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PREFACENarrative Matters Turns Ten
With this issue, Health Affairs celebrates the tenth anniversary of publishing first-person Narrative Matters essays. The fact that many readers tell us it’s the first part of the journal they read is a powerful testament to the durability of the idea, which is about the power of stories and storytelling, and their role in forming policy. The idea for Narrative Matters was originally championed by the journal’s founding editor, John Iglehart, who wrote in the July/August 1999 issue that "the voices of patients, their families, and their caregivers have often gotten lost in the shuffle" of America’s medical system and the making of health policy. He believed that the journal would be enriched by nurturing a form of health policy writing that afforded greater opportunity for new voices. Iglehart and Narrative Matters’ original editor Fitzhugh Mullan took the idea of the personal essay in a health policy context to the W.K. Kellogg Foundation. Happily, Kellogg had confidence in something called Narrative Matters, and it has funded and stood by the idea and us steadfastly ever since. Mullan, with the assistance of associate editor Kyna Rubin, launched the section with his introductory essay titled "Me and the System: The Personal Essay and Health Policy," which remains the single best expression of why Narrative Matters exists and what essays written for the section need to achieve. We continue to recommend it to our would-be essayists. Later Mullan created the phrase "policy narrative" to describe the type of essays we publish. In the decade since Narrative Matters’ founding, Mullan became an endowed professor in the George Washington University Department of Health Policy, and I came on board. Mullan remains a consulting editor to Narrative Matters and a contributing editor to Health Affairs. Editor-in-chief Susan Dentzer now sits at the journal’s helm. All the while, in issue after issue of the journal, great Narrative Matters stories kept coming out—and the section continues to extend its reach. In 2006, Narrative Matters: The Power of the Personal Essay in Health Policy, a collection of forty-six essays drawn from the Narrative Matters archives, was published by the Johns Hopkins University Press. The essays are being recorded now, too. National Public Radio (NPR) often invites Narrative Matters authors to read excerpts of their essays on air, with NPR’s Web site then linking back to the full-length Narrative Matters essays on the Health Affairs Web site. Beginning in 2009, again with a grant from Kellogg, we started creating author-read podcasts of the Narrative Matters essays. Later this summer we will start posting the podcasts on our Web site; soon they will also be accessible from a division of the popular iTunes Web site called iTunes U (for University). We think that hearing the authors read their own stories adds a level of immediacy to the essays. We hope you’ll listen and let us know if you agree. During the past decade, close to 150 Narrative Matters essays have been published, and the name "Narrative Matters" has become better and better known. The essays account for a huge number of hits and downloads on the Health Affairs Web site, and national and local publications (among them the Washington Post, the Los Angeles Times, and a popular New York Times blog) now reference, link to, or ask to republish Narrative Matters essays in their pages and online. At least one widely read Narrative Matters author, Texas geriatrician Jerald Winakur, received a book contract after his Narrative Matters essay was published. As Winakur notes, "Numbers never tell the whole story." And that could well be the motto for the Narrative Matters section. The peer-reviewed personal essays link a health care–related story or anecdote to the bigger picture. In doing so, underlying all of the undeniably important statistics and data involved in policy, they demonstrate the basic truth that health policy has human consequences. The Narrative Matters essays tell about those human consequences, directing their messages to the people who shape and make policy. As a result of reading the essays, these people are touched and informed, and they often find themselves thinking about important health care issues in creative new ways. That’s the point. That’s the power of well-crafted stories. We’re pleased that it’s ten years and counting for Narrative Matters—even as we know that "ten years" is yet another number that doesn’t tell the whole story. In this case, it’s merely a way station to even more stories that reach out to readers. In this tenth-anniversary section of Narrative Matters, the tradition continues with essays by Narrative Matters’ original editor Fitzhugh Mullan and writers Julia Alvarez, Alexander McCall Smith, and Abraham Verghese offering up policy narratives that present new perspectives to focus policy deliberations. As always, we urge you to read, enjoy, and ponder them.
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