The founder of the field of narrative medicine describes why it’s so important to listen to patients’ stories as part of their treatment and healing.
In this special episode of Health Matters, we explore the power of storytelling in a health journey. As part of the Art of Wellbeing series at Lincoln Center, a collaborative effort with NewYork-Presbyterian, the official Hospital for Lincoln Center for the Performing Arts, we attend a storytelling workshop with The Moth, a nonprofit dedicated to the art and craft of storytelling. The workshop guided attendees through telling a personal story about their own health, led by an expert instructor. Health Matters host Courtney Allison discusses the healing power of storytelling with workshop facilitator, Anna Roberts, and reflects on the importance of stories with Dr. Rita Charon, a general internist, founder of the field of narrative medicine, and chief of the Division of Narrative Medicine at Columbia. Dr. Charon helps train doctors to be better listeners so that they can treat the whole patient.
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Dr. Rita Charon is a general internist and literary scholar who originated the field of narrative medicine. She is Professor and Founding Chair of the Department of Medical Humanities and Ethics and Professor of Medicine at Columbia University. She completed her MD at Harvard in 1978 and PhD in English at Columbia in 1999, concentrating on narratology. Her research focuses on the consequences of narrative medicine practice, narrative medicine pedagogy, and health care team effectiveness.
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Health Matters is your weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday.
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Courtney: Welcome to Health Matters, your weekly dose of the latest in Health and Wellness from New York Presbyterian. I’m Courtney Allison.
This week we have a special episode that brings to light the power of sharing your story – and how that can even benefit your health.
Recently, I attended a storytelling workshop that was part of the Art of Wellbeing series at Lincoln Center, a collaborative effort with NewYork-Presbyterian, the official Hospital for Lincoln Center for the Performing Arts. In partnership with instructors from The Moth, workshop attendees were encouraged to explore their personal stories about health and wellness.
Do you feel like there's power in sharing your story?
Guest 1: Oh, absolutely. Yes. Because you inspire other people. And they think, my goodness, you know, she went through all that. Well, if she can do it, then so can I.
Guest 2: My stories cause other people to share their stories. So when you’re open and sharing, other people get relaxed and feel permission.
Guest 3: What helps people heal and thrive and grow is really the stories that connect us all and The Moth does that.
Courtney: At the end of the workshop, I spent a few minutes talking with the instructor from The Moth, Anna Roberts.
So for this event today, how did the team at The Moth decide on the prompts to guide this session?
Anna Roberts: So we worked with NewYork-Presbyterian to make sure that they were prompts related to health and wellbeing. When we think about story prompts, we are always trying to find moments of transformation or help somebody think of one particular memory. Stories are about something that happened that has changed you. And trying to think of one specific moment to sort of trigger or conjure the story up is really what we were thinking about.
Courtney: Do you feel like there's healing in sharing a story?
Anna Roberts: Oh, absolutely. That's one of the things I think is so helpful about storytelling in general is, particularly personal storytelling in the Moth style. When you're sharing a story, you are deciding how you wanna show up in that story, you're deciding what is it that has impacted you or what are you taking away from the experience? So there's a sense of agency.
Which I think a lot of times when people are experiencing difficult health challenges, it can feel like the world is acting on you and you might not have control. But when you're able to tell the story and recount that experience, you can make decisions about how you're going to share that or what you're going to share. And you can take some ownership and some agency over events.
Courtney: How do stories help us see what really matters?
Anna Roberts: It's not just about not having these symptoms anymore. It's, “I don't want these symptoms because I am a caretaker for an elderly family member, or my job is so important to me, or I make this beautiful art,” or whatever it is, that those are the stakes, right? Understanding why getting better or why this treatment or why whatever it is is important to the patient I think is really, really key in getting to the heart of that.
So I just really appreciate what you all are doing around narrative medicine for that reason too. We've seen the impact of that and some of the shows that we've done over the years. So yeah, thank you all so much for the work that you're doing too.
Courtney: Oh, thank you!
To reflect more on why it’s so important to hear a person’s story, and how doctors can use the power of listening to better help their patients, I talked with Dr. Rita Charon, an internist with Columbia. Dr. Charon founded the field of “narrative medicine” and trains doctors with NewYork-Presbyterian.
Courtney: Dr. Rita Charon, it’s such an honor to have you here today. Welcome to the show.
Dr. Rita Charon: Thank you! Thank you for having me.
Courtney: Could you please define “narrative medicine” for us and tell us how you got into this work?
Dr. Rita Charon: I am both a doctor and a literary scholar because as I started in my medical practice, I knew that I was simply not absorbing what patients were trying to tell me. And I knew that there were serious, serious things that they couldn't speak about and I didn't have the wherewithal to help them speak about it. And so I said, who can help me with this? And it was really the people who read and write stories.
As I finished my courses in the English department, I realized that my practice had been transformed and I was talking with patients in completely different ways because I had learned something about what their words convey and how much skill it required from me to stay with them as they were telling me about their situation.
And I learned not to interrupt people to say, and when was your last mammogram? Or to say, you can talk to the social worker about that. Let me ask you about your chest pain. And because I had this wonderful training in listening and interpreting stories I used it on behalf of my patients. So I became a listening doctor. And then I wanted other people to learn how to do this. So I got a whole bunch of people together and I found some funding and we did research and we developed what's now internationally known as narrative medicine.
Courtney: If someone were to ask you what are the healing benefits of storytelling, what would you say?
Dr. Rita Charon: Knowing thyself. It is not until we tell or write or sing or draw something that we know it. And so patients tell me in order to know what they think and they don't know it until they say it. And it's when the clinicians write down what we see happening with a patient that we come to recognize it. What's healing about it is that we're not strangers to ourselves.
It helps because at least you know the importance of what you're going through. But, the teller needs a listener. Who can say, not only, now I understand better what your headache does in your day, but now I understand what you're going through.
Medicine sounds objective and scientific and technical and that's not what people who are suffering feel at all. They put up with that. But what they're looking for is a way to understand what they're going through.
Courtney: I can see how being asked, tell me about yourself. That's very different from, tell me about when those symptoms started. You know, I might share something totally different. How important is trust in the relationship between doctor and patient?
Dr. Rita Charon: Oh, trust. What is powerful and trust-building is the humble capacity for the listener to absorb what's told without interrupting. Now, when was that? Now, how old were you now? Now, what? No, no. Sit there. I used to sit with my hands in my lap. You know, I mean, I learned how to do that, to just not interrupt, to let the teller choreograph the telling, including maybe some tangents. People think that what doctors want is only the medical part. And I tell 'em no. Are you kidding? The chitchat. The chitchat, the things that are not purely, purely bio technical are what we need to hear.
Courtney: The chitchat is life.
Dr. Rita Charon: Yes. Thank you.
Courtney: And that leads me to my next question. If patients have deep worries, fears, and questions that go unaddressed when they work with a doctor, how might that affect their treatment?
Dr. Rita Charon: I mean, imagine a checklist. My right elbow hurts, my left knee had a ACL two years ago, my period was late this month, and I ran out of my simvastatin. Now what are you gonna do with that? And that's what you get, you know, because we make people fill out these little checklists, but even before they come in the office, I say, oh, I see you ran out of your simvastatin. But there's no coherence.
It is not the case that stories are magic. It's not like you need stories in order for the simvastatin to work.
Courtney: Right.
Dr. Rita Charon: It's not that. But it's a deeper effort to tune in, to be attuned to the complexity, the singularity of this patient and this patient only. This 82-year-old woman in my office now, who has trouble getting her shoes on because of her bunions, this 82-year-old woman, what is she going through? And I never know what's gonna be important, but I have learned because of my love affair with stories, I have learned not to dismiss a plot, a situation.
This is what's needed is to truly, truly see and feel, experience that what you have done with the patient in your 15 minutes in the office matters.
It's kind of our duty to keep learning, keep doing, keep growing this tremendous commitment to the telling and the listening and the absorbing of one another's stories of suffering and stories of survival and stories of partnership.
Courtney: Thank you so much, Dr. Charon, for your time and insight.
Dr. Rita Charon: It was my pleasure
Courtney: Our many thanks to Dr. Rita Charon, Anna Roberts, and the participants of The Moth workshop. I’m Courtney Allison.
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