A friend of a friend (Eric Chow stand up and take a bow) linked the following article to me via fb.  Skeptical at first, I decided to give it a gander.  Awesome fusion of realworld immunology with the allure of old world mafia, circa 1930?  Check.  Tight, dynamic writing? Check.  Before I knew it, I was done with the article, wanting more.

And as the fates would have it, the article had been published by none other than ‘The Scientist” magazine, which had done a story about NCL only some weeks back.  Tracking down the author should be easy, right?  Not so much.  Our modern day Oracle at the Delphi, Google, lead me to a number of stories, but no contact details.  Thankfully, I was able to contact the writer who had worked with us on the ‘Playing Doctor’ piece who agreed to let this ‘Jef’ know that we were hoping to speak with him.  I say him in jest as it was only after a bit of searching that if became apparent on a Twitter profile that Jef was in fact short for ‘Jennifer’.

Our two pronged attack (an inmail via LinkedIn and reaching out to a colleague) seemed to do the trick.  July 16th, the world of Soma brightened, and contact was made. Stay persistant, kids, is the moral of this story.  After settling down and having numerous discussions on vision, metaphorical learning, the budget constraints of a startup and how the eff to post on wiki (an ongoing learning process), the position of HealingBlade Lead Creative/Science Fusion Ecrivan was born.  Oh happy day!

I’ll let the results speak for themselves.

Welcome aboard, Jef, if that is your real name.

As physicians, we are bombarded by narrative, and in many ways, rounding is like working through a book of short stories each day, only that we contribute to the narrative, page by page, in the form of progress notes.  Documentation, or the ‘D’ word as some would have it – is a reality of medical practice.  And given how much we take down, one would imagine that we as physicians would be excellent tellers of stories, sharing captivating yarns of woe and intrigue, with works ranging from tragedy to hope and victory through the tales of our patients.  Sadly, this seems more the exception that the rule.  Physician documentation is often workman-like, placing emphasis on objectivity, assessment and planning, which I suppose is not a bad thing.  Scientific documentation should be heavy on details and analysis.  Still, one can’t help but wonder if narrative exposition helps add important nuance that may provide clues to the physician upon re-reading.

Consider these two statements:

• Ms. Jones is awake, alert and pleasant, not complaining of any fever, nausea or chest pain.
• I met Ms. Jones while she was sitting up eating breakfast. She had no complaints, but seemed sad.  When asked, she told me that she missed having breakfast with her husband two years ago and didn’t have much of an appetite.

Far be it from me to criticize one description over the other – however, upon re-reading those, which one creates a clearer picture in you mind?  It is these recollections that we go on to develop as we hand off our patients, whether it be to oncoming colleagues, consultants or the patients PCP’s.  The more vibrant a picture that we create both for ourselves and our colleagues, the stronger the engagement and activation of their deductive processes.   This is by no means a unique notion – kudos to @KateEllington, whom I follow on Twitter, for linking to and discussing the power of narrative medicine.  Furthermore, Rita Charon founded and runs the program in Narrative Medicine at Columbia, which runs three-day workshops to help providers hone their powers of observation, analysis and description of the things that they see, day-to-day.   Here’s to taking back our calling!

Stay thirsty, my friends.