Storytelling Helps Hospital Staff Learn About The Person, Not Just The Patient

VA hospitals are pioneering the use of storytelling to strengthen the relationships patients have with doctors and nurses. With more information about patients, there may be some health benefits.

RACHEL MARTIN, HOST:

When you go to the hospital, your doctors and nurses can find out all about your medical conditions by reading through your electronic medical record. But how can you get them to see who you are as a person? Bram Sable-Smith reports on the answer.

BRAM SABLE-SMITH, BYLINE: During the Vietnam War, Bob Hall was a Marine. When he got home, he served a decade as a Massachusetts state senator. He spent three more decades leading professional associations. But in 2013, he was forced to retire. He needed a lung transplant. He was 67 at the time and living near Madison, Wis. So he got the transplant done at the Madison VA hospital. There were complications. He ended up back in the hospital five more times. And during one of those days, a volunteer walked into his room and asked if he wanted to tell his life story.

BOB HALL: Though I'm very shy and unused to public speaking, as you can guess from my background, I said, sure.

SABLE-SMITH: As you can hear, Bob Hall is not actually shy.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED VOLUNTEER: Today is March 6, 2014, and we are speaking with Robert Hall.

HALL: Is this where we tell you my life story?

UNIDENTIFIED VOLUNTEER: Yes. You can...

HALL: It could take a while.

UNIDENTIFIED VOLUNTEER: (Laughter).

SABLE-SMITH: It did take a while. He ended up talking to the volunteer for over an hour about everything - like, his high school days...

(SOUNDBITE OF ARCHIVED RECORDING)

HALL: I was a D student in high school. I tell people I graduated in the top 95 percent of my class.

SABLE-SMITH: ...To his time in the military.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED VOLUNTEER: And why did you pick the Marines over all the other branches?

HALL: Well, you know, I guess maybe I wanted to prove something.

SABLE-SMITH: The interview was part of a project called My Life, My Story. Volunteer writers seek out vets like Hall, who are staying at the hospital, and ask them all about their lives. Then they write up a life story, a thousand-word biography, and attach it to the patient's medical record so any doctor or nurse can read it.

(SOUNDBITE OF ARCHIVED RECORDING)

HALL: One of my hobbies is writing. I've published hundreds of articles and opinion pieces, plus some short fiction and poetry.

SABLE-SMITH: Hall was one of the earliest patients to be interviewed for the project, which was only at the Madison VA at the time. And by his own admission, he was kind of a pain in the butt.

HALL: Being a writer, I rewrote the whole thing.

SABLE-SMITH: Now more than 2,000 patients at the Madison VA have their stories in their charts. About 40 more VA hospitals around the country are looking into doing the same. And it's not just the VA. Hospitals like Brigham and Women's in Boston are also giving storytelling a try. That's a lot of confidence in the value of something that began as a simple solution to a pretty common problem. Back in 2012, Dr. Elliot Lee was a medical resident on rotation at the Madison VA. He wanted to find a way to bring new doctors up to speed on their patients. Not just their health histories, but things like their hobbies and who they trust to help them make decisions.

ELLIOT LEE: It seemed to make sense that maybe the patient might know a lot about themselves and could help provide information to the new doctor that they're going to be meeting.

SABLE-SMITH: But how do you get someone to tell their own life story? Lee says they tried getting patients to write it themselves, but not many people really wanted to. They tried surveys. That worked OK. And then someone realized they could hire a writer. And it just so happened there was a poet in town, named Thor Ringler, who also happened to be a therapist and knew how to talk to people.

THOR RINGLER: And they were looking for someone who had a writing background and who also was a therapist, you know, to interview (laughter) people to tell their stories. And I was like, that's crazy.

SABLE-SMITH: Ringler's run My Life, My Story since 2013, and he says hospitals really only need one writer, working half or full time, to manage a storytelling program like this. That means spending as little as $23,000 to address the complaint that Ringler says is common to patients all over health care.

RINGLER: I think everybody has the same complaints about health care - I don't get to see anybody for very long, and nobody knows who I am.

SABLE-SMITH: There is research that suggests when caregivers know their patients better, those patients have improved health outcomes. One study, for example, found that doctors who scored higher on an empathy test have patients with better-controlled blood sugar. Another found the common cold was shortened by almost a full day in patients who thought their doctors were more empathetic. Professor Heather Coats at the University of Colorado studies the health impact of biographical storytelling. She points to a 2008 study that looked at what happened when radiologists were simply given a photo of the patients whose scans they were reading.

HEATHER COATS: They improve the accuracy of their radiology read, meaning less misspelled words, a better report that's more detailed.

SABLE-SMITH: And Coats says the kind of storytelling happening at the VA isn't just about patients, either.

COATS: So I consider it a gift to the nurses and the doctors who are caring for the patient.

SABLE-SMITH: Indeed, a survey at the Madison VA showed 85 percent of clinicians thought reading the stories Thor Ringler's team provides is a good use of clinical time, and it also helped them improve patient care. Take Dr. Jim Maloney, the surgeon who performed Bob Hall's lung transplant.

JIM MALONEY: It gives you a much better understanding of the entirety of their life and how to help them make a decision.

SABLE-SMITH: Only about half of the people who undergo a lung transplant are still alive after five years. Dr. Maloney says knowing a patient's life story makes it easier to have difficult conversations, like how aggressive to be if a complication occurs.

MALONEY: And so My Life, My Story allows for near-immediate access of this background - what they've experienced and what they're about, and what their goals are - for the entire team.

SABLE-SMITH: And as Bob Hall learned, the stories can be meaningful to caregivers even when they're not working, like it was for one of his nursing aides.

HALL: She came in one night and sat down next to my bed just to talk to me for a while 'cause she'd read my story. And I found out later, she wasn't on the clock. She'd just come in after her shift and to chat for a while.

SABLE-SMITH: It's been five years since Bob Hall's lung transplant. He's breathing well, he's moving well, and he even found a part-time job putting his writing skills to work at the My Life, My Story program. In just two years, he's written 208 biographies of veterans just like himself who come to this hospital for care. For NPR News, I'm Bram Sable-Smith in Madison, Wis.

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