Assistant Professor, Social Medicine
Assistant Professor, Medicine, Division of Geriatric Medicine
PhD 1985, Cornell University
MD 2000, University of North Carolina - Chapel Hill
I work at the intersections between medicine and literature generally, with a particular emphasis on medical autobiography and what’s been described lately as narrative medicine. My background in the humanities includes MFA (creative writing—fiction) and PhD degrees (nineteenth-century British literature) in English, both from Cornell. My published work over the past several years, both critical and narrative, has been concerned with questions of how narrative conditions our perceptions. I am especially interested in how we confront our mortal condition, or fail to, and the roles narrative serves in that vexed recognition.
I approach these and related questions in a variety of modes. I am primarily a writer of short stories. Much of my writing over the past thirty years has been in a mode usually characterized as “imaginative”; in these pieces, in addition to questions of mortality, I am interested in how consciousness arises in language, how language and culture condition our capacity to comprehend our situation, and whether narrative might transcend or reinforce those conditions. I am interested, finally, in how narrative offers an entry into experiences we have never had (and the implications this might have for physicians, such as in the cultivation of empathy), and how such participation might change us as individuals.
I also write stories told from the point of view of a medical practitioner. These pieces consider how the encounter with a patient changes the doctor’s perceptions of himself as a caregiver, of his power to heal, of the limits of those powers, and how we negotiate those limits. I do not take for granted that narrative is necessarily a force for good: stories are as capable of lulling us into false security, of reinforcing pernicious myths and stereotypes, as they are of bringing us to terms with the realities of our work. But I write these stories, at least in part, to test the hypothesis that narrative, if pursued rigorously, offers us (as writers and readers) an opportunity to see the doctor’s situation clearly, and see it whole, free of the mythologies of preterition and heroism that haunt popular representations of medicine.
I also work in the form of personal essay, approaching subjects from the morality of health-care reform to what doctors might learn from their own experiences of illness. Much of this has been published in Men’s Health, where I have been a contributing editor for the past several years. I also occasionally publish, or present at conferences, critical work on or about narrative medicine. My particular interest in this area is doctors’ autobiographical writing, and how it can function to critique or to reinforce stereotypes of doctoring.
My interest in language and literature has extended to clinical research as well. Over the past several years I have conducted small studies on the effect of autobiographical writing on mood and adjustment in cancer patients, and on speech patterns in elderly people hospitalized for treatment of depression. I am at present engaged in setting up a study of autobiographical writing in residents of retirement communities. In 2009-2010, I hope to publish the results of the first two studies, and start trials in the third.
As a teacher, my work in Social Medicine has been in two areas. In addition to the yearly survey “Medicine and Society,” I also offer annually a semester-long writing workshop in autobiographical narrative. I am also at work, in collaboration with members of the Department of English and Comparative Literature, on establishing a new, multidisciplinary course on literature, medicine and culture, which will anchor a proposed cluster of undergraduate courses in this area, and ultimately provide the nucleus for an interdisciplinary MA program in medicine and literature.
Finally, but uniting all of these interests, I work as a clinician in the Division of Geriatric Medicine. Much of my clinical work is centered in a local continuous-care retirement community, where I provide primary care to residents in independent and assisted living, and long-term care to residents of the skilled nursing facility. I also attend on the Division’s inpatient Acute Care of the Elderly unit, supervising house-staff in Internal Medicine, students in the School of Medicine, and subspecialty residents in Geriatrics.
I find providing medical care in all of these settings fascinating and deeply rewarding, and that moving between literature and medicine deepens my understanding and practice of both. Working at the University of North Carolina, with its historical commitment to providing care and education to all residents of our state regardless of their economic status, has been and continues to be an extraordinary privilege.
Office: 346-B MacNider Hall
Post: Terrence Holt / CB#7240, Department of Social Medicine / University of North Carolina at Chapel Hill / Chapel Hill, NC 27599-7240Published work online:
"What We Learn from the Dying," Men’s Health (also posted on MSNBC)
"Survive Your Doctor," Men’s Health
"A Second Opinion About Second Opinions," Men’s Health
"A Dose of My Own Medicine,"
"Orphan," Boston Review nov./dec/2005
"O Logos," Zoetrope/All-Story Vol 4., no. 1
"Bad News," Boston Review July/August 2006