This past year I led two discussion groups on “Conversations for Physicians,” where we explored the nature of the physician-patient relationship and what it is like to be a physician.
In the first, held in the spring of 2003, 14 practicing physicians participated in “William Carlos Williams: A Physician for Our Times,” a series of four weekly discussions using Williams' The Doctor Stories to explore what happens between doctor and patient in the clinical encounter. Williams is a master at capturing the experience in words that are so true to life and so far away from the technical language that physicians may use to distance themselves from emotion and (at times) from the patient.
Discussing these thinly veiled autobiographical stories written by a practicing physician, the doctors in this group were given license to talk about their experiences in ways they had not done before. One older doctor said this to me in his class critique: “I have talked with other doctors for decades about cases, about business, but I have never talked with them about what it is like to be a physician.”
The second series, held last fall, was called “The Fortunate Physician: Learning from Our Patients,” inspired by John Berger's A Fortunate Man: The Story of a Country Doctor, a book-length essay about the life of Dr. John Sassall. The descriptions of Sassall's professional development and the clinical vignettes showing him at work opened discussions that provided us with many opportunities to explore concepts of therapeutic alliance, transference-countertransference, self-inquiry, empathy and intuition, and clinical process without using psychoanalytic terminology that may seem irrelevant, if not off-putting, to physicians.
With my encouragement, a few tried their hands at narrative writing, which, they came to discover, stimulated self-reflection and led to deeper insight into their encounters with patients.
Randall Paulsen and I find our work with practicing physicians an exciting and rewarding analytic experience. We hope that our experience will encourage you to find your own ways of engaging in interdisciplinary outreach to physicians. We will be leading a discussion group at the June 2004 APsaA meeting in SF on “Conversations with Doctors: From Balint Groups to Narrative Medicine.” Please join us there to continue the discussion.