Prompts for clinicians, students, patients, and carers who want to write about the experience of illness and care — and a simple method for using them.

Most people who want to write about medicine never start, and it is almost always the same problem: the blank page asks for everything at once. A prompt solves this by asking for one small thing instead. Not "write about your hardest day," but "describe your hands during a procedure you have done a hundred times." The narrow door is the one you can actually walk through.

What follows is a working set of prompts we use and return to at HEART, grouped by who might find them useful and what they open up. Take any one of them. You do not need to write well. You need to write whatever's in your heart.

How to write to a prompt

The method comes from narrative medicine practice, and it is deliberately unfussy.

Set a timer — five minutes to begin with, longer once you have the habit. Write by hand if you can; it slows the censor down. Then write without stopping, without correcting, and without deciding in advance whether it is any good. If you stall, write the last word again until the next one arrives. When the timer sounds, stop and read it back once, kindly. That is the whole practice.

The point is not a finished piece. The point is to notice what surfaces when you give a single moment your full attention. Some of it will be worth keeping. Most of it is just the clearing of the throat that lets the real voice through.

Prompts for clinicians and students

These begin at the clinical encounter and work outward from it.

• The last patient you thought about after you got home. Start with what they were wearing.
• A time you did not know what to say. Write the silence, not the words you wish you had found.
• Describe your hands during a procedure you have done a hundred times.
• The first death you witnessed. Begin at the moment just before you knew.
• A patient who frightened you. Then, separately, a patient who frightened you for an entirely different reason.
• A room you have delivered bad news in. Describe the room. Leave the news out.
• Something a patient taught you that is in no textbook.
• The distance between what you charted and what actually happened.
• Write about the first time a senior colleague was wrong and you said nothing.
• Your worst mistake, addressed as a letter to the person it touched. You need not send it.

Prompts from the other side: patients, carers, and families

Illness is not only a clinical event. These are for anyone who has been on the receiving end of care, or has given it at home.

• The waiting room. Describe it as though you will never have to return.
• Write about your body as a place you once lived in comfortably.
• A sentence a clinician said to you that you have never forgotten, kind or otherwise.
• The night before a diagnosis, when you did not yet know. Write from inside the not-knowing.
• Caring for someone on an ordinary Tuesday, not on a dramatic day. The small logistics of love.
• The word prognosis. Circle it. Write everything around it without ever defining it.
• What you carried in your bag to the hospital, and what you actually needed.
• The first meal after bad news. Who cooked it, and whether anyone ate.

Close reading: writing in response to a text or image

Narrative medicine grew out of close reading — the literary habit of attending to how something is written, not only what it says. These prompts start from another work and let it pull yours into being.

• Take a poem you love. Steal its first line. Write your own second line, then keep going until it is no longer borrowed.
• Find a line in a patient's chart that reads, by accident, like literature. Build a paragraph outward from it.
• Describe a painting or photograph of illness. Then write what happens one minute after the frame.
• Read a piece in a journal that unsettled you. Write the reply you would send the author if you were braver.

The parallel chart

Rita Charon, who founded the field at Columbia, gave clinicians a tool she called the parallel chart: a place to write what has no line in the medical record — what a patient's illness stirs in the person treating it. The official chart holds the potassium level. The parallel chart holds the fact that she reminded you of your mother.

• Write today's parallel chart for a patient you saw this week. Nothing that belongs in the notes. Only what you took home.

Objects and small things

Some of the truest writing about care comes in sideways, through a single object.

• An object a patient gave you, or one you could not bring yourself to throw away.
• What is in your pocket at the end of a shift.
• A piece of equipment you have complicated feelings about.
• The last thing a person owned. Describe it without once saying that they died.
• A photograph on a hospital noticeboard that has been there too long.

Thresholds, time, and loss

• Write about a single door in a hospital. Who goes through it, and in which direction.
• A shift that changed you, told only through what you ate that day.
• Describe five minutes in a life that is now measured in months.
• The moment you stopped being only a clinician, or only a patient, and became both.
• A goodbye you got to say properly. Then one you did not.

Using these in a group or classroom

These work as well in a seminar room as they do alone. The usual shape: read a short poem or prose passage aloud together, sit with one prompt, write to a timer for five to eight minutes, then invite people to read what they wrote — with the firm rule that no one comments on the writing, only receives it. In narrative medicine teaching this is the sequence of attention, representation, and affiliation: we notice closely, we put the noticing into words, and we share it so that it belongs to more than one of us. Medical students, residents, and qualified clinicians all take to it, often to their own surprise.

Whatever you write from these, we would love to read it. HEART publishes clinician stories, patient and carer voices, poetry, and reflection across our departments — Stories, From the Other Side, Verse, The Things We Carry, Close Looks, and Scribbles. A five-minute piece written to one of these prompts has, more than once, become something we were proud to publish.

If you want more to read while you write, see our reading list of the journals, newsletters, and books we return to. And if a prompt here opened something, tell us in the comments which one, and what it found.

Submissions and hellos: narrativesmedicineheart@gmail.com.