Narrative medicine
Narrative Medicine is a discipline of applying the skill of analyzing literature to interviewing patients. A basic premise of Narrative Medicine is that how a patient speaks about their illness or problem is similar to a story in literature in that the account has a "plot" (how they relate what is going on) with "characters" (themselves and others in their lives) and is filled with "metaphors" (picturesque, emotional and symbolic ways of speaking), and becoming conversant in literary stories facilitates understanding the stories which patients bring. Narrative Medicine is a medical approach that utilizes patients' narratives in clinical  practice, research, and education as a way to promote healing. Beyond the attempt to reach a more accurate diagnosis, it aims to address the relational and psychological dimensions that occur in tandem with physical illness, with an attempt to deal with the individual stories of patients. In doing this, narrative medicine aims not only to validate the experience of the patient, but also to encourage creativity and self-reflection in the physician. History of the development of Narrative Medicine. In 1910, the Carnegie Foundation for the Advancement of Teaching created the "Flexner Report", which set out to redefine medical educational  practices. In this report, it argued that the proper goal of medicine is "an attempt to fight the battle against disease most advantageously to the patient." Flexner wrote that "the practitioner deals with facts of two categories. Chemistry, physics, biology enable him to apprehend one set; he needs a different apperceptive and appreciative apparatus to deal with other more subtle elements. Specific preparation is in this direction much more difficult; one must rely for the requisite insight and sympathy on a varied and enlarging cultural experience." In the late 20th century the emergence of narrative medicine came as an effort  to re-emphasize an aspect of wider cultural elements in medicine. From the 1990s, physicians like Rachel Naomi Remen and Rita Charon, who also holds a doctorate in English literature, argued that medical practice should be structured around the narratives of patients. In the year 2000, Rita Charon, first publicized the term "Narrative Medicine" to describe a method of using what she calls "narrative competence," which is "the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness." Method of Narrative Medicine. The teaching strategy of Narrative Medicine typically involves the three steps of close reading of  a text, followed by a writing assignment of personal reflection about the text, and then sharing and discussing the personal reflection. With the development of "narrative competence," the goal is then to approach a patient's situation with more accuracy in understanding and with greater empathy, in order to help the patient and clinician to work together. Close reading Close reading is a technique in teaching literature wherein the formal aspects of a text are studied. As an example, students are encouraged to the read a text "for its information, ambiguity, complexity, texture, and mood as well as for its  plot." These methods can be adapted to film, art and music in the form of "slow looking" and "close listening." Creative writing Following the close reading of a text, the student writes in a creative way what the encounter with the text meant for them, which "unleashes the curiosity and imagination of the writer." Discussion The Narrative Medicine faculty then applies "close reading" to the creative, reflective writing by the student, in order to more deeply understand what was communicated by the student. Allied use of narrative in medicine. The term "Narrative Medicine" specifically refers to the training in interpreting  literature and then applying that skill to understanding the accounts which patients tell. Associated fields of the use of narrative in medicine is called "Narrative-based Medicine", and also the more wide field of narrative in general. Narrative-based Medicine. A main proponent of Narrative-based Medicine is the English General Practice doctor John Launer who also holds a degree in English literature. His approach to understanding the stories which patients relay to doctors comes from an orientation of Family therapy counseling wherein patients are invited to expand on and explore new directions in the accounts of their illness. Narrative  in medicine. A more broad field is the use of narrative in general in helping doctors and patients deepen the understanding of the ways of relating to illness and healing. In the 1990s and early 21st century, this approach is exemplified by the American doctor Lewis Mehl-Madrona and the British doctor Trisha Greenhalgh. Educational programs. A number of schools in the United States offer advanced classes in narrative medicine. This growing field of narrative medicine extends beyond the United States: