Tenth International Conference on Health, Wellness & Society

Abstract

The US healthcare system has suffered a tremendous commodification by social and economic forces that have stripped its ability to deliver quality care, resulting in a model that pays little regard to the patient’s life. A narrative-guided ethic centered on patient stories is a liberatory tool that can reshape our approach to care. An exercise in reflexivity, this intersubjective practice slows the encounter between the “self” and “other” through a practice of close reading, creative writing, and attentive listening, cultivating a state of critical consciousness. Engaging in such a practice reveals our social positionalities, privileges, and ideological commitments, and how each works to relegate certain voices to the margins. The field of narrative medicine takes an interdisciplinary approach in order to honor marginalized stories, ranging from formalized qualitative studies to oral history projects. We pose that by attuning ourselves to these stories, we can implement healthcare policies that specifically address illuminated needs. In addition to carefully attending to the patient’s singular story, we must also contend with the structural variables that drive health inequalities. Drawing from the fields of critical race theory, gender/queer studies, and disability studies, the framework of “structural competency,” is grounded in recognizing the structures that shape clinical interactions and using the practices of structural humility to observe and imagine systemic interventions. We draw from Paulo Freire’s “Pedagogy of the Oppressed” and Metzl and Hansen’s theory of structural competency to describe how narrative medicine might be used as a tool to transform the healthcare industrial complex.