From narrative wreckage to islands of clarity: stories of recovery from psychosis.

Medicine is a narrative art based on science. Narrative training, according to Dr Rita Charon, a general internist with a PhD in English, improves clinical skills in medicine. Charon defines narrative medicine as “medicine practised with narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others.”2 As family doctors, we act on the narratives presented to us daily by patients, their families, and other health care team members. The late Dr Miriam Divinsky, family physician, wrote in the February 2007 issue of Canadian Family Physician, “Stories offer insight, understanding, and new perspectives. They educate us and they feed our imaginations. They help us see other ways of doing things that might free us from self-reproach or shame. Hearing and telling stories is comforting and bonds people together.”3 Narratives of recovery from psychosis can also be disturbing and awakening. Narrative medicine has interested me for the past several years. I have twice attended the amazing international interdisciplinary conference, Narrative Matters, held in Canada, and I traveled to Columbia University in New York, NY, in 2003 to attend a world-class colloquium on narrative medicine hosted by Charon.4 Most recently, I immersed myself in the literature on narrative in order to better understand a critical issue in my best friend’s family life—a daughter with psychosis. As a medical practitioner, I am not alone in doing so. An article in the Globe and Mail told the story of how his son’s illness spurred Dr John Roder, a researcher at the University of Toronto in Ontario, to shift his own scientific research from cancer to schizophrenia.5 The diagnosis devastated the Roders. “You have hopes and dreams for your kids and they don’t include schizophrenia,” said Maria Roder, Nathan’s mother. “At the center of narrative ethics is the wounded storyteller. What is ethical is found in the story, and the story depends on the wound.”1 Personal illness stories or those of a close friend or relative describe the wound. Dr Rachel Naomi Remen writes of her life with Crohn disease: My illness has been one of the great forces in my life, ... the inner process of illness rather than the outer process of cure. I realized that this search for healing that was awakened in me also was awakened in others when they were challenged with a disease. It is this search that has driven my career. Not healing just for me—because something just for yourself is hardly worth pursuing—but healing for us all.6