Narrative Medicine for Doctors

Toby Campbell understands that storytelling is good medicine. As an oncologist and associate professor in the Hospice and Palliative Medicine Fellowship Program at UW Health—the academic medical center and health system at the University of Wisconsin in Madison—he teaches fellows that communication with patients is not about delivering statistics but rather helping them to imagine possible outcomes for their care. In Campbell and his fellows’ specialty, these outcomes are often inherently grim. New doctors assume a significant emotional burden as they lead patients through end-of-life care; seasoned clinicians must resist becoming jaded to their work while finding ways to replenish their own emotional resources. This is where Campbell sees another, perhaps more surprising place for storytelling: in helping doctors to process and sustain their most demanding work.

Since 2017 Campbell has partnered with novelist Michelle Wildgen to offer writing classes to the fellows in his program, as well as other interested doctors in the UW hospital system. While the field of narrative medicine—the practice of using personal storytelling as an element of clinical care—has grown in recent years, traditionally its application has focused on patients. Campbell, who previously directed the fellowship program, believes it may be among the first in the United States to flip this script and develop a writing class that applies narrative medicine to hospice fellows’ self-care. The idea was born of Campbell’s own experiences in college writing workshops and, later, journaling and publishing articles about his work. He found that the practice of constructing narrative “aligned well with the way I like to process things.” Initially Campbell himself led short writing exercises during biweekly self-care workshops for fellows, before deciding to call upon Wildgen’s expertise to expand the program.

Wildgen, whose books include Bread and Butter (Doubleday, 2014) and who founded and codirects the Madison Writers’ Studio, was eager to take on the challenge. She believed the opportunity to develop a concrete skill might appeal to the driven personality of her new students, in addition to offering respite and space for self-care. To better understand the demands of doctors’ jobs and how the workshop would fit into fellows’ routines, Wildgen spent a day shadowing Campbell in his clinical rounds. “I’d only been there until lunchtime, but I felt exhausted—all I had done was sit and stand, but it was emotionally really heavy,” she says. “I had never experienced that before, where the emotional experience you had felt physical.”

The classes consist of seven or eight students and convene one morning a month in a meeting space on the hospital campus, before scrubs are donned and the day’s pressures set in. Wildgen organizes each class around adding a new skill to the doctors’ toolkit as writers, with the season’s final meeting focused on revision. The class centered on sensory detail is a favorite: “They’re doctors, so they’ve got some really gnarly stuff if they want to call upon it,” says Wildgen. While many doctors use the class as an opportunity to write directly about their work, the choice of topic is theirs. At first Wildgen considered making medical writing the explicit focus of their assignments, but she soon realized that this undercut what she hoped to offer to the doctors: “They are people beyond just being physicians, and part of self-care is allowing for that.” Similarly class readings include classics of medical narrative, like the work of Oliver Sacks, alongside that of literary vanguards such as Seamus Heaney and Alice Munro. At the end of the semester, a public reading at a local independent bookstore showcases the doctors’ work as well as the skills and community they’ve built.

The doctors’ writings offer a window