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From the poetry of William Carlos Williams, the novels of Walker Percy, and the short stories of Anton Chekov to the contemporary essays of Atul Gawande, physicians' contributions to literary genres have been significant. This article explores the specific form of confessional writing offered by physicians during the past half century, writing that often exposes medical error or negative feelings towards patients. A history of confessional practices as a legal tool, as religious practice, and as literary genre is offered, followed by analyses of selected confessional writings by physicians, many of them found in clinical journals such as Journal of the American Medical Association, Annals of Internal Medicine, and the Lancet. The authors of the narratives described here are engaged in several or all elements of the confessional sequence, which may offer them some resolution through the exposure and acknowledgment of their shared humanity with their patients and their expression of regret for any harm done.

In this essay we link the rationale for the medical humanities with radical hermeneutics, a move that infuses the medical humanities with incredulity and suspicion. This orientation is particularly important at this historical moment, when the evidence-based and competency blanket is threatening to overpower all aspects of medical education, including the medical humanities discourse itself. Radical hermeneutics works relentlessly against the final word on anything, and as such, it provides a critically provocative way of thinking about doctors, patients, illness, health, families, death--in short, the experience of being human. We use three literary examples to illustrate the complex, contradictory, perplexing, and disturbing questions related to a life in medicine: Rafael Campo's "Like a Prayer," Irvin Yalom's "Fat Lady," and Richard Selzer's "Brute."

The professional development discourse currently circulating in academic medicine owes much to the work of the American Board of Internal Medicine (ABIM) and their Project Professionalism. They identify the elements of altruism, duty, excellence, honor and integrity, accountability, and respect for others as forming the basis of professional development. While an admirable effort, Project Professionalism remains primarily an abstract set of attitudes and behaviors with a number of vignettes that are of limited use to medical educators attempting to foster the development of professionalism in medical students. This paper outlines an approach to professional development grounded in medical narratives written by physicians, including memoirs, essays, and poetry, that may help students grapple with the challenges of medicine that involve those very elements put forth by ABIM. An argument is made that literature may be a superior medium for engagement with these elements because of its ability to evoke discomfort and vulnerability in ways the case report does not.