At the heart of the medical enterprise

Stories, said Sayantani DasGupta, M.D., M.P.H., are at the heart and core of the medical enterprise. “Before clinicians had MRIs, lab tests, all-body CT scans, what we had was the ability to be present for life and birth and death and suffering, and to stand witness to our patients’ words and our patients’ lives,” DasGupta told an audience at internal medicine grand rounds on Jan. 29. “What I’m here to suggest is that in our increasingly full black bags, we have perhaps lost or are at risk of losing that attention to stories.”

DasGupta, an assistant professor of clinical pediatrics at Columbia University’s College of Physicians and Surgeons, is also co-chair of the university’s Seminar in Narrative, Health and Social Justice. She has, she said, spent her academic life thinking about stories and healing. Her talk at grand rounds was held as part of the Department of Internal Medicine’s annual Writers’ Workshop that showcases the writings of residents. The workshop is led by Anna Reisman, M.D., associate professor of medicine, and Lisa Sanders, M.D. ’97, HS ’01, associate professor of medicine.

Stories, DasGupta continued, are important to the ill. “We all have our life’s story,” she said. “Illness functions as a narrative wreckage, a big breach in the hull or our life’s ship. Illness has the potential to unmoor us, to lead to psychic and social chaos, unless we can repair the hole in our life’s vessel with a new set of stories. Illness stories help us make sense of who we are. Illness stories help us make sense of a life that has otherwise fallen apart.”

Because these stories are so important, DasGupta said, it’s critical to teach young doctors and medical students how to listen to them. Understanding how to listen is crucial to better medical care. “It’s absurd to say that we cannot teach these skills,” she said. “They are deeply teachable and they are skills that we can and must pass on to our students.”