The Ultimate Writing Prompt

English: Golden Gate Bridge and San Francisco ...
English: Golden Gate Bridge and San Francisco at sunset (Photo credit: Wikipedia)

Yesterday we wrapped up the student-led group presentations in our narrative medicine course. There were eight in total over a period of four weeks. As I mentioned before, I chose the eight topics: aging, cancer, death/dying, disability, drug addiction, infectious disease, mental illness, and racism. During our first class session students signed up for one of the eight topics. My instructions for the group projects were as follows: each group will do a class presentation on their topic for 45 minutes. For your presentation please include a one page (front/back) handout that includes your main references on the topic as well as two in-class writing prompts. The group project/presentation was worth 40% of their final grade. I referred them to the excellent website/resource NYU Literature, Arts, and Medicine Database as a starting point for resources, but asked them to expand upon this, bringing in different arts and literature examples they found particularly helpful.

There are two things I would do differently with the group presentations the next time I teach this narrative medicine course. One is that I would set some parameters around the main focus of their presentations. All eight groups used PPT for their presentations, but more than a few had many ‘busy’ PPT slides with statistics on the ‘dis-ease’ topic of the day–stats such as prevalence of suicide. And their writing prompts reflected this clinical gaze, for instance showing a video clip of a person about to commit suicide by jumping off the Golden Gate Bridge; their writing prompt being “How would you feel if you were on that bridge with them, and what would you say to them?” Which leads to the second thing I’d change in the course, and that would be to find a way to help guide the groups in writing good writing prompts. I wouldn’t want to be too controlling with it, but I would want to help students develop more artful/less clinical writing prompt and response skills. For instance, for the above student-generated writing prompt I’d suggest changing it to, “Write about a time you worked with a patient who was in despair.” But I mostly resisted the temptation to step in during class and refine the student’s writing prompts.

Writing good writing prompts is a more advanced skill and one that only comes from lots of trial and error. I don’t know of any specific guides or sources of narrative medicine-type writing prompts, but here are two books I turn to when I’m stuck for ideas. The main one is Kim Addonizio and Dorianne Laux‘s The Poet’s Companion: A Guide to the Pleasures of Writing Poetry (WW Norton & Company, 1997). For instance, at the end of their chapter “Images” they have this excellent writing prompt: “Describe a pair of shoes in such a way that a reader will think of death. Do not mention death in the poem.” (Perhaps Joan Didion used this writing prompt for the powerful shoe portions of her book The Year of Magical Thinking). A second resource is Susan Zimmerman’s Writing to Heal the Soul: Transforming Grief and Loss Through Writing (Three Rivers Press, 2002). A prompt she includes in the chapter “Experiencing Death” is a common but still effective writing prompt: “Write about your own first experience of death, the awakening to the fact of death’s reality.” My students used this one in their presentation on death/dying. It was an effective prompt based on the quality of student writing.

For the ultimate writing prompt–one that I haven’t used in class but plan to try out is “Write your own obituary.” A twist on this one is included in Brenda Miller and Suzanne Paola‘s Tell It Slant: Writing and Shaping Creative Nonfiction (McGraw Hill, 2005–second edition 2013). In their chapter “Last Words” they include the writing prompt: “What are your ‘last words’? What would you write if you knew your time was up?” There’s a recent example of a Seattle-area writer who wrote her own obituary, which her family paid to be published in the Seattle Times on July 28th. It was written by Jane Lotter, age 60, who died at her home on July 18th from uterine cancer–under our state’s Death with Dignity Act. Michael Winerip wrote about it for the NYT “Dying with Dignity and the Final Word on Her Life” (Aug 5, 2013).

4 thoughts on “The Ultimate Writing Prompt

  1. Dr. Ensign,
    I love reading about the work you and your class are doing.
    You are right, Prompt writing is, indeed, an art. I haven’t seen a working definition of a “good” prompt but have come to know one when I see it. Your example regarding your students’ prompt about what would you say to the person on the bridge is very illustrative. The main concern, I’d say, is that the prompt causes the writer to imagine a hypothetical situation. This is not very relatable, it doesn’t connect in an emotional way and isn’t from personal experience. Your idea went most of the way to resolve these issues. I’d suggest a prompt that is even more general/less clinical. Something like, “Write about a time you or someone you knew was about to jump.” This prompt allows for a literal or metaphorical interpretation, opening it up to a variety of experiences, e.g. someone about to quit her career due to burnout. The bridge image is so strong it would be in writers’ minds without mentioning it and calls for a dire (though not necessarily suicidal) situation from the writer’s own experience. Reconnecting with those memories and sharing them might provide students a step towards recognizing their common humanity and that which they have in common with their patients. And perhaps a less clinical gaze.

    Phillip Mitchell
    MS in Narrative Medicine
    Columbia University


    1. Excellent suggestion Phillip. I especially like the reference to a metaphorical jump such as ‘someone about to quit her career due to burnout.’ Now that writing prompt I could write for days on! I do find though that teaching/using narrative medicine with nurses or other clinicians it is good to mix in use of some clinically-referenced writing prompts along with non-clinical/generic ones. Otherwise I risk losing the very concrete, practical sorts of students.


  2. Josephine, I just got a terrific book edited by Kevin Young called The Art of Losing: Poems of Grief and Healing. I think you’ll find a lot in there. Also, a couple of years ago at Napa Valley Writers Conference, Jane Hirshfield gave us a prompt that was close to writing your own obituary, but it was more a reflection of looking back from now and what would you say. Here is a rendition of a prompt that Patricia Smith gave us in a workshop. Write about the thing you know LEAST, the thing that is “behind the curtain or wall” that tugs at you and you ignore. (It could be an area of nursing or not).


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