For Cara Coleman, a graduate of the Narrative Medicine Certification of Professional Achievement (CPA) program, narrative medicine is personal. Coleman’s daughter, Justice Hope, spent the majority of a year in the hospital at the age of six, following a right colonic volvulus. Justice’s story of living with disabilities and special health care needs inspired Coleman’s book, I Am Justice, Hear Me Roar. After receiving an opportunity to read the book and share Justice’s story with medical students at the hospital, Cara was offered a faculty appointment at the Virginia Commonwealth University School of Medicine, leading her to co-create a fourth-year medical student elective, co-direct a longitudinal course, and host monthly lectures.
Justice died in 2017 at the age of 11. The importance of narrative medicine in Justice’s health care experience and Coleman’s drive to honor her daughter’s life inspired her to found The Bluebird Way Foundation, a 501c3 committed to using the arts and humanities to humanize health care and health profession education. One small way the foundation carries on Justice’s spirit is by supporting the annual Justice Hope Bluebird Humanism in Medicine Award.
“The ‘Bluebird Way’ embodies Justice: who she was, how she lived, what she gave and taught, as well as how she died: at home, surrounded by love,” said Coleman.
In a recent interview, Coleman spoke about her advocacy for children with complex medical needs, how she shares the tools of narrative medicine with others through the elective courses she runs, and highlights from her time in Columbia’s Narrative Medicine Certification of Professional Achievement (CPA) program.
Tell us a bit about your background and career.
I grew up moving around quite a bit, including living overseas in Chile, Venezuela, and Bangladesh. My father worked as a water resource engineer, and my mother was a nurse who worked in school health clinics. She was also very involved in the communities in which we lived, and so, in turn, were my brother and I.
I began my graduate studies with an MPH focused on violence against women, with the hope of doing international health and development work. However, my internship with the Office of Public Health as part of the New Orleans coordinated community response to domestic abuse introduced me to the court system and how it interacts with the health and well-being of women and families. After working in a domestic abuse shelter for several years, I went to law school. I landed my dream job at AYUDA, a nonprofit organization dedicated to serving low-income immigrants in the Metro DC area, specializing in cases under the Violence Against Women Act. After my daughter was born with multiple complex medical conditions and disabilities, I shifted from the practice of law to health care.
My advocacy for children with medical complexity has involved working with national organizations like the Institute for Patient and Family-Centered Care and Family Voices, as well as serving in leadership and advisory roles at the state and national levels. I am the first public member associate editor of Family Partnerships of the Executive Editorial Board of Pediatrics. I have worked as part of an educator team to co-create and edit pediatric complex care entrustable professional activities (EPAs). I have leaned heavily on my experiences and the relationships I have formed with other families and health professionals to guide the work that I do.
Why did you pursue a CPA in Narrative Medicine?
I started the CPA program during a time of personal and professional introspection. As I approached my 50th birthday, I felt increasingly disconnected from the concept of justice and the reasons that motivated me to begin my health care work. I was the director of federal policy and advocacy at Family Voices, but even though we were working to bring about policy change, attitudes often did not shift, stories were dismissed, and plans continued without accounting for the very real gaps, needs, and issues shared.
I wanted a tool to do upstream work to bring people and teams together so they could see and hear each other at the depth needed to bring about culture change in terms of disability justice, family-centered care/partnerships, and humanism. I first experienced a narrative medicine workshop in 2015, and while I knew its potential then, it was not until years of systems-level work that I felt ready to return to learn the practice so I could apply it everywhere.
What do you think is the value of a CPA in Narrative Medicine? And how did you find managing the requirements of the program with your daily life?
The CPA program is the exact amount of training in the facilitation of narrative medicine needed if you want to apply it in practice. The program was manageable even with full-time work and family life. Taking the CPA courses laid the foundation, while regular practice transformed me, enabling me to apply my skills not just in education but within the much broader community of pediatric health care. I felt both equipped and excited to hit the ground running as soon as I completed the certificate program.
I was surprised at how much connection I experienced almost entirely asynchronously. It taught me that virtual and asynchronous methods can be just as impactful, which in our busy health care world is sometimes the only way to connect.
While there are many new challenges in health care, such as the role of AI or the dismantling of Medicaid, the problems and solutions are age-old. Narrative medicine offers the mirrors and bridges we need to be able to see ourselves and each other, process trauma, build communication, and move forward with hope and compassion.
What skills or lessons from the program do you apply to your work now?
I see narrative medicine everywhere. I see its potential for use in every aspect of pediatric healthcare.
I have spent the past 12 years working as a family partner/advocate in pediatric research, advocacy, health profession education, quality improvement, and systems change. While I have seen successful and transformational projects, so many fell short—teams were still siloed, and burnout and dehumanization have risen for all. The CPA has given me tools: the foundational movements of narrative medicine offer a tangible way to share perspectives, bridge divides, and bring about connection, communication, and action.
Currently, I am using narrative medicine in health profession education, within an interprofessional disability-focused training program, with families, and with interprofessional teams. I am most proud of my work, which brings together families, doctors, nurses, and social workers together in the same workshops, using narrative medicine to help us share perspectives and transform care.
About the Program
The non-degree, online Certification of Professional Achievement in Narrative Medicine is designed for professionals who seek ways to bring narrative methods into their current careers. The program prepares health professionals, writers, and scholars to apply the skills and values of narrative understanding to improve outcomes for both patients and caregivers. Learn more here.
