Comparative study blends medicine practices for holistic health care
The practice of medicine goes beyond diagnosing and treating illnesses. It involves understanding patients' stories and experiences to provide holistic care with compassion. Narrative medicine (NM), introduced by Rita Charon in 2001, emphasizes the competence of physicians to comprehend and respond to patients' stories. NM uses tools like close reading and reflective writing to help doctors connect with patients' illness narratives.
When NM was introduced in China, it generated significant interest and discussions among Chinese medical professionals. TCM scholars recognized that many core concepts of NM align with the practice of yi'an, which is a type of medical case record or clinical case study used in TCM. Yi'an documents the diagnosis, treatment, and outcomes of patients, often in the form of written narratives. This led to discussions about integrating NM with TCM, although the precise implementation process remains unclear.
To address this, Professor Ting Gui from Liaoning University of Traditional Chinese Medicine, set out to investigate the similarities between NM and yi'an, as well as explore methods for the effective integration of NM into TCM. Her article was published in Chinese Medicine and Culture.
NM aims to correct the limitations of biomedicine by emphasizing the humanistic aspects of medicine and understanding illness as a cultural and symbolic reality. "TCM has been traditionally seen as an ideal 'other' to biomedicine due to its emphasis on a compassionate, holistic approach to medicine. This approach values the well-being of patients, which is why there is a strong resonance between TCM and NM," explains Prof. Gui.
Yi'an is equivalent to the case history in Western medicine while maintaining a rich narrative tradition in TCM, influenced by both historical and literary factors. It serves as a means of transmitting medical knowledge and is a valuable resource for both learning and research purposes.
"In this comparative study between NM and yi'an, it becomes evident that NM is searching for a lost tradition of narrative case histories, while yi'an functions as a living tradition within TCM," observes Prof. Gui.
Case histories and yi'an share common features, including their close relationship to history, the mixed influence they gain from literature and medicine, their use of narratives to transmit medical knowledge, and their evolution driven by legal cases and the biomedicine model.
Yi'an can serve as a tool for promoting humanitarian reading and writing as a habitual practice for doctors in NM. To facilitate the integration of the two practices, it is crucial to encourage a more detailed description of yi'an, capturing its intricate details, cultural codes, and interpretations.
The findings of this study significantly enhance our comprehension of the applications of NM both within China and internationally, with a specific focus on its connection to TCM. In contemporary China, read and written case histories and yi'an coexist in medical teaching and practices. NM provides an opportunity to celebrate the similarities between these two genres and gain insights into their differences.
In the West, NM has brought changes in the way medical cases are written and published, encouraging the dissemination of more comprehensive case reports that allow for nuanced descriptions and thoughtful reflections.
By integrating ancient wisdom with modern medical approaches, we can pave way for a more compassionate, patient-centered, and holistic health care system.
More information: Ting GUI, Rethinking Yi'an (Medical Cases) as a Tool for Narrative Medicine in China, Chinese Medicine and Culture (2023). DOI: 10.1097/MC9.0000000000000063