Report Date
February 2015
Learning Log

“The Course of True Learning Never Runs Smooth”: 
Three Takeaways From The First Six months

Everywhere you look these days, people are talking about “story” and the importance of narrative. This is probably a good thing, but because we live in a hyper-marketing environment where competition drives large companies to seek every competitive advantage some are using story concepts in a deceptive manner.

Nationwide Insurance, for example, ran a Super Bowl Ad that epitomizes the new trend: the ad told the horrifying story of a dead child and all that he would miss, and the company tried to link its brand with this story. Here’s what the company said when questioned about its motives:

“The sole purpose of this (Super Bowl) message was to start a conversation, not sell insurance. We want to build awareness of an issue that is near and dear to all of us—the safety and well being of our children.”

We all care about our children and their safety, but the spot actually drew more attention to the question of, “Who green-lighted this ad and what were they thinking?” Nationwide, which was also involved in a Supreme Court case brought by a former employee who’d been fired from her job because she asked to pump breast milk at work, is herein engaged in “story abuse,” not story telling. The company seeks to manipulate its audience through sensationalism by borrowing values that are not core to its operations. Who really believes that Nationwide is not trying to sell insurance by pandering to audience concerns about dead children? Not me.

Here’s how several commentators reacted to the controversy:

Johns Hopkins University marketing lecturer Keith Quesenberry said Nationwide fumbled by trying to raise an important social issue at the very moment when Americans were in a collective party mood. "Most consumers want to support serious causes, but there is a time and place," Quesenberry, an expert on Super Bowl advertising, told AFP. The controversy around NBC news anchor Brian Williams is another more personal example of story abuse. Although bloggers and news officials are going after Williams a little too gleefully, it’s clear that Williams developed the habit of lying about his exploits as a war correspondent. Again, his purpose was to borrow values about bravery under fire that he may not have, enhancing his credibility.

I have always believed that stories have great power and that a storyteller must have integrity. I am saddened to see so much story manipulation in the marketplace and am appalled at the cynicism that this kind of abuse yields.

This is the opposite of what I want to accomplish with stories. To heal, stories must be true to life if not literally true, and if they cross the line into falsehood, stories can hurt.

In medicine, the power of stories can be harnessed to build relationships between clinicians and patients and expand diagnosis and treatment. In addition, stories can help medical institutions understand how best to support the communities that rely on them for treatment; and, stories can enlighten these institutions about their own histories in relation to the community. When stories are used in these ways, they can be especially impactful in healthcare.

When I began my Fellowship Program, I assumed that I would attend Columbia University and learn, through its Narrative Medicine program, principles that would be useful in helping to improve healthcare delivery. My thoughts and feelings have changed a great deal since then. Here are three big takeaways from my experience thus far:

  1. Narrative Medicine, as taught in institutions, is too narrow a focus for what I want to achieve with my Fellowship. During my initial interview at Columbia, I learned that the M.S. Program in Narrative Medicine was not especially clinical in nature. In fact, the program focused on reading five books and writing five papers a week, with little if any time allocated to hospital rounding with physicians. I now understand that the reason for this is that most students who attend the program are science majors and do not have a literary background.

    After attending a professional seminar on Narrative Medicine at Columbia, which I enjoyed immensely, I also got to know the program’s director. We corresponded for several weeks, the school published a poem I’d written in its newsletter, and we were on the verge of forging a good relationship. But over time, the school lost interest in me even as I came to understand its limitations. A physician who attended medical school out East came to hear me speak about Narrative Medicine in December and warned me that “the problem with Columbia is that it is a very political place.” That comment rang true to my experience.

    To accomplish my goals, I need to learn about the broader subject of Narrative Healthcare – or, how narrative can advance community and public health goals. Narrative Medicine, per se, is too insular because it concerns teaching physicians narrative skills that they can use. Narrative Healthcare, on the other hand, is about teaching both sides of the healthcare equation the value of stories to reveal important and perhaps lifesaving information in a life-care context. This is what I want to do.

  2. I need to broaden my scope of learning to incorporate community leadership skills because the community is where the action is. The Bush Fellowship has allowed me to donate time to community organizations on the frontlines of healthcare issues. At this point, I’m working closely with the Cultural Wellness Center in Minneapolis, thanks to Andriana Aribotes, on a couple of grant-making initiatives that have the potential to improve healthcare in the Backyard Initiative. I am trying to focus on these initiatives and have not been seeking additional consulting clients.

    There’s a complexity to working in communities that, while not unexpected, remains challenging because of my corporate background. Especially within communities, relationships are vital to positive outcomes, and I’m hopeful of forging productive relationships with those who are already doing the work. I have great respect for non-profit leaders like Atum Azzahir, who runs the Cultural Wellness Center, and I am learning to throw myself into the midst of unfamiliar situations and simply work hard to make a contribution. At the same time, the Backyard Initiative is a partnership that includes Allina Health, where the need for physician resilience is paramount. My hope is that as I learn how to work with communities, I can also become a kind of cultural translator between the people in those communities and the institutions that serve them.

  3. I must write my own book about self-healing during the Fellowship and ensure that it is published. Perhaps my greatest goal is to turn the pain of my childhood trauma and its adult manifestations into a work of art that can guide others who are on a similar journey. I am like a sponge right now, reading everything from “The Power of Habit” by Charles Duhigg to “Being Mortal” by Atul Gawande to “Shakespeare After All” by Marjorie Garber. Reading and research into technical aspects of story, trauma studies, and into my own genealogy has been especially enlightening. What I am doing is teasing out story fragments from my parent’s and grandparent’s lives, tracking down the truth about trauma and looking at how such an examination has helped me to heal. As I do this, the story continues doesn’t stop. In fact, it continues to develop with my Dad’s major illness and my mother’s decline.

    Although this work is intensely personal, I am realizing just how universal it is and how needed. The truth is, if we can unravel the truth behind our lives, many of our most common illnesses might be more manageable. There is a direct relationship between historical and personal trauma in communities of color and healthcare disparities that have ravaged many communities. Those aspects of life that keep us separated -- race, socio-economics and other factors – are the things that make us sick as individuals and as a society. We have to change this story!

One quarter of the way through my Fellowship, to sum up, I’ve become more self-motivated and less dependent on academia; more eager to work with community and institutional partners who are highly interested in change; and dedicated to telling my own story. This is not precisely what I expected but I am grateful that my program is turning out to be a journey of surprising discovery – one that has not been smooth but that is, nevertheless, intensely rewarding.