Health Story Hub
Witnessing his father’s decline from cancer, an oncologist wrestles with his own fears and desperation. The story illustrates what happens when roles are flipped and a health professional finds himself at the centre of a family health crisis. What would you, as a health professional, do when faced with a similar situation?
The story could be used to promt discussion about care at end of life and provider-patient communication.
This personal essay, appearing in JAMA’s regular “A Piece of My Mind” feature, details a health care provider Cia Merin Bishop’s experience of going through unsuccessful infertility treatment while practicing medicine and caring for patients in a pediatric intensive care unit. The essay poignantly portrays the emotional experience of undergoing infertility treatment. It also speaks to what it is like to be both physician and patient and the coping, support, and resilience she marshalls in order to continue to function at work while dealing with the physical and emotional impact of her own medical treatment. The author points out that this experience is not uncommon, citing studies that suggest about a quarter of female physicians experience infertility and 31% of female oncologists reported infertility requiring counseling or treatment. As she says, “I write this piece in solidarity with other women physicians. I write this piece as an anthem of our strength. And I write this piece to acknowledge the suffering within us, as we tend to the suffering around us.”
The dual focus of this moving and readable essay would make it equally useful for discussions of infertility and reproductive health as well as physician stress and resilience. It could also be a useful in a course or unit on narrative medicine as an example of how physician’s writing their own stories helps to humanize medicine.
Black Dog Institute is a nonprofit organization dedicated to medical research related to mental health. This online collection houses 18 different stories related to mental health (including bipolar disorder, PTSD, anxiety, depression), each representing the lived experiences of those who wrote them. Each story has a short description. A majority of the stories are from patient perspectives while some of them are based around a provider narrative. Since the themes throughout the stories vary so much, this site could be utilized in any syllabus focused on mental health. Such stories show the personalizing of diagnoses as well as show variability in how they are experienced, which can help to expand the general notions and stereotypes that are held around mental health
“When Breath Becomes Air” is a memoir by Paul Kalanithi, a neurosurgeon who was diagnosed with stage IV lung cancer at the age of 36. The book is a reflection on life, death, and the intersection of medicine and humanity.
The narrative unfolds in two parts. In the first part, Kalanithi shares his journey from being a promising neurosurgeon and scientist to grappling with the reality of his own mortality. He goes into his passion for literature and philosophy, and how these interests shape his perspective on life and death. The second part of the book is written by Kalanithi’s wife, Lucy Kalanithi, after his death. It provides insight into the last months of his life, his battle with cancer, and the emotional and existential challenges faced by both Paul and his loved ones. Throughout the memoir, Kalanithi explores questions about the meaning of life and the purpose of medicine. He provides the experiences of both the doctor and the patient, offering a unique and intimate perspective on illness and the medical profession.
“When Breath Becomes Air” is celebrated for its uniqueness, as it not only captures the intellectual depth of Kalanithi but also the emotional journey of a man coming to terms with his own death. The book has resonated with readers worldwide, sparking conversations about the fragility of life and the importance of finding meaning in the face of inevitable death.
This book could be used in a class that discusses topics of aging, death, and dying or for any class interested in hearing about illness from a provider’s perspective. Students could discuss the differences between a physician and patient narrative, as well as what happens when doctors get sick. It raises questions of medical ethics, as well, as Kalanithi reflects on what he wants in his own death.
Through beautiful description and comparison Selzer writes about an interaction between a patient, his doctor, and his family at the end of his life. In the story, the patient is in the hospital, suffering and in pain. This piece serves as the doctor’s narrative, as he, too, suffers in deciding how to ease his patient’s pain, which can only be done by euthanasia. The doctor deliberates back and forth about the options and ultimately gives the patient what should be a fatal dose of morphine, yet still, he does not die. This piece raises questions about medical ethics, listening to patients, listening to families, and making informed decisions in healthcare.
This narrative could be used in courses regarding medical ethics, death, medicine, and narrative medicine. This piece could prompt discussion about medical ethics, who gets to make choices, and why certain choices are made in healthcare. It can be used to show the place of creative writing in medicine, as it provides a creative account of an interaction between a doctor and a patient.
This one hour PBS broadcast features voices of many physicians of color at the University of Minnesota. Each physician talks about instances of race impacting their practice as well as the care that patients of color receive. It begins discussion of why race is important to talk about in health care and ends on each provider’s favorite aspect of teaching and medicine.
Beyond – and more important than – the medical details, this article raises questions about the power of individual stories, in this instance case studies, of what might be fluke happenings or might be patterns of rare but significant side effects of a vaccine. Deep reflection on what happened when the teller was not just a patient but a scientist, one of several authors on a peer-reviewed article reporting findings in a journal, and how his trajectory would have been lost in a randomized clinical trial but might be quite significant if put together with two or three others with similar progressions. Also significant that his radiologist and co-author was his brother; not everyone has such a keen listener to their health narrative, nor would most people be able to tell them in such detailed and credible ways.
Useful for discussions of scientific knowing vs storytelling in e.g. a rhetoric or composition class; science writing (author reflects at the end on her hesitation about writing the story at all, given potential misuses and misstatements of the facts she presents); power of stories; doctors as patients.
This project paired poets with NYC-area physicians to write poems as a way to provide space within and beyond the creative process for catharsis, shared understanding, and healing. The project started in spring of 2020 as a collaboration between two sisters–poet Elizabeth Fernandez and physician Nicole Fernandez. At the time I accessed this (8/11/22) there were 13 poems by 8 poets, written “for” 8 physicians. The poems (from June and July 2020 and October 2021) capture the experiences and emotions of these front-line health care providers during the early part of the COVID-19 pandemic.
A contemplation of the limits of medical care through many specific stories of decision points about when to stop treatment in favor of palliative care. Gawande has been a physician for a long time and an activist/ writer on the side of “know when to say when” – i.e. just because medical technology exists to prolong life doesn’t mean that’s the best thing to do – for almost as long. He makes convincing cases for stopping expensive treatment and “giving life to days” more often than Hail Mary passes that might bring on the 2% chance of a cure.
The book is a readily accessibe read for many audiences and could be assigned in full or excerpted. It was also the subject of a PBS documentory that could be used to supplement class use and bring the text to life.
This is the first post in a new blog on U Mass Med School Medical Humanities Lab, 2019. It is an articulation of why all physicians are storytellers and why most would do well to write them down. This could be beneficial for medical students to reflect upon in order to show the importance of health narratives to new physicians.