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Medically Assisted Procreation and young General Practitioners’ experiences: two project works from the Master in Applied Narrative Medicine

by Paola Chesi and Alessandra Fiorencis

Procreazione assistita

Christian Schloe – A Midsummer Night’s Dream

We present two project works developed during the third edition of Master in Applied Narrative Medicine, with the aim to underline and value the practical aspect of the ISTUD Foundation’s training path: that is, to give Narrative Medicine concrete tools to effectively act in health contexts, to improve work climate, relationships in care teams, and doctor-patient relationships.

Couple infertility and Medically Assisted Procreation paths (MAP) are the themes of the project “Becoming parents”, by Francesca Memini (digital communication consultant), participating to the third edition of the Master. According to the World Health Organization, many women facing MAP show (even if in different ways) symptoms of stress, irritability, deep sadness, guilt, loss of energy and motivation, hypersensitivity, and tendency to isolation. Medical attention and sensitivity to emotional aspect of infertility reveals very important for couples, in particular for women: international institutions suggest an empathic approach by doctor, considered as essential for a good treatment.

The project aimed to analyze offered MAP path’s quality, eventual coping strategies, management of psychological and social experiences, and information about risk factors. Narratives, all made by women, were collected through a blog, sustained by a promotion activity on dedicated forum and social networks.

During analysis, narratives highlighted several dimensions liked to infertility and MAP. Among them, emerged: the difficult relationship with doctors (“doctor shopping” phenomenon) and healthcare system; the importance of internet as cognitive coping tool, and of social networks as an emotional support room. Furthermore, emerged the imaginary surrounding infertility condition, MAP paths and individual and couple psychological life, sometimes presented as metaphors: the desire of having a child that becomes dream, the hope in a miracle, the sense of solitude facing this “war”; feeling as real warriors in a difficult path, or as victims of fate.

The second project work we present, by Grazia Chiarini (physician), concerns narratives of young General Practitioners’ experiences and expectations. The project aimed to collect and interpret stories of professional decisions and of first care experiences of young doctors: motivations for faculty choice, expectations hanging around path; difficulties faced, hopes animating years of study; first relationships with patients, and their changes during time. Other objectives followed this general one, such as an incentive for reflection, the analysis of doctors’ experiences, the individuation of criticalities, with the perspective of improving self-awareness of one’s own role in the relationship with patient.

The project was conducted through the collection of narratives of graduated medicine students, doctors at the first year of General Practitioner training course, and doctors who have already ended it; doctors who, even if trying to pass the exams for limited number courses, couldn’t access any of them.

As methodology, were used semi-structured stories that represent the track to develop narratives. These were analyzed according to Narrative Medicine classifications. The author analyzed the emerging medical figure, the deriving care relationships, metaphors, and did a quantitative analysis of recurrent words. Furthermore, she identified some cruxes in which collect elements from narratives, with the aim to compare their common aspects and their differences: the choice of title and faculty, and episodes and persons that influenced this choice; expectations before and after specialization choice; the first contact with patient, the important episodes signing relationship with patients, or those with tutor and colleagues. There is a plurality of choices and motivations at the base of the training, working and living path, after graduation. “Professionals” difficulties sum up with apprehensions for the future.

Allow young doctor to express these tensions can help them to have more awareness in their motivations, expectations, desires. The doctor revealing from narratives is a professional who, even if uncertainties and reconsiderations, with an expertise of notions and personal life stories, is able to take care about his or her patients, from a clinical and a relational point of view. Bureaucratic aspects and depersonalization of work environment do not help. This is why the voice of “taking care” must spread.

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