Narrative Medicine

An Introduction to Janus

Janus is a student-run publication developed for UTHSC students, residents and faculty to reflect on our experiences through writing, artwork, and photography.

The title of this publication is in reference to a symbol, or, in more clinical language, in reference to a sign. Janus was the Roman god of transitions and beginnings, and in some sense time. He is often symbolized by a doorway, an arch, or a two headed effigy that looks in opposite directions. Our “January” hails from his name, a time of reflection and anticipation.

Upon reflecting on some of these attributes I would like to consider Janus as a sign of many of the values and expectations inherent to the practice of medicine. Medicine requires a central position in time. As medical practitioners we are positioned between the patient’s past history, present state, and his prognosis It is here that the double-headed statue, with faces looking in opposite directions, assumes a meaningful pose in its metaphorical relation to the physician’s place in the temporal aspect of care.

Next, and perhaps surprisingly, Janus derives from the word “janitor,” someone who tends and maintains doorways and thresholds. While it may seem a long way to travel from the lofty notion of divinity to the humble position of janitor, the journey affords some insight into our roles as healers. We often encounter people who are very much in a transition. This may be a transition into sickness, and all of the cognitive and emotional processes involved; a transition into new life for the recently born child and family; a transition into absence in the case of a family of one who is recently deceased; or even a transition as simple as a patient empowered by their physician to make decisions that will affect their future health. The physician serves the role of being present to and managing these transitions. It is a humble role because he is present in situations of gravity, and this gravity belongs to those who must bear it. This is not a role of glory or self-promotion, but is rather one of duty and often times self-denial. It takes the form of long hours, high stress, and plenty of sacrifice, but these things are only proportional to the importance of their function. If we learn to serve our roles as janitors well, as people who help tend to thresholds and transitions, then we will be better able to help patients through the important trials and joys they face in their lives.

Finally, working further off the notion of Janus as a multi-faceted (and indeed multi-faced) entity, we can extrapolate the concept of “perspective,” or to borrow an astronomical term used by James Joyce, “parallax.” Parallax is the phenomenon of an object that appears to change depending on the perspective and location of the viewer. As many of us can attest from the many different backgrounds we come from, our perspective greatly affects the way in which we view the objects before us, and these perspectives are often different from other’s views. This concept presents us with two of the primary tenets we hope to accomplish through this journal: 1) to foster a more widely embraced view of the many disciplines and perspectives that must exist within the physician’s professional, ethical, and human makeup—essentially to develop a greater “parallactic” understanding of the patient, and 2) to provide a medium where exposure to these new perspectives may take place. With this journal, we hope to encourage each other’s humanistic development by contributing to a multidisciplinary, well-rounded, and vibrant culture within our medical school environment that will aide us all as we strive to become more compassionate and effective physicians, scientists, thinkers, artists, and people.

An interesting article from Journal of American Medical Association about Narrative Medicine

Issues will be posted on this website as they are produced. For more information or to submit your writing, contact Bo Franklin at rfrank11@uthsc.edu.