection of Chekhov's medical tales. Jack Coulehan, Ed. Forward by Robert Coles. Kent and London: Kent State Univ. Press, 2003. 91-134.
Couser, G. Thomas. "Rhetoric and Self-Representation in Disability Memoir". in Signifying Bodies: Disability in contemporary life writing. Ann Arbor: The U of Michigan Press, 2009.
- - - . Vulnerable Subjects : Ethics and Life Writing. Ithaca and London: cornell Univ. Press, 2001.
Carver,Raymond. “Cathedral.” “Put yourself in my shoes". In Where I’m Calling From . (קיים בעברית)
Frank, Arthur. The Wounded Storyteller: Body, Illness, and Ethics. The Univ. of Chacago Press, 1995.
Gawande, Atul. Being Mortal: Medicine and what matters in the end. New York: Metropolis Books, 2014.
Hawkins, Ann Hunsaker. Reconstructing Illness: Studies in Pathography. West Lafayette, Indiana: Purdue U Press, 1993.
Halfi, Rachel. A Picture of Father and Daughter. Keshev: Tel Aviv, 2004.בעברית
Helman, Cecil G. Culture, Health and Illness. 4th Edition. London: Arnold, 2002.
Holt, Terrence E. “Narrative Medicine and Negative Capability.” Literature and Medicine 23.2 (2004): 318-333.
Hunter, Kathryn Montgomery. Doctors' Stories: The Narrative Structure of Medical Knowledge.Princeton: Princeton UP, 1991.
Kleinman, Arthur. The Illness Narratives: Suffering, Healing and the Human Condition. New York: Basic Books, 1988.
Launer, John. Narrative-based Primary Care: A Practical Guide. Abingdon: Oxon Medical Press, 2002.
Mates, Onthank Susan. "Laundry." In The Good Doctor. Iowa City: The U of Iwoa Press, 1994. Pp. 9-14.
Mitchell, David T. and Sharon L. Snyder. "Narrative Prosthesis and the Materiality of Metaphor." In Narrative Prosthesis: Disability and the Dependencies of Discourse. Ann Arbor: The U of Michigan Press, 2000. pp. 47-64.
Monro, William. “Performing Persons: A Locus of Connection for Medicine and Literature.” The Body and the Text: Comparative Essays in Literature and Medicine. Bruse Clarke and Wendell Aycock, eds. Texas Tech UP, 1990. pp. 25-40.
O’Connor, Flannery. “The Lame Shall Enter First.” In Mystery and Manners.
Raul, V. at al. "Narrating the Unspeakable: Interdisciplinary readings of Jean-
Dominique Bauby's The Diving-Bell and the Butterfly." Literature and Medicine 20.2 (2001): 183-208.
Selzer, Richard. "Tube Feeding." In The Doctor Stories. New York: Picador, 1998. pp. 108-113.
Sontag, Susan. Illness as Metaphor and AIDS and Its Metaphors. 1978, 1989. Rpt. New York: Anchor Books and Doubleday, 1990.
Williams, Carlos William. The Doctor Stories. 1932. Intro. Robert Coles. Afterword William Eric Williams. New york: New Directions,1984.

Course/Module evaluation:
End of year written/oral examination 0 %
Presentation 0 %
Participation in Tutorials 10 %
Project work 40 %
Assignments 40 %
Reports 10 %
Research project 0 %
Quizzes 0 %
Other 0 %

Additional information:
The reading materials are in English and Hebrew. Required reading materials may be also in Hebrew. Students should be responsibile for reading and/or translation of the Hebrew texts.