Narrative Medicine And Acute Myocardial Infarction : The Heart Of The Stories – Speech by Marco Cordero

Between the 19th and the 21st of May in Porto (Portugal) took place the “Humanism in Surgery” Symposium. The last day was dedicated to The European Narrative Medicine Society (EUNAMES) Congress. We are happy to shere some of the speeches and slides of the participant.

Marco Cordero, Hospital Universitari de Bellvitge Barcelona, Spain.

As a cardiologist working between the Emergency department and the Cardiac Intensive Care Unit, we wondered how we could humanize the way we take care of patients through the terrifying experience of such a disease like the Acute Myocardial Infarction (AMI) and we thought that narrations from patients hospitalized in the very early phase of AMI were likely to disclose the way they really lived it. 

We collected narrations from 13 patients shortly after diagnose and primary percutaneous revascularization for AMI, admitted to our tertiary care hospital in Barcelona’s south area (Spain). All patients were given a semi-structured trace and were asked to write down their experience in the first 48 hours after admission. We discovered that everyone of them lived the experience of the disease form a different point of view. Every AMI was a unique and different event. Disease was the same but sickness or illness were totally different in everyone of the included patients. Thank to narrations, we discovered that the knowledge of the real feelings, thoughts and context which emerged in the written texts was a tool to better know the patients, to take them  by hand and lead them through the difficult moment they were living, to establish an empathic communication with them and focus on the strategies and elements of coping by which everyone of them faced the disease. Narrations made of every AMI an experience of life, not just an hospital admission because of an organ dysfunction. 

On the other side we also asked patients to narrate their experience after recovery and rehabilitation therapy and we observed how things changed at the very beginning of the disease and after a few months elapsed and patients managed to improve their conditions. From the static, retrospective, closed and dark narrations of the acute phase where words like “defeat”, “fear”, “fall down”, “guilty” and “end” were clearly dominant, we moved to the prospective, dynamic narrations of the recovery phase where “hopefulness”, “future”, “projects” were the dominant tones. 

Thank to narrations we observed how patients moved across a journey from the feeling of death to the wish of rebirth.  Rehabilitation represented a powerful medical strategy to do that. 

Narrations helped us to better understand the whole person hidden behind the patient with AMI, to identify in each specific case which is the thread to pull, in order to help every person to go through it, to individualize medical care according to the context and feeling of every patient. We could definitely say that thanks to narrations our view of the cardiology and our very essence of cardiologists really got to change. Narrations taught us to listen the story of the heart and not simply to the heart of the story.

The European Narrative Medicine Society was born from an idea of the Italian Society of Narrative Medicine (SIMeN), and  it is an association of non-profit researchers dedicated to the investigation of Medical Humanities and Humanities for Health in the medical, health care, social services.

The purpose of this European Society is to promote and strengthen dialogues, discussions on the present and the future of Medical Humanities and narrative medicine, for health professionals, researchers (both academics and non-academics), humanists, teachers and other professionals coming from every branch. All this with the aim to contribute to improve both the well-being of people who suffer from a physical condition or a mental illness, and the health workers, the caregivers, the social services and the citizenship.



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