AREAS OF FOCUS
Narrative Medicine
Medicine begins with a story. Long before a test result or a scan, a patient arrives with an account of when the pain started, what changed, and what they fear it means. A doctor’s first task is to listen well enough to understand the story. This idea, taken seriously, is called narrative medicine: the practice of bringing the skills of careful reading and honest writing to the work of caring for patients. Holding that level of attention to a person’s story is not a soft addition to good medicine but part of its substance. Dr. Shulman writes in this tradition, and his forthcoming book, Cramp: A Doctor’s Notes on Pain, belongs to it.
An old alliance between medicine and writing
The pairing of doctor and writer is far older than the modern field. Anton Chekhov, one of the great short-story writers, practiced medicine throughout his life and called it his lawful wife, with literature as his mistress. John Keats trained as a surgeon-apothecary before poetry claimed him. William Carlos Williams spent his days as a pediatrician in New Jersey and his evenings as one of America’s essential poets, often writing about patients he had just seen. At the turn of the twentieth century, William Osler, often called the father of modern medicine, urged physicians to read widely and kept what he called a bedside library of great literature, convinced that studying human beings on the page made for better doctors. The idea that medicine and storytelling belong together is not new; it is one of the oldest instincts in the practice of care.
How a tradition became a field
More recently, this instinct was named and codified. In 2000, Dr. Rita Charon, a physician and literary scholar, founded the Program in Narrative Medicine at Columbia University. Trained as both an internist and a scholar of literature, with a doctorate in English, she argued that the same close attention a reader brings to a difficult text is exactly what a clinician needs to truly hear a patient. From that idea grew an academic discipline, part of the broader medical humanities movement, now taught in medical schools and offered as a graduate degree. It trains doctors to attend to the shape of a patient’s story as well as its facts: to notice what is said and what is withheld, and to treat illness as something lived, not merely charted.
What it looks like in practice
Narrative medicine is taught through two core exercises. The first is close reading, the slow, attentive study of a poem, a passage, or a painting, learning to notice tone, perspective, and what a text leaves unsaid. The premise is that a clinician who reads a page this carefully will listen to a patient the same way. The second is reflective writing, often in what practitioners call a parallel chart: alongside the standard medical record, a student or doctor writes about the patient in ordinary language, capturing what the clinical note has no place for, such as the fear in the room, the family’s exhaustion, and the doctor’s own response. Reading and writing this way are not extras layered onto medicine but training in the attention that good care depends on.
What it contributes to medicine and culture
Narrative medicine earns its place by doing practical work in two directions. Inside medicine, it sharpens the clinical skills that matter most and are hardest to teach: listening closely, observing carefully, and understanding a patient as a person rather than a case. A story fully heard is often where a diagnosis begins, and this kind of attention has been shown to deepen empathy and help clinicians carry the emotional weight of the work. Outside medicine, the physician-writer has long served as a bridge between two worlds, conveying the inner experience of illness and care to a general readership and bringing a more humane sensibility back into medicine. When a doctor writes well, patients and colleagues alike come away seeing more than they did before.
A living tradition of physician-writers
That work continues today. Oliver Sacks turned neurological case histories into human portraits; Atul Gawande opened the workings of surgery and mortality to a wide audience; Abraham Verghese has insisted on the primacy of the patient at the bedside; Jerome Groopman writes about how doctors think and where they go wrong; and Siddhartha Mukherjee gave cancer a biography that reached millions. Their books share a conviction that medicine is best understood through story and that clear writing is itself a form of care. In this company, both old and new, Cramp takes its place.
Where Cramp fits
Cramp is a work of narrative medicine in both senses of the term: it is about patients’ stories and is itself a story, told by a doctor who became a patient. It moves between the clinic and the self, using the tools of the genre, including close attention, honest reflection, and a scientist’s respect for how things actually work, to make chronic pain legible to a general reader. Dr. Shulman does not write from above the material but from inside it, as someone who has sat on both sides of the exam table. For him, narrative medicine is continuous with his clinical and scientific work: the same attention that helps him recognize a pattern in a difficult case is what he brings to the page, and the writing, in turn, sharpens his listening. Cramp: A Doctor’s Notes on Pain is written in the belief that understanding a disease and understanding a person are, in the end, the same work.
Frequently Asked Questions
What is narrative medicine?
Narrative medicine is an approach to medical care that brings the skills of careful reading and writing to the process of understanding patients. Dr. Rita Charon at Columbia University coined the term and developed it in 2000; it trains clinicians to listen closely to the stories patients tell, on the premise that a well-heard story is central to good diagnosis and care. The term also describes a broader literary tradition: doctors who write about medicine, illness, and their patients for a general readership.
Why do doctors write about their patients?
Doctors write about their patients to make sense of work that is often emotionally and intellectually demanding and to help others understand it. Writing demands a kind of attention that the medical record does not, capturing the human dimensions of illness that a chart leaves out. For readers, this writing opens a usually hidden world, showing what it is like to receive a diagnosis, face uncertainty, or care for the seriously ill. Done well, it helps patients and other clinicians better understand the experience of illness and care.
What is a physician-writer?
A physician-writer is a doctor who also writes seriously, usually about medicine, illness, and the human experience of both. Some historical examples include physicians who balanced full-time clinical practices with celebrated writing careers, such as Anton Chekhov and William Carlos Williams, while others were literary figures who left medicine behind or pursued it only briefly. Many are working clinicians who turn to the page to explain their world. They share a double vantage: the training to understand disease and the craft to render a life, which lets them write about medicine from the inside. It is the tradition Dr. Shulman writes in, and the one Cramp joins.
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