Dr. Suzanne Koven, a primary care physician who was recently named the inaugural writer-in-residence at Massachusetts General Hospital, understands the nexus between medicine and the humanities. An English major in college, Koven went on to receive both her MD and then her MFA in nonfiction writing. She has been on the faculty of Harvard Medical School for over 25 years. Her writing accolades include the Will Solimene Award for Excellence in Medical Writing from the American Medical Writers Association, which she won for her monthly column “In Practice” that appeared in The Boston Globe.
Koven recently spoke to JewishBoston about her new role at MGH and how the humanities can cultivate empathy in doctor-patient relationships, as well as other roles in the hospital.
How do you integrate your roles as a doctor and writer?
When I started writing—even when I was writing about medicine—I didn’t think of it as being part of my medical career. However, as I brought reading and writing into my hospital life by running reading groups and coaching writing to hospital employees, it started to feel connected. When I wrote a column for The Boston Globe, I often received emails from people about how a particular column related to their situation. That started to feel like a public extension of my one-on-one doctoring in the exam room. As the years have gone by, I have become more convinced that the humanities aren’t separate from medicine. I feel reading, writing and storytelling are at the center of medicine.
How has the rise in narrative medicine influenced your work as the writer-in-residence at MGH?
I don’t consider that what I do is narrative medicine. It’s a bit different. Narrative medicine is specifically a discipline in which you are studying literary texts. It’s an academic discipline, and I’m not an academic. I teach literary texts as a way of sharpening narrative skills, which are central to diagnosis and empathy. I also run a monthly discussion reading group where we look for big themes and stories that relate to our work. The work we read doesn’t have to be about medicine or a hospital to relate to it or discuss it. For example, we recently talked about Alice Munro’s “The Bear Came Over the Mountain,” which is a story about a woman who seems to be slipping into dementia. It’s also the portrait of a marriage, and the discussion ran the gamut of how dementia affects a marriage as well as our patients, neighbors and perhaps ourselves. I also offer one-on-one coaching to people on staff in the hospital who are writing.
Who attends the workshops and reading groups you facilitate?
The long-running monthly group was initially made up of nurses, administrators, doctors and chaplains. Now that the program has expanded, I’ve led reading and writing workshops with chaplains, Ph.D. researchers and just about anybody who works in the hospital. My goal is to extend even further and engage interpreters, maintenance staff and cafeteria workers. Working in a hospital exposes you to human vulnerability and drama in a way that other workplaces don’t. The MGH cafeteria is not the same as a cafeteria in an office building.
There are other hospitals and medical schools that have writing programs, but the MGH model is very much focused on hospital staff in all roles, which makes it unique. I think the culture of MGH in general is distinctive. Given the fact that there is this role of a physician who is also the writer-in-residence is a testimony to its distinctiveness.
How do you think the advancement of the humanities will affect the future role of a doctor?
When I was in medical school, I don’t recall anybody talking much about learning to be empathic and learning to communicate effectively with patients. I remember being asked as a medical student to go to the ICU waiting room to tell a patient’s wife that he died unexpectedly. I had no idea how to do that, and I did it awfully. The big question now being asked is: Can empathic behavior be taught? When I reflect on my experience in the ICU, I don’t think I conducted myself badly in that conversation because I was not an empathic person; I simply hadn’t been taught how to do it. The use of model patients, which is now routine in medical schools, helps students to learn how to have difficult conversations or deliver bad news.
I also recently observed an interesting program at Children’s Hospital with professional improv actors doing improv with doctors around difficult conversations. The improv actors gave the doctors direct feedback about how their body language and their words were making the actor feel in the moment. I found that fascinating.
How do your Jewish values inform your practice of medicine and influence your writing?
I grew up in a relatively secular home that was very culturally Jewish. There was a rich tradition of storytelling and joke-telling in my family. In general, there was a reverence for the written word. My family also placed high value on helping other people. I brought those values with me to medicine and writing.
This interview has been edited and condensed.