Abstract
The authors explain the design of a survey that provides a new technology for physical therapy clinicians to use while treating patients. The survey dovetails knowledge from the fields of writing and medicine to provide a resource for patient education. In a medical clinic, a patient is asked to numerically rate how he or she feels; however, the new survey discussed not only looks at how patients feel numerically, but also how they subjectively feel using writing. This survey is a new tool that encourages communication between patients and clinicians, makes patients more aware of what they are feeling when they write down responses, and helps clinicians adjust treatment plans when they read what the patients write. Through writing, patients become accountable for their actions and increase their education. The authors focus on the connections among writing, positive outlook, and healing, as well as the lessons they learned from working together and discussing their fields of expertise.
TopIntroduction To A Synergistic Collaboration
When writing meets medicine, exciting possibilities occur in the fields of patient education and teacher education. Dr. Jennifer Bird is an English professor and Dr. Eric Wanner is a physical therapist. We learned a significant amount about each other’s fields through a research and writing project we designed together. Patients at Eric’s physical therapy clinic used strategies from Jen’s writing classroom as we studied how writing about emotions affected physical health. We want our research and writing to continue to help the patients at Eric’s clinic and the students in Jen’s classroom.
Change takes courage. Most people live their lives never leaving their comfort zones. Johnson (2005) observes, “teaching superbly is like running a marathon by yourself in the dark. Few people even notice what you’re doing, and those who notice don’t pay much attention – but their oblivion doesn’t slow you down. You still enjoy the thrill and satisfaction of finishing the race, and you are definitely a winner” (p. 5). But education doesn’t have to be each teacher alone in a classroom, especially with technology that makes collaboration only an email away. Teachers tend to stay in their own classrooms; every once in a while they might venture down the hall to have a conversation with a colleague, but then they lock themselves back in the world of literary criticism. People often choose the safe route or the path of least resistance with their lives and with their health, even with new information, technology, and resources that could make their lives easier. At first glance it may seem unlikely that an English professor and a physical therapist would want to work together to create positive change in the lives of patients and students. Despite our divergent backgrounds, both of us share passion for research and compassion for people. We used this common ground to learn from each other and find trends between emotional writing and physical healing.
Each person has a story. Eben Alexander and Hilary Tindle are both medical doctors who advocate awareness of thoughts and feelings. Alexander (2012), a neurosurgeon, believes, “true thought is pre-physical. This is the thinking-behind-the-thinking responsible for all the genuinely consequential choices we make in the world” (p. 84). He elaborates that it is “the subliminal thinking that is always there, when we really need it, but that we have all too often lost the ability both to access and to believe in” (pp. 84-85). Tindle (2013), a doctor of internal medicine, also refers to mindfulness and explains, “this is called the triangle of awareness, in which we remain mentally centered in the midst of our thoughts, feelings, and physical sensations, each of which represents a point on the triangle” (p. 104). In her medical research, Tindle discovered that simple behavior changes could lead to better health, but most people never make changes. Tindle wondered what the script might be in the heads of the one percent of people who achieve ideal cardiac health.
To answer such questions, thinking outside one’s field can prove beneficial. Writing teachers advocate for students to reflect on the script in their heads by writing about their thoughts and feelings. Cameron, a writing teacher, (1998) explains, “when we write about our lives we respond to them ” (p. 94).
However, the domains of the writing classroom and the medical clinic don’t typically collide. One exception is the story Rasminsky (2012) presents of Rita Charon, a medical internist who also earned a PhD in literature and explains how “Charon is the founding director of the Program in Narrative Medicine at Columbia University, where future MDs participate in writing workshops” (p. 88). We also designed a collaboration between writing and medicine and learned lessons in working together that you can apply to your life, either when sharing ideas with colleagues from different subject areas or motivating a class of students to work together.
Key Terms in this Chapter
Wanner-Bird Healing Survey for Pain Recovery: An original survey designed by Dr. Eric Wanner and Dr. Jennifer Bird. This survey features both numerical subjective questions, where patients are asked to respond to statements by circling a number from 1-5, and written subjective questions that score patients’ written responses on a rubric with a score of 1, 3, or 5. The rubric incorporates both the technical and artistic dimensions of writing.
Artistic and Technical Writing: Artistic writing focuses on the writer’s tone of word choice, also known as voice, while technical writing focuses on the writer’s specificity of word choice. English teachers often design rubrics that incorporate both artistic and technical writing when evaluating student essays.
Neck Pain Journal: Jen created a journal of how her neck was feeling and what she was doing when her neck felt pain. Eric read the journal and diagnosed what Jen needed to do to make her neck feel better.
Behavior Changes: Making a conscious effort to make lifestyle changes. Medical doctor Hilary Tindle researched patient outlook in medicine; some people make negative choices to deal with stress, such as the numbing strategies Brene Brown researched, while other people make positive choices to deal with stress, such as following the exercise recommendations suggested by experts at the American College of Sports Medicine. Ultimately the choice of which behavior changes to implement in order to cope with stress belongs to each individual.
Journal Writing: The process of a person responding to prompts and writing about his or her thoughts and feelings. While journal writing is typically associated with writing classrooms, writing teachers including Julia Cameron, Natalie Goldberg, and Donald Murray advocate that journal writing can be done by anyone, anywhere. Students in an English classroom, patients in a physical therapy clinic, and readers of this chapter in their living rooms can pick up pen, paper, and just write.
Synergistic Collaboration: Adapted from the dictionary definition of “synergistic,” this process describes people that work together and accomplish more than they could alone. When people of different disciplines work together toward a common goal, they achieve excellence and make a difference.
Writing Voice: Voice in writing describes how a writer uses word choice and tone to compose a journal entry or other written composition that reflects the personality of the writer.
Interdisciplinary Collaboration: This describes the teamwork that occurs when colleagues from different disciplines work together in order to learn about each other’s field of expertise. As a result of interdisciplinary collaboration, opportunities are created that may not have been discovered if the collaboration had not taken place.
Physical Therapy Outcome Measures: Tests used by physical therapists to measure the progress a patient makes, such as such as the DASH (Disabilities of the Arm Shoulder Hand), LEFS (Lower Extremity Functional Scale), NDI (Neck Disability Index), and Modified Oswestry (for back pain).
Heart Maps: Discussed in the field of writing by Georgia Heard, heart maps ask writers to draw a heart and inside the heart write things that the writer loves.
Narrative Medicine: The field of medicine, used by programs such as the one Rita Charon founded at Columbia University, which encourages medical practitioners to use theories from the fields of literature and composition to enhance comprehension of the stories patients share.
Multigenre Writing: Discussed in the field of education by Tom Romano, a multigenre paper consists of two parts: creative writing in multiple genres and the writer’s analysis of the genres.
Before, During, and After (B-D-A) Lessons: A lesson planning framework in the field of teacher education discussed by Richard and Jo Anne Vacca and used by teachers to evaluate student learning before, during, and after the reading of a text.