The essay by Charon and associates in this issue [1] discusses in considerable and illuminating detail both the formal study of literature in medical schools over the last 23 years and related developments. As worthwhile as the endeavors chronicled by these authors are, many resident and staff internists still feel inadequate as reader-interpreters of novels, poems, and stories. Why is this so, and what can be done about it?

We all carry the weight of our experiences with the worst English teacher to whom we have been exposed, the teacher who foisted such ridiculous but durable notions as that of "figuring out" a poem, of finding the "right" interpretation of it, or, worst of all, of reading as duty rather than as immersion in soul-satisfying, gripping, exciting, rebellious, or underground stories. Although many of us also had wonderful teachers of literature, damage from pedants—along with the tremendous and recurrent problem of finding time and energy amid the busy life of practicing medicine—has assaulted the habit of inviting books into our lives on a daily basis. This frame of mind can increase an unfortunate and unjustified suspicion when one notes that Charon and colleagues' paper about literature has the word "clinical" in its title, and yet only two of its seven authors are physicians. Among its 149 references are many from the profoundly alien realm of literary criticism, some with titles incomprehensible to almost every internist.

Physicians are also ill at ease because of experiences during their years of professional schooling. Even if the decision to pursue medicine sprang not from technical orientation but from an attraction to the abundant interpersonal and social elements of medicine, one usual consequence is a distancing from narrative reading and writing. Another result is greater comfort with the concreteness of science than with the ambiguities of the humanities. One of us remembers thinking, joyfully, that with matriculation in medical school he would never have to write another literary analysis.

How, then, can we become at home with books and stories? First, we can regard the paper by Charon and associates as the Harrison's Principles of Internal Medicine for literature and medicine, that is, as a scholarly compendium full of important theory, basic science, and practice, an invaluable reference not meant for wholesale, cover-to-cover absorption in the short term. This granted, we can allow other sources, such as papers in the Annals series The Internist's Reading [2] and this editorial, to provide the humble but practical guidance of a Washington Manual of Medical Therapeutics.

A key element to the enjoyment of books is confidence about one's perceptions of and reactions to books, without reference to literary critics. Our experience as readers, and as teachers of literature and medicine, has consistently been that stories engage readers. If one wants orientation and background about a writer, the straightforward accounts in such reference works as the multivolume Contemporary Authors—New Series, available in many nonmedical libraries, serve this function. Nothing that a critic can say will undo the reader's personal, unprepared, and valid response to a story or poem.

As a first step, we recommend sampling many small, manageable works; completion and mastery are important elements of the satisfaction to be found in books and stories. Short stories are especially well suited to the half hour that may be at one's disposal of an evening, and our reference list provides a minute sample [3-5]. Accounts and stories by physicians are especially likely to hold our attention [6-11], but don't stop there. Some anthologies are particularly convenient [12, 13].

The decision whether to buy books or borrow them from the library is a difficult one. For some, the comfort of being able to keep the book and even to write in it (something that one of us has nearly cured the other of doing) justifies spending the money. For others, a test drive from the library, or the habit of not acquiring, minimizes household clutter, particularly if the threshold for purchase is kept high. Even such preferences as ours for hardcover rather than paperback books need not be regarded as banal and can be dealt with if made explicit.

After reading, talking about stories is crucial. Discussion can be informal and extempore, and need not be any more pretentious than conversation. Although time constraints are a barrier, a reading group provides a wonderful opportunity for discussion. Having nonmedical members is vital. Physician and nurse colleagues, office support staff, patients, and family members can all illuminate and challenge one's perceptions of a book. Every person for whom one feels any respect or affinity at all is a suitable discussant with whom to enjoy the sharing of a story.

Let's get literature off its high horse. We advocate that books, stories, poems, and plays be enjoyed on one's own terms, that is to say, without enslavement to the pronouncements of any party besides the writer and the reader. If internists can regard and use stories on these terms, books will constitute not another burdensome demand on the overextended self, but an enrichment both of personal life and pleasure and, yes, as Charon and colleagues assert from experience and from the limited data at hand, more humanely attuned physicians.