Journal Information
Vol. 40. Issue 2.
Pages 145 (February 2021)
Vol. 40. Issue 2.
Pages 145 (February 2021)
Letter to the Editor
Open Access
On the left side: The importance of the narrative of the heart for a better understanding of medicine
Sobre o lado esquerdo - A importância da narrativa do coração para uma melhor compreensão da medicina
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Francisco Rosário
Serviço de Endocrinologia, Hospital da Luz, Centro de Estudos Anglísticos da Universidade de Lisboa, Lisboa, Portugal
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To the Editor:

The use of narrative has been proposed as a way to improve knowledge of the patient and the quality of medical practice.1 The narrative medicine movement began in the late 20th century but goes back to the ideas of William Osler, for whom “[i]t is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.”2

Acknowledging the relevance of the patient’s narratives helps to reduce the differences between patients’ and physicians’ knowledge models, leading to a closer and more empathic therapeutic relationship.1,3,4 Literary texts have been used both in medical education and in clinical practice,5–7 and have had objectively demonstrated positive effects on disease control.7 As Hannah Arendt put it, “storytelling reveals meaning without committing the error of defining it.”8

In 1968 Carlos de Oliveira, that extraordinary poet, published a poem entitled Sobre o lado esquerdo (“On the left side”), in a collection of poems of the same name. The poem is shot through with social and political concerns and the anxiety that the writer was experiencing, which he transformed into a sleepless night of unbearable tension centered on his heart.

According to close friends, de Oliveira felt threatened by disease throughout his life. Is not the image he used in this poem—the heart as the focus of suffering—just like a common complaint we encounter in daily clinical practice?

On the left side

Now and again insomnia rings out with the clarity

Of a bell, of a crystal. And then, one of two:

The unbearably tense strings of the harp

Will break, or they will not.

And if they do not, the sleepless man thinks:

“Better to turn onto my left side,

Shifting all the weight of blood to the more worn-down

Side of my body, to crush my heart.”

Conflicts of interest

The authors have no conflicts of interest to declare.

References
[1]
R. Charon.
Narrative Medicine. Honoring the stories of illness.
Oxford University Press, (2006),
[2]
R.L. Golden.
Osler´s legacy: the centennial of The Principles and Practice of Medicine.
Ann Intern Med., 116 (1992), pp. 255-260
[3]
R. Loewe, J. Freeman.
Interpreting diabetes mellitus: differences between patient and provider models of disease and their implications for clinical practice.
Cult Med Psychiatry, 24 (2000), pp. 279-401
[4]
J. Freeman, R. Loewe.
Barriers to communication about diabetes mellitus. Patients’ and physicians’ different view of the disease.
J Fam Pract., 49 (2000), pp. 507-512
[5]
R. Charon, N. Hermann, M. Devlin.
Close reading and creative writing in clinical education: teaching attention, representation, and affiliation.
Acad Med., 91 (2016), pp. 345-350
[6]
R. Charon.
Narrative and medicine.
N Engl J Med., 26 (2004), pp. 862-864
[7]
F.S. Rosário, D.V. Almeida, J. Oliveira, et al.
A randomized trial of the close reading and creative writing program: an alternative educational method for group care intervention in type 2 diabetes management.
Can J Diab., 44 (2020), pp. 253-260
[8]
H. Arendt.
Man in dark times.
Harvest Books, (1995),

Please cite this article as: Rosário F. Sobre o lado esquerdo - A importância da narrativa do coração para uma melhor compreensão da medicina. Rev Port Cardiol. 2021;40:145.

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