From the Members Section | The Power of Narrative Medicine: Unveiling the Unspoken Stories

The Power of Narrative Medicine Unveiling the Unspoken Stories

I had a love-hate relationship with my visits to the doctor when I was growing up. They always managed to make me feel better, no matter what ailment I had. But there was always something unsettling. I'd sit in a paper gown on a cold bed, waiting for the doctor, with time to think about what to express. Yet, they would enter and exit swiftly, leaving the experience a blur. Left alone with cold stethoscope imprints, I felt something important was left unsaid.

Despite my lingering experiences from past doctor visits, I remained committed to becoming a physician. I yearned to understand why those visits felt incomplete and how I could ensure my future patients had fulfilling experiences. It wasn't until my first year of medical school that I began to find answers.

I remember my first patient encounter like it was yesterday. I approached the room with an air of confidence, having carefully rehearsed the patient encounter script for countless hours. I convinced myself it would be a breeze. We had eight minutes to get the encounter done but I prided myself that I could get it done in six.

With a firm knock, I entered the room, prepared to solve my patient's problem. In an instant, it was over. The encounter unfolded precisely as I had practiced, efficiently concluding with a treatment plan that I thought addressed my patient's concerns. All that remained was a debriefing with the physician and my colleagues who were also in the room observing my interaction.

During the debriefing, I received unexpected feedback that shattered my complacency. It was in the poignant words of the patient that I recognized the stark truth: I had unwittingly "assumed the role of a robot," devoid of the "empathetic touch" that defines true health care.

Lost in the fervor of taking meticulous notes, I failed to perceive the silent distress etched upon my patient's face, a reflection of the burdens he carried beyond his medical condition. Oblivious to his nonverbal cues, I missed the opportunity to offer emotional support and genuine understanding.

Moreover, the patient also expressed discontent with my proposed treatment plan, which served as an unwavering reminder that my hasty assumptions had led me astray. It was in that moment I realized I had inadvertently become the shortcomings I had once despised about my own experiences as a patient. I was perpetuating a system devoid of human connection and holistic care.

 I learned to listen with my heart, attuned to the unspoken words and subtle cues that reveal the intricate tapestry of a patient's experience. 

My first patient encounter served as a wake-up call that transformed my perspective on patient care. Throughout the ensuing year, as I engaged in more patient encounters, I consciously redirected my focus, channeling my energy towards being present in the moment rather than being consumed by notes and scripts.

I learned to listen with my heart, attuned to the unspoken words and subtle cues that reveal the intricate tapestry of a patient's experience. No longer content with a superficial understanding of their primary complaint, I longed to unlock the depth of their narratives, to create a space where their voices could be heard, and their stories could unfold.

Patient encounters became sacred exchanges where I offered solace and genuine empathy. This transformation led me to embrace narrative medicine, where physicians actively participate in their patients' stories, fostering a more complete understanding of their health concerns.

To implement a narrative approach in medicine, I adopted guiding principles. I used open-ended comments like "tell me more" to delve into the patient's perspective. I valued uninterrupted dialogue, resisting the urge to interject or offer quick solutions.

I allowed patients ample time to express themselves fully. I avoided assumptions and judgment, reframing noncompliance as a blocked narrative to explore underlying barriers. I embraced moments of silence, giving patients space to share their deepest worries.

In the complexity of medicine, the principles of narrative medicine may seem simple, but they are often overlooked. Yet, as physicians undergo years of rigorous training and navigate the demands of a fast-paced profession, it's easy to lose sight of these foundational aspects.

During my first year, I humbly learned valuable lessons, cultivating skills for a narrative approach in medicine. These encounters allowed me to address the lingering questions that had haunted me, bringing completeness to the patient's visit, and fostering a more profound connection.

As I embark on the journey to becoming a full-fledged attending physician, I hold onto the hope that I will forever carry these elements within me, preserving the narrative approach to medicine. For it is through these small yet profound gestures that we can truly honor the essence of our patients' stories and provide them with the holistic care they deserve.

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Sathvik Srikalyani

This article was authored by Sathvik Srikalyani, a medical student at the University of North Texas Health Science Center in Forth Worth and a member of ACC's Medical Students Member Section.

Clinical Topics: Cardiovascular Care Team

Keywords: Cardiology Magazine, ACC Publications, Narrative Medicine, Delivery of Health Care, Patient Care, Empathy, Feedback

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