Get Lost in a Story

Stories have been told since the beginning of civilization- sharing our own or listening to
anothers. 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. This blog is another avenue for storytelling, one in which tales of
research, medicine, patients, and education all converge.

There is a very powerful story I encourage you to read, especially as part of the medical
community. The Spirit Catches You and You Fall Down by Anne Hadiman is expertly
narrated and examines the cultural, medical, and language barriers of a refugee family
from Laos and the medical community of Merced, California as they treat their 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 within the healthcare system.

I have been witness to many stories during the past year at OHSU and the VA Medical
Center on 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 nave, 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, as
clinicians, 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 a storied
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. It is these stories that make us better clinicians,
better people.

I challenge you the next time you visit with a patient- learn one thing no one else
knows about them. You may be surprised by the story you hear.