THE IMPORTANCE of STORYTELLING in HEALTH CARE

In one of their “Sunday Review” sections, The New York Times published an article titled “Why Doctors Need Stories.” It was written by Peter D. Kramer, a professor of psychiatry at Brown University, whose focus in the article is on the advantages of including stories about the treatment of particular patients in medical journals and of using such stories to inform the understanding and practice of (particularly psychiatric) medicine. In concluding the article, he states, “We need storytelling, to set us in the clinical moment, remind us of the variety of human experience and enrich our judgment.” I would like to suggest that Dr. Kramer’s thesis could be applied more broadly to include patients and caretakers of all sorts. We all need stories. We need to tell stories and we need to hear stories.

Patients need to tell stories. I vividly remember my first appointment at a neuro-oncology clinic where for ten years I received follow-up care while being in remission from brain cancer. A nurse practitioner conducted an interview with me that must have lasted a full hour. She didn’t just ask me about my cancer, the symptoms I experienced, the treatments I received, and so forth. She prompted me to tell my story, the story of my life and how cancer had become a part of it. That was important to me. It didn’t seem particularly important from a medical perspective. What I needed (and continue to need) is to have regular MRI scans and to have those scans professionally evaluated to determine whether I have remained cancer free. It was important, however, to feel that I was being treated as a human being and not just a specimen, to know that someone there knew me as a person, as a priest, and as a friend who would really care if I ever suffered a relapse.

Doctors and other medical caretakers need to hear patients’ stories. This is important not only in order to correctly diagnose and effectively treat the patient’s illness, but also to remind the doctor of her proper role in relation to the patient. Doctors and patients are equals with respect to their human dignity, but are not equal when it comes to the balance of power and knowledge in the clinical setting. This imbalance can have the perverse effect of inclining doctors and other caretakers to think and act as though they were technicians whose job it is to fix the broken human bodies in their charge. Listening to patients’ stories, doctors and other caretakers are reminded of their patients’ humanity, which is the basis of their fundamental equality. They are better equipped to think and act as healers, whose job it is to help their fellow men and women achieve restoration of health and wholeness. Since medical doctors are healers of the body, they will naturally listen to the stories of their patients paying special attention to their experience of bodily activities, functions, and ailments. However, if they also attend to the entirety of their patients’ experience, they are more likely to recall that, while it is bodies that they are healing, it is persons whom they are helping.

Chaplains, priests, and pastoral caretakers also need to hear patients’ stories. They need to hear patients’ stories because patients need to tell stories, and medical professionals, as much as they might be willing, do not always have time to listen to all a patient needs to tell. Chaplains can take on the role of “professional listener” for this purpose. Having listened, a chaplain or pastoral minister may then be in a position to offer helpful encouragement or counsel.

As a priest working in the hospital setting, I have sometimes been called a “doctor of the soul.” There is certainly truth to that. By virtue of my priestly ordination, I am able to administer the sacraments of healing: absolving sins and anointing the sick. These sacraments impart special graces of God in the souls of those who receive them. To achieve their intended healing effects, however, the sacraments must be received by free persons who willingly cooperate with the grace God bestows. Cultivating such willing hearts is the task of pastoral ministry, and that begins with listening.

Listening to a person’s storyis the first step in establishing a relationship of trust. When trust is established, when genuine care grounds the interaction between persons, then one person is truly able to hear what the other has to say from a place of loving concern. Hearing the patient’s story, the pastoral caretaker will naturally pay special attention to the story of the soul, just as a medical caretaker will be more attentive to the story of the body. Nevertheless, an effective pastoral minister will attend to the story of the whole person, knowing that it is the whole person whom God seeks to save. For the Christian pastoral minister, and indeed for any Christian witness, it is listening that begins to establish the conditions in which the gospel can be proclaimed and received. And it is when the gospel is proclaimed and received that the sacraments are most fruitfully administered, conferring God’s saving grace.

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