Wisdom in Practice: A Leader’s Journey Through the Lens of Narrative Medicine

When Cindy Smalletz reflects on healing in healthcare, she doesn’t begin with clinical data or medical procedures — she starts with the power of story. She’s especially  enthusiastic about the lesson that true healing starts with listening, humility, and human connection amplified in the tales from Three Pines, the fictional village nestled deep in the forests of Quebec, brought to life by her favorite author, Canadian mystery writer, Louise Penny.

“It’s an imaginary town, but it’s based on a real place I love dearly — full of people, community, food,” Cindy says. “It includes life lessons including the four statements that lead to wisdom by Chief Inspector Armand Gamache: ‘I don't know. I need help. I'm sorry. I was wrong.”

 “These are lessons for us all and for our students,” says Cindy, Program Director for the Certification of Professional Achievement (CPA) in Narrative Medicine at Columbia University and Associate Faculty, and Department of Rehabilitation and Regenerative Medicine

The New Jersey resident juggles multiple roles in addition to her Columbia posts as faculty and program director—occupational therapist, biofeedback practitioner, homeless center volunteer, and Spin instructor at  YMCA Of Montclair.  She has spent her career asking a powerful question: How can the knowledge of what to do with stories change how we attend to one another as caregivers, peers, and mentors and how can that affect healthcare today? A voracious reader, she believes that stories — whether in novels or in patient narratives — offer a mirror into the human experience.

Caring On

What Cindy's resume does not reflect is her lifelong lived experience as a caregiver. From her childhood helping to care for her grandparents to her recent role caring for her mother through her final health journey and taking over care of her father since her mother’s passing in August, Cindy her has juggled her own busy career commitments and racing back and forth from New Jersey to North Carolina. She also brings her patient experience, struggling with chronic migraines, to her multiple caring roles.

“I remember the day I finally found a doctor who pushed aside the stack of records and said, ‘Tell me about yourself,” says Cindy. “That is the kind of attention I have been passionate about bringing to each person I interact with from students to clients, to patients. The narrative medicine work helps me continue to seek comfort in uncertainty in a way that helps me bring compassion to each patient I have the honor to witness and curiosity to more deeply engage in learning the stories they carry.”

Building trust, asking questions, and then “just listening,” are the lessons Cindy tries to impart with students and in her own care.

Where Story Meets Practice

The questions, like in Penny’s novels, drive Cindy’s role at Columbia, where she oversees the pedagogical, programming, and curricular work of the Division of Narrative Medicine, including designing educational offerings such as the open virtual group sessions, lecturing to various clinical programs, mentoring students, alumnx and other faculty, and designing, building, and launching the Certificate (CPA) program in the Fall of 2017. Leveraging a former career as an educational technologist, Cindy continues to create the online coursework for the CPA program. To date, there have been 260 graduates in the program and 160 enrolled students.

In her occupational therapy practice, Cindy returns again and again to the power of narrative — which is more than just storytelling, but a way being with others. She argues that participating in narrative medicine work isn’t just therapeutic for patients — it’s crucial for all caregivers as well.

“As an occupational therapist and biofeedback practitioner, I am excited to continue to find ways to bridge my work in narrative medicine and occupational therapy, expanding beyond just patients and clinicians,” she says. “So many people are quietly suffering. Narrative medicine gives them ways to process, to reflect, to reconnect with their 'why.'” She encounters this regularly while running a weekly late night virtual narrative medicine group on the island of Haida Gwaii where for over five years, those sessions continue to remind her why this work matters for herself as much as it does for others. 

In one of varied OT roles, she supervises Columbia Occupational Therapy students in their Level II Fieldwork at a behavioral health residential program, PIBLY Residential Programs, Inc., which is a Bronx and Brooklyn-based, not-for-profit organization certified by the New York State Office of Mental Health. She uses The Kawa Model,  a therapeutic method developed in Japan by occupational therapists that is steeped in empowering clients to construct their own stories using the river, “kawa,” as metaphor to depict a patient’s life journey to help them create ways to restore their healthy life flow.

Driven to Make an Impact

To say Cindy’s CV is extensive, and super impressive, is to understate. She’s earned two M.S. degrees from Columbia in Narrative Medicine and Occupational Therapy, an M.A., from Seton Hall University and a B.A. from Wake Forest University. The credentials after her name include, MS, MA, OTR/L, BCB. Her early career experience included stints as Senior Project Development Specialist, Learning and Education at PwC and she moonlighted to pay the bills as ashift manager at  Starbucks. Currently she’s also the faculty co-coordinator of OT services for The Columbia-Harlem Health and Medical Partnership (CHHMP), a student-run free clinic dedicated to ensuring that everyone in the community has access to care and provides free, quality medical care to unhoused, uninsured, and underserved individuals in the West Harlem neighborhood of Manhattan.

A New Kind of Medical Training

Under Cindy’s direction, Columbia’s Certificate (CPA) in Narrative Medicine has grown into a model of innovative, human-centered education. She designed the program from the ground up — integrating asynchronous online coursework with live workshops and readings that challenge students to think beyond diagnostics and delve into the lived experience of illness and life.

Her favorite writers — a blend of literary icons and contemporary thinkers — are part of the curriculum and part of her personal toolbox. They offer what she calls “narrative curiosity” ways to approach ambiguity, hold space for suffering, and resist reductive answers.

“When we read Toni Morrison in class, we’re not escaping healthcare,” she says. “We’re deepening our understanding of it,” she says, ”The authors we read help us name injustice, honor identity, and validate pain in a way charts and codes never could.”

Creating the Future of Healthcare

As medicine reckons with its limits — technological, ethical, emotional — Cindy sees narrative medicine not as a luxury, but a necessity. A way forward.

“Data can tell you what’s happening,” she says. “But stories tell you why it matters — and only then can the path forward be created.”

With health systems increasingly recognizing the value of empathy, cultural humility, and patient-centered care, Cindy’s approach is more relevant than ever. And for her, it all starts with reading differently, listening more deeply, and seeing health not just as the absence of disease, but the presence of meaning.

“My goal for the Certificate (CPA) program has always been to build a community of to passionate people who want to change the world,” says Cindy. 

Getting to Know Cindy

1.  What is your idea of perfect happiness?

My perfect happiness is being present for myself and for others. This can happen meeting hikers on a mountain far away, just like it can happen in a nursing home sitting and being gifted with someone’s story. This can happen in a phone call, or a passing conversation at the farmers market, or a friendly wave on my morning run. Being filled with stories from others is my happiness. Now, if that were to happen on an autumn day up north with leaves changing and fresh air and food, that’s even better, but waiting for the perfect day is futile, and focusing on the little moments makes every day full of possibilities.

2.  What do you consider your greatest achievement?

Finishing occupational therapy school was huge. Was it my greatest? Probably not. But it was significant enough, going back to school mid-life and working full time during school and also managing the difficulties of my life at the time, really made that success something I still can’t believe I got through.

3.  Describe yourself in six words.

Curious, smiling, energetic, imperfect, hopeful, determined

4.  What are you most grateful for?

I’m grateful for so many humans and animals who have seen me and witnessed me through the good and the mess up until today – some are friends, family, colleagues, healthcare professionals, and clients, and so many others are strangers who I might speak to on the street, or sit next to once on a train, or chat with over a poem at a restaurant. These are the people who see me, and some see me in that moment and some see me over my lifespan, but each one of those “little angels” as I call them, teaches me something about life, about showing up, and about what I strive to be for others in my life.