Celebrate Diversity: Empathy and Respect for Differences

World Kindness Day is celebrate each year on November 13. This celebration grew out of the World Kindness Movement (WKM), which is a nonprofit group that formed in Tokyo in 1997. According to WKM (2020), their mission is to inspire individuals to be kind by creating kindness at a national level. More than 29 countries are members of this organization to promote kindness among different nations. On World Kindness Day, individuals, groups, and organizations celebrate and promote good deeds. According to National Today (2020), World Kindness Day was first celebrated in 1998, and people from every inhabited continent have since participated in some way. Although it is celebrated every year, it is still an unofficial holiday in the U.S. 

Image courtesy of Flickr. 

On November 16, 1995, the United Nations Educational, Scientific, and Cultural Organization (UNESCO) signed the Declaration of Principles on Tolerance. According to the United Nations (2020), "the Declaration affirms that tolerance is neither indulgence nor indifference. It is respect and appreciation of the rich variety of our world's cultures, our forms of expression and ways of being human. Tolerance recognizes the universal human rights and fundamental freedoms of others. People are naturally diverse; only tolerance can ensure the survival of mixed communities in every region of the globe." All organizations participating in the UN are morally and politically obligated to abide by the guiding principles of tolerance set forth in this declaration. The International Day for Tolerance is celebrated each year on November 16 to celebrate this declaration. 

Photo courtesy of the UN. 

Medical humanities examines the non-technical side of medicine through the intersection of medicine and the creative arts (i.e. literature), the humanities (i.e. ethics, philosophy) and the social sciences (i.e. sociology, psychology). Medical humanities allows us to explore what it means to be a human and how all aspects of our cultures impact our lives and our deaths. Through medical humanities, we can gain a better understanding of what our patients are going through and thus develop empathy. We can learn about ourselves as clinicians and how our own thoughts and feelings impact how we treat patients.  Narrative medicine is just one part of the medical humanities.

Narrative medicine applies the concept of understanding the meaning and significance of stories as well as the use of storytelling and creative writing to health care. It can be used to help clinicians better understand and empathize with patients. Clinicians can also cope with their own emotions and experiences via storytelling. 

Charon (2001) introduced the concept of narrative medicine and explained its impact in the following four aspects of medicine (note that although she refers to the clinician in this situation as "physician," it can refer to anyone caring for a patient):

• Patient-physician relationship: When the patient and physician meet, they have a conversation. In this conversation, the patient tells a story of their illness. When listening to this story, the physician must uncover the meaning of the verbal, non-verbal, and emotional information in order to understand the patient and what's truly behind their illness. An understanding of the patient's story also demonstrates empathy. If the physician can't connect with the patient in an attempt to derive meaning from the story, the patient may be reluctant to share information with the physician.
• Physician-self - Reflection in practice: In this situation, physicians reflect on their own emotions and responses in caring for patients in order to better understand how their own experiences impact patient care. Physicians often turn to humanities to help uncover this understanding.
• Physician: The daily life of the physician is filled with narratives in teaching, research, and scholarship. Charon says medicine's theoretical knowledge becomes practical knowledge through narrative.
• Physician-society - The public trust: Physicians are members of their cultures and their communities. They must understand how to empathize with community members and they must also understand how to connect with members of their communities on a narrative level to build public trust. This trust is important for improved health outcomes.

Read more of Charon's work: Charon, R. (2001). Narrative medicine: A model for empathy, reflection, profession, and trust. JAMA 286(15), 1897-1902. 10.1001/jama.286.15.1897

Dr. Rita Charon. Photo courtesy of Wikimedia.

Building Empathy

Medical humanities and Narrative Medicine