Storytelling

Dr. Daniel Becker
Photo by Tom Cogill

For Dr. Daniel Becker, an essential part of a physician’s training is learning how to listen and observe. In the accounts that patients give and the symptoms they exhibit, physicians find the first clues to their diagnosis. But there is more to this material. These symptoms are expressions of a life. As physicians grow closer to patients over the course of treatment, they gain valuable insight into how people deal with pain, fear, and their own mortality.

There is another essential skill for physicians, one that builds on seeing and observing—the ability to tell a story. Most often, these stories are rendered in standardized notations on a patient’s chart. But at other times, they are formulated in much more personal terms, as stories told quickly at the nurses’ station or recounted over dinner with family and friends. Touched by what they see, observe, and intuit in their patients’ experience, doctors form their impressions into stories as a way to understand it themselves and, by conveying it to others, to validate their understanding. “Composing and telling stories is one way for people to figure out who they are,” Becker says.

Becker’s interest in these stories—and the power of telling them—has an informal outlet in the narrative poetry he writes most mornings and a more formal one in the online journal for healthcare workers that he founded last year. Hospital Drive (http://hospitaldrive.med.virginia.edu) made its inaugural appearance in July and accepts submissions of short stories, poems, and photographs from doctors, nurses, and other healthcare workers—including medical support staff, drivers, and administrators—from around the country.

Storytelling has also become an important part of the curriculum of Leadership in Academic Medicine. The course, which Becker helps teach, is offered by the dean's office in the School of Medicine as a continuing medical education program for promising faculty who may develop into department chairs or division heads. “Leadership is about telling a story that other people want to be part of,” Becker says.

Becker also uses stories as a learning tool. As someone who practices both primary care internal medicine and palliative care, he understands that doctors are inevitably called on to have difficult conversations about end-of-life issues, yet receive little training in this skill. With funding from the School of Medicine, he has developed and tested a computer game that simulates difficult conversations and helps medical students become more sensitive and effective communicators.

Rather than tell students a story, Becker puts them right in the middle of one, discussing the results of a CT scan with a virtual patient suffering from progressive breast cancer. “The goal is to allow students to have a difficult conversation in a safe environment,” he says. “As they learn what to do, they learn about themselves.”