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BLOG: The power of stories
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I love a good story. I love to hear them, and anyone who knows me knows that I love to tell them.
My patients tell me stories, and I encourage them to do so.
A good story has elements that make it good: It must be true, it must be at least whimsical (if not outright funny) and it must be used to make or illustrate a point. It is in this last element where the story has its value or power.
In patient care, we must take a good history as part of the evaluation of the patient. I work with my students to try to teach the art of taking a good history. Unfortunately, many of my students and perhaps many doctors in practice have adopted the philosophy of Detective Sargent Joe Friday from the old Dragnet series: “Just the facts, ma’am.”
In a rush to get on to the next patient, doctors try to cut off their patients’ story before they even get warmed up. In doing this, they often miss the subtle symptoms and the patients’ concerns about their symptoms and they often miss the diagnosis as well.
In my current area of optometric specialty, I work with patients who have suffered a concussion or other type of acquired brain injury. These folks have some real stories to tell, and I have learned that in these tales lie the keys to their treatment program.
In the health care business world, we often need to evaluate situations and make decisions that will affect future policies and procedures. We start with a set of facts that define the situation. In reviewing these, we may find that some of the facts are contradictory.
It is here that I often ask for the story behind the facts. My lawyer friend and colleague calls this “adding color” to otherwise black and white facts. In is in the back-story that the truth is often revealed and the path to the decision often becomes clear.
Stories reveal the bias, the prejudice and the values of the storyteller. You may often hear a very different story from two people describing the same event. The telling of the story can sometimes disprove the very point that the storyteller is trying to make. If you miss the story and just take the conclusion at face value, you will have been misled.
Stories are a powerful teaching tool. An excellent example of this is the many stories of the Bible and other religious tomes whose stories weave the fabric of most major religions. In the clinical externships of optometry training, patients with syndromes and other medical maladies of the eye can bring pathology to life with the stories about how the problem affects their everyday life. If you remember the story, you will remember the pathology and the related ramifications. In the next patient with a similar story, you may be the one to clinch an otherwise clinically subtle diagnosis.
So, in your care of your patients and in many aspects of life, take the time to listen to the story. If you are like me you may find that not only will your doctoring improve, but your interpersonal relationship may improve as well.