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words, agonize over sentences and pay attention to the world.” The transformative power of words is further illustrated in her work, Illness as Metaphor, which critically examines how the use of metaphor creates harmful myths and beliefs surrounding illness (cancer, AIDs, etc.). Re-imagining the language of healthcare is necessary in order to destigmatize illness for patients—to move from a language of illness to one of healing. The thoughtful cultivation of words can help patients heal and breakdown barriers to treatment that myths, such as guilt, shame, fear, and/or embarrassment, insidiously create.2 Dr. Wald believes that guided, reflective writing allows physicians and patients to listen to how they are feeling, hear one another, and cultivate a sense of shared consciousness.
Still, what does narrative or story have to do with medicine? Storytelling is the way we make sense of the world, and, in turn, our world view informs how we practice medicine. Elevating stories of patients can humanize their experiences; the co-creation of a new story, informed by the patient-physician relationship, can help humanize the healthcare experience. Too often, electronic medical records reduce patients to statistics: gender, age, diagnoses, comorbidities, etc. Medicine is a narrative form; it involves points of view, descriptions, dramatic themes, and moral dilemmas. For patients, narrative can bring a sense of personal agency and resilience to their health; they have the power to create their own story, decide what defines them, and not be a footnote to their disease. For medical students and physicians, narrative can help foster empathy, especially in working with difficult, challenging, or angry patients and situations. Studies suggest that reflective writing can help with burnout by providing space for medical students and physicians to make sense of existing dichotomies, internal changes and struggles to find meaning.3
In addition to empathy, storytelling can aid what Dr. Hedy terms both “intellectual flexibility” and “narrative humility.” Intellectual flexibility means allowing space for ambiguity. Although it sounds like a paradox, medicine has a lot of grey amid the seemingly black and white canvas of biology, chemistry and anatomy, and the more you open yourself up to its ambiguity, the more it can help stretch your view of the world. Narrative humility is equally important for both physicians and patients. It is vital to remember that the narrative in our minds does not equate with our patient’s, and to honor their experience and their own reality.
At Boston Children’s Hospital, Dr. Wald helps to drive a resilience and wellbeing program called WE CARE (Wellbeing, Education, Coaching, Awareness, Resilience, Engagement) whose mission is to create meaning and wellness through the use of narrative. They have been successful in developing faculty resilience videos and professional workshops. As the use of storytelling in medicine
Hedy Wald, PhD
“Love words, agonize over sentences and pay attention to the world.”
-Susan Sontag