Not Everything That Can Be Counted Counts, and Not Everything That Counts Can Be Counted

Abstract

counted.” Albert Einstein Palliative medicine addresses the relief of suffering on the levels of mind, body and spirit. To fully grasp the nature of this suffering and to work toward its relief, the illness experience for the patient must be elicited and understood for goals of care and treatment to be most effective. (1) Narrative medicine allows the patient’s story to teach us about the nature of suffering and our role in assisting in its relief. (2) To fully understand the suffering of another, the wholeness in the clinician must be engaged. Too often, medicine, and in particular, palliative medicine, is taught in a highly clinical, fact oriented and detached manner. (3) The emotional connection between the clinician and the patient is frequently dismissed in our educational efforts, and learners do not appreciate the art of giving comfort, facilitating the dying process, being silent and present when needed, and engaging in effective communication about patient and family goals and decision-making. The strong emotions associated with grief and loss, death, isolation and loneliness lie within the fabric of medicine and are heard through illness narratives. Can our educational methods help learners effectively address the wholeness in our patients, their families, and in ourselves? Can we touch the raw emotion that comes with mortality or with pain, be it spiritual, emotional or physical pain? Or must our educational processes stay “clinical” and therefore detached from life? We value what can be counted, but the essence of our most compassionate and effective work with patients is often beyond what can be quantified, cured or fixed. Teaching what is needed requires that we include stories about what people experience as they become ill and what will help them heal. The use of narrative through Marchand: Incorporating the Arts and Humanities in Palliative Medicine Education