S7E7: Enhancing Patient Care Through Storytelling in Medicine

Mariam: Testing, one, two, three. La-la-la-la-la. Okay. I'm sorry, guys.

Hạ: Hello.

Mariam: I always wish that I was a good singer, but I'm not.

Hạ: Me too. I'm tone deaf. But it's the Mariam and Ha soulmate episode.

Mariam: Soulmate reunion.

Hạ: Soulmates forever.

Mariam: That's our little theme. So adorable. Well, welcome back everybody to "Bundle of Hers." So excited to be back in the virtual studio recording with said soulmate, Ha. Say hi.

Hạ: Hello. Where's Timmie?

Mariam: Oh, he is . . . Timmie the cat, the official mascot of "Bundle of Hers," by the way, is hanging out in my room, just doing his thing, chilling with us, motivating us to get our episodes recorded in a timely fashion.

Anyway, this episode is really just about the power of storytelling in medicine. I felt like this was a topic that I really wanted to kind of expand upon on "Bundles" because, one, "Bundles" is a really unique platform that I think centers on the power of storytelling, but to my knowledge, I don't think we've ever had an episode specifically dedicated to exploring how storytelling can be used in activist spaces. It's something that I've been thinking a lot about, and so I wanted to do this episode.

And I'm so happy that I'm doing it with Ha, because fun fact, I feel like my and Ha's relationship . . . We started out as big sib, little sib. We have this mentorship program at The U, and she was my big sib because she was a year ahead of me, and that's kind of what started our mentorship relationship. But I feel like our friendship was really rooted in that power of storytelling and connecting to identity through storytelling.

I feel like Ha is probably one of my friends where I can see that the most in how she approaches her activist work, and so I'm so happy to be on this episode with you, Ha.

Hạ: Yeah. I'm excited to be on this episode with you just because you're my soulmate, so I think that's what matters. But also, I love talking about storytelling, and the medical humanities, and all of that stuff.

As people may or may not know, depending on how loyal you are and whether or not you choose to screen out my episodes or not, I used to do extracurricular journalism throughout high school and college. So I love hearing people's stories and telling stories.

But before we start talking about stories, because I'm a working individual, I always need to put in the disclaimer that the views expressed in this episode and what we talk about do not reflect the views of our employer or the institution to which we are associated and this podcast is associated. It is just our own opinion.

Mariam: I ditto that. Cool. All right. So let's just jump right in.

So I guess I will kind of start with how I started thinking about this topic a little bit more in depth. I think about a week ago I attended this tatreez workshop. For those who don't know, tatreez is in Arabic means embroidery. It was a workshop that kind of talked about the history and the cultural elements of Palestinian embroidery, and how it's used as a way to kind of preserve culture, and celebrate culture, and also to tell a story.

I just thought it was so beautifully said, and it reminded me a lot of my own culture, because Persians, Afghans, we are huge into embroidery and weaving and we are known for our beautiful rugs and just art collections that tell beautiful stories that are passed down from generation to generation.

And it really just had me thinking about how when we think about different communities, for example, indigenous communities here in the States or communities globally in the Middle East, these communities all go through different struggles.

There are really difficult things that a lot of these communities have gone through, including assimilation and ethnic cleansing, and how a lot of that is really rooted in not just an erasure of people and bodies, but an erasure of culture and art and all the things that are beautiful that make us feel connected to our humanity.

It's just something that I, again, was thinking about quite a bit, especially as I'm ending my career as a medical student and entering into residency, and wanting to rethink the ways that I approach activism and rethink the ways that I want to center my patients in that work as well. And so that's kind of what we're going to chat about today.

I love to open up my episodes with really broad questions, because I'm just cool like that. But it's also because I'm a little bit lazy and I don't like asking detailed, thought-provoking questions when I first start a topic.

But question for you, Ha. In what ways have you, I guess, related to storytelling or used storytelling just in your own life?

Hạ: I think I start thinking a lot about storytelling first in just my upbringing. A lot of the ways that my family really helped pass on our traditions and our culture and also our history was really by telling stories of their experiences.

I just feel like for how youthful I was, young I was, I think my mom and my grandparents were still fairly honest about their experiences growing up in Vietnam, particularly for both generations during a time of war. They grew up during World War II, and then my mom grew up during the Vietnam War, and those stories were really ingrained.

I would also hear stories about my great-grandparents and about all of the things that they did.

And so it was so funny because I felt like even my family history was created into something that often felt like a legend, a really big tale and very epic. From that, it started making me really love stories.

And as a child, I also just really liked reading books. My mom, our weekly activity is that we'd do the laundry and then I would go to the library and just spend hours in the library reading, or checking out movies and then watching movies.

So a lot of my life growing up was ingrained in just stories all around me through different forms in media, be it oral, be it written, be it visual.

And it carried into when I decided to . . . I started doing journalism in high school. The thing that I really loved about journalism was the excitement that people felt when I was able to tell their story. When I featured things that they were passionate about, my fellow classmates were super stoked. They were like, "Thank you for featuring the play that I was in."

That carried into college when I chose to do arts journalism, which allowed me to do a lot more feature pieces, and really getting people to be excited about their art and be excited about the ways that they view the world. And really being able to emphasize that and elevate it, that brought me so much joy.

And so I think stories just . . . it was a way for me to really center it on people. I felt like stories were so interconnected to people and their experiences. And I felt that way both in a very . . . I guess I'm thinking about books, more like nonfiction sort of way, but then I also saw it a lot in fiction too, how people process their experiences through it.

In medical school, I was super into the medical humanities and doing . . . narrative medicine is the word. Narrative medicine. And it was because I felt that it was such a powerful way for us to process really hard things, and for us to really even share our viewpoint with others. It was such a healing way for us to really get to the heart of medicine that I think gets lost in the facts.

I just feel like whenever you ground anything in stories, it becomes real. It becomes tangible. And it's also just because . . . I'm sorry this is such a ramble, but I just . . .

Mariam: No, I love it.

Hạ: I guess I have so many thoughts about storytelling. But I think it's also just because particularly when I do activist work, I think sometimes we can get caught up in . . . I don't like the word branding, but the image, the vision of what being an activist is. And it can sometimes lead you astray when you really just lean into that vision instead of really grounding it on the stories of the people.

And so that's another reason why I really just love grounding things in stories, because whenever I go back to the people that I'm serving and their stories and people's experiences, I'm brought back from this very high academic or this very high . . . It feels like you are brought down into something that's more tangible and more real, and also able to do more connection.

Mariam: Kind of similar to you, I think growing up in . . . This isn't specific to immigrant households, but I really feel like a lot of us, as the children of immigrants, really learn a lot about our parents through stories.

I remember I talked about this in my Afghanistan episode back a couple of seasons ago, about how I learned about my mom's side of the family and learned about my mom as a person and my Afghan culture was not through my mom explicitly telling me throughout my upbringing, but was really more through bedtime stories.

When I couldn't sleep at night, I would go into her room and I would be like, "Mom, I can't sleep," and she would be like, "Okay, [inaudible 00:10:19], I'm going to tell you a story and then we're going go to bed." She would start singing a traditional Afghan song because that's the way that traditionally Afghans would start their stories.

She would always tell me these stories from her childhood of when she . . . She has these hilarious stories of when she would go to school and all the naughty little childlike things that she would do to get in trouble.

One time she burned her professor's beard with a candle. That's a whole other story. It's one of my favorite stories of all time, but I pictured little [Fauzia 00:10:53], that's my mom's name, just running through a school in Afghanistan and being this strong independent little girl who grew into this really strong independent woman.

It just made me not only appreciate the culture that I grew up in and how she was raised and how that informed how I was raised, but it helped me also better understand my mom, and it made me feel so much more connected to my identity, and also just generally made me feel more Afghan.

I have tried to read history books, nonfiction books, watch documentaries, stay informed about my culture, for example, and what's going on politically and all these different things, but really what makes me feel so connected to my culture is storytelling.

I think it really started with my mom's stories, but there are also other ways through which I felt like I learned a lot about things that were really important, especially in the social justice space that were rooted in identity that were conveyed through storytelling, and not necessarily through oral storytelling, which is what my mom did when I was younger, but through different means.

This tatreez workshop, the embroidery workshop, that was so beautiful. I was really moved because not only did we learn about the history of tatreez and how it's been used as a way to preserve Palestinian culture and celebrate Palestinian culture, but we also learned the basic skills of tatreez. You get a real appreciation for how people connect to the resources that they have in their land and how they use it to really write a beautiful story.

I will tell you it is very hard. Me doing any type of embroidery was very laughable. But it was actually such a beautiful way to connect to something that felt really meaningful.

And I think through the practice of doing the embroidery, I felt like I could really understand at least some aspect of the stories that were conveyed historically through these pieces.

It's interesting because we can tell stories through so many different means. We talked about embroidery. Another thing I think about is food is another way to tell stories, especially in our culture.

I remember after my dad passed away, my grandmother who was this renowned . . . she could literally open up her own Persian restaurant, right? She's so talented. I remember after he passed away, her way of grieving was through the way that she cooked her food. It was very specifically not adding sugar to a specific dessert recipe, not adding a specific spice that really flavored a dish a certain way to really convey how she was feeling.

In a lot of ways, it's kind of how we communicate with each other and how we grieve and how we express our emotions and also how we tell our stories. So it's just kind of a multifaceted, I guess, experience with the different ways through which we tell stories and how we connect to our cultures and our identities.

Hạ: As you said, there are so many nuanced and so many beautiful ways of telling stories, and yet I also always feel like there are certain ways that you tell stories or certain perspectives in which stories are told that have a bit more weight and a bit more relevance and a bit more acclaim than other things. It's really interesting.

I think maybe I'm thinking about it a bit more because I'm currently listening to the audio book "Yellowface" by R.F. Kuang. And for our readers who don't know, basically the whole plot and gist of it is about this white woman who steals the ideas of her recently passed away Chinese classmate, and she publishes it under the moniker of Juniper Song, which Song is her middle name. And basically it's just this whole thing about what it means to publish in the industry, and it's very interesting.

But it's making me think a lot about how we put weight on certain stories, and the power that we give by allowing certain stories to be more prevalent and beloved than others.

Mariam: You kind of alluded to this a little bit, but I'm hoping you can expand on this, Ha. Storytelling in your experience, how has it shaped your identities, but also how you approach work and social justice, especially being a resident and wanting to be an attending physician soon?

Hạ: For me, when I used storytelling, it was often really ways for me to process things in medical school. I would write a lot of poetry and I would write a lot of fiction, trying to process an experience.

But I also sometimes feel like when we tell people . . . There are always a lot of vent sessions in medicine where you're talking through a patient situation or you're trying to process something. That, I think, is seen as just venting, but I think that's also a form of collective storytelling where you share your own patient experiences and try to connect with each other in that way and finding that shared experience.

I think one of the things I reflect on a lot is about how different stories can be interpreted in different ways. As a resident, sometimes I'll get this message from one person in the care team saying this, and then I talk with a different person and they say this, and then I talk to the patient and they say this. It's very easy to prime yourself and to think you know a situation just based off of what others tell you.

Even on the EMR, sometimes for certain patients it will show up with this flag, right? Like a behavioral flag or things like that. That's a way of telling people a person's stories.

One of the things that I'm always finding myself, checking myself, and remembering to relearn, especially in trying to be a very patient-centered provider, is to take in the different perspectives from other people, but not let it affect how I approach a situation that I have with a patient.

Oftentimes I find that certain things that I've been told are completely miscommunicated, and it's not on the other person, but that's how they perceived it, right? And it makes me realize how tricky that is. When you're trying to advocate for patients within the clinical setting, how much stories can be really misconstrued and how important it is to center it on the patient's story and the patient's perception.

I feel like it's more often than not that in situations where I'm made to feel like something is a bit bigger and more serious, I'm always . . . When I walk into the room with an open mind and I'm ready to have that conversation, I'm always pleasantly surprised by the fact that it's not as big as it was made to be to me.

And I think that comes back into then how I also think a lot about doing activist work. Especially I love a lot of medical education and I'm really interested in curricular development, because I feel that's the best way that we're able to really create impact because you're trickling it down in a way.

But it also means if we are designing this curriculum for this patient, or thinking about education for patients, why is it that oftentimes it's us going off of studies or going off of things and not really centering people's stories?

I feel like there's kind of more work now about bringing in perspectives and collaborations with youth or with families about really being able to guide how we do things, and I think that's also really helpful. That all just goes back to stories.

Mariam: Yeah. And I think I can relate to a lot of that too, because it had me thinking about . . . Especially when you're talking about the patient care aspect of things, when I've been on rotations . . . When you're a medical student, you have, I would say, the pretty unique opportunity to spend more time with your patients because you have less of a patient load. And on top of learning the medicine, you're also learning how to interact with patients in the healthcare system.

Usually you'll follow anywhere from two to four patients as a medical student, which is significantly less than residents are expected to. And so with that extra time, as you're learning the ropes, you're also sitting down and ideally listening to your patients a lot more, right?

I think it really struck me when I first entered my clinical years as a third-year, being able to sit down with some of my patients. There were days where it was a little bit slower and I was only following two patients, and so I would really just sit down and want to hear a patient's story.

And what's really funny is a lot of these patients were so eager to tell their stories too. I mean, being in the hospital is not an ideal place to be, but patients want to feel heard and seen, and unfortunately the hospital and this healthcare system is not a place where patients tend to always feel that way, right?

And so sitting down with a patient and really just hearing their story . . . and it didn't have to relate to their illness or why they were in the hospital in the first place. I would hear patients talk about their marriages, their families, what they love to do, their travels, things that were really important to them, their cultures.

I think it would do a couple of things. One, it would bring a lot of perspective into this process and how I thought of my patients and how invested I was in their care. The other thing, too, is it brings lie this level of humanity into medicine that's just taken away from our training.

I think, again, the healthcare system is a business, right? And it's about getting people in and out of the hospital. It's really high turnover, so you don't pause and think about the people who you're actually treating. I think that level of humanity and bringing that back into medicine as much as possible is really important.

One of the ways that I really was able to appreciate that was through listening to my patients' stories when I could, when I had more time as a med student. And of course, as a resident, that's going to be really challenging. I'm sure you can really feel that right now, Ha, because you're just about to wrap up your intern year.

But it's just something that I think I was really able to appreciate when I was a student and is something I want to hold onto as much as I can moving forward, even when I don't have the time, is at least recognize that every patient comes in with a story, and how powerful that is, and how that shapes how we approach the ways that we interact with the communities that we want to help.

And I agree, from the medical education side of things, the few opportunities where I was able to engage in some type of Narratives in Medicine workshop or something that was more rooted in storytelling was really impactful for me and helped me grow and shape my perspective in how I wanted to approach medicine.

And that includes "Bundle of Hers." I feel like "Bundle of Hers" is a place for us to tell our stories. Something that I've always really appreciated about this platform is that we don't come in as the experts. We come in as just people in medicine talking about our experiences, how they relate to our identities, and things like that.

It's very much so rooted in that storytelling, and I at least hope that our listeners can appreciate some of that too and kind of see how impactful storytelling really can be in that.

We talked about a lot of things. Wow. I'm like, "Did we cover it all? Did we do this topic justice?" But I think this has been a really awesome conversation.

One thing I guess I kind of want to wrap up on . . . another thing that you alluded to, Ha, is connecting storytelling to activist work. I think when we think about activism and we think about doing social justice work, we typically think of more traditional organizing or protesting. All of those things are really important, but I also feel like creating spaces to preserve stories and really develop community through a means of storytelling is a way to rethink activist work.

Hạ: I feel like that is so true, and that's also I feel like why some stories and narratives people try to erase with people in positions of power. And it's because stories are a way of being able to provide perspective and to provide nuances and different truths to a situation.

I think a lot of what people try to do is to try to control the narrative, right? That's a lot of what people do, is they try to control the narrative and they try to give a certain narrative. But stories ultimately destroy those attempts, especially when they're coming from places that are often unheard and often not given the space.

And activism, I feel like, is always about elevating voices and stories that are not heard of before or that just don't get the platform that they deserve to get.

Mariam: Yeah, definitely agree. I was talking to one of my friends about this, and I think at times we all feel some level of inadequacy when we're pursuing activist work, because it always feels like we're not doing enough.

But sometimes when we come back to connecting to the things that we really believe in and preservation of cultures through storytelling and things like that, connecting to our identities, and really celebrating the things that make us who we are is a really important way to approach activist work that I think often gets neglected in a lot of these spaces.

And so I hope that for our listeners today this inspired you to kind of think about the ways for you to explore creative outlets and reimagine what activism and resistance can look like, especially through storytelling.

So yeah, thank you all for listening to our podcast. Sorry, guys. I don't know how to end this. Ha, take it away.

Hạ: Well, all to say is thank you, our dear listeners, for listening to it. I like to think something that I recently came up with is that we are all works in progress, including this episode is a work in progress too. But I hope that it really has helped you, like Mariam said, start getting your creative outlets rolling.

We want to thank you. Listen to us wherever you listen to podcasts, be it Spotify, be it Apple Podcasts, be it the "Bundle of Hers" website. You follow your heart there, and you can also follow us on Instagram @bundleofhers.

Listen to us. We'll always have episodes every other week. You can hear our controversial hot takes on things. You can maybe hear Mariam and I loving each other because we're soulmates. Yeah, we are.

Mariam: Because were' in love.

Hạ:We love each other. Yeah.

Mariam: Thank you, dear listeners. We love you guys too. Bye.

Hạ: Bye.