The mental health benefits of storytelling for health care workers

For the last few years,

I've been a writer in residence
at the Stanford Medical School.

I was hired by an incredible woman,

she's a poet and an anesthesiologist,

named Audrey Shafer,

and she started the Medicine
and the Muse Program

to reintroduce humanities back
into medical education and training.

My job was to teach writing, storytelling

and general communication skills

to physicians, nurses, medical students

and other health care workers.

And I thought I'd get
a ton of great student essays

about dissecting cadavers
and poems about the spleen.

And I did.

But almost immediately,

I started getting more essays
that made me really anxious

and really worried.

My students were writing
about their crushing anxiety,

the unbearable pressure
on them to succeed,

their mental health diagnoses,

their suicide attempts,

how alone and isolated they felt

and wondered if they'd gone
into the right profession,

and they weren't even doctors yet.

This is my student Uriel Sanchez.

(Audio) Uriel Sanchez:
The choice you are given through medicine,

from a lot of your mentors even, is like,

you have to choose,

like, being a really good person
or a really good doctor.

(Music)

Physician's own humanity
and emotional well-being

are almost never made
a core part of their training

or even acknowledged.

And real vulnerability,

like sharing certain mental health
diagnoses for example,

can be absolutely career-ending.

But nearly 30 percent of American
medical students are depressed,

and one in 10 have thought about suicide.

And it's actually even worse
for practicing physicians.

There's really widespread
job dissatisfaction,

high rates of depression,

and doctors have one
of the highest suicide rates

of any profession in the United Sates.

This is scary.

Not just for them, but for us too.

I really think doctors
have the most important job.

And if their lives are at stake,

ours are too.

Now, I am absolutely not
a mental health professional,

I'm a writer,

which most days is absolutely
the complete and total opposite.

But I can tell you
that the more opportunities

that I give health care workers

to share their daily frustrations,
their fears, their joys,

what surprises them, whet they resent,

the better they seem to feel.

So at Medicine and the Muse,
we offer evening, weekend

and day-long storytelling workshops

at farms and other places
with really good food.

I invite other journalists,
writers, producers,

podcasters and poets

and they teach writing,

communication and storytelling skills
to our participants.

And those participants
practice being vulnerable

by sharing their stories
out loud with one another.

And in doing so,

they reconnect with what drew them
to medicine in the first place.

These are the skills they'll draw on

when they realize and are confronted
with the stressful, messy reality

of the work they've chosen.

This is how they realize it's a calling.

So I have a prescription
here for you today.

It's not from physicians, it's for them,

and I asked my students for help.

And before I start,
let me just say I work with doctors,

but I'm absolutely convinced

that this applies
to almost any profession,

especially those of us
who are so committed to our work

and it can be so intense and overwhelming,

that sometimes we forget
why we chose to do it in the first place.

To me, sharing a true vulnerable story

is a lot like raising
a flag up a flagpole.

Other people see it,

if they agree with it
and it resonates with them,

they come and stand under it with you.

That's what my student
Maite Van Hentenryck did.

(Audio) Maite Van Hentenryck:
I mean, it was super anxiety-inducing,

and I shared parts of myself

that I really have probably told
five classmates.

When Maite was a baby,
she had to have her leg amputated.

When she got to medical school,

she was taking just a standard class quiz,

and she got asked the question,

"Please tell us about the first time

you encountered someone
with a disability."

She wondered if her supervisors
had ever considered

that the person with the disability
was her, the doctor.

So she talked about it in front
of about 100 of her friends, peers,

which is a big deal, because,
you know, she's really shy.

And afterwards, what happened,

is a number of students with disabilities,

that she didn't know,

came up to her and asked her
to colead a group on campus

that's now advocating for more visibility
and inclusion in medical training.

In English, we tend
to call people creatives

if they have a certain job.

Like, designer or architect or artist.

I hate that term.

I think it's offensive and exclusionary.

Creativity doesn't belong
to a certain group of people.

A lot of my work with physicians
and medical students

is just reminding them that no matter
what profession we choose,

we can make meaning,

find beauty in the hard stuff, and create.

This is medical student Pablo Romano.

(Audio) Pablo Romano: My parents
immigrated here from Mexico

many years ago,

and when I was in college,
they passed away.

I was 18 when my dad died,
and then 20 when my mom died.

Not only has Pablo been talking
publicly for the first time

about being an orphan,

but together, we started a live
storytelling series we're calling Talk Rx,

and it's become a really
popular place for his peers

to show their most vulnerable
and powerful thoughts and feelings.

(Audio) PR: I go to a school

that cares so much about data
and research and numbers.

At the end of the day,
what moves people is stories.

Laurel Braitman: Arifeen Rahman
is a second-year medical student.

And before she was born,

her parents immigrated from Bangladesh
to the United States.

She grew up in a really beautiful home
in Northern California,

very safe and stable,

her parents are still together,

she never went hungry
and she graduated from Harvard.

(Audio) Arifeen Rahman:
I didn't feel like the stories I had

were worth telling or that they mattered.

LB: Arifeen did have stories, though.

Recently, she gave a talk
about being maybe

the only Bangladeshi American girl

to win an essay contest

from the Daughters
of the American Revolution --

(Laughter)

and then dress up for Halloween
as the Declaration of Independence.

And I love Arifeen's story so much,

because to me it represents
all that is good and bad

and hard and exhausting

about representing the new American dream.

(Audio) AR: The hardest thing
was coming up against that voice

that was telling me
no one wants to hear my stories,

like, why invest the time in this thing

that doesn't really mean anything
in the grand scale of life.

Maybe the biggest thing is,
like, maybe it does.

LB: Life is so short.

For me, the only thing,
really, that matters with my time here

is feeling like I can connect
with other people

and maybe make them feel
slightly less alone.

And in my experience,

that's what stories do
absolutely the best.

So, my student and a collaborator
in a lot of these endeavors

is Candice Kim.

She's an MD PhD student
in medical education.

She's written about #MeToo in medicine,

navigating her queer identity
in a conservative field,

and her mom's metastatic cancer diagnosis.

And recently, she started also
doing some really interesting research

about our work.

(Audio) Candace Kim:
We've seen that students

who participate in our
storytelling opportunity

show between a 36 and 51 percent
decrease in distress.

If this was a mental health drug,

it would be an absolute blockbuster.

Results seem to last up to a month.

It might be longer,

a month is just when Candice
stopped measuring.

So we don't even know.

Not only that, but 100 percent
of our participants

recommend these opportunities to a friend.

For me, though, the most important thing
that our work has done

is create a culture of vulnerability

in a place that there was
absolutely none before.

I think what this does

is that it allows doctors and other folks

an opportunity to envision
a different kind of future for themselves

and their patients.

This is Maite again.

(Audio) MVH: I want to be the doctor
that remembers when your birthday is

without having to look at the chart.

And I want to be the doctor who knows

what my patient's favorite color is

and what TV shows they like to watch.

I want to be the doctor
that's remembered for listening to people,

and making sure
I take care of all of them,

and not just treating their disease.

Being human is a terminal condition.

We all have it,
and we are all going to die.

Helping health care professionals
communicate more meaningfully

with each other,

with their patients and with themselves,

is certainly not going to magically change

everything that is wrong
with our contemporary health care system,

and it's not going to live to the immense
burdens we place on our physicians,

but it is absolutely key

in making sure that our healers
are healthy enough

to heal the rest of us.

Communicating with each other
with vulnerability,

listening with compassion,

is, I believe, the absolute best
medicine that we have.

Thank you.

(Applause)