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Editorial: The Healing Power of Seeing—and Being Seen

Editorial: The Healing Power of Seeing—and Being Seen

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Editorial: The Healing Power of Seeing—and Being Seen

By Sarah Blanton, PT, DPT, NCS

Download the article (pdf)

“We miss more by not seeing than by not knowing.” — Sir William Osler

Sir William Osler (1849-1919) was a renowned teacher-scholar-clinician, and one of the four founding physicians of Johns Hopkins Medical Center. His thought-provoking reflections are often quoted for their timely wisdom and insight. A foundational premise in cultivating humanism in clinical care is recognizing the critical importance of presence with our patients—understanding intuitively what Osler meant when he said, “We miss more by not seeing than by not knowing.” The mission of the Journal of Humanities in Rehabilitation (JHR) is to create an engaging and creative space that welcomes interdisciplinary scholars who share a passion for this art of seeing. They challenge us to view, experience, and contemplate our work from different angles and diverse opinions. Exploring this concept of “seeing,” we come to understand not only the value of observation in clinical diagnostics, but also the impact of “being seen” within the context of the therapeutic relationship.

Cultivating empathy begins with the ability to convey that we have recognized the other in our first step toward understanding their lived experience. In our busy days, how easy it is to forget this powerful dimension of humanism in both the clinic and the classroom—our ubiquitous need simply to be recognized, to be understood. Forging stronger connections with the humanities provides health science education new avenues to develop these critical skills, whether through visual thinking strategies when viewing art in museums, or incorporating aspects of narrative medicine into our clinical encounters to co-create stories with our patients.

The writer Parker Palmer reflects on this gift of presence: “The human soul doesn’t want to be advised or fixed or saved. It simply wants to be witnessed—to be seen, heard, and companioned exactly as it is. When we make that kind of deep bow to the soul of a suffering person, our respect reinforces the soul’s healing resources, the only resources that can help the sufferer make it through.”2 Part of our job as clinicians is to recognize that while our knowledge and skills are the tools to facilitate the body’s recovery from illness, it is our shared humanness, our presence, that supports the healing power of the soul.  How we dance along those lines—recognizing where our role is to fix or simply be present—is the beautiful, sometimes haunting part of the rehabilitation landscape that the humanities can help us navigate.

Questions we may ask ourselves at the end of each day may begin with: “How well did I see each of my patients today?” Then perhaps we can reflect more deeply and ask: “Did I interact with my patients so they felt seen today?”

Our Fall 2019 Issue provides innovative ideas to prompt us to explore these avenues toward personal and professional growth.

Calling us forward, Gail Jensen and colleagues share their professional insights in their Book Review, Exploring Excellence: Author Reflections on Educating Physical Therapists. In their vision, they “see the integration of the humanities into professional education as an essential component for preparing adaptive learners who can navigate uncertain situations in complex systems, act as advocates and moral agents, and demonstrate the moral courage to address societal needs, call out and seek to change substandard practice, and meet our professional obligations.”1 These scholarly leaders embrace JHR’s mission, providing support for adopting the humanities across the curriculum.

We are excited about our third installment of our Profiles in Professionalism series, in which we sit down with Nancy R. Kirsch, PT, DPT, PhD, FAPTA, program director and professor of physical therapy at Rutgers University in Newark, NJ—a thinker whose compassionate, prolific scholarship is recognized throughout the field of rehabilitation. In this interview, Dr. Kirsch explores how physical therapy has evolved, and the critical role the humanities play in developing caring and compassionate professionals.

The Fall 2019 Issue of JHR also features these fascinating articles, poetry, and essays:

Portrait of Spirit: One Story at a Time

Melissa McCune

Billy Howard and Maggie Holtzberg offer us a new angle to view the world, challenging us to closely examine the lived experience of disability through narrative and photography.  Their work is an intimate and moving opportunity to appreciate the role of humanities to broaden our lens outside of ourselves, extending our view towards others. It is compelling, in part because of the beauty of the images and language, but as art is known to do, their work causes us to pause, reckoning with the paradox of the ubiquity of disability (most likely we will all be disabled at some point in our lives), yet our society is structured such that the lives of those with disability goes largely unnoticed. As with any tendency towards stigma, bias, preconceptions—it takes engagement on a personal level, knowing, hearing each other’s stories, before attitudes and prejudices shift. And that is the power of this type of project, which takes us deeper into the lives of individuals.

Critical Disability Studies With Rehabilitation: Re-thinking the human in rehabilitation research and practice

Donya Mosleh

In this issue’s Perspective, Donya Mosleh, PhD argues for a new mode of scholarly practice that recognizes and addresses tensions between two fields that seemingly occupy opposite ends of a continuum. In order to promote a more productive engagement, critical disability studies with rehabilitation sciences unsettles knowledge relations that position these two fields as oppositional and incompatible.

Reading Eucalyptus

Christy DiFrances Remein

In this report, Christy DiFrances Remein, director of the Narrative Writing Program at Boston University Medical Campus, skillfully illustrates her encounter with a work of fiction, offering us an awareness of narrative’s ability to promote resilience through the practice of reflection, exploration, and healing.

Finding Help

Shaun R. Cleaver and colleagues

The main focus of rehabilitation is to provide help to those who need it. But does the Western definition of “help” always apply in other regions? In Finding Help: Exploring the Accounts of Persons With Disabilities in Western Zambia, the authors present the concept of help in a completely new light and offer suggestions for a more societally-based approach to healing.

Human Anatomical Gifts and Informed Consent: Three Perspectives

Chase Montague, Deon Thompson, and Jason Lesandrini

The United States abides by the Revised Uniform Anatomical Gift Act to regulate bodies donated to science; prior consent must be given. When DPT students at Georgia State University had the opportunity to attend an anatomic exhibition displaying preserved human specimens from another country, many ethical questions arose. In this article, three writers offer their perspectives, developed during the discussions that ensued, on the ethics of anatomic study—and exhibition.

The Best is the Enemy of the Good

David Gillette

The healthcare professions often attract talented, committed perfectionists. But what can practitioners do when that perfectionism negatively affects rehabilitation? In this Reflection, David Gillette describes how his PT residency experience, and the thoughtful guidance of his mentors, helped him confront the negative aspects of his perfectionism and turn his thoughts toward the good.

CHEP-JHR Essay Contest

The winning essay in the second annual physical therapy student essay contest, co-sponsored by the ACAPT Consortium for the Humanities, Ethics, and Professionalism (CHEP) and the JHR, was featured in our Spring 2019 issue.

In this issue, we showcase the work of our two finalists. Congratulations to Mercedes Aguirre and Jake Raecker!

In a sensitive reflection, Out of Oxygen, Ms. Aguirre describes an incident during her first clinical experience that taught her the importance of taking a deep breath—and speaking up on behalf of one’s patient.

In Beyond First Impressions, Mr. Raecker provides a powerful account of an interaction with a patient during his first clinical rotation that taught him to see past a shocking first impression—to focus on care and compassion.

The Third Annual Student Essay Contest is Now Open for Submissions!

The essay prompt for the 2019-2020 physical therapy student essay contest is:

Working closely with patients, families, and colleagues offers healthcare professionals opportunities for meaningful connection. However, challenges may arise when we encounter perspectives, values, priorities, and communication styles different from our own. Describe a time when you were challenged in such a way, and how you responded.

Timeline: Submissions will be accepted from November 15, 2019 to January 5, 2020. Any submissions sent in after 11:59 PM (EST) on January 5, 2020 will not be reviewed. The winner and two finalists will be announced in the Spring 2020 issue of JHR.

For more details, see our CHEP-JHR contest webpage. For more information about CHEP, please see their CHEP webpage.

We Welcome a New JHR Editorial Board Consultant, and a Faculty Associate Editor

We are honored to welcome Cindy Smalletz, MS, MA, one of the first graduates of the Columbia University Narrative Medicine Master’s program, who went on to become the creator, designer, and director of Columbia’s first online certificate program in Narrative Medicine. By bringing together narrative medicine with her extensive training in education and technology, she seeks to change healthcare around the world through better training, communication, self-awareness, and action.

Additionally, we welcome Cynthia Dodds, PT, PhD, PCS, associate professor, Medical University of South Carolina, as JHR’s Faculty Associate Editor. Dr. Dodds will be assisting our Perspectives in Art History Section Editor Siobhan Conaty, PhD in the development and review of articles.

Congratulations to Melissa McCune—the 2019 Frank S. Blanton, Jr. MD Humanities in Rehabilitation Scholar

Emory DPT/MPH student Melissa McCune was awarded the Frank S. Blanton, Jr., MD Humanities in Rehabilitation Scholar award in recognition of her dedication to the pursuit of knowledge in the humanities, a deep desire to foster awareness of humanities in health professions, and a gentle kindness and compassion in relating with others. This award recognizes interdisciplinary graduate students who exemplify a dedication to the pursuit of knowledge in the humanities, a deep desire to integrate the arts and sciences in health professions, and gentle kindness and compassion in relating to others.

Thank you for joining us. We hope you enjoy the Fall 2019 Issue of JHR.

If you are interested in submitting your work to JHR, please review our Submission Guidelines. If you are considering being a reviewer, please contact Dr. Sarah Blanton: follow the Contact link, indicate the content area you are interested in reviewing, and attach your CV.

References

1  Jensen GM, Mostrom E, Hack LM, Nordstrom T, Gwyer J. Educating Physical Therapists. Thoroughfare, NJ: SLACK Inc., Healio.com; 2019.

2  Palmer P. The gift of presence, the perils of advice. OnBeing newsletter. Available at: 

https://onbeing.org/blog/the-gift-of-presence-the-perils-of-advice/. Accessed August 31, 2019.


This work is licensed under a Creative Commons Attribution 4.0 International License.

About the Author(s)

Editorial: The Healing Power of Seeing—and Being Seen

Contents
About the Author(s)
Share this:

Editorial: The Healing Power of Seeing—and Being Seen

By Sarah Blanton, PT, DPT, NCS

Download the article (pdf)

“We miss more by not seeing than by not knowing.” — Sir William Osler

Sir William Osler (1849-1919) was a renowned teacher-scholar-clinician, and one of the four founding physicians of Johns Hopkins Medical Center. His thought-provoking reflections are often quoted for their timely wisdom and insight. A foundational premise in cultivating humanism in clinical care is recognizing the critical importance of presence with our patients—understanding intuitively what Osler meant when he said, “We miss more by not seeing than by not knowing.” The mission of the Journal of Humanities in Rehabilitation (JHR) is to create an engaging and creative space that welcomes interdisciplinary scholars who share a passion for this art of seeing. They challenge us to view, experience, and contemplate our work from different angles and diverse opinions. Exploring this concept of “seeing,” we come to understand not only the value of observation in clinical diagnostics, but also the impact of “being seen” within the context of the therapeutic relationship.

Cultivating empathy begins with the ability to convey that we have recognized the other in our first step toward understanding their lived experience. In our busy days, how easy it is to forget this powerful dimension of humanism in both the clinic and the classroom—our ubiquitous need simply to be recognized, to be understood. Forging stronger connections with the humanities provides health science education new avenues to develop these critical skills, whether through visual thinking strategies when viewing art in museums, or incorporating aspects of narrative medicine into our clinical encounters to co-create stories with our patients.

The writer Parker Palmer reflects on this gift of presence: “The human soul doesn’t want to be advised or fixed or saved. It simply wants to be witnessed—to be seen, heard, and companioned exactly as it is. When we make that kind of deep bow to the soul of a suffering person, our respect reinforces the soul’s healing resources, the only resources that can help the sufferer make it through.”2 Part of our job as clinicians is to recognize that while our knowledge and skills are the tools to facilitate the body’s recovery from illness, it is our shared humanness, our presence, that supports the healing power of the soul.  How we dance along those lines—recognizing where our role is to fix or simply be present—is the beautiful, sometimes haunting part of the rehabilitation landscape that the humanities can help us navigate.

Questions we may ask ourselves at the end of each day may begin with: “How well did I see each of my patients today?” Then perhaps we can reflect more deeply and ask: “Did I interact with my patients so they felt seen today?”

Our Fall 2019 Issue provides innovative ideas to prompt us to explore these avenues toward personal and professional growth.

Calling us forward, Gail Jensen and colleagues share their professional insights in their Book Review, Exploring Excellence: Author Reflections on Educating Physical Therapists. In their vision, they “see the integration of the humanities into professional education as an essential component for preparing adaptive learners who can navigate uncertain situations in complex systems, act as advocates and moral agents, and demonstrate the moral courage to address societal needs, call out and seek to change substandard practice, and meet our professional obligations.”1 These scholarly leaders embrace JHR’s mission, providing support for adopting the humanities across the curriculum.

We are excited about our third installment of our Profiles in Professionalism series, in which we sit down with Nancy R. Kirsch, PT, DPT, PhD, FAPTA, program director and professor of physical therapy at Rutgers University in Newark, NJ—a thinker whose compassionate, prolific scholarship is recognized throughout the field of rehabilitation. In this interview, Dr. Kirsch explores how physical therapy has evolved, and the critical role the humanities play in developing caring and compassionate professionals.

The Fall 2019 Issue of JHR also features these fascinating articles, poetry, and essays:

Portrait of Spirit: One Story at a Time

Melissa McCune

Billy Howard and Maggie Holtzberg offer us a new angle to view the world, challenging us to closely examine the lived experience of disability through narrative and photography.  Their work is an intimate and moving opportunity to appreciate the role of humanities to broaden our lens outside of ourselves, extending our view towards others. It is compelling, in part because of the beauty of the images and language, but as art is known to do, their work causes us to pause, reckoning with the paradox of the ubiquity of disability (most likely we will all be disabled at some point in our lives), yet our society is structured such that the lives of those with disability goes largely unnoticed. As with any tendency towards stigma, bias, preconceptions—it takes engagement on a personal level, knowing, hearing each other’s stories, before attitudes and prejudices shift. And that is the power of this type of project, which takes us deeper into the lives of individuals.

Critical Disability Studies With Rehabilitation: Re-thinking the human in rehabilitation research and practice

Donya Mosleh

In this issue’s Perspective, Donya Mosleh, PhD argues for a new mode of scholarly practice that recognizes and addresses tensions between two fields that seemingly occupy opposite ends of a continuum. In order to promote a more productive engagement, critical disability studies with rehabilitation sciences unsettles knowledge relations that position these two fields as oppositional and incompatible.

Reading Eucalyptus

Christy DiFrances Remein

In this report, Christy DiFrances Remein, director of the Narrative Writing Program at Boston University Medical Campus, skillfully illustrates her encounter with a work of fiction, offering us an awareness of narrative’s ability to promote resilience through the practice of reflection, exploration, and healing.

Finding Help

Shaun R. Cleaver and colleagues

The main focus of rehabilitation is to provide help to those who need it. But does the Western definition of “help” always apply in other regions? In Finding Help: Exploring the Accounts of Persons With Disabilities in Western Zambia, the authors present the concept of help in a completely new light and offer suggestions for a more societally-based approach to healing.

Human Anatomical Gifts and Informed Consent: Three Perspectives

Chase Montague, Deon Thompson, and Jason Lesandrini

The United States abides by the Revised Uniform Anatomical Gift Act to regulate bodies donated to science; prior consent must be given. When DPT students at Georgia State University had the opportunity to attend an anatomic exhibition displaying preserved human specimens from another country, many ethical questions arose. In this article, three writers offer their perspectives, developed during the discussions that ensued, on the ethics of anatomic study—and exhibition.

The Best is the Enemy of the Good

David Gillette

The healthcare professions often attract talented, committed perfectionists. But what can practitioners do when that perfectionism negatively affects rehabilitation? In this Reflection, David Gillette describes how his PT residency experience, and the thoughtful guidance of his mentors, helped him confront the negative aspects of his perfectionism and turn his thoughts toward the good.

CHEP-JHR Essay Contest

The winning essay in the second annual physical therapy student essay contest, co-sponsored by the ACAPT Consortium for the Humanities, Ethics, and Professionalism (CHEP) and the JHR, was featured in our Spring 2019 issue.

In this issue, we showcase the work of our two finalists. Congratulations to Mercedes Aguirre and Jake Raecker!

In a sensitive reflection, Out of Oxygen, Ms. Aguirre describes an incident during her first clinical experience that taught her the importance of taking a deep breath—and speaking up on behalf of one’s patient.

In Beyond First Impressions, Mr. Raecker provides a powerful account of an interaction with a patient during his first clinical rotation that taught him to see past a shocking first impression—to focus on care and compassion.

The Third Annual Student Essay Contest is Now Open for Submissions!

The essay prompt for the 2019-2020 physical therapy student essay contest is:

Working closely with patients, families, and colleagues offers healthcare professionals opportunities for meaningful connection. However, challenges may arise when we encounter perspectives, values, priorities, and communication styles different from our own. Describe a time when you were challenged in such a way, and how you responded.

Timeline: Submissions will be accepted from November 15, 2019 to January 5, 2020. Any submissions sent in after 11:59 PM (EST) on January 5, 2020 will not be reviewed. The winner and two finalists will be announced in the Spring 2020 issue of JHR.

For more details, see our CHEP-JHR contest webpage. For more information about CHEP, please see their CHEP webpage.

We Welcome a New JHR Editorial Board Consultant, and a Faculty Associate Editor

We are honored to welcome Cindy Smalletz, MS, MA, one of the first graduates of the Columbia University Narrative Medicine Master’s program, who went on to become the creator, designer, and director of Columbia’s first online certificate program in Narrative Medicine. By bringing together narrative medicine with her extensive training in education and technology, she seeks to change healthcare around the world through better training, communication, self-awareness, and action.

Additionally, we welcome Cynthia Dodds, PT, PhD, PCS, associate professor, Medical University of South Carolina, as JHR’s Faculty Associate Editor. Dr. Dodds will be assisting our Perspectives in Art History Section Editor Siobhan Conaty, PhD in the development and review of articles.

Congratulations to Melissa McCune—the 2019 Frank S. Blanton, Jr. MD Humanities in Rehabilitation Scholar

Emory DPT/MPH student Melissa McCune was awarded the Frank S. Blanton, Jr., MD Humanities in Rehabilitation Scholar award in recognition of her dedication to the pursuit of knowledge in the humanities, a deep desire to foster awareness of humanities in health professions, and a gentle kindness and compassion in relating with others. This award recognizes interdisciplinary graduate students who exemplify a dedication to the pursuit of knowledge in the humanities, a deep desire to integrate the arts and sciences in health professions, and gentle kindness and compassion in relating to others.

Thank you for joining us. We hope you enjoy the Fall 2019 Issue of JHR.

If you are interested in submitting your work to JHR, please review our Submission Guidelines. If you are considering being a reviewer, please contact Dr. Sarah Blanton: follow the Contact link, indicate the content area you are interested in reviewing, and attach your CV.

References

1  Jensen GM, Mostrom E, Hack LM, Nordstrom T, Gwyer J. Educating Physical Therapists. Thoroughfare, NJ: SLACK Inc., Healio.com; 2019.

2  Palmer P. The gift of presence, the perils of advice. OnBeing newsletter. Available at: 

https://onbeing.org/blog/the-gift-of-presence-the-perils-of-advice/. Accessed August 31, 2019.


This work is licensed under a Creative Commons Attribution 4.0 International License.

About the Author(s)

Sarah R. Blanton, PT, DPT, Editor-In-Chief

Dr. Sarah Blanton is a Professor of Rehabilitation Medicine at Emory University School of Medicine, Division of Physical Therapy. She graduated from the University of Virginia in 1987 with a BA degree in biology, from Emory University in 1992 with her masters in physical therapy and received her clinical doctorate in physical therapy in 2003. Dr. Blanton has had several research grants exploring the integration of caregivers into the rehabilitation process and her current research focus examines the impact of using a telehealth platform for the delivery of a theory-based, family-focused intervention program for stroke survivors and their carepartners in the home setting. Dr. Blanton’s Lab, DISCOVER (Digital Scholarship Enhancing Rehabilitation), explores various ways digital scholarship can enhance rehabilitation research, education and clinical practice and promote interdisciplinary collaboration. Dr. Blanton is a Fellow of the National Academy of Practice in Physical Therapy. In 2018, she was awarded the American Physical Therapy Association Societal Impact Award and the Emory University Creativity and Arts award for healthcare faculty. Dr. Blanton’s interest in the Journal of Humanities in Rehabilitation stems from her ongoing exploration of the intersections of creativity and spirituality to gain insight into the human experience of suffering, joy and mystery. In her teaching, she has found the use of narrative to be an exceptionally powerful tool to foster reflection and personal insight for both students and patients. In her research, she is incorporating multi-media formats to develop family education interventions in the home environment. A photographer since childhood, she has enjoyed sharing her artwork through exhibits at Emory University, speaking with chaplaincy students on “Reflections of Art and Spirituality in Appalachia” and as a guest contributor to the Public Radio show, On Being. See Dr. Blanton's recent feature in the Emory Report: https://bit.ly/46mqXVp

 

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Editorial: The Healing Power of Seeing—and Being Seen

Contents
Healthcare Education and Narrative
Health Science and Storytelling
Naming Vs. Knowing—and Healing
About the Author(s)
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Reading Eucalyptus: Reflections on Narrative Education in Medicine and Health Sciences

By Christy Di Frances Remein, PhD, MA

Download the article (pdf)

I discovered Murray Bail’s Eucalyptus: a Novel1 while undertaking a creative writing course in Australia just after completing my undergraduate degree. Published in 1998, the novel received both the Commonwealth Writers’ Prize and Australia’s prestigious Miles Franklin Literary Award. In the years since I first encountered the text’s unique blend of the realistic and fantastical, serious and ludic, my thoughts have returned often to Eucalyptus as I ponder the ways in which it offers keen observations that are surprisingly relevant to education in academic medicine and health sciences. 

Bail’s story is set in an imagined Australian past, where a widower named Holland promises his daughter Ellen’s hand in marriage to any suitor who can correctly name the thousands of eucalyptus species growing on his vast property. Eucalyptus may, and probably should, be read as a fable open to various interpretations. As is the case with most good fiction, it invites us to extrapolate beyond the immediate storyline, to navigate themes that transcend plot. At first glance the book seems rather like a contemporary fairy tale, and closer investigation does indeed reveal astute sociological insight lurking beneath its seemingly whimsical veneer. Thus, Holland’s mysterious admonition that his daughter “beware of any man who deliberately tells a story” (p. 53) may be read as a subtext with broad cultural implications.

Healthcare Education and Narrative

Like the cautious father in Eucalyptus, healthcare education at times emanates subtle warnings about stories, which are by nature equivocal. Notwithstanding a rich history of medical humanities that prefigured the more recent narrative medicine movement, in both overt and tenuous ways a bio-medical curriculum rooted in Enlightenment tradition sometimes looks askance upon the abstractions intrinsic to narrative.2 Stories are, after all, so liminal, so terribly apt to resist definition and classification: they possess an uncanny power to affect learners in unpredictable ways. Nevertheless, we identify with the comforting, re-orienting powers of narrative when, like the novel’s heroine, we too feel “frail at the edges, at times curiously elongated” (p. 221). 

In Eucalyptus, the narrative act, or process, can be viewed as being personified in a character referred to as the “stranger,” who succeeds, initially, in gaining Ellen’s trust and, ultimately, in healing her undefined illness through his imaginative recounting of stories. Ironically, the reference to this man as a “stranger” seems an intentional misnomer: of all characters in the book he is perhaps the most familiar—however curious he may seem. 

The stranger’s luminous tales offer glimpses of life beyond the confining geographical boundaries of Ellen’s context, encouraging her to reflect and gain new perspectives. Thanks to him, she allows “the world, which was his and far beyond, to come to her. His roundabout way of telling one story after another depended on imagination and a breadth of experience” (p. 159). At first Ellen perceives the stranger’s narratives as being arbitrary. Only later does she realize that the motifs which repeatedly surface through his storytelling are anything but random, their focus becoming “more and more directed at her” (p. 166) and the complexities of her unique situation and illness. 

A wonder of memorable stories is their universality, the transferable potential of literary themes that have stood the test of time. Eventually, the narratives become for Ellen a source of strength and newfound independence amidst a physical and emotional context that seems to have spiraled beyond her control as an unwanted suitor closes in on naming all of Holland’s eucalypts. Ellen’s feelings of helplessness might be read as reflecting the situation of a beleaguered medical student, an exhausted resident, a burned-out physician, nurse, surgeon, or researcher. 

Health Science and Storytelling

Eucalyptus highlights cultural aspects of health sciences that I have observed first-hand as an educator working in academic medicine, particularly as director of the Narrative Writing Program at Boston University Medical Campus, where I have helped clinicians and other professionals to employ writing as a means of processing difficult emotions and voicing their unique stories. Often, I notice that, like Ellen, my colleagues prefer learning and being known through stories1 rather than through the rigidly delineated world of taxonomical structures inhabited by most characters in Eucalyptus, who ascribe to a paradigm wherein knowing frequently becomes conflated with labeling. As literary scholar John Attridge points out, Bail’s novel highlights a subliminal cultural conflict between classification and narration.3

Through my work I have realized just how true it is that today’s medical and health sciences professionals operate in a context marked by an “emphasis on facts, almost an obsession. We are not comfortable if a thing we have seen isn’t attached to a name. An object can hardly be said to exist until it has a name, even an approximate name” (p. 251). Yet the technical knowledge symbolized by such “naming” often is insufficient for the achievement of professionalism and personal resilience, thus generating a philosophical dilemma at times when the painstakingly acquired (and socially lionized) quantitative “know-how” ultimately falls short.

As I consider the challenges faced by my colleagues, I wonder if our cultural dependence upon “naming” explains why Bail’s fictional physician is unable to facilitate the healing process for Ellen, a failure that seems not to arise from any lack of knowledge bur rather from an inability to contextualize her ailment apart from its elusive name. In this case, routine medical exams and procedures, however adeptly performed, prove entirely ineffectual (p. 215). “Every morning,” Bail’s narrator conveys, “the doctor arrived, but still he couldn’t give a name to the illness” (p. 232). A simple enough formula: no name, no cure. Yet somehow we are hardly surprised to read that, despite the fictional physician’s best efforts, “day after day Ellen lay gradually fading” (p. 218). 

Interestingly, the physician’s perspective can be read as mirroring that of the novel’s “suitor” characters, particularly the relentlessly technical Mr. Cave. Symbolically, he possesses “ways of knowing,” which vie with narrative (the “stranger”) for Ellen’s attention—and by extension for our own. Mr. Cave’s interactions with Ellen and her eucalypt-filled world resemble attempts to categorize and conquer, whether this means successfully passing Holland’s tree-naming test or delineating and defeating his daughter’s mysterious illness. Such actions illuminate a practical as well as theoretical elevation of empirical knowledge, which—in this scenario—crowds out narrative as a complementary way of knowing. 

Naming Vs. Knowing—and Healing

Unfortunately for Ellen, scientific acumen alone simply won’t do to help her: “she could only be brought back to life by a story” (p. 234). Thus, what might be conceptualized as Mr. Cave’s attempted use of empirical solutions devoid of narrative contextualization backfires: his efforts to aid Ellen’s recovery lack efficacy because he neither understands nor relates to her as a unique individual. Indeed, to Mr. Cave she embodies “a complete mass of confusion and mystery” (p. 233). Thus, “on the seventeenth day Ellen still lay in her room,” (p. 240)—suffering from an unknown illness that readers infer to be connected as much to her heart as to her body. “No one had told a story to bring her back to life. If anything Mr. Cave’s story only made matters worse” (p. 240). Despite much well-intentioned effort, “Ellen’s decline became steeper. No one could do anything (p. 233)”—or so we despairingly assume.

Re-enter the stranger—in this reading, the allegorical personification of narrative. His adept employment of creative inquiry provides Ellen with the freedom to let down her guard and engage in open and honest dialogue. Almost without realizing it, she begins to establish trust: in another human being, in the stories, in herself. We might say that she enters into a dialogue which eventually brings healing—so the narrator is quite right in observing that Ellen is brought “back to life” through storytelling, which succeeds in curing her “illnesses without a name” (p. 234). 

Eucalyptus serves as a poignant reminder that the realms of the empirical and theoretical are not dichotomous but fluid, their boundaries shifting and overlapping in mysterious ways and at unpredictable times. We humans are tethered body and spirit, so it is hardly surprising that narrative should be linked to both physical4-6 and psychological wellness,7,8 which is so critical to foster amidst the current epidemic of depression and burnout in medical students, trainees, and faculty.9-16

I have been fortunate to experience first-hand the powerful ways in which narrative can promote self-reflection and resilience among healthcare professionals. Although sometimes viewed as a “stranger” in the world of traditional medical education, storytelling can provide a framework for cultivating self-reflection, communicating knowledge, fostering connections in ways that align rather than alienate, and listening for meaning that exists beyond the immediately observable. 

Certainly there is a need for more scholarly exploration of the intersection between narrative’s uniquely equivocal nature and the cultivation of holistic approaches to education in academic medicine and health sciences. Thankfully, literature like Eucalyptus reminds us of narrative’s ability to provide a generative space for reflection, exploration, and healing—even, or perhaps especially, amidst our increasingly technologized healthcare system. And that, I think, is a story worth sharing.

References

  1. Bail M. Eucalyptus: A Novel. 1st ed. New York, NY: Farrar, Straus, and Giroux; 1998.
  2. Katz Y. Against storytelling of scientific results. Nat Methods. 2013;10(11):1045.
  3. Attridge J. Detourism: Murray Bail’s Photographic Fiction. J Commonw Lit. 2004;39(3):69-91.
  4. Robinson H, Jarrett P, Vedhara K, Broadbent E. The effects of expressive writing before or after punch biopsy on wound healing. Brain Behav Immun. 2017;61:217-227.
  5. Koschwanez HE, Kerse N, Darragh M, Jarrett P, Booth RJ, Broadbent E. Expressive writing and wound healing in older adults: a randomized controlled trial. Psychosom Med. 2013;75(6):581-590.
  6. Weinman J, Ebrecht M, Scott S, Walburn J, Dyson M. Enhanced wound healing after emotional disclosure intervention. Br J Health Psychol. 2008;13(Pt 1):95-102.
  7. Van Emmerik AA, Reijntjes A, Kamphuis JH. Writing therapy for posttraumatic stress: a meta-analysis. Psychother Psychosom. 2013;82(2):82-88.
  8. Johnson DR. Transportation into a story increases empathy, prosocial behavior, and perceptual bias toward fearful expressions. Pers Individ Dif. 2012;52(2):150-155.
  9. Zhang YY, Han WL, Qin W, et al. Extent of compassion satisfaction, compassion fatigue and burnout in nursing: a meta-analysis. J Nursing Manage. 2018.
  10. Dugani S, Afari H, Hirschhorn LR, et al. Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: a systematic review. Gates Open Res. 2018;2:4.
  11. Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214-2236.
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