Interview to Marco Testa, cardiologist, participant to the Fifth Edition of the Master in Applied Narrative Medicine
Why did you choose a Master in Narrative Medicine?
I have always tried to consider the patient as an ill person, rather than the guest of a pathology. After my degree, I cared for clinic research for several years, then, about 15 years ago, I came back to cardiology, in particular caring for heart failure, a chronic condition affecting elder people, very difficult to face for the big impact on their lives. For this condition, a long term and continuous relationship of care is required: visit after visit, you can know the patient’s story and his/her ordinary life, the family and social context. This relationship of care is based on empathy and is very demanding for the physician. “Can this approach also improve the therapeutic outcomes?” me and my colleagues were wondering. This was my reflection, when I discovered “something” named Narrative Medicine, and it seemed being able to give me the answers I was looking for, to improve my clinical practice.
Had you ever heard about Narrative Medicine? And what did you expect from the course?
No, I hadn’t heard about it till last year, when I discovered this discipline; from that moment my interest increased more and more. I read the Charon’s book “Narrative Medicine: Honoring the stories of illness”, I caught something interesting, but it still wasn’t so clear to me. I found the Master in Applied Narrative Medicine organized by ISTUD on internet and I considered it as the opportunity to understand more what Narrative Medicine was and how to apply it in my clinical practice.
What did you find? What did you discover throughout Narrative Medicine?
I found more than I was expecting for. A group of passionate and expert people able to involve me to enter in the Narrative Medicine “world”. This group was composed by the national and international faculty, but also by the other participants to the course, a varied and rich mixture of professionalisms and points of view, but homogeneous in the fresh interest in Narrative Medicine as a way to improve the own practice.
Through Narrative Medicine I understood that the time spent to talk with the patient is a earned time, not only because it improves the empathy, but also because paying attention to the patient’s living, the social and family context, the identification of coping strategies, together with clinical elements, allow to personalize the pathway of care and transform health care professionals into “tutors for resiliency”.
I discovered that all this can be taught, and specific narrative based competences exist to be integrated to the evidence based protocols, to obtain important information.
How your project work was welcome by your patients, colleagues and health care managers?
I didn’t have doubts regarding my project work, although I could imagine possible difficulties, I wanted to focus on my patients with heart failure. This is a very impacting chronic condition, and the narrative approach can be easily used, even if most patients are old and already full of tasks for the followed treatment. I expected that most of them wouldn’t have participated to the proposed activity to write the story of the impact of the disease on their life. Some of them, indeed, did not participate, but others were happy to be involved. We experimented that neither the age and the level of instruction affected their availability to write their story.
My colleagues reacted in different ways: at the beginning they were a little skeptical, but gradually I had the opportunity to explain to them the project and finally they accepted to be involved, even if not always in an active way!
The health care managers were not involved in my project work, but they allowed me to organize a training event on Narrative Medicine within the hospital.
Do you have any projects on Narrative Medicine?
During the master I realized how much important is the training on Narrative Medicine addressed to future health care professionals and that in Italy there are a few experiences. My dream was to plan a course on Narrative Medicine at the Faculty of Medicine of the Sapienza University, in Rome. I talked about this idea with the directors of the faculty and they supported me in the organization of the course. We found the financial support – from Pfizer – and the course will be held next academic year, 2017/2018, at the third year of the Faculty of Medicine, when students start their direct experiences in the wards. The hope is to teach students to listen to in a real way the patient, with empathy. In this course we want to involve experts with direct experiences in the approach of Narrative Medicine. This will be a unique experience in Italy, in my opinion, but I hope it could be diffuse all over the Country, since I believe Narrative Medicine should be taught in all the Faculties of Medicine and the other courses for health care professionals.