From Telling to Teaching: Storytelling as a Training Method

1
From Telling to TeachingStorytelling as a
Training Method
2

• A word is dead
• When it is said,
• Some say.
• I say it just
• Begins to live
• That day.
• Emily Dickinson

3
What this workshop is not

• Evidence based
• Medical model with high value on data
• Linear
• Objective
• Based on traditional science
• A therapy session

4
What This Workshop Is

• Right-brained
• Non-linear
• Subjective
• Perceptive
• Connecting
• Emotional
• Storytelling is ephemeral, subjective, personal

5

• Medicine is not a science. Instead it is a
  rational, science-using, inter-level,
  interpretive activity undertaken for the care of
  a sick person
• Kathryn Montgomery Hunter
• Doctors Stories
• The Narrative Structure of Medical Knowledge

6
Rules of Storytelling

• Usual rules of confidentiality
• Have fun
• Embrace uncommon thoughts
• Make eye contact
• Be sincere and humble
• Be vulnerable
• Dont resist connections

7

• Snake vs. Squirrel

8
How do you obtain stories?
9

• Exchanging stories
• Listening
• Reading
• Writing
• Media

10
How many times today have you told someone a
story and theyve told you a story in return?
11
Traditional elements of a story

• A protagonist the listener cares about (Are we
  always the hero of our own stories?)
• A catalyst compelling the protagonist to take
  action
• Trials and tribulations
• A turning point
• A resolution

12
Storytelling Practice

• Choose a story from your life, or a patients.
• Think of the story in terms of the traditional
  elements protagonist, catalyst, trials, turning
  point, resolution (if there is one). If no
  resolution think of what it might be.
• Tell that story to your partner or group. Try to
  include what made the patient do something, what
  trials and tribulations resulted, what was the
  turning point, how did the patient resolve the
  story.

13
The storyteller Whose story are you telling?

• A first person story (an I story) is always
  about the I.
• When I first met John I didnt think hed live
  another week. I saw a thin man, looking much
  older than his stated age. I heard loud breath
  sounds. I.
• The person telling the story is always in the
  listeners line of vision.

14
Another point of view

• Narrative (Third person)
• John was a 34 year old man who looked close to
  death. His skin was pale. His respirations were
  wheezy and labored. He stated he had been ill for
  about 2 weeks.
• The third person narrator has all the information
  and puts the focus on the protagonist.

15
Its Awkward

• Avoiding full responsibility for the story (or
  action in the story)
• After the abdomen was prepped and draped we
  made an incision.
• This social worker completed the ADAP form and
  submitted it.
• The attempt to take yourself out of the story
  serves to focus the story on you

16

• The stories people tell have a way of taking
  care of them. If stories come to you, care for
  them and learn to give them away where they are
  needed. Sometimes a person needs a story more
  than food to stay alive. That is why we put these
  stories in each others memories.
• Barry Lopez

17
The functions of stories

• Make something difficult approachable
• Build trust and support
• Engage
• Educate
• Create a connection
• Create empathy
• Foster thinking out of the box
• Bring meaning All suffering is bearable if it
  can be seen as part of a story.
• Containers of history (nation, tribe, family,
  individual, religion)

18

• Story creates context. The context sets events in
  a time and place. It was a dark and stormy
  night
• When the context is set, the story begins to
  happen to real people who have relationships.
• As a story is told we begin to put ourselves into
  it.

19
How will we use stories in the context of our HIV
work?
20

• To learn about a patient
• To teach a patient or family
• To teach each other
• To provide information
• To convey history
• To explain

21
The time it takes.

• Sometimes stories are episodic and take a long
  time to emerge.
• How do we keep the door open?
• How do we remain patient?
• Are we contributing to blocking the story?

22
More than wounded legs
23
Using stories for changeThe Yellow Leaf
24
Storytelling Exercise

• Tell a story about a patient, yourself, family
  member or.. in which there is a negative outcome
  or no resolution.
• Now, retell the story giving a more positive
  outcome or a resolution. This part may be done as
  a collaboration.
• How might the new story be taught to the patient
  so it becomes part of his ongoing story ( For
  example medication adherence, correct injection
  technique, diet changes)

25
An exercise about teaching
26

• You are in a room full of people who know very
  little about HIV.
• Rather than just giving facts, tell them a story
  (protagonist, catalyst, trials, turning point,
  outcome) about how HIV is transmitted and how it
  can be prevented.

27
(No Transcript)
28
TEN PATIENTS, AND ANOTHER

• I. Mrs. G.
• The patient is a sixty-odd-year-old
• White female, who presents with fever, cough,
• And shaking chills. No further history
• Could be elicited she doesnt speak.
• The patients social history was non-
• Contributory someone left her here.
• The intern on the case heard crackles in
• Both lungs. An EKG was done, which showed
• A heart was beating in the normal sinus
• Rhythm, except for an occasional
• Dropped beat. An intravenous line was placed.
• The intern found a bruise behind her ear.
• She then became quite agitated, and
• Began to sob without producing tears.
• We think shes dry. Shes resting quietly
• On Haldol, waiting for a bed upstairs.