Gillie Bolton

1. Gillie Bolton is freelance Literature and Medicine consultant, author, and Associate Editor to:

• The Journal of Medical Humanities (BMJ Publications)
• Journal of Poetry Therapy (Brunner Routledge)
• Progress in Palliative Care (Maney Publishing, Leeds University )

What and why Literature and Medicine?

Reading Literature

Readers learn about sickness, death, dying, bereavement from those great observers of humanity ? novelists and poets. Discussions arising from such reading range over ethics and values, practices and philosophies, lay understandings and clinical blunders.

Our great writers present pictures and reflections upon life, human dilemmas, philosophy, deep thinking and insight in story form: accessibly and memorably. The fictionality of literature does not devalue depicted issues, as it is created from deep experience.

Poetry offers concise and precise insight, using tropes such as metaphor in a way which no other written form can. Fiction creates satisfying plot structure, rounded characters, effective description; it can leap over boring bits, tackle issues head on, convey multiple viewpoints, sidestep confidentiality problems, and offer readers the complexity of ambiguity. Clear-cut or final conclusions and summaries are not offered. The reader has to form their own opinions about actions and events, thus developing their own values and ethics.

Reading literature can widen experience and knowledge about the human condition, help develop individual values, and improve communication and understanding 1 . It has transformative power: the understandings and insight engendered can alter perceptions permanently. Through literature we can experience and reflect upon things that are totally different from anything we'll ever experience in our own lives: situations, incidents, and issues; cultural and social norms and expectations; different or alien ways of thinking and being; emotions and their effects upon people.

Reading sharpens ethical wits: weighing, judging, developing and refining personal values, what is the right decision according to readers' own principles and values. Fiction readers are invited into other's way of understanding and perceiving the world, and their relationship to it. They have to be critical of the point of view offered by the text's narrator, and imagine how the situation appears from other characters' perspective.

Literature can enable clinicians to relate closely to characters' pain and their emotional and social response to it 'at the remove of the imagination' Charon & Montello 2002 , in a way they could not possibly afford to with their patients. This can develop understanding of the impact on patients of, for example, illness, disease, diagnosis, treatment, pain, disfigurement, hospitalisation, terminal diagnosis, or suffering.

Literature cannot alone create more ethical and sensitive clinicians. But it can offer practice in relating to and understanding the narrative nature of human experience.

Rita Charon & Martha Montello (2002) Stories Matter: the role of narrative in medical ethics. New York : Routledge

Read about Gillie's Publications and Experience.