The decision by educators at the Menninger Clinic in Topeka, Kan., two years ago to integrate short stories with lectures on normal development and psychopathology proved to be a good one.

"The psychiatric residents enjoy the short stories so much that they asked that the class be extended, so we now meet for 80 minutes rather than 50," said Alice Bartlett, a psychology doctoral student and certified psychoanalyst at Menninger.

She and co-teacher John Sargent, M.D., a child and adolescent psychiatrist and pediatrician at the Menninger Clinic, spoke at the annual meeting of the American Association of Directors of Psychiatric Residency Training (AADPRT) last month in Puerto Rico.

The class for PGY-1 residents runs for a full academic year and is the introduction to a three-year sequence on developmental psychopathology, said Sargent.

Two anthologies of short stories on families were chosen "because they offer different perspectives on developmental changes in the context of diversity, gender, and culture," said Sargent. The books are American Families, edited by B.H. Solomon, and Family: Stories from the Interior, edited by G.G. Chavis. Bartlett noted that short stories from other sources were added since the class began in 1998.

"To not overwhelm the residents, we chose short stories that can be read in about 45 to 75 minutes," said Sargent.

Each resident is asked to reflect on several questions after reading the story, including how the historical and cultural context influences the story, the storyteller’s point of view, the main developmental conflict for the storyteller and other characters, and multigenerational factors that influence the current situation, according to Bartlett.

For example, "Two Lives" by Amy Tan in the Oxford Book of American Short Stories is the assigned reading for the session on early childhood—development of self/other.

"The story, based on Tan’s book The Joy Luck Club, reveals the conflictual relationship between an American-born daughter and her Chinese-born mother. The girl resists her mother’s attempts to make her a child prodigy so the family can take full advantage of all that American life has to offer," said Bartlett.

"We also learn that the mother left behind two daughters when she fled China’s Cultural Revolution," Bartlett added.

The story stimulates the residents to think about how parents and children from different cultures have conflicting expectations for their relationship, the psychological implications of immigration, and the role of a person’s culture of origin on his or her worldview, identity, and concept of self, explained Bartlett.

The short story "And Sarah Laughed" by Joanna Greenberg is assigned for the session on early childhood and family development. "A woman in rural America first describes her decision to marry a deaf man and then her realization that their children are born deaf," said Bartlett.

The story provides snapshots of the family’s development over time. A milestone occurs when one son returns home with his deaf wife who decides to teach the family sign language. "We look at the stress of adding a new adult family member on the family unit as well as on each family member and their unique psychological struggles in meeting this enormous challenge," said Bartlett.

"The story also helps the residents think about generational differences in approaching disability. The mother wanted her family to pass as ‘normal,’ thus minimizing their disability, in contrast to the daughter-in-law, who has learned the language of the new deaf culture," said Bartlett.

Sargent commented that the story is powerful for him and for residents who are new to Menninger. "We also encourage the residents to think about the stories in the context of their lives such as going from medical school to residency," said Sargent.

Adrian Sondheimer, M.D., a child and adolescent psychiatry training director at the University of Medicine and Dentistry of New Jersey, uses short stories in a six-week seminar on literature and medicine to discuss the making of a physician from different perspectives.

Sondheimer participated in the session with Sargent and Bartlett at the AADPRT meeting.

The first assigned short story, "The Carnival Dog, the Buyer of Diamonds" by Ethan Canin, is about a third-year medical student who calls his parents to tell them he is dropping out of medical school, said Sondheimer.

"The father reacts to the news by traveling across the country and showing up on his son’s doorstep. They play a game of ‘one-on-one’ on the basketball court, and the father ends up sitting on top of the son and asking him, ‘Do you give?’ The son basically responds ‘What can I do?’" said Sondheimer.

The story raises questions for the first- and second-year medical students taking the seminar about their decision to become physicians and the demands on them in medical school, said Sondheimer.

"They initially are adamant that they made the decision to become doctors completely independently. But, eventually, they acknowledge the possibility that other influences may have played a role," he added.

He recommended Canin’s collection of stories Emperor of the Air published when Canin was a 27-year-old medical student.

Sondheimer uses other short stories about physicians to discuss the role of empathy in dealing with patients and how the students would react in similar situations.

The last assigned reading in the seminar is the novel Ordinary People by Judith Guest. Sondheimer noted this is the only novel students are required to read, and so far none of them has complained about its length.