title: A model for humanization in critical care.
abstract: We present a case in which narrative medicine was used to assist a patient with amyotrophic lateral sclerosis who was dependent on mechanical ventilation and prolonged hospitalization. Implementing narrative medicine led to the development of more effective communication that strengthened the therapeutic relationship, enhanced humane care practices, and resulted in greater physical and psychological comfort for the patient. Narrative medicine is a discipline that has been progressively incorporated into medical training to restore a humane and individual physician-patient relationship. The patient is viewed, not merely as a case to diagnose, but as a person with a story that evokes emotions in those who assist him or her. In fact, narrative medicine can be understood as a model of medical practice based on narrative competence, ie, the ability to acknowledge, to absorb, to interpret, and to respond to a person's story. It strengthens empathy, rescues patient individuality, and facilitates solutions to conflicts in complex settings, such as critical care units, where clinicians are constantly exposed to existential issues, both moral and ethical.
authors.affiliation: Department of Research and Scientific Communication in Brasília, DF, Brazil. facioli@gmail.com
authors.forename: Adriano Machado
authors.initials: AM
authors.lastname: Facioli
authors.forename: Fábio Ferreira
authors.initials: FF
authors.lastname: Amorim
authors.forename: Karlo Jozefo Quadros
authors.initials: KJ
authors.lastname: de Almeida
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology*; D003422:Critical Care / Q000379:methods*; D006760:Hospitalization; D006808:Humanism; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D009633:Nonverbal Communication; D010817:Physician-Patient Relations; D012121:Respiration, Artificial; D014140:Tracheotomy