Viewpoint: How telling stories gives physicians more grit

Harrison Cook -

Storytelling is a critical component of self-care for physicians, Jessica Zitter, MD, a critical care and palliative care physician at Oakland, Calif.-based Highland Hospital, argues in an op-ed published in Harvard Business Review.

Here are four things to know:

1. In the article, Dr. Zitter describes the medical experience that first lead her down her narrative journey. Recognizing a patient was past the point of medical intervention, Dr. Zitter instructed her team to stop medical interventions. Some protested, some persisted, and Dr. Zitter crumbled under pressure, leading to the patient's exacerbated death.

2. The current medical culture often instills a sense of "moral distress" in physicians who do not feel comfortable to "diverge from scripted approaches," even when those scripts can potentially cause a patient more harm than good, according to Dr. Zitter.

"In my experience, engaging in honest exchange about these dimensions is rare in medical culture — in fact, it is tacitly discouraged," she writes.

3. Dr. Zitter said sharing stories like her own can help create genuine conversation surrounding the emotional and psychological challenges of working in healthcare.

4. Narrative Medicine, a program first created at New York City-based Columbia Medical School in 1990, has since spread to other medical schools and training programs. The program introduces storytelling techniques to help physicians process challenging experiences and, in the process, generate a more "humanistic healthcare culture."

"By p­­­­rovidin­­­­­g a safe space for telling stories and listening to each other about our pain and personal conflict, we restore ourselves, and are better prepared for that next encounter," Dr. Zitter writes. "Then we will be fully available to do the hard work of patient-centered decision making in the moments when it is really needed — at the bedside of a dying patient."

More articles on integration and physician issues: 

National Academy of Medicine elects 85 new members
How medical schools are battling stereotypes about elderly patients
Probation status lifted for SLU medical school

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