Article Review: "The Healing Power of Story"

I read the article The Healing Power of Story by Elizabeth Cooney and released on the Harvard Medical School Website.

The article briefly lays out the new Writer in Residence program at Division of General Internal Medicine at Massachusetts General Hospital.  For this program, author and HMS assistant professor of Medicine Suzanne Koven guides workshops for physicians that focus on looking at literature, applying the themes to real life situations and discussing the questions that arise from the readings.  As expressed by Koven, “These are difficult questions and I find that people who do this kind of work are very eager to talk about them and feel very grateful to have an opportunity to talk about them.”  By removing oneself from the somewhat invasive nature of the questions, physicians find it easier to discuss personal matters that arise in appointments. 


Approaching and discussing sensitive personal matters through the veil of story makes perfect sense to me, and is much of what this blog is about, but I ask, is using classical literature is necessary to discuss these themes?  Koven states, “The storytelling is really where the medicine is.  There is nothing that I can think of, there is no kind of testing, there is no sort of physiology or pharmacology that is more essential to clinical skill than the ability to elicit, interpret and communicate someone else’s story.”  From here, however, the workshops focus on  the interpretation of literary masterpieces.  Why can we not focus on the stories told by patients - when a doctor asks “What’s wrong?” should a patient be expected to relate their physical experience using metaphors?

That’s not to say that I think this is a bad idea - literature moves us and helps to explain experiences that are foreign.  More often than not, a patient’s explanation of “Where does it hurt?” will not be as comprehensive as one crafted by George Orwell (one of the authors studied in this workshop), and I believe this is an amazing first step in opening doctors to listening more carefully.  As put by Koven, “…The professional has to write notes in cold, clinical terms. And they can’t discuss what happens freely, out of respect for privacy. Their training teaches them to bottle up these thoughts and emotions.”  Literary studies clearly show a step in improving and increasing the comfort and productivity in patient/physician relationships.

Despite the grand intentions of this program, I feel the program does place a burden on the patient - being inspired and able to tell a story upon entry.  Similar to how doctors have been trained to bottle thoughts and emotions while diagnosing a patient or providing general care, patients often don’t want to open up to the doctor any more than necessary - say what’s wrong, turn your head and cough, and get out of there.  I would hope that, simultaneous with learning to interpret literature, doctors are taught how to elicit stories from patients.  Although these new stories likely won’t be peppered with the same colorful or enrapturing language, by better hearing and interpreting personal stories I think doctors would find ways to better care for the individuals.

Furthermore, the article states that this opening of conversation will improve care by practitioners, but it doesn’t clearly explain how this will occur.  There will be more communication in the process, but I was left wanting a more scientific explanation of how this will improve care.  Why wouldn’t a unbiased, unelaborated look at symptoms and situation provide a clearer diagnosis of a patient’s condition and provide a clear best path for recovery?  I don’t think this would provide a better diagnosis, but this article didn’t provide evidence or reasoning to back that up.

This program sounds like a grand idea, and a great start, but it seems to keep the focus on the doctors’ process instead of the patients’ care.  My gut suggests that this interpretation of literature could have more effect if it were coupled with workshops on helping patients tell a story, but I similarly don’t have data to support that.  I want this data - if anyone reading can provide any sources with such information, please post .  I also would also love to hear your thoughts on my critique, so please post comments.

Article: Elizabeth Cooney. “The Healing Power of Story.” Published May 15, 2015. Accessed January 17, 2016. http://hms.harvard.edu/news/healing-power-story.