Exercises and Readings for Narrative Medicine Groups
General Writing Prompts
These prompts can be used in narrative medicine groups as icebreakers at the beginning of a meeting or after reading a short piece of literature together.
“Write about the story of your name.”
This prompt works well as an introduction exercise. Have participants write for 3 minutes and then share what they wrote in dyads, in triads, or with the whole group.
“Write about one of your scars.”
This prompt also works well as an introduction exercise. Have participants write for 3 minutes and then share what they wrote in dyads, in triads, or with the whole group.
“Imitate the form of this piece of writing.”
This prompt can bring forth things from the reader and writer that surprise them and can instill a sense of confidence in new writers.
“Write about a patient whose suffering has moved you.”
This can be used as a prompt for writing that takes 20 minutes. It intends to draw attention to the fact that all narratives are written from a particular perspective that reflects individual histories, values, expectations, and social positions. Reading these stories to one another will illuminate the differences in perspectives. To further this exercise, participants can then chart notes for the patient they wrote about to examine contrasts in tone, meaning, perspective, language, and emotion expressed in a medical record versus a story.
Close Reading Pieces & Writing Prompts
The following pieces of literature are effective narrative selections to read together in narrative medicine group meetings with health care clinicians, patients, or other communities. After reading them silently or aloud, group members can consider and discuss the elements: frame, form, time, plot, and desire. Some of the suggested pieces explicitly pertain to Veteran and combat experiences, some concern health care delivery, and some are more generalized. (PDFs of pieces are included on Whole Health website.)
Achilles in Vietnam, Jonathan Shay
- This entire book can be taken up by an ongoing group meeting or extracts can be drawn from it.
The Things They Carried, Tim O’Brien (excerpts from pp. 2-3 and 14-16)
- This collection of related short stories is based on author Tim O’Brien’s own experiences as a soldier in the Vietnam War. It is quite an accessible text, written in unique and thought-provoking forms, and captures universal themes through personal narratives of soldiers. It could be especially effective to use with Veterans, VA providers, and anyone in military communities. Any of the stories could be read, but the excerpts on pp. 2-3 and 14-16 work well with the following prompt.
Prompt: “Make a list of what you carry, or what your patients carry, imitating the form from the passage (They carried…They carried…They carried…).”
“For Esmé—with Love and Squalor,” JD Salinger (The New Yorker, 8 April 1950)
- This is a longer short story that would need to be read before the group meets and can be used just for close reading. The protagonist, an American soldier stationed in England and then in Bavaria during and just after WWII, suffers from a nervous breakdown. Through an unusual friendship with a young girl, the soldier finds hope and healing. The explicit portrayal of varied aspects of the soldiering experience makes it a relatable text for VA providers and Veterans. (Searchable on the web.)
Health care delivery
“Blood,” Zdravka Evtimova from Pale and Other Postmodern Bulgarian Stories, Vox Humana Books, 2010
- This is a very short story that can easily be read on the spot and is an excellent text for facilitating participants to bring their own experience to the story. It concerns anxieties about boundaries in care-giving relationships, the limits of responsibility, and how to determine how much is enough to give.
Prompt: “Write about a time you did or did not give the blood of a mole.”
The English Patient, Michael Ondaatje (the first two pages)
- This novel is set in Italy during WWII. The first two pages work well to read together during a narrative medicine group meeting. They introduce a nurse and her patient in a vivid and intense depiction of pain and care-giving.
Prompt: “Write about a scene of suffering.”
“The Ship Pounding,” Donald Hall
- Clinicians and patients alike can connect to this poem, which is directly about medicine, unlike some of the other pieces suggested. When first orienting people to narrative medicine, it can be helpful to use something directly related to medicine.
Prompt: “Write about the hospital as a place.”
“The Short Arm of Chromosome 4,” Frank Huyler
- This short story concerns the role social, medical, and family values play in health care. It can be divided into two parts: Begin with the group reading the first two pages together, alerting them that this is not where the story ends. Pause and discuss. Then ask participants to respond in writing to the prompt (below). After they write, share, and discuss with the group, hand out the final two pages. Read the author’s ending and discuss.
Prompt: “Write the rest of the story.”
“The Death of Fred Clifton,” Lucille Clifton
- This short and rich poem addresses the death of a spouse. It is a good piece for encouraging group members to consider the setting, who is speaking, who the speaker is speaking “for,” and the power of just a few words arranged in a particular way.
Prompt: “Write about the things themselves.”
“Bird Understander,” Craig Arnold
- This is a powerful poem about the expectations and limitations of care-giving.
Prompt: “Write about a time when you took care of someone or when someone took care of you.”
“Girl,” Jamaica Kincaid
- Responsive writing based on this poem works well when participants fully attempt the form Kincaid uses, pouring their content into her “container.” (Searchable on the web.)
Prompt: “Write instructions to yourself in the style of Kincaid’s piece.”
“Sometimes,” David Whyte
- Clinicians, patients, and families all face uncertainty at times. This poem lends itself to an exploration of how we respond in situations when answers are not clear.
Prompt: “Write about the questions that are patiently waiting for you.”
“The Broken Column”, Frida Kahlo
- This self-portrait from 1944 explicitly represents the pain and suffering Frida Kahlo endured throughout her life. Encourage participants to spend a long time looking at the piece, all its details. Ask them to tune into what it evokes in them emotionally, and any memories it stirs up. Highlight the juxtaposition of pain and beauty captured in the painting.
Prompt: “Depict (in words or image) your pain, present or past.”
Veterans’ Narratives for Reading and Discussion
These Veterans’ narratives can be read or watched and discussed together in groups.
- Capps R. Back from the brink: war, suicide, and PTSD. Health Affairs. 2010:29(7):1407-1410.
- Speeches by disabled Veterans Nathan Short and Neil Colomac:
- Colomac N. Please lord, let me provide for my family. 2012. Vital Speeches of the Day website. Accessed May 26, 2018.
- Short N. How a camel and Congress put me where I am today. Vital Speeches of the Day. 2011;77(10):372-375.
- VA Patient Narrative by third-year medical student Amy Waldner
- Nineteen stories by veterans and civilians are collected in the anthology Retire the Colors: Veterans & Civilians on Iraq & Afghanistan, edited by Dario DiBattista.
- Prose and poetry by Veterans and their family members published in The Journal of Military Experience, Blue Streak: A Journal of Military Poetry, and The Blue Falcon Review.
- The Veterans Writing Workshop (VWW) features Veterans’ writing samples on their website.
- Writing from members of the Syracuse Veterans’ Writing Group.
- 7-minute video clip about the My Life, My Story VA initiative
“Exercises and Readings for Narrative Medicine Groups” was written by Annie Robinson, M.S (2014, updated 2018).
This Whole Health tool was made possible through a collaborative effort between the University of Wisconsin Integrative Health Program, VA Office of Patient Centered Care and Cultural Transformation, and Pacific Institute for Research and Evaluation.