From Medicine to Storytelling
Posted by Kathryn Fox on February 18, 2014
People often ask me how it’s possible to transition from medicine to storytelling.
The answer is simple. Both involve compelling stories and mysteries. And medicine is really about solving those mysteries.
Patients arrive in the surgery with a problem. Or a premise, if you like.
The challenge is more often discovering the backstory behind the presentation. All the high-tech tests and investigative procedures mean nothing unless we listen to what the patient is saying, and as importantly, what they don’t say.
A ‘missed diagnosis’ could lead to litigation. So Doctors often run barrages of tests, sometimes invasive and expensive, to ‘cover’ themselves.
I’m not saying these tests are unnecessary, but they are never a substitute for taking a proper history. A story. Listening to the patient, in his or her own words.
That’s the secret to diagnosis, problem solving and great medicine.
A friend of mine was lucky enough to intern with the world renowned, Dr Tinsley Harrison. The editor of the most widely read and regarded medical text book, Harrison’s Principles of Internal Medicine, still used today.
One night on the ward, my inexperienced friend was overwhelmed and at odds to work out why a patient’s blood test results were abnormal. Dr Harrison had one piece of advice.
“Sit on the bed and look the patient in the eye.”
My friend sat and stared into the woman’s eyes. The diagnosis didn’t come to him.
Dr Harrison then instructed him to talk to the patient. He said that 80% of the time, the diagnosis is in the story, and tests merely confirm it.
Not surprisingly, the young intern soon had a tentative diagnosis of a rare glandular disease and successful treatment began.
Dr Harrison knew that if the diagnosis doesn’t come straight away, more conversations should take place. Something in the backstory could provide a vital clue. If all else fails, go back to the premise and listen again.
Along the way, doctors are privileged to hear some incredible stories. I never meet a patient who couldn’t teach me something or move me in some way.
I really feel sad for doctors who forget the importance and joy of talking to patients.
If ever you feel a doctor doesn’t listen you don’t have to continue. Find one who understands the importance of the story – in particular, your story.