1Ever since its groundbreaking introduction in 2000 by Columbia Professor Rita Charon, Narrative Medicine (NM) has had a drastic impact in medical education and practice, as well as the Humanities and the Arts. The practice of NM aims at combating the dehumanization of commercialized healthcare in the western world by honing clinicians’ (self-)diagnostic and bedside skills through the guided narratological analysis of literary texts. Success in practice has led health professionals along with literature scholars and artists to not only establish NM workshops and even entire programs in institutions of higher learning and research, but also to work towards creating a robust corpus of NM scholarship comprising both theoretical texts and textbooks/practice guides, following Charon’s latest, collectively authored and edited anthology, the much-translated The Principles and Practice of Narrative Medicine (Oxford UP, 2016).

2Within this context, the present anthology by Rasmussen, Mai and Hansen falls solidly on the practical side as both a “how to” case study and manual for NM scholars/practitioners and a student textbook. For easier use, each chapter is conveniently accompanied by a clear abstract and its own reference list. The contributors’ qualifications combine two or more specializations in (comparative) literature, ethics, sociology, anthropology, philosophy, IT, medicine and other aspects of health sciences and/or practice—a breadth of scholarly viewpoints that is one of the main advantages of the anthology, reflecting the hybrid nature of NM and also highlighting how each approach contributes uniquely to the sensitization of medical practitioners. It also offers a welcome variety of tone, with the more conversational humanities pieces alleviating the more cut-and-dried medical ones.

3The volume is forewarded by Charon herself; she presents its internationality and transdisciplinarity as paradigmatic of the next phase in NM, which “has evolved into a systems narrative medicine since it is increasingly influenced by and influencing global and social processes far afield from actual clinical settings” (7). In enunciating the challenge of navigating a complex global field, but also in recognizing the systems’ properties of autopoiesis and emergence, Charon offers a definition of systems thinking that is akin to appreciating a poem, “closely observing, interpreting, and interacting with the unpredictable and beautiful unity” (8).

4There follows an introduction, where the anthology editors identify its singularity in that the majority of its contributors are affiliated with the University of Southern Denmark (USD) with its innovative combination of programs in Culture, Literature and Medical Humanities (20). Rasmussen, Mai, and Hansen emphasize the systemic social and practical orientation of the volume towards “developing a health system that recognizes each person as an individual with social relations in the context of diagnosis, treatment, nursing, and care” (13). They outline the four parts of the anthology, review the history, goals and scholarly research done in recent years in NM and conclude by focusing on the Nordic tradition in Medical Humanities and their scholarly efforts to establish NM as a seminal part of Denmark’s medical education.

5The first section of the anthology, “Narratives in Medicine,” begins with a chapter by Rutgers English professor Ann Jurecic, who asks “Is Teaching Empathy Possible?” For Jurecic, empathy is difficult to define, teach and more so, measure via short-term, formulaic or standardized methods (27), since true empathy “refers to social and emotional practices that are learned…over years and decades” and “draws on many different habits of the mind, including attention, curiosity, openness, flexibility, imagination, and self-reflection” (30). Jurecic recounts personal experiences as a humanities teacher of medical students, advocating for a radical restructuring of medical teaching in favor of slow learning “that reinforces the habits of mind that support empathy, including attention, curiosity, reflection, and an acceptance of both ambiguity and complexity in human lives and relationships” (36).

6Chapter 2, “The Role of Narrative Structures and Discursive Genres in Healthcare Education and Practice” by Medical Humanities professor Ronald Schleifer offers a practical “how to” diagnostic guide that emphasizes the importance of discerning the “six elements” of narrative structures for understanding patients’ stories, especially that information that remains unspoken/repressed, yet often is of vital importance in understanding the nature of the complaint. Combining those structures with Schleifer and Jerry Vannatta’s three “orders of cognition” in patient-doctor interactions—“biomedical understanding,” “the patient’s understanding” and agenda, and “affective engagement” (45)—allows the physician to shift the focus of the medical history interview from the “chief complaint” (the medical problem) to the “chief concern” (a patient’s understanding of, investment on, and expectation regarding, their situation).

7The emphasis on the role of storytelling in the diagnostic-healing process continues with “Vulnerable Reading: Stories as Good Companions” by Sociology professor Arthur W. Frank, who advocates offering up cases of vulnerable individuals from literature as “companions” for ailing people to identify with, and thus alleviate some of the stress, solitude and sense of despair their illness inevitably engenders (53)—in a sense, what literature has been doing all along. The advantage of vulnerable reading, according to Frank, is that it transcends the “subject/object split” (54) between clinicians (who are trained in NM) and patients (their objects), since it makes ill people the acting agents of their own story, offering a sense of empowerment.

8Chapter 4 inaugurates the second Section of the anthology, “Narrative Medicine in Healthcare Education” with an article by NM professor Anders Rasmussen and medical professor Morten Sodemann, titled “Prescribing Stories before Medicine. Narrative Medicine in the Teaching of Medical Students and Physicians.” It is a foundational article in the anthology, offering a comprehensive overview of NM and showcasing the obligatory course in NM at the USD as the impetus for the anthology. The article offers a detailed description of the program components situated within a broader overview of NM as a discipline, laying particular emphasis on empathy and structure-making: “The healing power of a story is often linked with the narrative’s potential to create a plot to ascribe meaning to experience and to inscribe events into a context that makes cultural and personal sense” (74). At the same time, for clinicians, NM works as a “parallel chart” where they monitor their own emotional states/symptoms, allowing them to recognize and alleviate the stress of their environment.

9Similarly, Chapter 5, “Connecting Classwork to Clinic: Narrative Medicine for Healthcare Professionals and Students” by Cindie Aaen Maagaard, Helen Schultz and Anita Wohlmann focuses also on the NM program at the USD with a detailed overview of its elective Master’s course. They present the two narratological approaches covered in the course, the “instrumental close reading” for “understanding concepts through a literary text” (91) and the “exploratory close reading” of affective and intellectual interaction with a text (94), with the benefits and challenges of each for professionals during clinical practice. The chapter actually is a meticulous and complete course blueprint, very useful for anyone wishing to implement their own NM course.

10The next section, “Narratives of Healthcare Practice” opens up with a psychiatry professor Anette Søgaard Nielsen and psychologist Jakob Emiliussen’s “What’s with the Drinking? Narratives about Alcohol Abuse.” Drawing from their own experience and studies on substance abuse, the two detail the “five master narratives” (107) of how people become alcoholics, and how the invocation of the appropriate master narrative through NM methods is instrumental in complementing diagnostic criteria which often overlook the cultural and non-biological meanings of drinking, while avoiding the (re-)conferral of social stigma upon the patients (112).

11Next, Anette Grønning and Anne-Marie Mai combine their expertise in Communication technologies and Literature to address a feature of 21^st century healthcare in “E-mail Consultation in General Practice: Reflective Writing and Co-created Narratives.” The article extends the narratological practices of NM to patient emails of illness narratives in the context of the “Digital Consultation” program by the USD (121). Gleaning material from patient and doctor interviews as well as from Nordic literature, the article illustrates how close-reading competence in digital/asynchronous consultation offers clinicians a valuable diagnostic enhancement, especially considering how, today, “E-cons,” which comprise 1/5^th of Denmark’s annual medical consultations, “are set to remain a permanent and ever more challenging part of the GP’s everyday life” (133).

12The final part of the anthology, “Narrative Medicine in Interventions,” begins with “Creative Writing as Rehabilitation” by Sara Seerup Laursen, Tine Riis Andersen and Helle Ploug Hansen. The three NM scholars chronicle in detail a workshop for rehabilitating chronically ill patients through creative writing. “Writing as a form of therapy” is well-established from a literary perspective; but now the hypothesis is entertained from a medical perspective with “measurable” positive results for “rehabilitation, health promotion, palliative care, and treatment” (138). The researchers admit that “Illness can cause chaotic thoughts, loss of the language needed to express oneself to those around you…” (139); nevertheless, they stand by CW as improving communication, enabling self-expression, and alleviating illness conditions.

13Chapter 9, “Poetry Prescribed for Loneliness: Shared Reading for Men Near Retirement” by Marie-Elisabeth Lei Holm, Peter Simonsen, Mette Marie Kristensen and Anna Paldam Folker, a group also coming to NM with joint Humanities specializations, takes occasion from a review by the World Health Organization (WHO) “who has singled out art and culture as important resources that can be integrated into various forms of health initiatives” (153). The article details the elements and results of their USD-affiliated project, “Read, Man!” aimed at retired men, a group “vulnerable in terms of experiencing loss of meaning and loneliness when they are no longer working” (155), to conclude that literature, whose universal character offers more widespread potential for recognition (identification, catharsis, empathy), “does seem to have the potential to promote enhanced health when read, used, and shared among different groups of people” (164).

14The final Chapter of the anthology, Jeanette Bresson Ladegaard Knox’s “Socrates and Sickness: On Philosophizing through Narrative” takes basic NM from narratology to philosophy. Knox, a professor of Medical Ethics and Philosophy, delineates through an actual session example how oral narratives of personal stories by cancer patients, when dialogically processed through Socrates’ “midwifery” method, lead patients to “think chorally” (168) about their own experiences, and thus achieve a philosophically palliative perspective on their predicaments. It can also “help doctors to refine their interpretation of patients’ perceptions of their own illness, make nurses better at safeguarding their own values and those of others, and improve patients’ ability to cope with the uncertainty of their situation” (179).

15The volume closes with an afterword by Rishi Goyal, Head of the MA program in Medical Humanities at Columbia, who recalls encountering chasms in patient-doctor communication as a young doctor-in-training, since “simply put, we had not been trained in the imagination” (183). This led to the realization that healthcare is always-already embedded in larger social and cultural structures of “biopolitics and biopower” (185), such as the changes from a paternalistic to a patient-interactive clinical model and the effects of increasing “migrancy, race, or poverty” (185) on the quality of healthcare. Goyal concludes that “Biological existence is reflected in political existence” (186), echoing Charon’s original impetus for the institution of NM as offering practical justice on matters as vital as life, health and death. Thus, the transplantation of the American-born NM ideal worldwide concludes appropriately by acknowledging the challenge of global migrancies on the future of that ideal and its practices.