Founder’s Statement

The common starting point for understanding most things is a story. Even highly technical subjects and difficult concepts are made more understandable and palatable when they are set in the context of stories. Thinking of Einstein’s theory of relativity in relation to trains moving in opposite directions or dynamic equilibrium as balls bouncing against a sticky wall helps many of us to grasp the complex underlying principles. Medicine, with all the recent advances in the identification of common underlying mechanisms, and the discovery of new treatments, still begins with a patient’s story and those stories are embodied in good literature.

The mission of Bellevue Literary Press is to bring together medicine, science, and humanism through literature. The unifying theme of the press is the conviction that in sharing what Anatole Broyard termed “the wonder, terror, and exaltation of being on the edge of being” (Anatole Broyard, Intoxicated by My Illness), physicians and patients might be better informed, able to cope with the demands that illness imposes, and that medical care will be more humane.

The common starting point for understanding most things is a story. Even highly technical subjects and difficult concepts are made more understandable and palatable when they are set in the context of stories. Thinking of Einstein’s theory of relativity in relation to trains moving in opposite directions or dynamic equilibrium as balls bouncing against a sticky wall helps many of us to grasp the complex underlying principles. Medicine, with all the recent advances in the identification of common underlying mechanisms, and the discovery of new treatments, still begins with a patient’s story and those stories are embodied in good literature.

My interest in the importance of stories in medicine can be said to have begun when, on my teaching rounds at Bellevue Hospital, an intern started his presentation, “this 62 year old homeless man, was brought to the hospital…” I stopped him and asked. “What do you mean by homeless?” Never missing a beat, he replied, “undomiciled.” I assured him that I knew what the word meant but I wanted to know why this man was homeless. When he regained his composure, he was able to recall some of the history that he had gotten, but did not think to present. The man had recently come to NY from California, had no money and was sleeping on park benches. “What did he do in California?” “Oh, yes, I remember now, he had something to do with films, but I don’t know anything more.” After hearing about his breath sounds and abnormal blood gases we went to the bedside. I asked the man what he did in California and learned that he was a bit part movie actor. I asked if there was any film in which I might have seen him. His eyes brightened as he asked me if I had seen Klute, a film with Jane Fonda. “In that scene where this young woman goes into a bar and a guy talks with her…that was me.” None of us had seen the film; the house staff recognized that this “homeless man” seemed quite ill with pneumonia. The following day, the same intern announced that he had rented the video and indeed our homeless man was the actor. It did not change the fact that he went on to die of pneumocystis pneumonia, but all later agreed that the care he received and the way the house staff physicians experienced his death were very much affected when he ceased to be “a homeless man on morning rounds.” The message, that patients have names and stories, and that these matter a great deal when one is ill, is one that I have never forgotten.

Having spent my entire medical career caring for patients and teaching in Bellevue Hospital, I welcomed the opportunity to be one of the editors of the Bellevue Literary Review, created in 2001 by the Chief of Medicine, Dr. Martin Blaser. It was soon evident that stories were on the minds of many people, sick and well alike. The rapid success of the BLR prompted the daring step of establishing the Bellevue Literary Press in 2005.

— Jerome Lowenstein, New York City, March 2009