15 Tips for Writing Narratives in Medicine by Aeman Muneeb and Asad I. Mian

We do not claim to be experts on Narrative Medicine ‘criteria’ - particularly where the reflective aspect of the writing is concerned. However, based on our experience of reading and writing reflectively, we provide the following 15 key suggestions for effectively written medical narratives.

1. Keen observation is very important. Medicine is fast paced so taking time to reflect on every day happenings can make way for some very interesting narratives. 

2. Have a central ‘message’ that needs to come across without sounding didactic / academic, lecturing, holier than thou, etc. Think of this as a subtle point you’ll be making to the reader by the manner in which you narrate the happenings. 

3. Honesty is important because it is difficult to pretend when you are writing. Sure you can but when you write about real things it shows. 

4. Be creative and purposeful in writing.

• Is the purpose to advocate for the patient and/or patient's family?
• Or is the purpose to advocate for the medical team?
• Or is it both the above?
• Or neither of the above? Simply to write without any purpose? And that too is fine, as long as you have articulated that to yourself.
• However, writing with a purpose is more meaningful and impactful. 

5. Have a word limit in mind (say ~ 500-700 words or 1 page) if objective is to write for a newspaper / blog.

• It is possible to write freely and shorten the length later on.
• Some will find it easier to just keep writing when in the mood.
• Sometimes you might be unable to write a paragraph and at other times you’ll write 2000-3000 words in a sitting.
• Don’t be too stringent about word limits, if you feel that is inhibiting.
• Fewer words make it easier to publish but someone would probably never write because of feeling ‘limited’. 

6. The narrative’s title is important!

• Generate a brief, catchy, meaningful title (~10-12 words).
• Using hyphens / colons in titles can help truncate and make them more insightful.
• Titles should complement the write up and vice versa.
• This is only possible if the significance of the title is somehow explained in the text.

7. Don't be overly regimental / task-list or criteria orientated as that tends to inhibit creativity in writing. However, in general:

• Write simply and in a conversational manner.
• Keep your audience in mind. Writing for a biomedical journal will be different from writing in a magazine even when narrating the same story.
• ‘Talk’ to the audience you have selected. Don’t ‘talk down’ to them!
• One caveat: perhaps medical jargon can be used when writing for a medical audience? It may make communication better amongst medical people who speak a ‘different’ language altogether.
• Tie beginning of essay into ending and vice versa.
• Tell a complete story through your writing. 

8. Don’t just be a reporter!

• Go beyond just being superficially descriptive. Be expressive. And reflective. Go beyond just reporting to reflecting (understanding / questioning / analyzing the event).
• Write so that your, i.e. the narrator-writer’s, presence at the scene is evident.
• Write so that the challenging/conflicting aspect of the encounter becomes more evident to you and the reader.
• Write in a manner that pays attention to your emotions about the scenario; that way both you & the reader gain emotional insight. 

9. Be humorous without being crass or disrespectful.

• Humor, other than being a strong defense mechanism, can be an exceedingly potent ‘teaching’ tool in writing.
• Have the ability to laugh at yourself or at the situation you find yourself in (with all due respect to the patient / family).
• Humor can make writing all the more satisfying for the writer. You learn to see things in a new, more detached perspective.
• One of the greatest benefits of humor comes to the writer. Taking a detached view and laughing at an unpleasant situation or a mistake can be helpful. It doesn’t seem like as big a deal as it first did. 

10. Include a photo or 2 if possible (not patient's), but something visually captivating that might enhance the writing (as in photo-blogging). 

11. Patient confidentiality is important so refer to the patient in a way that he/she cannot be identified. 

12. Show first few drafts to someone you feel really comfortable with, who will provide candid critical feedback about your writing. That can tremendously improve the quality of the work (coherence, grammar, syntax, etc.). 

13. Consider poetry / verse (or prose-poetry, even) as a means to narrate in medicine. 

14. Write a lot. Not all of it can be published. But the more you write the more chance of increasing the publishable material. 

15. Generate your footprint in narrative medicine.

• Consider starting your own blog.
• Consider publishing your work more extensively by sending articles to relevant biomedical journals or even newspapers (as blogs or op-eds).
• Over time enough material may be gathered to put together as your first book. 

Wishing you all a happy writing journey!

[from Narrative Medicine]

About the Authors: Aeman Muneeb is from the AKU MBBS Class of 2017. Asad Mian MD, PhD is an Associate Professor at the Aga Khan University. This article's copyright belongs solely to the authors.

Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20^th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of  AKU.