Can stories bring connection back to healthcare?
With Elisabeth Poorman, MD, and Audrey Provenzano, MD, MPH
On a rainy night in November, dozens of healthcare providers filled a dimly lit restaurant in downtown Boston. In an event hosted by Primary Care Progress, surgeons, primary care doctors, research scientists, medical students, and clinical staff came together to share stories from the frontlines of medicine.
Edward Billingslea talked of the sense of “not belonging” as an African-American man in biomedical research. Joe Wright and Elisabeth Poorman spoke of lessons learned in the trenches of the opioid epidemic. Sara Selig recalled caring for both her husband and her Native American patients at the ends of their lives. Nic Nguyen reflected on the unfairness of luck in the work of healing.
Just six weeks later, another group of clinicians — this time, with patients — gathered in a renovated warehouse in downtown Atlanta to break bread and share stories. There were tales of stolen bikes, homeopathic mistakes, and lessons taught by patients. Hosted by clinicians from Grady Health System, and joined by colleagues from Kaiser Permanente, Morehouse School of Medicine, and Emory University, it was easy to forget that that kind of community is the exception — not the rule — in healthcare today.
But in that community, magic happened. Amid the loneliness and frenetic pace that often marks medicine, we — patients and providers — had taken the time to connect, and in doing so, felt a kind of agency and renewal that we hadn’t felt in years.
The provider as storyteller
There’s no question that to be a clinician is to be a storyteller. Over years of training, clinicians learn how to craft intricate narratives out of disjointed details, shedding light on the lives, choices, and circumstances of patients. Through stories, meaning is made for and with those we serve.
And yet, rarely do the personal experiences of healthcare professionals find their way into the daily discourse. Maybe it’s the grueling training or some misguided belief that vulnerability is weakness, but at some point along the way, providers stifle their lived experience, avoiding talking about how the daily work as healers impacts the spirit — how it chips away at one’s humanity to bear witness to the systemic injustices that cause patients to suffer, like watching a diabetic patient ache to decide between insulin for herself or food for her children. Providers struggle to talk about their battles with isolation and depression, and what it means to work in a system engineered to work against them.
To be fair, some of that sentiment is starting to change, as more attention is paid to the important role and unique power of story in medicine — clinicians’ stories — thanks to visionaries like Atul Gawande and others willing to open up about mistakes, hard losses, and moments of triumph.
And yet, we need so many more of these accounts.
Stories are how we learn from and about each other. We use stories to remember rare disease, to warn of potential complications, and to distill vast amounts of data into an assessment and plan. They’re how we — inside and outside of medicine — make meaning of our work and our lives.
Harvard lecturer and narrative legend, Marshall Ganz, Ph.D., says of story that it enables us to “access, express, and cultivate emotional resources embedded in shared values — resources that are necessary to confront challenges with courage, resilience, and agency.”
And so, when we fail to tell our own stories, the tragedies we observe fester within us. We thus lose an opportunity to grow, to heal, to organize. And more importantly, we lose a chance to coalesce around those shared values that we discover in the stories of others to move real change forward.
Practicing medicine is a difficult — at times near impossible — task. Burnout is at an all-time high. Clinicians are caring for increasingly complex patients in an immeasurably cumbersome system that simply doesn’t align with the values of providers.
We — patients and clinicians— need to come together to change the narrative. And we have to start by telling our stories.
Maya Angelou famously remarked that “there is no greater agony than the untold story.” Nowhere is this agony felt more than in healthcare — both in the need to tell our own stories, and in the urgency for us to collectively write a different ending for healthcare. On a rainy night in November and a warm evening in Atlanta, our stories bred hope that we can begin to heal medicine — and each other.
A special thanks to @j_sumitani, @gradydoctor, @DrPoorman, and @audreymdmph for your vulnerability in sharing your own journeys in medicine, as well as Primary Care Progress for your commitment to training healthcare professionals in the practice of narrative as a tool for changemaking.
Can stories bring connection back to healthcare?
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