1. Narrative Medicine: Encouraging Patient Resilience and Hope
Rob Slocum, D. Min., Ph.D.
Narrative Medicine Program Coordinator
Markey Cancer Center
UKHealthCare

2. Learning Objectives
Describe basic principles and methods of Narrative Medicine 
Apply basic principles and methods of Narrative Medicine in interactions with patients
Identify appropriate cases for referral to a Narrative Medicine facilitator

3. Financial Disclosure
The presenter has no relevant financial relationships to disclose

5. Narrative Medicine is…
Patient Centered
Listen!
Respect!
See the whole person
Interactive & Dynamic
Expect the unexpected!
Collaborative
Share information and insights with treatment team members!

6. Engaging Patients’ Stories
Patients may…
Perceive their illness, treatment, & entire lives in terms of stories
Recover or rediscover meaning & identity in terms of stories
Reframe their self-understanding with a new story
Claim the role of central character in their own story

7. Core Questions What brings you here? What helps you the most?
Do you see anything differently?
What comes next?

8. Will to Live
Patients bring with them (and may change) their own attitudes concerning…
Illness
Treatment
Living

9. What brings you here? Story Symptoms Diagnosis Getting to treatment
“Underdiagnosis”/“Overdiagnosis”
Getting to treatment
Prognosis
Treatment plan

10. What helps you the most? Observe Identify or discover values
Frequent answers
Faith
Family
Friends
Personal strength
Favorite activities
Staff & outstanding facility

11. Do you see anything differently?
Different perspectives?
Different priorities?
Has anything changed?
Frequent answers
Don’t take things for granted
Thankful attitude
Some things that seemed important are not important
Give time to things that matter most
Don’t put off or defer important things
Acknowledge limitations

12. What comes next? What do you look forward to?
What do you want to do with the rest of your life?
What will you do first when you get home?
Frequent answers
Deferred dreams, goals, adventures
Family milestones
Complete projects, plans
Favorite work or recreational activities

13. Additional Possibilities
Follow-up visits
Life review
Journal writing
Journal workshop

14. Journal Workshop

15. Overview and Summary of Studies

16. Narrative Ethics Factual scenarios as stories
Characters, conflict, possible resolutions
Does the story “make sense” of the facts presented? 
Is something “missing”? 
Does a different story make better sense of the facts presented?

17. Narrative & Patient Identity
Patient’s essential identity – who the patient is – understood in terms of each patient’s story
Patient’s illness has “biographical disruption”
Impact of symptoms understood relative to identity
Patient may reclaim or rediscover identity during treatment – exploring story to renegotiate identity

18. Journal Exercise