Lauren Small is on a mission to bring the entire Johns Hopkins Medicine community together, in groups large and small and in different venues, for a discussion of one piece of literature: a short story by author Wendell Berry called “Fidelity.” The story focuses on the final days of Burley Coulter, 82, a character who appears in many of Berry’s stories. Coulter is in failing health and ends up in the hospital hooked up to tubes and monitors, causing anguish for those who love him — and a controversial action by his son.

The yearlong One Health Care Community One Book initiative, which kicked off in November, is an extension of AfterWards, a narrative medicine program that Small co-founded in 2014 that brings Johns Hopkins clinicians together to discuss, write about and reflect on a piece of literature or art with a medical theme. To open a discussion about pain, for example, one AfterWards meeting featured paintings by Frida Kahlo.

“I loved the idea of reading and writing in the context of a medical institution,” says Small, a novelist and part-time assistant professor of pediatrics who holds a doctorate in comparative literature. To date, she has led more than 50 sessions of AfterWards.

Through the book conversations that are central to One Health Care Community One Book, Small aims to promote empathy, reflection and self-care for Johns Hopkins Medicine employees, and build community across the health care professions — by engaging all 41,000 members of the community.

“It’s AfterWards on steroids,” she says.