Content Warning: This piece explores themes of trauma and death.

With the end of my time at the London School of Hygiene and Tropical Medicine looming, I have found myself reflecting on my past year studying at the institution. Near countless hours clocked on Zoom; the tired, albeit smiling, faces of peers tiling my computer screen as we mull over our latest coursework. To say it was an experience like no other would be an understatement. But it is in my more recent periods of reflection that I’ve begun, at least with more fervor, to wonder about the lives of my peers outside of their self-contained Zoom tiles. What exists for my peers outside of the immediate reality we’ve spun for ourselves to fill the virtual spaces we’ve occupied for the past year?

In trying to make sense of the ambiguous unknown that exists just beyond my reach, or in this case my gaze, I’ve been drawn again towards narration as a tool to not only give dimension to the flat affect a computer screen imbues, but to bridge the spaces that exist between that which is known and that which is unknown. 

In healthcare, the use of narration or storytelling to further contextualise, grapple with, and reflect on any number of moments or interactions is known as narrative medicine. In much the same way that a virtual platform created spaces of ambiguity between myself and my peers, modern healthcare forces similar spaces of ambiguity between providers and patients; where the four corners of a Zoom tile are replaced by the four walls of a patient exam room. Narrative medicine purports that within these spaces of ambiguity lie stories that if uncovered have the power to transform the ways in which healthcare is experienced by both the patient and the provider. Stories that further validate and humanise the unique ways in which we experience illness and disease. Stories that allow for us to take pause and reflect on the moments that changed us. Stories that, if nothing else, allow for us to begin the process of healing.

I spoke with Shaun Flynn, a first year Family Medicine doctor practicing in the rural South-West United States about the impact that writing and narration has had on his career in medicine. This is what Shaun had to say: 

“Throughout medical school and residency, narrative medicine helped guide my development as a physician. It allowed me to interact with patients, not just as lab values, images, diagnosis, but as people—listening to their stories, attempting to understand their experiences as they unfold in often brief but powerful interactions. Healthcare workers have the unique experience of being present with patients during their worst moments, but also their best. Entering into my professional career as a physician, now almost a full year in, I’m striving to continue that practice of meeting patients wherever they are in their story.”

Image Credit: Unsplash

Bedtime Rituals

Your eyes: glassy, high 

off the copper, tungsten, zinc, lead

that leach and burn

in the back of your head. 

Calm voyeurs walk to your side

What else is there to do? 

It was unsafe at the scene, otherwise you’d 

already be dead.

Follow protocol, strip your clothes, 

comment politely on your youth, 

look down and up with sympathy, 

coagulate by your side with sympathy. 

Look anywhere but your eyes. 

Use a machine to probe for answers 

Answers already known.

This way, 

we don’t have to look at you, 

we look at the screen instead.

We look into you. 

Into your heart. 

The valves, closed doors,

to the four perfect chambers, 

where blood used to

transiently reside. 

Now, it drips at our feet, 

clots in your veins. 

Someone covers you with a thin white sheet, 

just like my father did for me 

with three big waves, 

the cool air touching my face 

till the sheet slowly descended 

so I could sleep. 

Go to sleep. 

Sleep with those 

glassy eyes wide. 

We’ll be here,

looking the other way.

When asked what impact narrative medicine has had, Shaun said: “For me narrative medicine helps bring humanity back into challenging experiences and reflect on the moments that have shaped my practice.”

My desire to understand my peers beyond their 2D selves appears in stark contrast to that of a young physician reflecting on what it means to feel when confronted with death and suffering, although they are ultimately connected by writing and storytelling to further humanise the people and experiences from which we feel disconnected. So as our journeys in the fields of public health and healthcare continue to unfold, I urge you to take pause and reflect upon the experiences and moments that have shaped your practice. Experiences and moments that further validate and humanise the unique ways in which we experience illness and disease. Experiences and moments that changed us in ways previously indescribable. Experiences and moments that if nothing else allow for us to begin the process of healing.