Hearing Patients, Healing Pain: Leslie Jamison and Will Boast on Narrative Medicine

“Suffering creates its own kind of sphere of silence,” said author Will Boast in a conversation with authors Leslie Jamison and Nellie Hermann at the Faculty Club of Columbia University Medical Center. The December 3rd event was a session of Narrative Medicine Rounds, monthly lectures or readings presented by scholars, clinicians, or writers engaged in work at the intersection of narrative and health care. It was presented by the program in Narrative Medicine of Columbia University, which studies the power of narrative to enhance healthcare. The talk convened Boast, author of the new memoir Epilogue; Jamison, author of the essay collection The Empathy Exams; and moderator Hermann, author of the novel The Season of Migration and creative director of the Narrative Medicine program.

Hermann introduced the themes of the evening’s discussion: “How is what we do with our pain influenced by what society and culture says we should do? Is there a difference between male pain and female pain in actuality and in perception? … Does all pain have a source? And if not, what do we do with and about pain that is sourceless?”

Jamison addressed the way that medical practitioners sometimes undermine a patient’s pain due to a gender bias. For her essay “Grand Unified Theory of Female Pain,” she uncovered medical studies on women’s pain. She wrote, “Despite evidence that ‘women are biologically more sensitive to pain than men … [their] pain reports are taken less seriously.’ Less seriously meaning, more specifically, ‘they are more likely to have their pain reports discounted as ‘emotional’ or ‘psychogenic’ and, therefore, ‘not real.’ ” She said to the crowd, some of whom were medical professionals in a position to diagnose such conditions: “There’s a shame felt here [about being in pain]. There’s something collective about that shame.”

Boast, reading from Epilogue, explored his personal perceptions of pain, handed down to him from his stoic father. He recounted one story in which his father was hurt during a rugby match. “He'd played out that game with an excruciating injury and done so with pride,” Boast wrote. “The point of the story, I understood, was not that winners could suffer through and losers could not. The point was that showing your pain was a choice, and the choice not to show it required only an exercise of will.” He summed up his father’s philosophy for the audience: “If you complain about being hurt, you’re weak...It’s not that your body is weak; there’s something intrinsic to your self that is weak….I think the gendered aspect of that [assumption] is part of what Leslie’s book intelligently captures.”

During the Q&A portion of the event, one audience member asked, “For many of us who are clinicians or who will be clinicians, how can we better hold our patients’ suffering, and how can we listen to and hear that pain better?” Boast said, “You have to go past your initial response” – perhaps shock or sadness – ”and listen as much as possible.” Jamison said that, as a patient, she sometimes felt that doctors failed to consider the symptoms she described. “It felt really, really important in those times to be listened to.” She added that medical practitioners must try “to allow the patient’s voice to be part of the process.”

Hermann asked about the role of empathy in terms of reporting on someone else’s experience or reading about someone else’s experience. Jamison said that she wanted to frame empathy as “a function of choice” – not something passively received but rather something actively achieved. It’s a message that resonated not only among the creative professionals in the audience, but also among the medical practitioners for whom absorbing and interpreting patients’ narratives can change the way care is given and received – for the better.