Several years ago I had the honor of having my piece "Who Am I, Again?" recognized by attorney and brain injury activist Gordon Johnson. He then took it upon himself to sponsor a filming of a production of the story as his kickoff project for his TBI Voices project which features the stories of brain injury survivors.
Recently, Attorney Johnson has begun a blog for the Chicago Brain Injury group that features good articles about recovery, including some commentary about scenes from my story. I encourage you to take a few moments and look at both sites - both are filled with good thoughts and observations about recovery.
Enjoy.
Showing posts with label Articles / Books. Show all posts
Showing posts with label Articles / Books. Show all posts
Tuesday, June 7, 2016
Thursday, February 25, 2016
Article Review: When Patients Share Their Stories, Health May Improve
The New York Times article “When Patients Share their Stories, Health May Improve” shares a summary of information that has already been presented in this blog. As stated in the article, “…Stories are an essential part of who we communicate, interpret experiences and incorporate new information into our lives.” It then goes on to cite a study reported in The Annals of Internal Medicine suggesting storytelling helps patients with high blood pressure. The article succinctly presents the information as, “…It appears that at least for one group of patients, listening to personal narratives helped control high blood pressure as effectively as the addition of more medication.” The article goes on to suggest that storytelling can be most helpful in “silent” diseases - in other words, diseases that have few symptoms that are not externally obvious or immediate, such as diabetes or high blood pressure. Due to the lack of external symptoms, these conditions are easy to ignore even after diagnosis, yet, as in the article, “Stories help break down that denial by engaging the listener.”
My response to this article is brief - I like it. It is a summary of what is starting to happen in storytelling medical research. It also recognizes what has hampered storytelling research for many years, the lack of quantifiable evidence. As noted in the article, “A vast majority of studies (about storytelling) have been anecdotal, offering up neither data nor statistics but rather…stories to back up the authors’ claims.” This piece then goes on to cite the high blood pressure study in African American patients, a study mentioned in a previous article review, and recognize how quantifiable data is becoming available to support the medical benefits of storytelling.
The aspect of this article that most excites me is the fact it was in the New York Times. This demonstrates that the idea of storytelling in medicine is becoming more accepted by popular culture and publicly recognized by the medical community. Granted, as far as I can tell, it has not received mainstream recognition, but something is happening. My hope is that this blog will continue to flourish, and help, in some small way, to further the this recognition and acceptance of medical storytelling.
Please share your thoughts below.
Article: Paulina W. Chen, M.D., “When Patients Share Their Stories, Health May Improve”. Published February 10th, 2011 in the New York Times. http://www.nytimes.com/2011/02/10//health/views/10chen.html Accessed February 5th, 2016.
My response to this article is brief - I like it. It is a summary of what is starting to happen in storytelling medical research. It also recognizes what has hampered storytelling research for many years, the lack of quantifiable evidence. As noted in the article, “A vast majority of studies (about storytelling) have been anecdotal, offering up neither data nor statistics but rather…stories to back up the authors’ claims.” This piece then goes on to cite the high blood pressure study in African American patients, a study mentioned in a previous article review, and recognize how quantifiable data is becoming available to support the medical benefits of storytelling.
The aspect of this article that most excites me is the fact it was in the New York Times. This demonstrates that the idea of storytelling in medicine is becoming more accepted by popular culture and publicly recognized by the medical community. Granted, as far as I can tell, it has not received mainstream recognition, but something is happening. My hope is that this blog will continue to flourish, and help, in some small way, to further the this recognition and acceptance of medical storytelling.
Please share your thoughts below.
Article: Paulina W. Chen, M.D., “When Patients Share Their Stories, Health May Improve”. Published February 10th, 2011 in the New York Times. http://www.nytimes.com/2011/02/10//health/views/10chen.html Accessed February 5th, 2016.
Wednesday, February 17, 2016
Article Review: The Importance of Telling (and Listening) to the Story
The article “The Importance of Telling (and Listening) to the Story" by Kirsti A Dyer, MD is an overview of reasons storytelling is important in the medical practice. The piece simply defines what it means by telling a story, and then goes through an explanation - filled with cited examples - of why this story sharing process is important.
Much of the work focuses on healing from grief, either due to a personal loss of ability or the loss of someone close to you. In Dr. Dyer’s words, “When a loss of significant life change occurs people need to adapt their life story to include the loss…Developing a narrative allows a person to weave there life changes into a new more cohesive story.” We need stories to makes sense of what happens - inserting events into a timeline that shows a complete process. I wrote about something similar to this in a previous entry (February 10th, “Life Will Happen”) and I agree that we need to see the prior and after events in a tragedy to understand the entire journey, but Dr. Dyer takes this idea a step further by suggesting using storytelling as the tool for that task.
She also emphasizes how storytelling is a tool to construct a set of purposes for a difficult situation. She writes, “Stories allow physicians and patients to communicate, look for meaning in their illness, and discover ways of coping.” This is something I hadn’t thought of, but can easily agree with - when a tragic situation that I cannot understand develops, I quickly fall back to a fatalist or nihilistic philosophy - what does anything matter, its all just random, meaningless events - and this can trample my urge to respond in a productive manner. With storytelling, as laid out by Dr. Dyer, one can transform the tragedy into a part of a grand story. My piece “Who Am I, Again?” attempted to do just that, and I can testify that since I began working with that story, the events of my accident, while still hard, seem less tragic and more passing.
There is also a recognition of the importance of listening by the physician in this process. In Dr. Dyer’s words, “By listening to the story of loss, illness or disease the physician gives the patient a chance to express his / her concerns.” By listening to a patient’s story, a physician is given the chance to take better care of that person. One of my first entries into this blog was about the nursing staff at my rehabilitation hospital in Philadelphia (January 14th, “A Good Memory from Magee Rehabilitation”), and in that entry, I mention how there was one nurse in particular (they were all good, but this man stands out in my mind) who would make it a point to kneel beside my wheelchair and really listen to my difficulties, and this simply task helped me to feel a greater sense of calm that made my time in that hospital endlessly better.
The entire article is filled with examples and support of the thesis that storytelling is important from both sides of a healing situation - from the patient as well as the care-giver. Dr. Dyer also acknowledges that there is beginning to be a recognition of the value of storytelling in healing in contemporary medicine, and she is glad for this and encouraging it to continue. As she concludes, “Physicians may be unable to take away the pain and grief following a loss, however we can listen. Listening to a patient’s story of loss or illness, if even for just a few moments, can be beneficial in integrating, healing and recovering from the loss.”
I loved this article for several reasons - it is direct and easy to understand, the information is presented in an objective manner, and there are a host of citations of studies (which I am in the process of following up on) that support the thesis that storytelling is important for healing. Previously (primarily while in graduate school for Storytelling), I had heard arguments about the medical benefits of storytelling laden with lots of impassioned sentiment - I do not mean to criticize such passions and I feel this passion holds validity, but the argument in this paper is presented in a pragmatic manner granting it more power in the scientific and medical communities.
Yet I still have questions that rose while reading. As part of her “Definitions” section, Dr. Dyer states, “Telling the Story focuses on the act of relating anecdotes and telling healing stories; this can be accomplished via several methods - verbal or written narratives, tape or video recordings.” My question - is there a difference in how these mediums affect the Storyteller (patient or grieving person)? I suggest that the immediate storytelling performance - the Storyteller speaking to his / her friends and family - is far more therapeutic - both for the performer and the audience - as the intimacy of a story cannot be replicated through any sort of video or audio production. I find the idea of a camcorder or a audio recorder set on a stand in front of the speaker to be very mechanized when compared to the engaging live interaction of storytelling. I have not, however, found any studies that support or refute this suggestion, but Dr. Dyer does not address the question.
My second question concerns the responsibility of the doctor to listen to and empathize with a patient’s story - this seems like it may be outside the physician’s expertise. As stated in the article, “May physicians may feel untrained with their patient’s grief.” I suggest that this is an unfair burden to place upon physicians. Listening is an active process, and to become a skilled listener can take a significant amount of training - granted, there are some people who are naturally good listeners, but to suggest that a physician should be trained and/or skilled in this ability seems out of place. Psychologists are trained to be listeners, and for that reason I suggest that patients would be better served if there can be an open dialogue between psychologists and physicians during a sever medical procedure so the Psychologist can assist n the listening process. Granted, I am ignorant in both fields, but from my experience, and having friends and relations in these professions, to expect a doctor to listen is putting another heaping ladle full of responsibility on a plate of duties that is already filled to the edge.
This is not intended take away from Dr. Dyer’s article in any manner - I believe she has a deep understanding of the subject matter through her research. I also expect I will be returning to this article many times for support of my thesis - that storytelling assists in physical and mental healing. My hope is that these questions continue the discussion, helping the medical field find the best ways to help people recover and become more fully alive.
Those are my thoughts - I highly recommend reading this article and would love to get your thoughts in the comments.
Article: Kristi A Dyer, MD, MS. “The Importance of Telling (and Listening) to the Story”. Published December 6th, 2001 on Journey of Hearts website. Accessed February 1st, 2016. http://journeyofhearts.org/kirstimd/tellstory.htm
Much of the work focuses on healing from grief, either due to a personal loss of ability or the loss of someone close to you. In Dr. Dyer’s words, “When a loss of significant life change occurs people need to adapt their life story to include the loss…Developing a narrative allows a person to weave there life changes into a new more cohesive story.” We need stories to makes sense of what happens - inserting events into a timeline that shows a complete process. I wrote about something similar to this in a previous entry (February 10th, “Life Will Happen”) and I agree that we need to see the prior and after events in a tragedy to understand the entire journey, but Dr. Dyer takes this idea a step further by suggesting using storytelling as the tool for that task.
She also emphasizes how storytelling is a tool to construct a set of purposes for a difficult situation. She writes, “Stories allow physicians and patients to communicate, look for meaning in their illness, and discover ways of coping.” This is something I hadn’t thought of, but can easily agree with - when a tragic situation that I cannot understand develops, I quickly fall back to a fatalist or nihilistic philosophy - what does anything matter, its all just random, meaningless events - and this can trample my urge to respond in a productive manner. With storytelling, as laid out by Dr. Dyer, one can transform the tragedy into a part of a grand story. My piece “Who Am I, Again?” attempted to do just that, and I can testify that since I began working with that story, the events of my accident, while still hard, seem less tragic and more passing.
There is also a recognition of the importance of listening by the physician in this process. In Dr. Dyer’s words, “By listening to the story of loss, illness or disease the physician gives the patient a chance to express his / her concerns.” By listening to a patient’s story, a physician is given the chance to take better care of that person. One of my first entries into this blog was about the nursing staff at my rehabilitation hospital in Philadelphia (January 14th, “A Good Memory from Magee Rehabilitation”), and in that entry, I mention how there was one nurse in particular (they were all good, but this man stands out in my mind) who would make it a point to kneel beside my wheelchair and really listen to my difficulties, and this simply task helped me to feel a greater sense of calm that made my time in that hospital endlessly better.
The entire article is filled with examples and support of the thesis that storytelling is important from both sides of a healing situation - from the patient as well as the care-giver. Dr. Dyer also acknowledges that there is beginning to be a recognition of the value of storytelling in healing in contemporary medicine, and she is glad for this and encouraging it to continue. As she concludes, “Physicians may be unable to take away the pain and grief following a loss, however we can listen. Listening to a patient’s story of loss or illness, if even for just a few moments, can be beneficial in integrating, healing and recovering from the loss.”
I loved this article for several reasons - it is direct and easy to understand, the information is presented in an objective manner, and there are a host of citations of studies (which I am in the process of following up on) that support the thesis that storytelling is important for healing. Previously (primarily while in graduate school for Storytelling), I had heard arguments about the medical benefits of storytelling laden with lots of impassioned sentiment - I do not mean to criticize such passions and I feel this passion holds validity, but the argument in this paper is presented in a pragmatic manner granting it more power in the scientific and medical communities.
Yet I still have questions that rose while reading. As part of her “Definitions” section, Dr. Dyer states, “Telling the Story focuses on the act of relating anecdotes and telling healing stories; this can be accomplished via several methods - verbal or written narratives, tape or video recordings.” My question - is there a difference in how these mediums affect the Storyteller (patient or grieving person)? I suggest that the immediate storytelling performance - the Storyteller speaking to his / her friends and family - is far more therapeutic - both for the performer and the audience - as the intimacy of a story cannot be replicated through any sort of video or audio production. I find the idea of a camcorder or a audio recorder set on a stand in front of the speaker to be very mechanized when compared to the engaging live interaction of storytelling. I have not, however, found any studies that support or refute this suggestion, but Dr. Dyer does not address the question.
My second question concerns the responsibility of the doctor to listen to and empathize with a patient’s story - this seems like it may be outside the physician’s expertise. As stated in the article, “May physicians may feel untrained with their patient’s grief.” I suggest that this is an unfair burden to place upon physicians. Listening is an active process, and to become a skilled listener can take a significant amount of training - granted, there are some people who are naturally good listeners, but to suggest that a physician should be trained and/or skilled in this ability seems out of place. Psychologists are trained to be listeners, and for that reason I suggest that patients would be better served if there can be an open dialogue between psychologists and physicians during a sever medical procedure so the Psychologist can assist n the listening process. Granted, I am ignorant in both fields, but from my experience, and having friends and relations in these professions, to expect a doctor to listen is putting another heaping ladle full of responsibility on a plate of duties that is already filled to the edge.
This is not intended take away from Dr. Dyer’s article in any manner - I believe she has a deep understanding of the subject matter through her research. I also expect I will be returning to this article many times for support of my thesis - that storytelling assists in physical and mental healing. My hope is that these questions continue the discussion, helping the medical field find the best ways to help people recover and become more fully alive.
Those are my thoughts - I highly recommend reading this article and would love to get your thoughts in the comments.
Article: Kristi A Dyer, MD, MS. “The Importance of Telling (and Listening) to the Story”. Published December 6th, 2001 on Journey of Hearts website. Accessed February 1st, 2016. http://journeyofhearts.org/kirstimd/tellstory.htm
Tuesday, January 19, 2016
Artcile Review: "The Healing Power of Storytelling"
Another article review, this one “The Healing Power of Storytelling” by Richard C. Senelick, M.D. written for Huffington Post.
In this article, Dr. Senelick advocates doctors using storytelling as a way to give advice and as an important part of understanding the patient’s condition. In his words, “Storytelling is a two-way street. Illnesses unfold as stories, and physicians need to learn how to listen to those stories. The same is true of giving advice, for if good advice is given in the wrong way (a listing of individual facts), the patient will not follow it.” To illustrate the importance of listening to patients, Dr. Senelick cites his time with an elderly Scandinavian ship captain, or an immigrant woman struggling in her new land, and how hearing these stories - and the stories of other patients - teaches him while allowing him to know the full context of a patients condition. He then compares this to the experience of taking his 95 year old mother to the doctor, and emotionlessly answering the required questions dictated by the appointed medical assistant. As he explains his criticism, “We might as well have been answering a robot, for when he was done, he knew no more about my mother than when we first sat down.” After recognizing the interpersonal benefit of stories being shared by patients, Senelick continues by citing specific ways and examples of how and why storytelling is an effective tool when doctors are providing information, primarily focusing on how a person is more likely to remember and apply a story as opposed to a listing of fact or processes.
Put simply, I love this article and it supports much of what I am coming to understand about storytelling as a medical tool. I particularly appreciate how Dr. Senelick acknowledges that a doctor must both listen to and share stories to make using storytelling as a tool fully effective. The previous article I reviewed (“The Healing Power of Story”) discussed using literature studies to practice listening to a patient, but this article emphasizes focusing on the patient’s story - studies of metaphor aren’t needed when discussing what actually happened to a person. Dr. Suzanne Koven (from the previous article) suggested that using literary examples makes it easier to discuss difficult topics with patients - that may be true, but I believe that if one is able to move beyond discomfort and listen to what’s actually happening without judgement, it provides an clearer picture of what’s occurring. Granted, some people may be hesitant to share personal information, and literary examples may help to provide comfort by making the reality of what’s happening more abstract, but in my experience, more often than not, people love to share stories if a listener shows genuine interest in what is being shared. From the tone of his article, it seems that Dr. Senelick is pushing for the doctors not to listen to patients because “they are required to” or “it’s part of the procedure”, but because there is a genuine interest in gathering more information. To make this interest genuine and not merely “put on” is, perhaps, the trickiest part, but I suggest that once a doctor is willing to truly listen, he or she will quickly see improvements in both his or her professional and personal life thus continuing this practice for reasons of enjoyment and self-improvement. This provides a departure from the methodic, banal procedures that might plague routine visits. Again, Senelick, “As we careen into the digital age…Storytelling, in its various forms, may be one way to connect more meaningfully with our patients, to both help us get to know them individually and help them understand their physical condition.”
Despite the praise I am heaping upon this article, there are questions that remain. First, Does a busy doctor have time to create a personal connection with every patient who comes through the office door? When Senelick describes hearing the stories of his sea captain patient, he says, in his words, “I always asked my office to block out twice the usual amount of time so I could get a double dose of his spellbinding stories.” This is wonderful if time allows, but as I understand it, many doctors are already overworked and taxed for time. Scheduling extra time to spend with someone because they are a natural storyteller is a privilege that many practitioners may not have. How does one deal with the limits of an 8 hour, or even 12 hour shift?
There is also the question of personal investment in a patient - by creating the personal relationship that naturally develops by sharing stories, could a doctor risk providing less sound medical advice because of personal feelings toward a patient? While I, admittedly, have never worked or received training as a medical practitioner, as I understand things, a doctor is expected to keep emotions out of the medical equation - would personal story sharing create emotions that could potentially cloud professional judgement?
I do not raise these questions as a nonbeliever in Dr. Senelick’s article, but as a critical reader. While my gut agrees whole heartedly with the ideas expressed in the article, I promised myself and readers of this blog that I would carefully examine everything read and posted - my goal is to find a truth about any benefits and share information, not to adhere to a dogmatic belief in the miracles of storytelling.
That said, my favorite part of Senelick’s article is when he backs up his claims and observances with facts. In 2011, the “Annals of Internal Medicine” published a study that looked at whether storytelling could improve the blood pressure of people with hypertension. In this study, two groups of African-Americans with high blood pressure were observed, one group heard stories from peers about how to deal with high blood pressure while the other group received different materials, and the results are what would be expected from reading his article. In Senelick’s words, “The group that watched stories related by peers who shared their problem were more successful in lowering their blood pressure than the other half. A story told by a friend or peer is most effective in creating a lasting memory.” While this is only one example, and can in no way provide proof of the power of storytelling, it is some does provide information that gives even more weight to the argument.
Those are my thoughts, but what do you think? Can anyone provide more examples of studies concerning the benefits or lack there of when using storytelling? Does anyone have any stories they would like to share?
Article: Richard C. Senelick, M.D. “The Healing Power of Storytelling.” Published April 9th, 2012 in Huffington Post. Accessed January 17th, 2016. http://www.huffingtonpost.com/richard-c-senelick-md/patient-care_b_1410115.html
In this article, Dr. Senelick advocates doctors using storytelling as a way to give advice and as an important part of understanding the patient’s condition. In his words, “Storytelling is a two-way street. Illnesses unfold as stories, and physicians need to learn how to listen to those stories. The same is true of giving advice, for if good advice is given in the wrong way (a listing of individual facts), the patient will not follow it.” To illustrate the importance of listening to patients, Dr. Senelick cites his time with an elderly Scandinavian ship captain, or an immigrant woman struggling in her new land, and how hearing these stories - and the stories of other patients - teaches him while allowing him to know the full context of a patients condition. He then compares this to the experience of taking his 95 year old mother to the doctor, and emotionlessly answering the required questions dictated by the appointed medical assistant. As he explains his criticism, “We might as well have been answering a robot, for when he was done, he knew no more about my mother than when we first sat down.” After recognizing the interpersonal benefit of stories being shared by patients, Senelick continues by citing specific ways and examples of how and why storytelling is an effective tool when doctors are providing information, primarily focusing on how a person is more likely to remember and apply a story as opposed to a listing of fact or processes.
Put simply, I love this article and it supports much of what I am coming to understand about storytelling as a medical tool. I particularly appreciate how Dr. Senelick acknowledges that a doctor must both listen to and share stories to make using storytelling as a tool fully effective. The previous article I reviewed (“The Healing Power of Story”) discussed using literature studies to practice listening to a patient, but this article emphasizes focusing on the patient’s story - studies of metaphor aren’t needed when discussing what actually happened to a person. Dr. Suzanne Koven (from the previous article) suggested that using literary examples makes it easier to discuss difficult topics with patients - that may be true, but I believe that if one is able to move beyond discomfort and listen to what’s actually happening without judgement, it provides an clearer picture of what’s occurring. Granted, some people may be hesitant to share personal information, and literary examples may help to provide comfort by making the reality of what’s happening more abstract, but in my experience, more often than not, people love to share stories if a listener shows genuine interest in what is being shared. From the tone of his article, it seems that Dr. Senelick is pushing for the doctors not to listen to patients because “they are required to” or “it’s part of the procedure”, but because there is a genuine interest in gathering more information. To make this interest genuine and not merely “put on” is, perhaps, the trickiest part, but I suggest that once a doctor is willing to truly listen, he or she will quickly see improvements in both his or her professional and personal life thus continuing this practice for reasons of enjoyment and self-improvement. This provides a departure from the methodic, banal procedures that might plague routine visits. Again, Senelick, “As we careen into the digital age…Storytelling, in its various forms, may be one way to connect more meaningfully with our patients, to both help us get to know them individually and help them understand their physical condition.”
Despite the praise I am heaping upon this article, there are questions that remain. First, Does a busy doctor have time to create a personal connection with every patient who comes through the office door? When Senelick describes hearing the stories of his sea captain patient, he says, in his words, “I always asked my office to block out twice the usual amount of time so I could get a double dose of his spellbinding stories.” This is wonderful if time allows, but as I understand it, many doctors are already overworked and taxed for time. Scheduling extra time to spend with someone because they are a natural storyteller is a privilege that many practitioners may not have. How does one deal with the limits of an 8 hour, or even 12 hour shift?
There is also the question of personal investment in a patient - by creating the personal relationship that naturally develops by sharing stories, could a doctor risk providing less sound medical advice because of personal feelings toward a patient? While I, admittedly, have never worked or received training as a medical practitioner, as I understand things, a doctor is expected to keep emotions out of the medical equation - would personal story sharing create emotions that could potentially cloud professional judgement?
I do not raise these questions as a nonbeliever in Dr. Senelick’s article, but as a critical reader. While my gut agrees whole heartedly with the ideas expressed in the article, I promised myself and readers of this blog that I would carefully examine everything read and posted - my goal is to find a truth about any benefits and share information, not to adhere to a dogmatic belief in the miracles of storytelling.
That said, my favorite part of Senelick’s article is when he backs up his claims and observances with facts. In 2011, the “Annals of Internal Medicine” published a study that looked at whether storytelling could improve the blood pressure of people with hypertension. In this study, two groups of African-Americans with high blood pressure were observed, one group heard stories from peers about how to deal with high blood pressure while the other group received different materials, and the results are what would be expected from reading his article. In Senelick’s words, “The group that watched stories related by peers who shared their problem were more successful in lowering their blood pressure than the other half. A story told by a friend or peer is most effective in creating a lasting memory.” While this is only one example, and can in no way provide proof of the power of storytelling, it is some does provide information that gives even more weight to the argument.
Those are my thoughts, but what do you think? Can anyone provide more examples of studies concerning the benefits or lack there of when using storytelling? Does anyone have any stories they would like to share?
Article: Richard C. Senelick, M.D. “The Healing Power of Storytelling.” Published April 9th, 2012 in Huffington Post. Accessed January 17th, 2016. http://www.huffingtonpost.com/richard-c-senelick-md/patient-care_b_1410115.html
Sunday, January 17, 2016
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.
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.
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