Stories have been told since the beginning of civilization – sharing our own or listening to another’s. We love to get lost in stories: films, books, readings, theatre – we are drawn to the lives of characters whose heartbreaks and triumphs we connect with and can reflect on as our own. I hope you enjoy this blog as it is another avenue for storytelling, one in which tales of research, medicine, patients, and education all converge.
A very powerful story I encourage you to read, especially as part of the medical community is “The Spirit Catches You and You Fall Down” by Anne Hadiman. Compassionately narrated, the author examines the cultural, medical, and language barriers of a refugee family from Laos and the medical community of Merced, California as they treat Lia Lee, a Hmong child diagnosed with epilepsy. This story embodies the term “narrative medicine.” Narrative medicine is not about medicine and technology but rather about people, their cultures, foundations, beliefs, denials and acceptances of patients within the healthcare system.
I have been witness to many stories during the past year at OHSU and the VA Medical Center on my rotations. These stories have been filled with hope and fear, science and faith, brilliance and doubt. The purest essence of storytelling exists in these wards and on these floors we have all come to know so well. In medicine, we tend to forget that we all have a story. We come in naïve, innocent, and open. We are trained, coached and critiqued on factual truth. We forget that History really means “his story” and “her story.” We talk about someone in the context of their illness – Mr. C with Type II Diabetes, Mr A. with a pneumothorax, Ms. R with cellulitis and COPD. When we talk to a person, we help him write his story, how he came to be where he is and how he is handling the issue. Family members and friends help enrich the story, allowing us to tease out the details and nuances.
These stories, the narrative encounters in medicine, are how we can create an understanding of not only our patients, but also our teams, preceptors, and fellow students. Medical explanations of health and disease are culturally driven. Narrative medicine is the link between the cultural and conventional wisdoms. It is the story that is ubiquitous across all bounds and frees us to be open to what that person wants and needs us to experience with them. Listening to these stories make us better clinicians and better people.
I challenge you – the next time you meet with a patient – learn one thing no one else knows about them. You may be surprised by the story you hear.
Shameless plug: There will be an open forum discussion about “The Spirit Catches You and You Fall Down” on Monday, January 27 from 4:30-6:30pm in the Student Center Media Room – please join us! Snacks will be served and the discussion lively!