THE POWER OF NARRATIVE

Language is what separates humans from the rest of our planet’s animal species. To formulate and communicate using words gave birth to the phenomenon of story. Stories have the power to evoke imagery, emotions, rekindle memory, and inspire. Stories do much more than entertain, they also teach and enlighten the recipient, that is so long as the recipient is open and willing to hear and understand the story being told.

How many times have a group of people listened simultaneously to the same story and have walked away with a completely different interpretation of what was heard? I recall with delight a children’s game called “telephone” where a message is repeatedly whispered from person to person. The last person would have to say out loud what was whispered. This usually resulted in uproarious laughter because the final outcome was completely different from what was originally said. The power of the narrative and it’s appropriate interpretation is crucial in the arena of health care. The misinterpretation of patient history can produce unexpected and at times tragic outcomes. Poor history taking can lead to an incomplete assessment or inaccurate diagnosis and clinical plan. Nurses are keen observers and by far, very proficient in using the power of narrative in advocacy and assessment of their patients. However, personal/cultural bias, be it conscious or unconscious, time and resource constraints can obscure the interpretation of the narrative and lead to taking the incorrect clinical pathway. Despite best intentions, all nurses at times have found themselves guilty of this.

I had the amazing privilege of being a nurse practitioner working for the US Peace Corps in support of medical personnel stationed abroad, often located in very remote parts the world. The majority of my tasks involved the triage and consultation of incoming calls about Peace Corps volunteers who were seriously ill or injured. It was my job to find ways to best treat the PCV in their host country or to Medevac them out for more advanced care. I worked with an amazing team of foreign nurses and doctors with varying degrees of medical/clinical training who were doing their very best with what resources were available. English was not the first language for many of these clinicians, making the challenge of getting the right context of the narrative that much more important. Working across cultures, being cognizant of nuances and contrasts in meaning and intent was key. Listening was key. The ability to listen and clarify paramount.

So here are two funny stories told to me during my PC tenure.