I have been asking myself this question for the past two days, ever since finding myself in the midst of cornfields and cows. I am at the University of Iowa’s narrative medicine conference “The Examined Life.” This conference seems to be grain-fed on the reputation of the Iowa Writers’ Workshop. So many excellent writers have gone through this program. I envision a young Flannery O’Connor riding by train here from Georgia. But few if any writers were actually from Iowa and few if any stayed in Iowa. Now I know why.  I walked around ‘downtown’ Iowa City yesterday four times in the search of food. This is a drinking college town, as there are only bars. I hear from some current writers in the Writers’ Workshop that the pubs and writing go together. I stumbled into the one coffee shop I could find and it ended up being Prairie Lights, the town’s iconic independent bookstore. When I asked the bookstore staff member to direct me towards books by local authors, he looked at me blankly and then showed me to a table full of the birds and flowers of the Iowa prairies.

The conference itself is interesting in a low-key sort of way. Held at the medical school it is unsurprisingly dominated by physician-types, including many local medical students. As the building is attached to the hospital, some are wearing scrubs and/or white coats. The philosophers don’t seem to be here as they were in Seattle. Much of the talk is about cancer narratives and end of life and palliative care, and about how doctors don’t get enough training in how to talk to patients. The most interesting part of the conference so far was a reading and discussion by the writer Chris Offutt, who is a visiting professor teaching at the Iowa Writers’ Workshop. The short story he read, “Out of the Woods” had a hospital and a dead body in it, so that was the connection to narrative medicine. He’s a great writer and with a theater background, does a wonderful job at reading his own work to a largish audience.

I have been thinking about how place affects the nature of writing and of any other creative endeavor, including the nurturing of narrative medicine. Even though Iowa City is home to the premier MFA writing program in the US, it does not have a creative spirit. Based on my informal street level culture index walkabout last night, this is not a creative place. I did not see any bohemians out and about, except for one lone Rastafarian young man, but he was outside of a smoke shop so must have been part of their advertisement. No street level coffee shops in which aspiring and real writers can go to hang out and work out their writer’s block in community. In fact, I was lugging my laptop around in hopes of being one of those coffee shop writers. Instead, I am writing this on the shiny vinyl floor, in a hallway of the Cancer Research Laboratory. Carts of large red biohazard bins keep rolling past me.

Narrative medicine in Manhattan, seemingly shared between Rita Charon and her colleagues at Columbia, and people at the NYU School of Medicine has more of a cerebral, sophisticated air to it, fitting with the culture of NYC. There is a budding narrative medicine culture in Seattle, fed off transplants from other places, but affected by the writing and creative culture of the city. Seattle—rainy, soggy, foggy, moody somewhat depressed over caffeinated introverted intelligent contrarian process-oriented full of causes and grand passions and changing the world idealist tree hugging serial killer—Seattle. Moss covered alternative healing modalities Seattle. Narrative medicine cannot help but be different in such a climate. I hope that in the PNW climate of inclusiveness, narrative medicine can become more than it is now in the rest of the country.

~addendum reflection after the Examined Life Conference: Iowa City began to cast its spell on me after three days of being there for the conference. The conference cast its spell as well. I am typically not a joiner-love-conferences sort of person, but I ended up attending all but one of the conference sessions. Since returning to Seattle I’ve been trying to figure out if that’s because there was nothing else to do in Iowa City, or if it is a positive reflection on the conference. I think it was the latter. I’ll be going back, and hopefully more nursing-types will join me there next year. A group of us from the conference, along with some PNW narrative medicine/advocacy people are beginning to plan a conference on narrative advocacy, to be held here in tree-hugging coffee-chugging Seattle–hopefully in another year or so, so stay tuned for that. And while you’re here, check out our independent bookstore Elliott Bay Book Company.