What is the experience of a person with a disability in every day life? How easy or difficult is it to access health care? What is the experience of the patient who has surgery, the effects of anaesthesia, the woman who gives birth in today’s hospitals? The narrative voice, with a sample of these experiences can inform improvements in health care and can remind health care workers of the patient’s vulnerability, anxiety and gratitude to find authentic kindness rather than to have to suppress memories of treatment viewed as dismissive. The narrative voice can influence the emotional outcome of the experience.
The World Health Organization has accepted that evidence in health care also includes narrative research. Narrative methods enhance qualitative research and allow health systems to become more ‘people centred’. A narrative or story can be defined as a subjective version of events told to a
listener or reader. The stories have a beginning, characters, complicating event, resolution and finally evaluation of the events.
Storytelling in medical practice allows a person to express his or her individual experiences of illness and to make sense of the experiences. The patient is able to share a unique point of view; this allows more empathy, understanding and communication between and among doctors, patients and caregivers. Communication allows these persons to reach a diagnosis,to personalise care, to understand the impact of the disease and to seek methods of coping.
The medical school ward round is not so stressful if the student realises that the patient’s story is what matters. An assortment of medical facts on a clipboard become the interpretation of the story of an illness. The new doctor may begin by fitting the narrative into the structured and sterile list of complaints and medical history leading to a management plan. Later, with experience based on repeated patient stories certain ‘classic’ symptoms and revelations emerge; skills that cannot easily be replicated by Dr. Google. Storytelling can make doctors better doctors.
Our ancestors were arguably involved in observational research and medical solutions through trial and error. Research has shown that cultural differences exist in the effectiveness of story telling on behaviour change. Conversations, for example via support group workshops, group counselling, guided discussions, informal talks and interactive presentations have been found to be effective to convince participants to change behaviour in a positive way, particularly in non-Western societies with a history of rich oral tradition. In other words, for certain cultural
groups, storytelling can help persons to overcome fears that interfere with their management, can increase engagement and can encourage and motivate others; stories are more memorable than a list of facts.
Public health centre services in most countries require speed and efficiency over time for interaction and active listening. After a few minutes, the client is interrupted so that specific symptoms can be documented. Physicians must pay equal or more attention to envelopes containing blood test results and the entry of data into computers than to the expression of
the client. Storytelling in medicine can reduce the number of diagnostic tests, promote better use of resources, may provide a more accurate diagnosis and may increase client cooperation. There may be also be a missed opportunity for a moment of empathy and compassion.
Patient storytelling humanises healthcare.