For centuries, humans have told stories as a way to inform others about their life events. Storytelling originated 30,000 years ago with visual stories, such as the cave drawings discovered in the Chauvet caves in France.
The ancient Egyptians communicated stories through a system of picture writing called hieroglyphs. These pictographs date back about 5,000 years and are recognized as one of the world’s earliest examples of putting pen to paper or, more accurately, putting chisel to rock.
Technologies such as the printing press, the camera, the internet, and social media have provided us with multiple methods to share our stories: visual stories in photographs, spoken stories in videos and recordings, and written words through blogs.
Consider some of our greatest storytellers and what they have offered the world: William Shakespeare, Charles Dickens, Roald Dahl, Steven Spielberg, and Walt Disney.
PHYSICIANS AND STORYTELLING
Unfortunately, some doctors may be reluctant to tell stories, compelled instead to use medical jargon and data to get their point across in a more “professional” way. Yet, today, more physicians and other healthcare professionals recognize the value of stories.
Storytelling is part of the curriculum in some medical schools and training programs. The Narrative Medicine movement at Columbia Medical School is based on the concept that using stories increases empathy, enhances wellness and resilience, and promotes a more humanistic healthcare culture.(1)
Sometimes, telling a story or relating an experience makes us more human; other times, it lightens our burden, as “getting it off our chest” makes a problem or a hardship easier to manage.
One of Anton Chekhov’s most memorable stories is “Misery,” which opens with the quote: “To whom shall I tell my grief?”(2) It is the story of Iona, a sleigh driver, ferrying late-night party revelers on a snowy Siberian night. Iona’s young son had recently died, and Iona desperately wants to share the story of his son with someone. None of the passengers in the sleigh are interested in listening, too caught up in their merriment.
Iona rides all night with his emotional pain. Finally, at the end of his long, lonely shift, he tells his story to his horse in the stable. The horse listens patiently and respectfully.
I believe this story is something that, as physicians, we can all relate to. When we are challenged to care for a dying patient, don’t we all wish that we might have a horse or, better yet, another human being with whom we can share our pain?
BENEFITS OF STORYTELLING
Storytelling is an invaluable tool for physicians, offering many benefits in patient care and professional development. Here are several reasons storytelling is important for physicians:
Enhanced Communication with Patients
Sharing stories can help physicians build rapport and trust with patients, making them feel more comfortable and understood. Medicine is a complex vocation, and the concepts are difficult to explain to patients. We can use stories to explain diagnoses, treatments, and procedures in a way our patients can understand.
Improved Patient Outcomes
Stories can engage patients more deeply than raw data by helping them understand and remember medical advice, which improves compliance and health outcomes.
Patients are more likely to adopt healthy behaviors and adhere to treatment plans when they are motivated by stories illustrating the benefits and consequences of specific actions, such as making lifestyle changes.
Improved Education and Training
Stories from experienced physicians can provide valuable insights, but these important lessons are not found in textbooks. The stories can illustrate the nuances of patient care, ethical dilemmas, and the human side of medicine.
Case studies — essentially structured stories — are a cornerstone of medical education. They help students, residents, and fellows understand how their knowledge can be applied in the real world.
More Reflective Practice
Physicians can use storytelling to reflect on their previous patient experiences, understand their emotional responses, and learn from their successes and failures. Sharing stories with colleagues can foster a sense of community, provide support during challenging times, and facilitate the exchange of knowledge and strategies.
Increased Awareness about Public Health and Advocacy
Physicians can use stories to raise awareness about public health issues, influence health policy, and advocate for their patients and communities. Examples of issues include:
Climate change.
The dangers of social media.
The role of artificial intelligence in modern healthcare.(3)
Stories can humanize health statistics, making the impact of diseases like COVID-19 and health policies more tangible to the public and policymakers.
Cultural Competence
Listening to and sharing stories from diverse patient populations can enhance physicians’ cultural competence, helping them provide more personalized and respectful care. We must become more sensitive to the healthcare disparities for marginalized groups and the risks of disease that are more common in certain populations. Stories can highlight health disparities and the social determinants of health, prompting physicians to consider these unique disparities affecting their patients’ well-being.
EXAMPLES OF STORYTELLING IN A MEDICAL PRACTICE
Here are some examples of how to use storytelling:
Relate to the Patient’s Experience
Share similar patient stories. If a patient is anxious about a procedure, the doctor can share a story about another patient who had similar concerns, successfully underwent the procedure, and experienced positive outcomes.
Example: “I had a patient in your situation who, like you, was really nervous about his surgery. After the procedure, he was surprised at how smooth the recovery was. He could return to work and sporting activities in just a few days. I believe you will have a similar experience.”
Simplify Complex Information
Use analogies and metaphors. Analogies can make complex medical information easier to understand.
Example: “Think of your bladder as an inflated balloon. When the balloon’s stem is compressed, no air escapes the balloon. However, if the stem is loosely compressed, it leaks out. Your bladder is like that balloon, and we must fix the stem or the tube (urethra) that transports urine from your bladder to the outside of your body. We will start with exercises to strengthen the muscles around that tube.”
Create a Narrative Around Treatment Plans
Outline the journey. Frame the treatment plan as a story with a beginning, middle, and end, highlighting milestones.
Example: “Your treatment journey will start with these initial tests. Based on the results, we will move to phase two, which includes medication and lifestyle changes like a weight loss program and exercise. We will also look into your diet by asking you to see a nutritionist. By the third phase, we’ll assess your progress and make any necessary adjustments. This approach has helped many patients just like you regain their health.”
Use Personal Stories to Build Rapport
Share personal experiences. Brief, relevant personal stories can humanize the doctor and build a stronger connection with the patient. These stories are especially compelling if physicians insert themselves into the narrative.
Example: “I, like you, had urinary problems, like getting up at night to urinate. I made changes in my fluid consumption, including limiting caffeine and alcohol in the evening. I had marked improvement in my symptoms.”
Highlight Success Stories
Inspire with positive outcomes. Share success stories to motivate and inspire patients.
Example: “I once had a patient who struggled with weight loss for years. He used one of the weight loss injections seen on TV and lost 50 pounds over a year. This has significantly improved his health. He now needs less medication for his diabetes and his high blood pressure. It’s a journey worth taking.”
Use Visual and Interactive Stories
Use images, diagrams, or videos to tell a story about the patient’s health condition and treatment.
Example to a patient considering a vasectomy: “Let’s look at this rubber band, which is the same size as your vas, the tube that transports sperm from your testicle into the fluid or semen that is responsible for initiating a pregnancy. During your procedure, I will divide and seal the tube, thus preventing sperm from entering the fluid. This procedure will not decrease the volume of your ejaculation or affect your ability to engage in sexual intimacy. It will only make you sterile and will prevent future pregnancies.”
Encourage Patients to Share Their Stories
Encourage patients to share their health stories and then listen attentively. Reflecting on their experiences can provide valuable insights and make them feel heard.
Example: “Can you tell me more about your feelings since your symptoms started? Understanding your story will help me better understand the problem and find a treatment to improve your condition.”
Address Emotional Aspects
Acknowledge emotions and address the emotional side of the patient’s experience through empathetic storytelling.
Example: “Dealing with a chronic illness can feel like a never-ending battle. One of my patients described it as climbing a mountain. There are tough spots, but reaching each new peak makes the journey worthwhile. It’s important to acknowledge these feelings and find ways to cope with them.”
Tailor Stories to Individual Patients
Tailor the stories to resonate with the patient’s background, interests, and values.
Example: “I know you love gardening. Think of managing your diabetes like taking care of your garden. The garden requires regular attention and care, but the results can be enjoyable and rewarding.”
Incorporate Patient Participation
Create a story with the patient about their health journey and future goals.
Example: “Let’s envision your future health journey. Imagine six months from now, you’ve been following the plan we discussed. What does your life look like? How are you feeling with this new you?”
By incorporating these storytelling techniques, doctors can make medical information more accessible, foster more robust connections, and motivate patients to take an active role in their healthcare.(4)
These examples illustrate how storytelling can be a versatile and impactful tool in various aspects of a physician’s practice, enhancing patient care, education, and professional development.
BOTTOM LINE
One of the most prevalent problems in medical practice is explaining the pathology and physiology of their medical condition to our patients in a language they understand. Storytelling is a powerful tool that can enhance the effectiveness of physicians by improving communication, fostering empathy, aiding in education, advocating for public health, and enhancing cultural competence.
We can become more effective and compassionate caregivers by incorporating storytelling into our practices.
REFERENCES
Miller E, Balmer D, Hermann N, Graham G, Charon R. Sounding Narrative Medicine: Studying Students’ Professional Identity Development at Columbia University College of Physicians and Surgeons. Acad Med. 2014; 89(2):335–342. https://doi.org/10.1097/ACM.0000000000000098
Ofri D. The Passion and the Peril: Storytelling in Medicine. Acad Med. 2015;90(8):10005–10006. https://doi.org/10.1097/ACM.0000000000000672
MediGroup. The Role of Artificial Intelligence in Modern Healthcare. MediGroup blog. February 24, 2017. https://www.medigroup.com/blog/the-role-of-artificial-intelligence-in-modern-healthcare/
Robertson C, Clegg G, Huntley J. (eds.). Storytelling in Medicine: How Narrative Can Improve Practice. New York: Routledge; 2024. https://doi.org/10.1201/9781003409151