get something down...anything

 

 

I've been posting a lot about the importance of telling your story...the one that needs to be told, the one that won't go away, the story others need to hear. But have I mentioned how hard this can be to do? Have I told you how hard it is to get started? How long it can take? How confusing it can be?

 

"If I'm gonna tell a real story,

I'm gonna start with my name."

~Kendrick Lamar~

 

The story I need to write has been nagging at me for over 65 years...since I was three years old. That's when my brother and I both went into the same hospital with the same illness at the same time. The story explores the divergent paths we took through life in the aftermath of our shared experience. And how long it took to share our separate truths.

 

It begins:

          "The aftermath of childhood illness can linger for a lifetime. You think you’re over it when, out of nowhere, you remember the way the nurse rolled you onto your side and bared your little buttocks. First came the jab, then the dull ache that lasted until the next shot was due. One moment you’re a fully functioning adult. The next, you’re a sobbing three-year old.

          Like a stain that won’t come out, like a fog that never lifts, it stays with you. It can send you down a path you never intended to follow. It has the power to transform you into someone you never wanted to be. The memory of it catapults you back to a time you'd rather forget."

I started working on this project in earnest six years ago. This is as far as I've gotten. The details are vivid in my mind, the story arc is clear, and I already know how it ends. What, then, is so difficult about it?

 

I think the hardest part is convincing yourself that your story is worth telling. And after that, engaging the reader. Convincing him that your story is also his. Compelling him to read on in order to make sense of his experience in light of yours. Finding meaning not so much in the recitation of events, but in their cause and effect, in your process and outcomes, in the truth you summoned the courage to share.

 



"When you stand and share your story...

your story will heal you

and your story will heal somebody else."

~Iyanla Vanzant~

 

 

For reasons that will take a full-length book to explore, my brother spent most his adult life battling the anxiety, fear, shame, and insecurity that followed his hospitalization, as well as the addictions that helped him cope. His story is an epic quest for healing.

 

I went on to study medicine.

 

If you are mystified by the way your life unfolded as it did, if you have spent sleepless nights reflecting on the people, places, and circumstances that shaped you as a human being, if you have ever wished things had been different, you have an important story to tell.

 

"Other people are going to find

healing in your wounds.

Your greatest life messages

and your most effective ministry

will come out of your deepest hurts."

~Rick Warren~

 

If you are discouraged about telling your story because you don't know where to begin, start by writing something. Anything. Start with your name.

jan

 

 

 

 

 

 

 

 



a story that needs to be written

This week I'm dog-sitting for these two gentle giants:



 

 

It's pouring outside, and it's chilly...a good day to curl up on the couch between two big dogs with my third mug of coffee while I share the wisdom of some brilliant writers and caring physicians. 

 

Sometimes we need to be reminded that medicine embraces both science and the humanities. It requires factual knowledge and technical expertise, but first and foremost, it depends on our relationship with the patient. A healthy doctor-patient relationship (no pun intended) is built upon mutual respect, trust, compassion, and intimacy...physical, emotional, and psychological. The healer must know the patient. The patient cannot be separated from his story.

 

There is a softer side to medicine than what can be delivered by a laser or through an endoscope. There is more to healing than what can be achieved by the latest innovation in drug therapy. There is more to the patient than what can be checked off on a bulleted EMR. The study of narrative medicine involves training in techniques that enable the provider to elicit, process, and respond to patients' concerns. It encourages healers to explore the patient's whole story. It requires patients to become storytellers, themselves.

 

In other words:

 

"It may take a doctor

to diagnose someone's disease,

but it takes a friend

to recognize someone's suffering."

~unknown~

 

"The good physician treats the disease;

the great physician treats

the patient who has the disease."

~Sir William Osler~

 

"Writing and humanities studies produce better physicians...

because doctors learn to coax hidden information

from patients' complaints."

~Rita Charon~

 

"Stories are not material to be analyzed;

they are relationships to be entered."

~A.W. Frank~

 

"Write hard and clear about what hurts."

~Ernest Hemingway~

 

"Every patient you see

is a lesson in much more

than the malady from which he suffers."

~Sir William Osler~

 

"Wherever the art of medicine is loved,

there is also a love of humanity."

~Hippocrates~

 

"It has become appallingly obvious

that our technology has exceeded our humanity."

~Albert Einstein~

 

"Dancing, singing, storytelling and silence

are the four universal healing salves."

~Gabrielle Roth~

 

"Writing is medicine.

It is an appropriate anecdote to injury.

It is an appropriate companion

for any difficult change."

~Julia Cameron~

 

 

My coffee mug is empty. The rain has stopped for now so it's time for us to stretch our legs. I plan to spend the rest of this week working on the opening pages of a memoir that needs to be written. Wish me luck.



"If a story is in you,

it has got to come out."

~William Faulkner~

jan

 

 

 

 

 

 

 

 



 



 

 

what the patient needs

Programs in Narrative Medicine, like the one at the College of Physicians and Surgeons of Columbia University, train health care providers (physicians, nurses, and therapists of all kinds) to recognize, absorb, interpret, and to be moved by stories of illness--the patient's chief complaint (CC), the history of the present illness (HPI), and the past medical history (PMH).



It is no longer sufficient to scroll through a bullet list of symptoms, ie. low back pain and stiffness. Check. Lower extremity weakness and numbness. Check. Calf swelling. Check.

The patient needs more from his provider than a diagnosis, and a referral or prescription. He needs to know that his provider hears him, understands him, and addresses all the ways he is suffering:
               ~physically because of the symptoms of his illness...pain, exhaustion, weakness, etc.
               ~emotionally because of anger, shame, guilt, or despair
               ~spiritually when there is no hope for recovery
               ~financially if he becomes disabled because of his illness or injury

"The good physician treats the disease:

the great physician treats

the patient who has the disease."

~William Osler~

Ten minute office visits do not suffice to expose all that must be said, nor do they permit the kind of longitudinal relationships that are so important to understanding and responding to illness. This process takes time.

"Medicine practiced without a genuine

awareness of what patients go through

may fulfill its technical goals

but it is an empty medicine,

or at least, half a medicine."

~Rita Charon~


 

The whole other issue in narrative medicine is the patient's ability to tell his story. Patient's are not born knowing the language of medicine. They don't know what the provider needs to hear in order to understand their illness. Fatigue is not the same as weakness. Tingling means something different from numbness. Stabbing pain means something different from aching pain.

"If storytelling is important,

then your narrative ability to put into words,

or to use what someone else

has put into words effectively,

is important, too."

~Howard Gardner~

 

Patients may be ashamed to admit to unhealthy behaviors that put their health at risk. They may be reluctant to share the emotional impact of their illness on their marriage, children, and co-workers. They sometimes lie in order to deny or minimize the seriousness of the condition, saying the crushing pain that accompanied their heart attack felt like "a little indigestion," or the fungating mass in their breast just appeared "a week or so ago." An attempt to assuage their worst fears.

Medical history taking is a collaborative effort. For both the storyteller (the patient) and the listener (the provider), it requires a shared language, common purpose, and mutual effort. It is never too soon to begin...to learn...to change.

"People hear facts,
but they feel stories."
~Brent Dykes~

jan