A physician, a patient and two poems

Elizabeth Lahti, M.D.’s “Heart” essay explores narrative medicine and professional practice

November 13, 2014

Have you ever been brought to tears during a grand rounds presentation? When Elizabeth Lahti, M.D., assistant professor of medicine, read a personal essay during a recent Department of Medicine grand rounds, she provoked an emotional reaction from colleagues that prompted her to submit the piece for publication.

Elizabeth Lahti, M.D.Entitled “Heart,” that essay (excerpted below) has since been published in the October 2014 issue of the Journal of General Internal Medicine. It’s about writing poetry with one of her patients – a practice that may not be found in medical school textbooks, but is a prime example of narrative medicine.

Dr. Lahti, who is also director of narrative medicine for YOUR M.D., had been writing informally about patients for the last 10 years as a way to “deepen the experiences with patients and balance my life outside of work. Since I’ve made more of a point to practice narrative medicine, I’ve begun involving my patients, as well.”

Increasingly, skills that were traditionally considered “unteachable” or intuitive are being integrated into formal curricula; the OHSU School of Medicine is a leader in this movement. From the multiple mini interview admissions process to the school’s new YOUR M.D. curriculum, skills such as professionalism, communication and empathy are fully integrated into a future physician’s training.

Narrative medicine fits right in with the collaborative nature of academic medicine. During rounds, Dr. Lahti encourages colleagues and trainees to write spontaneously about a patient at least once a week; then, the group comes together and reflects on their writing. “Narrative medicine brings the collegial relationship into light and opens up another dimension of caring for patients together,” she said. “From medical student to faculty, we’re on the same playing field.”

“I would encourage everyone to try it. It makes coming to work more meaningful and it enriches the environment all around,” said Dr. Lahti.

Interested in learning more about how you can incorporate narrative medicine into your professional practice? OHSU’s Write On group meets the second Wednesday of every month. Contact Dr. Lahti for details.

Excerpt of “Heart” by Dr. Elizabeth Lahti:

Delores Hailey* is a patient on the heart transplant wait list. Her case is unique in that she received a transplant 12 years ago. Despite impeccable self care and adherence to her medical regimen, her transplanted heart is failing. It was from a young donor, but like our own organs, has a genetic predisposition all its own.

I visit with Delores on rounds each morning. She greets me wearing brightly colored pajamas, her husband Winston by her side. Her breath is sometimes short. Her jugular vein quivers just above her clavicle. After I examine her and ask the official questions, the ones whose answers will appear in my chart note, I pull up a chair and ask the questions that connect us. She tells me about her family. She tells stories of her granddaughter, her friends and her faith. She tells me how hard it is being so far from home.

One day Delores tells a story about a group of people who have the same last name, but are not related. They meet once a year for a two-day picnic. There are over a thousand like-named people who come together and, according to Delores, have become a family of sorts. She tells me she would like to find all the other Haileys and do the same thing.

“You are the Delores of the thousand Haileys,” I say.

*Delores Hailey is not her real name


OHSU faculty and staff can access the full essay here.