Attending Physician: Rita Charon

An appreciation 

HUMANITIES, Fall 2018, Volume 39, Number 4

In June of 2013, while in London for “A Narrative Future for Healthcare,” an international conference cosponsored by Columbia University and King’s College London, Rita Charon and I visited the Mark Rothko installation at the Tate Modern. We entered the museum, buzzing with excitement about the conference—the conversations we’d had with scholars from around the world, the speakers who’d inspired us, the many workshops and panels that had infused our work with new perspectives and methods. 

Then we entered the installation—a small room with low lighting in which nine Rothko paintings cover most of the wall space—and Rita immediately fell silent, midsentence. I turned to see what had happened, and found her staring, rapt, at a painting across the room. I followed wordlessly as Rita, without taking her eyes from the painting, moved to one of the benches in the center, where we sat, back to back. I could feel Rita’s breathing relax into a deep, meditative rhythm, our muscles easing into restful, mutual support. We remained sitting there, silently turning together, as we moved our attention from painting to painting, our respective focuses always on opposite walls. After 45 minutes, perhaps an hour, we turned to each other, smiled, clasped hands for a moment, rose, and walked into the foyer. There, Rita burst into speech, enthousiastikós—possessed by Rothko—narrating her movement through painting after painting, each work a portal into depths of thought and feeling that I’d only glimpsed, sitting there beside her in the semidark. As we walked together toward King’s College, Rita returned to the themes of the conference, her experience with Rothko inspiring connections among phenomenology, graphic memoir, the body’s narration, and epistemic injustice, the habit of reflection, narrative identity, the ethics of self-care, and more. I returned to our conference that day with an entirely new understanding of and appreciation for our work.

During the twenty years I’ve known Rita Charon, I’ve witnessed this time and again. It begins when her attention is turned toward a fresh source of inspiration, whether from the arts, sciences, or humanities. Many thinkers are similarly inspired, of course, but few have an attentiveness both focused and capacious enough to forge entirely new connections, reshaping, reforming all that falls under its searching gaze.

Rita began searching at an early age. A brilliant young woman to whom many schools would surely have thrown open their doors, Rita chose to study at Fordham University’s Bensalem College. Named after the mythical, utopian island refuge of the lost seafarers in Francis Bacon’s The New Atlantis, Bensalem was among the most radical colleges founded in the ’60s. The very first seminar offered at Bensalem was on revolution. Perhaps, then, Rita was already primed to revolutionize health care by the time she entered Harvard Medical School in 1974. Soon after joining the faculty of the College of Physicians and Surgeons of Columbia University in 1982, Rita began publishing on the role humanities education might play in countering the process of medical student dehumanization. In her 1986 article, “To Render the Lives of Patients,” she contends that this dehumanization makes medicine “mechanistic, paternalistic, misguided, and ultimately ineffective.” She goes on to elaborate the mission that continues to guide her work to this day: to center medicine “on its true subject of concern: the lives of the people it serves.” I have no doubt that Rita’s remarkable capacity for attention predates her medical practice, but it was in this practice—attending to the suffering of her patients—that her attention found its abiding purpose.

Driven by her mission, Rita resolved to increase the already capacious reach and keen focus of her attention through the formal study of literature, completing an MA in 1990, then a PhD in 1999, in the Department of English and Comparative Literature at Columbia University. Her dissertation title alone speaks volumes about the work of Rita’s attention: “‘The Great Beheld Sum of Things’: Intersubjective Studies of Henry James, Literary Studies of Medicine.” She continued to publish prolifically while pursuing graduate studies, at the same time winning numerous awards for her teaching and curriculum development and honors for her service to medicine. Her publications in the ’90s reflect the ever-increasing breadth and depth of her attention: the role of imagination and narrative in clinical interviewing; Henry James on “the great empty cup of attention” and on the ethical dimensions of literature; issues in elderly patient-physician interaction; the implications of narrative theory for clinical work; narrative contributions to medical ethics; narrative and empathy; collaborative approaches to the study of medical discourse; narrative accuracy in the clinical setting; literature and medicine; feminist reader-response theory for medicine, and much more.

In 2000, Rita coined the term “narrative medicine” to designate medicine practiced with the narrative competence “to recognize, absorb, interpret, and be moved by the stories of illness.” That same year, she established the Program in Narrative Medicine at Columbia University. In the early 2000s, her writing reflected a progressively expansive understanding of the centrality of narrative to every health care field and practice. Rita was now recognized internationally for advancing, even revolutionizing, the health humanities. Yet she knew there was still a great deal of thinking to be done about why and how literary and narrative work in clinical settings might help both clinicians and their patients. In 2003, the National Endowment for the Humanities awarded Rita a grant—“Narrative Medicine: Teaching Humanities to Health Professionals”—to advance this thinking. With NEH support, Rita assembled a group of scholars, clinicians, and writers at Columbia who were all engaged with writing about and teaching humanities and medicine. I had the privilege of being among them, witnessing firsthand the genius of Rita’s ability to open a space for relation under the care of her attention. We met twice a month, teaching one another from our respective disciplines, and consulting leading thinkers in the health humanities outside Columbia. Together, we advanced the theory, pedagogy, and practice of narrative medicine. In 2006, Rita crowned our work with the publication of Narrative Medicine: Honoring the Stories of Illness. In 2016, many of the original NEH scholars, along with new colleagues at Columbia, coauthored The Principles and Practice of Narrative Medicine.

Over the past two decades, Rita has overseen the development of a required narrative medicine curriculum across all four years of Columbia’s medical school; an interdisciplinary education program for students and faculty from eight of Columbia’s health professions schools and programs; narrative medicine workshops that have trained thousands of health professionals, artists, and writers; a Master of Science in narrative medicine and a low-residency certification program at Columbia University; not to mention collaboration in developing programs with thinkers, writers, educators, and institutions worldwide. Most recently, Rita was named chair of the newly formed Department of Medical Humanities and Ethics at Columbia University Irving Medical Center, under which narrative medicine has advanced from a program to a division. I, for one, am in awe of the patience, the genius, the audacity, vision, and perseverance required for Rita to have accomplished all this, in face of the skepticism, dismissiveness, and, at worst, hostility of institutions and colleagues who lacked her capacity for attention and imagination.

In June of 2018, a group of scholar-activists, once again assembled by Rita, led a workshop on radical listening at Kripalu Center for Yoga and Health. On the opening day, our psychiatrist colleague Paul Browde asked the participants and faculty to form two concentric circles, the participants in the inner and outer circles facing each other. Paul then led us in a series of exercises, instructing the circles to rotate so that the persons facing one another in the inner and outer circles shifted after each exercise. Rita and I happened to be opposite one another when Paul instructed us simply to look into each other’s eyes, without breaking our gaze. At first, we smiled awkwardly, self-conscious, as one always is for this sort of exercise. But then Rita’s face softened into a look of the profoundest, unfiltered regard. For two minutes I was poured into “the great empty cup” of Rita’s miraculous attention. Reshaped, reformed there. This is her work—her gift to humanity.