Background and Rationale

At the center of each Health Humanities Portrait (HHP) is a first-person account of an illness experience. These narratives provide a foundation for the humanities-driven exploration of the HHP’s social theme. By immersing students in the subjective experience of an individual, these narratives engage students emotionally and are memorable and vivid in a way that scientific and medical literature often is not. The close reading of personal narratives offers the opportunity for students to engage in the critical methodologies typical of work in the humanities, which values and emphasizes the subjective. At the same time, an understanding of how individual experience is impacted by structural factors requires students to reach beyond one individual’s experience and to connect it with scholarship and critical analysis. The creative nonfiction component is designed to guide students toward combining the two kinds of information in order to tell more nuanced and layered stories about the structural inequalities and multidimensionality of the illness experiences initially presented in the HHP. In asking students to connect the two in a coherent narrative, the creative nonfiction component: it asks students to consider the different ways that readers process scientific and narrative information; it requires them to grapple with and make sense of contradictions that exist between personal experience and population data; and it illuminates the ways that their own perspectives and biases may guide the selection and omission of story elements.

Expanding Scope and Reach

The HHPs developed through the NEH grant were initially designed for medical and health professions education. In addition to learners in these fields, the creative writing component takes into consideration students enrolled in undergraduate health humanities courses and programs, where the popularity of health humanities content continues to grow, and in classes that meet over longer periods of time.

Learning Objectives

• Draw students’ attention to the power of stories to influence how social issues are perceived by individuals, communities, and beyond.

• Deploy elements of creative nonfiction that facilitates critical thinking about the complex interplay of patients’ experiences and the worlds they inhabit.

• Guide students through self-reflection as a means to consider the relationship between population data, personal narratives, and their own response to the material.

• Consider the nuances of how to deliver information about the social theme through creative nonfiction, that take into account the potential for these themes to elicit charged responses from learners and other audiences.

• Ground creative component within key elements of the HHP’s social theme.

Methodology and Grounding

Guiding students in how to frame their reactions to new and challenging material through the lens of curiosity should help diffuse some of the emotional charge of the material they encounter and thereby help them to maintain an openness to new opportunities for learning. After students have identified a first-person narrative in an existing HHP that appeals to them, the following steps should guide them through the in-class exercises, writing prompts and the composition of their final project:

• Identify your own emotional response(s) to something in the HHP that is unfamiliar to them.

• Be open to what you want to know more about, even if the subject is foreign or intimidating.

Workshop Exercises and Writing Prompts

The exercises and writing prompts below should be introduced after students have engaged critically with the materials in an HHP. They are designed to guide students’ thinking beyond the evidence presented in the HHP toward a recognition of their own responses to the material. Instructors can ask students to respond to these prompts in short, reflective paragraphs or in short answers on a worksheet. The important thing is to provide students with a structure for recording their initial responses and discoveries that they can refer to and draw from for the final project.

• Introduce the Feeling/Color Wheel exercise to provide students with a visual aid for identifying their feelings or emotional responses. Ask students to pick three colors that reflect them.

• Ask students to put into words their emotional responses in the form of short sentences, even single words; students should not be required to share them with the group.

• Students identify their relationship with the social theme; this involves explicit personal reflection and an exploration of their own positionality.

• Identify knowledge gaps – name three things you want to know more that were not covered in the HHP.

Final Project: A Synthesis Essay

For the final projects, students will compose a three-page essay that combines information about a situation or event depicted in the first-person narrative, the relevant research they conducted about two of their identified knowledge gaps, and a reflection on how their own individual experiences intersect, or not, with this material.

Options for Activity: Shorter and Longer versions

The creative nonfiction component consists of segments that can be delivered in part (to facilitate reflection about narratives) or in total (to result in the creation of an original narrative) depending upon the structure of the class and time available.

For the Shorter Version (1-1/12 hours, one time meeting).

• Give students an example of a published nonfiction essay to read in advance of class, along with the existing portrait elements (personal narrative and research/critical analysis paper). Explain that for the purposes of the portrait, we are focusing on three elements of a potential narrative, all of which are present in some form in the published essay:
  • An individual’s personal experience/story
  • Research/data/voices of experts that put the individual experience in context
  • A discussion (in some form) of the writer’s positionality—their relationship to the teller of the personal story, to the subject,
• Explain that in this (shorter) session, the focus will be on exploring the one absent leg of the three-legged stool: their relationship to/thoughts on/feelings about the theme.
• Identify examples where the writer of the essay makes their relationship to the subjects/content explicit
• Have students fill out a worksheet on their reading of portrait materials that includes:
  • Curiosity (three knowledge gaps)
  • Feelings (feeling wheel)
• Discuss depending upon time
• Creative writing exercise: Students are asked to write a scene that they themselves experienced or witnessed that has some connection to the theme (I have lots of instruction, including in the Lamb/Klugman book, about how to direct the writing of a scene). One page or less. Explain that it does not need to be good writing. Students will not read their scenes aloud!
• Discussion of the process of scene writing: Was this easy or hard? Did you remember anything new? Did anything surprise you? Do you think you would choose the same feelings from the feeling wheel now? How might a story that included all three of these things look?

For the Longer Version (two or three class sessions):

• The students actually put all three elements together in a coherent narrative and get (one hopes) all of the benefits of understanding how a writer chooses what to include, what to omit, how a writer reconciles and explains seeming contradictions between research and one person’s experience etc.