The Narrative Bridge: Connecting through the Health Humanities

Monday's Agenda

Monday, February 24, 2014

7:15-8:00am

Breakfast
Stono Ballroom

8:00-8:45am

Concurrent Sessions

The Anatomy of Bearing Witness: Surgical Culture, Visual Humility, and Narrative
Stono Ballroom

What does it mean to look at the body of another when it’s at its most vulnerable? This highly interactive workshop will consider the experience of those who bear witness as health care providers, students, and care-takers to the illness and body narrative, particularly in the context of the anatomy lab and the operating room. How do we respond to and process what we see when we see someone at their most ill, their most fragile, or their most (literally) open? How do we internalize it all in our own, individual narrative context? And most of all, what can we do to create greater awareness and care surrounding the experience of honoring the surgical experience of those to whom we are responsible above all: the patient? We will use the Narrative Medicine framework of reflective writing to help re-frame and re-consider the importance of humanity and humility in the operating room setting, remembering above all that we must acknowledge our own fraught emotions in order to honor the intimate spaces we enter.

Lauren Mitchell, MS, Columbia University Program in Narrative Medicine
Family Planning Co-Coordinator, NYU School of Medicine
Founder/Coordinator, The Doula Project

Caregivers are Heroes
Ansonborough

Caregivers are Heroes is an interprofessional experiential learning activity designed to enhance caring and compassionate attitudes towards caregivers in first-year occupational therapy, physical therapy, and physician assistant students. For the past five years, 180+ students/year have engaged in learning about the trials and tribulations of caregivers. The students are assigned to interprofessional teams and are prepared for an in-home caregiver interview through a series of four interactive large group sessions followed up by individual team meetings. At the conclusion of the semester, the interprofessional student teams creatively share their experiences through music, art, poetry, drama, etc. to present the humane perspective of the caregiver.

Paul F. Jacques, DHSc, PA-C
Holly H. Wise, PT, PhD
Nancy E. Carson, PhD, OTR/L
Maralynne D. Mitcham, PhD, OTR/L, FAOTA
College of Health Professions
Medical University of South Carolina

Spirituality and Healing: Faith Narratives from the Cancer Wellness Center of Buffalo
Harleston

For 10 years, a professor in the department of philosophy and religion and a colleague from the College of Nursing have taught an undergraduate course entitled "Spirituality and Healing," facilitating monthly sessions through the Cancer Wellness Center of Buffalo, New York. In this session, these teachers will focus on the various ways individuals in this course expressed the importance and meaning of spirituality in their struggles with cancer. Themes explored will include issues related to the power of mind and attitude, the importance of faith, and the various ways individuals experience a sense of a higher power in their lives.

Charles Sabatino, PhD
Professor in the Department of Philosophy and Religion
Daemen College

Cheryl L. Nosek RN, DNS, CNE
Associate Professor
Director, Undergraduate Nursing Programs
Daemen College

Memoir and Health: Reviving Worth in Seniors through Poetry Workshops
Wraggsborough

As a full-time English faculty member at a small liberal arts college, I was approached a few years ago about offering a community outreach course in poetry appreciation at a local assisted living retirement community. In five weekly sessions with six participants who were wise and on top of their game, the class focused on reading poetry and writing bits of memoir through short poems. On the last day of class, Dorothy, one of the participants, said, “I’ve worked out my life now.” I continue my work in nursing homes and retirement communities, offering similar workshops that focus on getting seniors to remember important moments and articulate the impressions and images associated with these memories. In this session, I will discuss the overall structure of these courses, giving examples of poems used and letting participants do a couple quick creative writing exercises. I will demonstrate how seniors have thousands of stories to tell—not just with their eyes, but with their pens.

Ethan Joella, PhD
Comenius Center Faculty
Moravian College

9:00-9:45am

Concurrent Sessions

Drawing (on) Life Experience: Reading and Creating Comics as a Reflective Practice in Medical Education
Ansonborough

In the fall of 2012, the University of Toronto Faculty of Medicine launched an illustrator-in-residence program to complement its existing medical humanities elective options for undergraduate medical students. One of the first initiatives of the program has been a seminar series, “Drawing (on) Life Experience,” designed to introduce participants to the use of visual narrative as a tool for observation, reflection, and communication. Specifically, the seminar focuses on “graphic medicine”—that is, the study and creation of comics within the domains of illness, healthcare, and medical education. The course moves from thinking about how comics make meaning through structure, style, and word/image combination, to a consideration of how these specific visual narrative modes inflect stories of illness and healthcare and capture the complex, multiple layers of seemingly straightforward situations. At each stage, participants analyze and discuss examples of the form, do hands-on exercises to practice applying these visual narrative strategies to moments in their own lives, and discuss their experiences with their peers. In this 45-minute session, I will briefly describe the D(o)LE curriculum and the rationale behind its design, and describe outcomes from the first three iterations of the course; after that, I will lead participants through a sample exercise in visual narrative.

Shelley Wall, PhD
Assistant Professor, Biomedical Communications graduate program (BMC)
Institute of Medical Science, Faculty of Medicine, University of Toronto
Department of Biology, University of Toronto Mississauga

The Story Circle: Narrative as Therapy
Harleston

Narrative inquiry provides a unique method of coping with and making meaning of illness. This type of inquiry can help providers better understand the lived experiences of patients by allowing patients to become storytellers. Storytelling in a “cancer circle,” for example, is a creative method of healing for someone faced with a chronic and sometimes terminal journey like breast cancer. In this session, we’ll practice this form of narrative therapy by exploring the facilitator’s past experiences with “cancer circles” and having participants create a “sharing circle” to learn the method.

Patricia K. Amado, RN, MS(ed), CNS, PhD (abd)
Delta Epsilon Iota (DEI)
Sigma Theta Tau International (STTI)
National League of Nursing (NLN)
University of Miami

‘I Think I Mattered to Him’: A Longitudinal Study of Patient Narratives and Professional Development for PT and PA Students
Wraggsborough

This project explores the potential role of writing patient narratives and developing a more humanistic relationship with patients. By capturing patient narratives at various stages of their curricular path, and having graduate students get accustomed to making the rhetorical shift from writing case reports to personal, reflective narratives, we will code and track language and perspective on patient interaction as it changes with advancing clinical experience. In this initial phase, we have collected reflective patient narratives from a class of beginning PT students prior to any programmatic clinical experience. In the next term, we will do the same with an entering class of PA students and will then track both groups regularly over the next 2 years, asking them to do increasingly more introspective and detailed narratives that probe the very nature of patient/provider relationships. Our analysis will attempt to discover any potential connection between such ongoing reflective narrative practice and an enhanced humanistic perspective on patient care.

Michael Strickland
Professional Writing and Rhetoric (PWR)
Department of English and Department of Environmental Studies
Elon University

10:00-10:45am

Featured Workshop
Stono Ballroom

The Stories We Carry: Witnessing Self and Other in Health Care

Sayantani DasGupta, MD, MPH
Assistant Clinical Professor
Department of Pediatrics
Faculty Member, Program in Narrative Medicine
Columbia University

10:45-11:15am

Break/Book Sale
Stono Ballroom

11:15-11:45am

Outburst Sessions

Body Movement as Discovery: Do a Verb!
Ansonborough

In The Creative Habit: Learn it and Use it for Life, choreographer Twyla Tharp describes one of her favorite exercises: Do a Verb. Tharp argues that this technique can help everyone (not just dancers) "achieve a creative momentum that's hard to stop" (Tharp, 2003). Deploying Tharp's technique, as well as additional creative-thinking research about the importance of play, this twenty-minute session aims to stimulate divergent thinking in medical professionals and those in the health humanities. In this workshop, participants will "do a verb," specifically those verbs that describe key actions of our work lives; with exaggerated actions, we will demonstrate how these practices play out. For example, what does "listening" look like? How can one represent "multi-tasking" without words? Participants will take turns acting out verbs and identifying what actions others are demonstrating. This playful practice will allow us to envision fresh approaches to those challenges facing us in our work lives and in our institutions. Fun and laughter guaranteed.

Deborah Murray
Director, Writing Center
English Department
Kansas State University

Postcards from Here and Now
Harleston

Postcards are condensed packets of words, sometimes with art, that communicate rather like a poem. I’ll provide the postcards. You jot the message. It could be a note to a patient, colleague, employer, journalist or family member—even yourself—inspired by a clinical encounter or conundrum. It could arise from a health crisis of your own. Is there someone you want to tell about it? someone you’re grateful for? someone you’re vexed with? Dash off a line or two to them. Maybe you’ll feel like sharing it, maybe not. Maybe it will shine a light where you least expect it. Come and find out.

Veneta Masson, MA, RN
Sage Femme Press
Washington, DC

12:00-1:30pm

Lunch and Keynote Address
Stono Ballroom

Whose Story Is It? Narrative Humility and Social Justice in Health Care

Sayantani DasGupta, MD, MPH
Assistant Clinical Professor
Department of Pediatrics
Faculty Member, Program in Narrative Medicine
Columbia University


1:30-2:00pm

Break/Book Sale
Stono Ballroom

2:00-2:45pm

Concurrent Sessions

Turning toward Suffering Using Narrative and Contemplative Skills
Stono Ballroom

Despite the inevitability of illness and death or pain and suffering, we often find it difficult to deal openly with these experiences. Whether facing human suffering as presented in a literary text, a patient in a hospital bed, or in a family member or loved one, we long for ways to honor and respond meaningfully without shutting down, turning away, or feeling inadequate. This session, led by a clinician and a health humanities educator, will provide participants with narrative and contemplative skills that foster new capacities of heart and mind for facing the challenges posed by actual encounters with suffering and dying individuals. To that end, participants will analyze the narrative dimensions of suffering and the dying process in excerpts from literary and filmic texts. This will be followed by instruction in several mindfulness practices. Such practices have been shown to reduce stress in caregivers and provide them with a greater ability to accompany those who are suffering. This unique and practical combination of narrative analysis and contemplative care techniques offers valuable opportunities to bridge the gap between those who suffer and those who encounter that suffering.

Joanie Webster, MD
Spiritual Care, Hospice Medina County
Adjunct Assistant Professor
Department of Family and Community Medicine
Northeast Ohio Medical University

Michael Blackie, PhD
Associate Professor of Biomedical Humanities
Co-Director, Center for Literature and Medicine
Hiram College

Finding Death and Life among the Monitors: Families’ and Learners’ Journeys
Ansonborough

The heart in ICU may be monitored as life begins to close, and loud alarms may mark impending transitions. Sometimes such care negates the power of emotional life, which it stigmatizes, pathologizes, even demonizes, sometimes without any intent to do so. The nurse and the physician may learn that some angles of professionalism dispense with caring and fence off one’s heart from the vicarious truths of pain, loss and transcendence. When professionalism serves as armor, families suffer, the person with illness suffers, and the caregiver suffers. What can oncologists and hospice physicians tell us about emotions and care at end of life? How do resident physicians find a place from which to care and advocate for families in ICU confines? What stories emerge when dying care is part of narrative listening and evocation for all involved? How do nursing students claim and reclaim the self as part of professional life? An ICU nurse-professor and mentor, a geriatrician/palliative care physician directing an extended care facility, and a health-psychologist with interest in medical humanities will bring forth anecdotes, images, writing exercises, and symbols to illuminate humanities and humanism in the life and death zones of health-care. All will draw from the words and experiences of learners and caregivers, in both nursing and medicine.

Mark Marnocha, PhD, MSN
Clinical Psychologist and Associate Professor (CHS)
Department of Family Medicine
University of Wisconsin School of Medicine & Public Health
Fox Valley Residency Program

Suzanne Marnocha, PhD, RN, MSN, CCRN
Professor, Assistant Dean and Prelicensure Director
University of Wisconsin
Oshkosh College of Nursing

Deb Schultz, MD, Geriatric and Palliative Care Boarded
Associate Professor (CHS), Department of Family Medicine
University of Wisconsin School of Medicine & Public Health
Fox Valley Residency Program
Medical Director, Brewster Village Care Facility
Medical Director, Calumet County Hospice

Pharmacokinetics of Humanities in the Medical School Curriculum: The Art of Selection, Timing, and Effective Delivery
Harleston

Humanities can be crucial to the enhancement of both empathic capacity and clinical acumen--if effectively delivered. This workshop will address strategies to enhance the impact of humanities delivery via attention to the selection of materials, modalities of presentation, and consideration of session length to achieve meaningful experience. Linkage of curricular goals to specific materials will be considered, and examples of the use of diverse materials will be presented and discussed. Goal-setting, format choices, and student engagement will be stressed. Participants will have the opportunity to select materials to match their interests, outline their goals for a session, and then present a brief humanities module for subsequent critique. Strategies to exploit brief and/or ad hoc opportunities will be stressed.

Stephen Sandroni, MD, FACP
Professor of Medicine and College Master
Paul L. Foster School of Medicine

Full-Spectrum Doula Support and Narrative Medicine
Wraggsborough

Gradually becoming more of a recognizable role, doulas--people who provide non-judgmental, non-medical support--are becoming more well known for their work on the fringes of medical care by adopting the emotional, physical and informational well-being of the patient as their singular purpose, most often during birth or death. The Doula Project in New York City is the first organization of its kind to normalize doula support throughout the spectrum of pregnancy, whether the outcome is birth, adoption, abortion, or stillbirth, miscarriage, or perinatal loss. We are currently working with providers in three different clinics in New York City, and have collectively worked with over 15,000 clients. In this workshop, two members of The Doula Project's leadership circle will discuss how narrative practice has influenced our trainings for activists and medical students in order to create context for new experiences and to increase awareness and empathy, as well as a means of supporting self-care in the face of emotionally draining work. Likewise, we will be able to answer questions about what it means to build or connect with an organization that uses our model of patient care and support. This workshop will provide specific examples of what we have used in the past, and what we are excited to try in the future in the name of increased awareness and community building in-or-on-the-sides-of medicine.

Lauren Mitchell, MS
Program in Narrative Medicine, Columbia University
Family Planning Co-Coordinator, NYU School of Medicine
Founder/Coordinator, The Doula Project

Annie Robinson, MS Candidate
Program in Narrative Medicine
Columbia University
Leadership Circle Member, The Doula Project


3:00-3:45pm

Concurrent Sessions

Using Reflective Writing to Cope with Post-Traumatic Stress Disorder (PTSD)
Stono Ballroom

Reflective Writing sits at the intersection of Narrative Medicine and Arts in Medicine, which both employ written reflection in educational and therapeutic settings—writing as healing for caregivers and sufferers alike. In this session, we will examine ways that the practice of reflective writing, to cope with PTSD, can be made more widely available to the community through outreach programs or other means. The year 2014 marks the centennial of the beginning of one of mankind’s most grievously destructive conflicts: World War One. The then-fledgling psychiatric community in Britain struggled to treat 80,000 soldiers suffering from the bewildering condition “shell shock.” Dr. W.H.R. Rivers, celebrated since in poetry and fiction, wrote of his patients’ suffering in 1917 that “the greatest relief is afforded by the mere communication of these troubles to another.” Rivers understood intuitively the cathartic benefits of sharing stories: a phenomenon which has shown, a century later, demonstrable physiological and psychological benefits in clinical trials. Today, PTSD still affects our soldiers, as well as victims of violence, terrorism, and natural disasters; emergency first-responders; abused children and spouses; and often physicians, too. With the awareness that so many can be affected, how can we bring the techniques of reflective writing to more people seeking to cope with PTSD’s debilitating effects?

Sandy Weems, PhD Candidate & Adjunct Lecturer
Department of English
University of Florida

Breaking Bread and Bashing Silos: How The Patient Experience Bookclub Enhances Engagement at an Academic Medical Center
Ansonborough

NYU Langone Medical Center’s A Novel Idea: The Patient Experience Bookclub was founded by a physician and staff from the patient experience office on one simple premise: the key to satisfied patients is engaged staff. For the past two years, we have led a truly interdisciplinary book club on campus, open to all members of the NYULMC community. In this session we will share how we created a “sense of urgency” among senior leadership to support our bookclub; impart some key lessons learned to keep our bookclub innovative and real – simple tips like how to choose the right book, who to ask to facilitate, the best time to meet and how best to advertise; report how we define and measure success; show how the bookclub has impacted faculty and staff by breaking down silos and improving engagement, and lead a highly interactive session where we explore the meaning of a Philip Roth excerpt.

Katherine Hochman, MD, FHM
Associate Chair, Quality
Director, NYU Langone Medical Center

Jacquelyn Dorsky, BS
Improvement Specialist
NYU Langone Medical Center

Reading and Writing about Illness and Care: A Narrative Medicine Workshop
Harleston

Why should students and providers of healthcare study literature? What do the practices of close reading and reflective writing offer those who care for the sick or who have experience with illness? Through a rigorous study of texts and theories from the humanities, narrative medicine equips us to recognize, interpret, and be moved by stories of illness. In this workshop, two current students in Columbia University’s Narrative Medicine Program will guide participants in close-reading a short text, followed by a reflective writing exercise, focused on themes of humility, caregiving, and illness. By the end of the workshop, participants will gain experience attending to the stories of others; generating personal narratives; and building empathy. These exercises will ultimately allow participants to better connect with patients and caregivers and to recognize healthcare as a collaborative enterprise founded on shared vulnerability.

Rebecca Tsevat, MS candidate
Program in Narrative Medicine
Columbia University

Helen Harley, MS candidate
Program in Narrative Medicine
Columbia University

Service Narratives of the Charleston Community: A Panel Presentation & Discussion
Wraggsborough

Teaching Diversity through Service Learning: The Charleston Community
While narrative medicine has largely been seen in terms of Rita Charon’s model—a tool intended to foster “intersubjectivity” between doctors, health care workers, and patients, this paper argues that using this model with first-year college students and community members allows for many of the same results. Our course, “Healing Narratives: Understanding Illness through Storytelling,” brings together an English and a Psychology class through a service learning project. While we will discuss the English and Psychology classes, our main focus will be on the results of our project, now in its fifth year. We argue that, when first-year students hear stories of illness from hospice patients, senior housing residents, and other community members, they realize not only that these people are individuals who happen to have illnesses, but also that these individuals have been socialized by historical events, political realities, and cultural situations (often) different from their own. Thus, just as narrative medicine helps the “patients” articulate their own stories and gain a sense of agency, it helps the students learn different models of thought, different realities than the ones they know. This, we argue, is true “intersubjectivity.”

Kathleen Béres Rogers, PhD
Department of English
College of Charleston

Silvia Youssef Hanna, PhD
Department of Psychology
College of Charleston

Community Connections Complete the Course
Through service learning, a former Medical University of South Carolina (MUSC) student shaped his own future as a physician-servant and spearheaded the launch of a campus-wide community service program for health care professional students. Liz Sheridan, MUSC’s Students Services Manager and Director of the MUSC Gives Back Student Volunteer Program, will provide a history and overview of the MUSC Gives Back program, reflect on how a student-centered community service program enhances the education of young professionals-in-training, and share ideas for adapting the model to other institutions.

Liz Sheridan, Student Services Manager
Director, MUSC Gives Back Student Volunteer Program
Medical University of South Carolina

Increased Wellbeing through Narratives for the Poor
In an article written for Harper’s, Earl Shorris, founder of the Clemente Course, claimed that the narratives of the humanities were “weapon[s] in the hands of the restless poor.” Such narratives provide the poor with a powerful tool –reflection. Wielding this weapon, the poor can then regain their forfeited power and, in so doing, heal themselves. With their healing, an imbalance in the larger organism of society is simultaneously cured. This paper describes the Charleston Clemente Project, which offers two free college-level humanities classes to the homeless and poor in the Charleston area. The project is composed of two semester-long classes, hosted by Trident Technical College, and uses the study of narratives in history, philosophy, and literature to promote increased wellbeing in an at-risk and marginalized portion of society.

Mary Ann Kohli, PhD
Director, Charleston Clemente Course
English Instructor, Trident Technical College

4:00-4:30/4:45pm

Outburst Sessions and Medical Theater

Gifts of Silence
Ansonborough

Silence is an opportunity to connect with our innermost soul, yet most often we ignore the soul’s needs until we are exhausted or become battle fatigued. The ability to remain silent is integral to the communication between healthcare professional and patient; however, it is also a valuable and necessary aspect of self-care. During this session, we will explore the beauty and grace that silence can bring to us and regain the wisdom silence can offer us.

Janet Lynn Roseman, PhD, R-DMT
Assistant Professor, Medical Education
Nova Southeastern College of Osteopathic Medicine

Truth Lines and Shared Images
Harleston

Poet Ellen Kort (Wisconsin’s first poet-laureate) has taught our nursing students and medical residents about poetry and listening for “the truth line.” In a 2003 graduation address at a regional university, she related an experience teaching poetry to women in prison. As the members of one group completed their prose, one woman volunteered to read her poem aloud. The woman insisted on standing, looking every other woman in the eye as she proudly read her own words. Kort said she learned from that woman that you must stand proud, even if you are in a miserable situation. After sharing with high school students a poem penned about her sister's battle with cancer, Kort had a young man question a line in the text about ants marching in a line, carrying a saltine cracker. It was only after Kort read the poem again that the student saw the meaning behind the line: that people must sometimes carry a heavy burden. He called it the “truth line.” “What are you willing to stand for?” Kort asked the graduates. “What is the truth line of your life? There are laser-like moments in your life that will be seen, felt, heard, touched, tasted, smelled, celebrated, endured and remembered.” Poetry and the healing community seek to speak truth, and to listen for “the truth line” in all narrative, especially at moments that matter. This session starts with brief drumming and release of stress, relaxation and imagery, and spontaneous writing as well as brief drawings. Participants will share and sequence the most powerful lines they have penned, then write forward the “found” poem of the sequenced verses. They will come together to assemble drawings collage-wise, and to dedicate work done in the session.

Mark Marnocha, PhD, MSN
Clinical Psychologist and Associate Professor (CHS)
Department of Family Medicine
University of Wisconsin School of Medicine & Public Health
Fox Valley Residency Program

Suzanne Marnocha, PhD, RN, MSN, CCRN
Professor, Assistant Dean and Prelicensure Director
University of Wisconsin
Oshkosh College of Nursing

Deb Schultz, MD
Geriatric and Palliative Care Boarded
Associate Professor (CHS), Department of Family Medicine
University of Wisconsin School of Medicine & Public Health
Fox Valley Residency Program
Medical Director, Brewster Village Care Facility
Medical Director, Calumet County Hospice

Breaking Bad: The Art of Delivering Bad News
Stono Ballroom
4:00-4:45pm

The Emergency Department is a minefield. Between the incomplete information, the chaos, the life-threatening diagnoses shrouded in benign complaints, it’s a wonder we manage to sleep at night. Worse still, we have to remain sympathetic, at times empathetic, and we have to deliver some pretty awful news. We’ve all seen this go well and go poorly. Other professionals grapple with similar issues, and we’d like to share with an interdisciplinary audience a “medical theater” training workshop model we have used with our residents. In this session, we’ll review the history of breaking bad news, and introduce a five-step approach that will make the experience smoother, more comfortable to clinicians of all professions, and ultimately more meaningful to patients. Professional actors will perform 5 separate notifications, ranging from death notifications to cancer diagnoses. Participants will discuss the pros and cons of each notification.

Geoffrey E. Hayden, MD
Assistant Professor and Emergency Ultrasound Director
Department of Medicine
Division of Emergency Medicine
Division of Pediatric Emergency Medicine
Medical University of South Carolina

Mary Fishburne Hayden
Actor and Voice Teacher

Thomas Keating, MFA
Associate Professor of Theatre
Charleston Southern University
Actor

Christina Leidel, PhD
Adjunct Professor of Physics
The Citadel
Actor

Doug McGill, MD
Associate Medical Director
Roper Rehabilitation Hospital
Actor

Town and dinner on your own

All sessions held at The DoubleTree Inn by Hilton Hotel and Suites in Historic Charleston, 181 Church Street

Please note that slight changes in times and/or sessions may occur. Web site will be updated periodically. Changes will also be indicated in registration materials at the conference.

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