The University Writing Program held an event titled Rx: Conversations about Medicine and Writing on Jan. 31. The first speaker was Dr. Lakshmi Krishnan, a historian of medicine, medical humanities scholar and physician currently working at Georgetown University. Krishnan received her M.D. from Johns Hopkins School of Medicine and attended the University of Oxford, receiving her D.Phil. in English Literature.
Krishnan started the event by providing two main ideas regarding the role of writing in medicine. She stated that writing shapes how thinking and engagement in medicine.
“Many aspects of medical writing are transforming, and attention to this is becoming more critical than ever as our media changes,” she said. “The move from paper charts to computer-based and electronic records, to now AI-assisted documentation and scribes.... Writing is really at the heart of understanding both of these pillars.”
Krishnan highlighted the purpose of writing by first emphasizing how many forms of writing she encounters as a physician, from formal documentation like overnight nursing documentation, documents outlining family meetings and notes from other specialists and care workers. Other types of writing that lie outside this category include pages to consultants, team group chats and even the verbal structures in conversations with patients and patient families. She then explained that each of these forms of writing is consequential.
“When we reason through and document a patient’s story, we’re not just solving a puzzle, we’re creating a record that will also shape that person’s future care,” she said. “The act of writing allows us to take a collection of evidence and patterns that we’re carrying around in our gut and in our brain, making those ideas move and reconstructing them.”
Krishnan also urged analysis of the use of AI in medicine. One role it could play is diagnostician, with previous studies showing that large language models outperform human physicians in diagnostic accuracy. Another potential use is drafting medical documentation for physicians to overview and edit if necessary, saving time and preventing potential burn-out.
In particular, she pointed out faults existing in previous models.
“What happens when AI not only assists but actively shapes our interpretive work? Does the physician’s role shift from primary diagnostician to narrative curator to archivist to editor?” she questioned. “AI scribes have already shown some concerning patterns, from omitting critical implied information and nonverbal cues to perpetuating racist language and generating hallucinated details.”
Krishnan ended her lecture by restating her belief in the necessity of writing skills in medicine.
“These skills are going to become even more crucial: interpretation and careful, ethical narrative construction are essential safeguards against both AI hallucinations and viral misconceptions about health. These steps help us maintain rigor while honoring the human experiences at the heart of medicine,” she concluded
The second speaker was Dr. Lenny Grant, an assistant professor at Syracuse University and founder of the Resilience Writing Project, which uses expressive writing as a tool for processing trauma for healthcare workers. Grant received his Ph.D. in Rhetoric and Writing from Virginia Polytechnic Institute and State University.
Grant first walked the audience through an exercise of expressive writing — a type of writing to get in touch with one’s deepest emotions. The instructions were to first write three things one is grateful for, next write the story of one’s life in six words and finally write down three wishes.
Grant then discussed a study funded by Kaiser Permanente in 2020, where eight physicians performed the exercise described above with their patients. The results showed a correlation between the expressive writing exercise and decreased stress levels for the physician, patient and the patient’s family.
“The next year seven of the eight physicians were still using that writing exercise because it increased communication so much,” he added.
Grant learned about the power of expressive writing during the pandemic, in June 2021, while working with a group of social workers working in community trauma response programs.
“[They] were really burning out. They were working long shifts at the hospital, which was understaffed, and volunteering to go out into the community to help folks who are having the worst days of their lives,” he explained. “Naively, being the only non-mental health worker who's on the trauma task force, I said, ‘Let me help. Can I teach you a writing workshop?’ And believe it or not, as insane as it sounds, they took me up on it.”
From there, Grant taught a writing workshop over Zoom. It first started with the social workers at Upstate University Hospital in Syracuse, then the nurses, then the doctors and finally reaching the surgeons.
“There's something to this writing. Everyone who writes knows that there's a transformative power of words,” he stated.
Grant credited James Pennebaker’s 1986 study on undergraduates confronting traumatic events as a critical moment where the power and benefits of expressive writing were displayed. In that study, half of the participants wrote about dorm room furniture for 20 minutes a day, for four days, acting as a control. The other half wrote about their most traumatic experiences for the same duration and interval. The researchers found that six months after the experiment, the subjects in the latter group used their campus health services significantly less.
“There is a positive effect. Armed with this information, I decided to re-humanize medicine by using its own research and giving it back to medicine. In effect, I created the Resilience Writing Project to care for the caregivers,” he stated.
Grant concluded his lecture by giving advice regarding the value of writing in medicine.
“I think expressive writing and the humanities… are an excellent complementary therapy that can be used so as many of you pursue your medical careers, remember that a few minutes of writing with the patient can significantly help them,“ he stated. “If you have somebody in your life who's maybe struggling, doesn't want to go and get services, or doesn't feel they're ready, ask them to write for it, they may get a positive effect out of it.”
The event concluded with a roundtable discussion involving Krishnan and Grant, with Johns Hopkins’s Professor and Chair at the Department of the History of Medicine Dr. Jeremy Greene moderating.
Greene consolidated the previous speakers’ message regarding the powerful connection between writing and medicine.
“As a historian and a doctor, I often find myself making a curious argument that we need to understand the humanities as basic sciences of medicine,” he concluded.
