The healing power of story

As a medical student on my internal medicine rotation, there was a patient with severe chronic pain admitted. He was well known by the nursing team as he’d been admitted several times before. The patient had been receiving methadone for pain and opioid use disorder. Pain is a subjective experience, hard to quantify and often challenging to treat. 

The patient distrusted the healthcare system and asked that the door to his room be kept open, so he could keep an eye on what was happening outside his door. When I tried to elicit more details of his medical history, he noted my badge that said “medical student” and didn’t want to speak to me. 

My senior told me about a time they used a narrative medicine approach to care for a patient that mistrusted the healthcare system. I decided to try it with my patient. I sat and wrote a second-person story detailing all that he had been through, from how it started with joint aches to a partially fused spine, to the multiple admissions, to multiple adjustments to his methadone dose without allieviating his pain. I went to his room and read him the story. I think he was able to understand that we’d listened to all his concerns and  had the same goals as him. I think this showed him that the healthcare team was here to help him, without judgement. It was a simple thoughtful exercise that changed the course of his stay. We were able to build rapport  and codesign a treatment regimen together. 

Although pain is often  invisible, it’s important for it to be recognized and addressed by the care team. The narrative medicine approach, of writing and reading a patient’s story back to them, can do wonders for assuring the patient that everyone is working toward a shared goal. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.