Phase 2, Module 7 of 12
Module 7: The Patient as a Person
Cassell on suffering. Charon on narrative. The parallel chart.
Core concepts
Cassell's argument
Cassell (2004) argued that suffering is experienced by persons, not by bodies, and that medicine's reductive focus on the body produces iatrogenic suffering when it ignores the person. Suffering happens when the integrity of the person is threatened. The clinical implication is that effective care must attend to the person, not only to the disease process.
Narrative medicine and close reading
Charon (2006) developed narrative medicine at Columbia as a method for restoring personhood to clinical encounters. The core practices include close reading of literature (to develop interpretive capacity), the parallel chart (where clinicians write the patient's story alongside the medical chart), and structured listening to the patient's narrative.
The parallel chart
The parallel chart is the workhorse of narrative medicine. For each patient encounter, the clinician writes a brief narrative entry capturing what the standard medical chart cannot: the patient's story, the encounter as it felt, what was said outside the medical content, and what the clinician noticed in themselves. Parallel charts are private, shared in trusted groups, and read aloud for collective interpretation.
Time and sequence
Total time
2 sessions of 90 minutes + 4 weeks parallel chart practice
Prerequisites
Modules 1-6
Pairs well with
Module 8: MatteringRecommended placement
Mid-second to early third term
Suffering is experienced by persons. Bodies do not suffer; persons suffer.