Rita Charon

Meet Rita Charon—physician, literary scholar and the Founder and Executive Director of Columbia University’s Program in Narrative Medicine.

Listening

Reminiscent of Gabriel Marcel’s (1889-1973) understanding of “presence” as spiritual “availability” (disponibilité), Charon (2005) described her style of listening to patients in terms of “donating the self toward the meaning-making of the other.” She emphasizes that listening is “a dramatic, daring, and transformative move,” and a “pivotal skill for anyone who wants to be a healer.” Compared to how listening is so often expressed in passive terms of “just” listening, Charon’s appreciation for the power of listening is striking.

Close reading

More recently, Charon (2017) talks about how attentive listening in healthcare is like reading a novel closely. “Close reading,” she says, “develops the capacity for attentive listening” (p. 166), and pays careful attention to metaphor and figural language, tone, and mood (p. 169). Her inspiration is American author Henry James (1843-1916), the subject of her Ph.D. dissertation. Taken from James’s “The Art of Fiction” (1888), Charon’s motto is “Try to be one of those people on whom nothing is lost.”

Charon describes her approach of “close reading” in her medical practice as follows.

As the shift occurs from “listening like a doctor” to “listening like a reader,” my self shifts within my body and consciousness. I roll my chair away from the computer. I let my hands sit in my lap. Instead of being on an edge of ignorance and challenge, I feel summoned by the patient—Is it her account? Is it her words? Is it her presence? Is it her action in having come to me because she thinks maybe something good will come of it?—to what feels like a different self, my readerly self. I think it is the difference between being a judging outsider who is being tested to know what to do about a problem, and being a welcoming stranger of its mystery, willing to sit within all its doubts.

“This sequence in the office is not unlike a sequence of close reading,” Charon (2017) explains. “The same alert, creative presence is needed by the reader or the listener; the same attention to all features of the narrating are awakened; the same intimacy between creator and receiver of the narrative is achieved” (p. 167).

Narrative medicine

For Charon, “narrative medicine is committed to developing deep and accurate attention to the accounts of self that are told and heard in the contexts of healthcare” (p. 157).

Moreover, she explains that “close reading” is narrative medicine’s “signature method” because if its (1) action toward social justice; (2) disciplinary rigor; (3) inclusivity; (4) tolerance of ambiguity; (5) participatory and nonhierarchical methods; and (6) relational and intersubjective processes (p. 172).

Spiritual Care

Regarding disciplinary rigor and inclusivity, Charon talks about how narrative medicine opens its doors to broader theoretical approaches, genres, artists, and perspectives” in the “geography of critical approaches, texts, and textual practices.”

Do spirituality and spiritual care appear anywhere in this landscape?

In addition to Henry James, who else is out there? Any hospital chaplains?

Anton Boisen

Of course, hospital chaplains, or spiritual health practitioners, have been applying “close reading” in their own clinical practice for decades. In his book, The exploration of the inner world (1936), Anton Boisen (1876-1965), one of the founders of hospital chaplaincy, described his aim to read patients as “living human documents.”

And, according to G. Asquith (1980), a close reading of Boisen’s work “indicates that he had a two-fold objective for his case study method. “I have sought to begin not with the ready-made formulations contained in books,” Boisen said, “but with the living human documents and with actual social conditions in all their complexity’” (p. 86; Boisen, p. 185).

For spiritual care, narrative medicine is an old friend; for narrative medicine, spiritual care is perhaps a surprise guest stepping through the door and joining the party as a new conversation partner.

Asquith, G. (1980). The Case Study Method of Anton T. Boisen. Journal of Pastoral Care, 34(2), 84-94.

Boisen, A. (1936). The exploration of the inner world: A study of mental disorder and religious experience. New York: Harper & Brothers.

Charon, R. (2005). Narrative medicine: Attention, representation, affiliation. Narrative, 13(3), 261-270.

Charon, R. (2017). Close Reading: The Signature Method of Narrative Medicine. In R. Charon, S. DasGupta, N. Hermann, C. Irvine, E. Marcus, E. Colon, et al. The Principles and Practice of Narrative Medicine. New York: Oxford University Press.

Marcel, G. (2011). On the Ontological Mystery. In B. Sweetman (ed)., A Gabriel Marcel Reader. South Bend, IN: St. Augustine’s Press.  (Original work published 1944).