How storytelling can improve health care

I love a good story, don’t you? An accomplished storyteller takes you on a journey away from your own experiences and helps you feel the characters’ emotions, conflicts, climaxes and endings (sometimes happy, sometimes not).

What does this have to do with health care, you may be wondering? Plenty, as it turns out, because of the growing interest in “narrative medicine.”

Narrative medicine usually refers to an approach to medical practice that focuses on the stories of patients as a way to improve care. Dr. Lauren Edwards of Stanford University explains it this way:

“Narrative medicine is the idea that understanding narrative (creative writing, fiction, literature, etc.) helps us physicians better understand the narratives of our patients: their life stories and how their illness fits into the context of those stories.”

The idea that writing and storytelling can be a powerful ally in health care arose about two decades ago at Columbia University, which now has a Division of Narrative Medicine. Today, more medical schools, including the University of Chicago, offer courses to not only student doctors, but also other caregivers, including nurses, chaplains, social workers and, yes, patient advocates.

Harvard University, for example, offers a nine-month graduate program, the Master of Science in Media, Medicine and Health, in which expert mentors guide students through the storytelling medium of their choice (for example, film, creative nonfiction, podcasting or graphic design) to design a public health campaign.

Dr. David G. Thoele, a pediatric cardiologist in Park Ridge, near Chicago, learned the healing power of narrative writing when his daughter got sick, and he experienced the health-care system from a parent’s perspective.

“I learned how challenging the medical system can be for patients, and also how some people working in health care have less than ideal communication skills,” he said. “Illness is stressful. I discovered that journaling helped me process the stress of illness and better navigate the health-care system. This experience made me curious about how writing might help patients in my own practice.”

He developed a short writing exercise, the 3-Minute Mental Makeover (3MMM), for doctors to use with their patients. He and his colleagues published studies showing that the 3MMM reduced stress for patients, families and health practitioners, and led to long-term benefits.

“My patients and I write what we're grateful for, summarize our day in six words, then write our wishes,” Dr. Thoele said. “The 3MMM helps immediately. It lowers our stress, helps us communicate better, and leads to better outcomes.”

He is now co-director of Narrative Medicine at Advocate Health, a regional health-care system in the Midwest. Its mission statement provides a good summary of what narrative medicine is:

“We tell stories, listen closely, write and share to facilitate healing, re-humanize health care, and increase capacity for empathy and self-reflection. We practice learning how to tell our stories and receive other people’s stories.”

As the mission statement points out, those who practice narrative medicine go beyond recording a patient’s medical history. Rather, they are able to empathize with their patients’ experiences and emotions. In fact, one of the speakers at a conference I’m holding this fall for nurse patient advocate entrepreneurs will talk about the neuroscience of empathy, something patient advocates need in abundance!

Some people come by empathy naturally because they have higher levels of oxytocin, a hormone and neurotransmitter sometimes called “the love hormone.” It can enhance empathy by affecting activity in brain regions like the amygdala, which is involved in processing emotions. Empathy, though, can be learned, and we can increase oxytocin with practices such as close physical contact and mindfulness meditation.

Paul J. Zak, one of the country’s most respected neuroscientists, did a study on empathy in 2017 in which he wrote: “We found that the change in oxytocin was associated with concern for the characters in the story. If you pay attention to the story and become emotionally engaged with the story’s characters, then it is as if you have been transported into the story’s world. This is why your palms sweat when James Bond dodges bullets. And why you stifle a sniffle when Bambi’s mother dies.”

There’s that word again: story. From time immemorial, humans have felt drawn to storytelling as a way of sharing knowledge, building wisdom and navigating their world.

To find health-care providers who practice narrative medicine, check with programs such as those at Columbia or Harvard or Advocate Health (advocatehealth.org). Meanwhile, nothing is stopping you from telling your own story to your health-care providers through journals or videos. It’s exciting to see this practice gain a foothold in the practice of medicine.

• Teri (Dreher) Frykenberg, a registered nurse, board-certified patient advocate, is the founder of www.NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” available on Amazon. Frykenberg offers a free phone consultation to readers. Contact her at Teri@NurseAdvocateEntrepreneur.com.