Each week, Fora Health, a Portland-based treatment center for those struggling with substance use, hosts an optional writing circle for in-patient residents. Sometimes the session begins by interacting with a piece of art and discussing it as a group. Which feelings does it elicit? What does it make the residents think of? The group will then start to write, reflecting on their own experiences in musings that can take any number of forms—haiku, flash fiction, memoir, or comedic writing.
During her semester-long internship at Fora, student intern Evelyn Gore BA ’26 came up with the idea to create a collective poem. Each line would be written by a different person, beginning with the phrase “Dear Inner Critic” and then assembled to form a cohesive piece of writing (see below). “I often began the circle with the question, ‘What do you need right now, and how can we, as a class, meet those needs?’” says Gore. “Through this process of cocreation, we found unity in our writing and brought the poem to life.”
Dear Inner Critic
Dear Inner Critic,
Who’d thought that you’d say
That I should go out and conquer the day.
Have you stepped outside today?
Felt the cold November wind on your back?
Dear Inner Critic,
oh how I’ve trusted you so,
You’ve shaped me and fed me, but
Never let me grow.
Like looking in a mirror,
Everything good is reversed.
We are one in the same.
Dear Inner Critic,
I listen and want to ignore you.
It’s okay when I slip and make mistakes,
But my mind, body and soul
it shall not take.
You push the blame, forever on me.
Dear Inner Critic,
I’d like to right my course,
Please may we adjust or talk things out
For I’m your only source.
I’m not sure which parts of me you’re made of,
Is it just the bad things, the sadness, the things I missed?
Dear Inner Critic,
Who gave you that power over me?
A group poem, created by Fora Health in-patient residents, based on the prompt “Dear Inner Critic.”
Lewis & Clark’s partnership with Fora Health stems from Alexis Rehrmann’s ongoing work to bring narrative medicine instruction to the college. Rehrmann, program manager of narrative medicine and community partnerships at the Center for Community and Global Health (CCGH), connected with Fora Health at a training session hosted by the Northwest Narrative Medicine Collaborative, where she serves as a board member. At the time, Fora was looking to enrich their narrative medicine work. Through a $750,000 Andrew W. Mellon Foundation Grant for the project entitled “Healing Social Suffering Through Narrative,” the college was able to fund a select number of student internships with the organization.
“Narrative medicine brings humanity into all of our health care interactions. It helps us increase our empathy for ourselves and others, and it helps us understand our own stories,” says Rehrmann. The three tenets of narrative medicine, she explained, are attention, representation, and affiliation: meeting our health with focused attention, allowing us to recognize something that might go unnoticed, and then coming together in authentic connection. “We think that the gift of attention, together with representation, brings us to this space of affiliation, which is a powerful place to start healing.”
Fora Health’s first Lewis & Clark intern, Edie Tavel BA ’23, was a sociology and anthropology major interested in developing narrative skills in a range of health care settings. Through this work, she was introduced to Fora and later brought in to help develop their narrative medicine curriculum. Fora Health interns shadow staff working across departments, from withdrawal management to residential and out-patient treatment, learning how to provide comprehensive, compassionate care.
After her graduation, Tavel was hired as a full-time intake specialist by Fora Health, where she continues to run the narrative medicine program while pursuing a master’s degree in social work at Portland State University. “Narrative medicine felt like a way to practice what we discussed in medical anthropology classes, noticing where there are gaps in the health care system and where people’s stories aren’t taken into account,” says Tavel. “It has such great potential as a healing tool for clients, as well as for people who are working in health care to help them process their experiences. It all weaves together for me, from SOAN to narrative medicine and now social work.”
Through Tavel’s efforts, and with the support of several Lewis & Clark interns, narrative medicine is now embedded in Fora Health’s programming. Following the success of the writing circle for in-patient residents, a group was formed to offer a similar service to outpatient clients. Fora has held over 10 “communities of practice” for staff, where close readings and reflective writing center around honoring the voices of diverse artists. Poems are posted in a designated “Residential Poetry Corner” in the patient library, and in February 2025, Fora hosted a showcase of writing from both in- and out-patient clients with an “Afternoon of Storytelling.”
Narrative medicine continues to grow and evolve at CCGH, housing internships with organizations like the Northwest Narrative Medicine Collaborative and the Chronic Pain Project. CCGH offers narrative medicine workshops to students enrolled in health studies courses, and is now training students to lead a narrative medicine activity for their own communities on campus called “Write 2 Relate.”
“Lewis & Clark is in a unique position—both to provide these tools to the health care community in the Pacific Northwest and to train our incredible student body in these skills,” says Rehrmann. “I believe it is because of our principles as a liberal arts college that we are so well situated to deliver on the promise of this field.”
Health Studies Narrative Medicine @ LC
Center for Community and Global Health Pre-Med
