Connections in the Clinic: Relational Narratives From Team-Based Primary Care

Book Title: Connections in the Clinic: Relational Narratives From Team-Based Primary Care

Editors: Randall Reitz, Laura E. Sudano, and Mark P. Knudson

Publication Details: Springer, 2021, 302 pp., $84.99, hardcover

Storytelling and medicine have been intertwined for centuries. Powerful narratives teach and enhance the evolving practice of medicine. Literature suggests that when we employ narratives in medical education, we not only engage learners and improve memory, but we also provide a context for understanding and a means for promoting professional identity and empathy.¹ Narrative medicine, quite simply, is the practice of medicine enhanced by someone “who knows what to do with stories.”² It is the ability to recognize, absorb, and interpret a story to both understand and subsequently share it with another—to be moved by a story and, in its retelling, move another.

In Connections in the Clinic, editors Randall Reitz, Laura Sudano, and Mark Knudson bring together more than 100 narrative pieces in an attempt to infuse meaning into the relationships inherent in team-based primary care. As Dr Sudano notes in the preface, the book is as “broad and grand as the constellations above us, encompassing the expanse of the human condition from birth to death” (p. viii). To provide structure to this enormity, Drs Reitz and Sudano, both licensed marriage and family therapists, and Dr Knudson, a family physician and educator, divide the work into six sections: Family of Origin, Teachers and Mentors, Our Patients and Ourselves, Colleagues and Collaborators, Clinician as Patient, and Death and Loss.

The result is striking. The stories are as varied as family medicine itself. In one narrative, for example, the author reconnects with an early mentor shortly before his death. In another, the writer describes the inherent self-doubt associated with teaching. In yet another, the storyteller shares personal difficulties encountered as a provider-turned-caregiver navigating the complexities of medical care for one’s family. Some narratives are poignant in their simplicity, such as the description of the pair of sneakers that awakened a medical student to the indignities associated with death. Other narratives are both heartwarming and comical, as when a deceased patient teases her longtime family physician from beyond the grave when her beloved Red Sox finally topped his Yankees in the league championship. Still other stories examine the more common frustrations and joys of the profession, such as when a lengthy patient complaint leads to frustration, anger, deflation, and eventually gratefulness.

With its repertoire of narratives, Connections in the Clinic provides a reprieve and a reflective space for family medicine providers and educators alike. The collection of varied narrative formats, including short stories, personal reflections, and poetry, are limited to three or four pages, a length that facilitates reading even when time is short. Emotional impact, however, is not lost at the behest of brevity because the reader’s assumed familiarity with family medicine provides the needed backstory to invoke an emotional connection in relatively few words.

In its thoughtful organization, the book comes full circle, following the paradigm from our childhood through life as students, clinicians, educators, colleagues, and ultimately, patients or caregivers dealing with personal loss and death. At what page in the book one’s viewpoint turns from personal association and empathy to acknowledgment and sympathy depends on one’s own career perspective. For the new-to-the-profession student or resident, the book serves as a preview and road map to anticipated experiences and emotions. For the seasoned provider, the narratives undoubtedly will trigger memories of similar personal and professional experiences.

Storytelling is essential to the practice and teaching of family medicine, reminding us to recognize and embrace the human side of medicine.³ For all involved in team-based primary care, this collection of narratives reminds us how to both listen and tell a story. Beyond its place in medical education, Connections in the Clinic also is opportune for supporting the well-being of the pandemic-weary provider. A common theme throughout the book, culminating in the final chapters, is the blurred line between work and life—a line that has become fuzzier since March 2020. While research supporting narratives as a tool in medical education and patient care continues to grow, the impact on provider wellness should not be underestimated. One senses a catharsis when recognizing oneself in the story of another, and the realization that others have experienced something similar is reassuring. If storytelling encourages educators to bring the humanity into the teaching of medicine, does it not also remind us of our own humanity and inherent vulnerabilities? Connections in the Clinic succeeds in both.