Why Storytelling in Medicine Matters

Editor’s note: The opinions expressed in this editorial do not necessarily reflect the opinions of the AAMC or its members. It is rare to read something that puts a lump in your throat, tears in your eyes, and matters of genuine importance into crystal clear focus. Two stories, written by students in the health professions and published in this issue of Academic Medicine, do all 3. In “Baby J.’s Song,”1 nursing student Hailey Sommerfeld describes an overnight shift on a maternity ward that brings to her experiences of loss and the sacred. In “A Drop of a Person,”2 medical student Caterina Florissi writes a love letter to the tiny cancer survivor who leaves a watermark on her heart. These stories join 4 more extraordinary student essays that appeared in the October and November issues of our journal this year. Nursing student Megan McDowell finds a way to honor the special request of her frail 90-year-old patient who is near death in her story entitled “The Cat.”3 In “Apartment 5 on Dolphin Drive,”4 medical student Noor Ahmed shares the story of Malcolm, who newly resides in a spotless, alpine-scented apartment, their first meeting having been at “Squirrel City,” a Northern California homeless encampment. Nursing student Erin Bowdish describes the tender connection and powerful moments she shares with a dying patient in her care in “A Quiet Place.”5 And medical student Danielle Collins, in “A Place for Grief,”6 tells the story of her brother, Darius, whose legacy she carries on her path to becoming a physician, and how his care as a seriously ill infant inspired her mother to become a nurse—a nurse who loves her pediatric patients “like they were her own.” Feeling the lump in your throat and tears in your eyes as you read these stories—and I am certain you will—means you have been moved by the humanity of their authors. The essays illustrate how human connection with our patients has immense meaning. Caring for our patients at times of vulnerability, as well as at times of resilience and unexpected grace, can nourish us as we serve in the health professions. Sometimes that sustenance is rich, replenishing, and abundant, and sometimes it seems just barely enough to equal the heartache of any given day. The essays show, too, how human connection with our patients can bring sweet surprises, as when a patient expresses pride in his health outreach worker who has been accepted to medical school or when one of our authors finds herself sneaking an orange tabby cat named Sam into the ICU. The 6 essays I have described were selected from nearly 500 entries by a panel of judges for the 2024 Dr. Hope Babette Tang Humanism in Healthcare Essay Contest. This national competition has been held annually by The Arnold P. Gold Foundation since 19997 and encourages medical and nursing students to engage in reflection and narrative writing.8 The collection of award-winning essays can be found at https://www.gold-foundation.org/programs/essay-contest/past-winners/. Our journal is honored to evaluate and publish the top essays each year to support the role of humanities in medicine and recognize the sterling work of The Arnold P. Gold Foundation in advancing humanism and professionalism in health care. An Association of American Medical Colleges report from 20209 describes how integration of the arts and humanities into medicine and medical education enables physicians to be “adaptive lifelong learners” who are prepared to bring together scientific knowledge, emotional intelligence, analytic skills, and social context. The first recommendation of the report asserts that “the practice of medicine is an art as well as a science, requiring a grounding in humanistic values, principles, and skills, including a deep understanding of the human condition.” The report articulates the value of arts and humanities in cultivating empathy and trust, strengthening observation skills and cognitive repertoire, and improving well-being and resilience in physicians and physicians-in-training. Exemplary programs, many of which have been described in Academic Medicine or in MedEdPortal, are highlighted.10 Importantly, the report outlines steps that can be taken to advance arts and humanities in academic medicine, such as engaging in faculty development; expanding the definition of scholarship used in faculty appointment, promotion, and tenure decisions; and collaborating with professionals within and outside of medicine to cocreate educational resources and teaching materials. Perhaps the most inspiring leader in narrative medicine is Dr. Rita Charon, who, in 2017, wrote in our journal about the role of medical humanities in equipping students for “effective doctoring.”11 She said, so eloquently and movingly: Here is a painful and bifurcated truth: Facing head-on the realities of serious illness in our settings of contemporary Western health care takes the savage imagination to recognize and then countenance the facts of suffering: unfair, unwarranted, vengeful, impersonal, neutral, demolishing of those whom it visits, without consolation …. There are only two paths open to those who must witness suffering: (1) pretend it is something else—predictable, resectable, eventually curable, spiritually enhancing, the thing that happens to others—or (2) see it fully and endure the sequelae of having seen. The authors of our 6 essays are moving through their experiences of witnessing suffering. They generously bring us along, offering not only the stories of patients but the stories of how they derived meaning through their connections with patients. We are their companions as they endure “the sequelae of having seen” by sharing their burden and their insights and illuminate a path of compassion through storytelling. Storytelling brings us into the experiences of others and causes us to feel, observe, remember, and learn. Storytelling can transport us from where we sit to a birthing center, a cancer unit, a morgue, an encampment, a hospice unit, or an NICU. For those of us who are clinicians and members of the health professions at all career stages, sharing our stories can help us to be more empathic and imaginative and to better communicate the nature and weight of our work with patients. And reflecting on our own stories helps us to focus with crystal clarity on what matters and what has brought us to the field of academic medicine.