← Leading Organizations That Matter
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- [00:00]
Dr. Annie Brewster
Foreign.
- [00:10]
Ray Spadoni
Welcome to Leading Organizations that Matter, a podcast about leadership, organizational culture and how we find meaning and purpose in our work. I'm your host, Ray Spadoni, and today's topic is the Healing Power of Stories, an interview with Dr. Annie Brewster. We pass information and history down through generations via stories. We gain understanding and insight about ourselves through stories. We teach and inspire others using stories. And I go so far in my own book, Saving Organizations that Matter, as saying that storytelling, the mission as I describe it, is vital and essential to creating lasting organizational change. Today we are going to discuss the importance and impact of storytelling to personal healing with Dr. Annie Brewster. She is, as you will learn, uniquely qualified to discuss this topic. Dr. Brewster is an assistant professor of medicine at Harvard Medical School, a practicing physician at Massachusetts General Hospital, a writer, and a storyteller. She is also a patient. In response to the great disconnection she experienced in health care, both as a patient and as a provider, and motivated by her belief in the power of stories, she started recording patient narratives some 15 years ago. Integrating her personal experiences with the research supporting the health benefits of narrative, she founded the nonprofit Health story collaborative in 2013. The health story Collaborative is committed to empowering patients and their loved ones, building community, strengthening patient provider connections, and and ultimately transforming healthcare through storytelling. Annie is widely published in the press and is the author of the Healing Power of Storytelling Using Personal Narrative to Navigate Illness, Trauma and Loss, which was published in 2022. I will provide links both to the Health Story Collaborative and to her book in the show notes. Welcome, Dr. Brewster. Annie, thank you for being a guest on Leading Organizations that Matter.
- [02:46]
Dr. Annie Brewster
Thanks so much, Ray. I'm really happy to be here. Call me Annie, not Dr. Brewster. Okay.
- [02:51]
Ray Spadoni
All right, I will. I will do exactly that, Dr. Brewster. Kidding. Annie, I gave listeners a high level resume version, if you will, overview of your background before recording. And I did mention that you have also experienced the healthcare system as a patient, but I did not go into any details. So I'm wondering if you can talk about your path, first to becoming a physician, and then second, realizing that personal stories could be an important part of the healing process.
- [03:25]
Dr. Annie Brewster
Sure, I'll talk about both because I think they're incredibly relevant to why I founded Health Story Collaborative, because really it was a response to what I feel is broken in the healthcare system. And I learned that from being both a doctor and a patient. So from the doctor side, I went to medical school relatively late. I was 27. I sort of resisted becoming a doctor for a while. For a lot of Reasons one being that my father was a physician and we have a complicated relationship. So I was sort of trying to avoid it, but I really kept being pulled back to medicine and to wanting to pursue this career. And it was really because I recognized that it was a privilege to be with people in really intimate moments and to hear stories. And so I ultimately went to medical school. I actually started in psychiatry again because I was really drawn to the stories. But then I really missed taking care of the whole person, body and mind. So I switched to primary care. And I think I had sort of a vision, idealistically, that I would be like a doctor of 100 years ago, where I could know all my patients and know their families and in the context of their lives and follow them longitudinally and have meaningful relationships. And primary care. I went into a practice in Boston. I inherited like, you know, 1500 patients all at once, even though I was only working part time then because I had young children. And it was really hard and really sort of soul killing in a way, because I realized I never got a chance to really sit with people and hear the stories of their lives. It was a system that was really driven by efficiency and honestly, money making above relationship building, because, you know, medicine is a corporation and it's become even more of a corporate enterprise since I left primary care. But in any case, I found it really hard and it made me really sad because I think what I felt saddest about was that there was almost like an antagonism between patient and provider, that what was supposed to be a therapeutic alliance between us was really challenged because patients weren't getting what they wanted and the doctors were feeling really stressed out. We were paid on productivity, we had no control over our schedules. And so there was this tension in what was supposed to be a caretaking relationship. And it felt really hard. Ultimately, I left primary care and I went into urgent care, which I did for a lot of years. And interestingly, I found that I could delve more into the stories in urgent care because I was more on my own time schedule. I could take more time if I needed to, but I think it was really just the sort of corporate efficiency side that really sort of broke my heart. And it was then in my early practice of primary care that I started thinking, like, how can I make this better? How can I really care for my patients in the way that I, that I want to? And I would wouldn't think that my patients really felt that I was rushing them, but I did feel rushed. And I think everyone in primary Care does. You know, you're. You're on a time clock. And so the wheel started turning, and I recognized, you know, I'm not a business person. I'm not going to be able to change the way this system is run. But is there a way that I can make space for patients outside of the exam room? But it was really my experience of becoming a patient that led me to do this work with storytelling and health. So it was sort of happening on a parallel track, but I didn't really bring the two paths together until much later. So while I was a resident, so I wasn't even out yet in primary care. I was 32. I was diagnosed with multiple sclerosis. And it was a long journey of sort of ignoring the symptoms for a while, ultimately having to come to terms with them, seeing a neurologist, having not a very positive experience with getting that. That diagnosis delivered, but that's another story. I think what was really a realization for me was, you know, how hard it was to integrate and accept a diagnosis of chronic illness. And I'd never really thought of that as a patient. I. I really had sort of an identity meltdown of sorts. I'd been someone who could always overcome obstacles just by sort of brute for force, persistence. I was young and naive at the time. I hadn't had something in front of me that I couldn't, like, fix. And all of a sudden I had this diagnosis with no cure. And it was really hard for me to accept that and integrate into my life. So I actually saw that neurologist, got the diagnosis and then left there and didn't see another neurologist for five years and really lived in denial for quite a while. And I felt a lot of shame about it, which is interesting, because I would never expect one of my patients to feel shame. And I really didn't tell anybody except my closest friends and family. And so over time, I started to realize that that was, like, not a sustainable way to live and that I couldn't live my best life if I kept living in secret. I had to find a way to integrate this diagnosis into my life. And it was really storytelling that helped me to do that. So first starting to tell my own stories and share it very gradually and recognizing that that story could help other people who were navigating similar challenges, really learning to accept challenging life circumstances, whether that's illness, trauma, or loss. And then I started thinking, how can I, as a provider, offer such an opportunity for my patients to tell their stories, not necessarily my patients, in terms of the Ones that I saw in clinic, but patients in General. So in 2010 I bought some recording equipment and I started learning how to audio edit and I started recording patient narratives. And I was really lucky back then that I had a connection at WBUR and I found a platform there and we formed something called Listening to Patients. And so that's how this all started, sort of as creating this library for people who are navigating a challenging circumstance to listen to how people move forward after challenge and make the best life they can despite the hardships. And then in doing the work, I realized that it was beneficial also to the person who was sharing their story, perhaps even more than to the listener, to have this space to have somebody receive their story, witness their story and then reflect it back to them and work with them on it. So that was sort of the seeds of health story collaborative. I can say a lot more, but I just said that a lot, so I'll stop there.
- [10:03]
Ray Spadoni
But yeah, thank you. Thank you. There's a lot in there and I was jotting down some notes as you were going and there's so many things I could react to and ask you about. But I'm struck by, first of all, that you felt as though you could get closer to get to know, spend more time with your urgent care patients than your primary care patients, because that feels as though it's flipping the model up know on its head. And, and also this notion that the Ms. Gave you something you couldn't fix. And I'm. I'm struck by that. This. There's a. There's a confrontation of sorts there which as a person who has, you know, been very achievement oriented and very successful and went to medical school and has done a lot to have been handed something like this for which there wasn't a path, there wasn't a hurdle you could get over all by yourself just due to elbow grease and determination. But there was more to it than that and there was a confrontation of sorts. So I'm struck by those two parts of your story so far.
- [11:09]
Dr. Annie Brewster
Yeah, well, I'll start with the urgent care. I mean, I think part of that is when I was in urgent care, I could make my own schedule so I could take a chart when I was ready and I could delve into a person's story. I could be quite efficient, but I had more control over that process. And that feeling that I had that control really gave me an ability to connect more deeply with people because I never liked thinking someone was waiting for me in primary care. I'm a Very like person who's sensitive to time. I think it's respectful for people to be on time. I hated being late, so that always constrained me. So it really freed me up to be able to have that control and see patients at my own pace. I will say something's lost, obviously it is flipping the system on its head because you don't get the longitudinal relationships. So I would think, oh, it's more like a short story than a novel, but I can really go deep with these people. But the truth is, in primary care now, I think it's so hard to make those longitudinal relationships because doctors have so many patients and you often don't get to see them. Like when I was in primary care, I would see people once a year. I would. It was really hard to really follow people's lives because you just, they're just so over committed right now. So yeah, it's a sad truth about the system that Urgent care felt like I could go deeper with people. But that is, that is the truth. And then the second part of your observation about not being able to fix something, say more about, about why that struck you. I mean that was, that was the challenge for me of coming to terms with. I mean, I think that's something we all come to terms with in life. We can't fix things. But I think the key for me was that this was like an identity issue. And I had never thought about that as a doctor. Right. I had thought like, okay, my job as a doctor is to be like a detective. And obviously I thought to take care of my patients and be with them. And I was yearning for that. But really we're trained, sort of come up with a diagnosis. It's like a funnel. You start with a lot of information, you funnel it down, you come to an answer, here's the diagnosis, here's your treatment plan, go forward. And what I learned as a patient is it was, it was so different than that. Like, for me, like getting told that I have this diagnosis, I couldn't accept that all at once. I wasn't ready to jump on a treatment plan. There was this whole other piece of, of integration that the medical system was not set up to help me with. And as a doctor I realized I had never really thought about that, that you know what happens. I give a life changing diagnosis to someone and then for them the story is just beginning. And sometimes for the doctors we think, oh, the story, we have solved the puzzle and the story's over, or at least there's some sort of closure. But that's really just the beginning. So it was that interest in identity and integration are really the two key points that I think led me to storytelling, that we have to engage with our stories in order to move forward. We have to shift our narratives when something happens to us that is unexpected and we have to rewrite them in a way. And that is really hard, but it's also really good for us. Since I started Health Story Collaborative, which began as sort of this intuitive understanding of the power of story from my lived experience experience, I work very closely with a psychologist who studies the health benefits of narrative. So he's taught me a lot about that. And research really supports that that sort of as this question of identity and narrative are very linked and that it really helps us sort of integrate challenging life events by rejiggering our stories and editing them, per se.
- [14:59]
Ray Spadoni
Well, that's a, that's a. Maybe that's a great point to jump off of here, you know, in your, in your book. It's such the podcaster thing to say in your excellent book to a guest. But I can, I can assure the listeners here that I'm very sincere when I say that it's an excellent book. It's called the Healing Power of Storytelling Using Personal Narrative Narrative to Navigate Illness, Trauma and Loss. And I'll make sure I put a. It's a mouth, it's a mouthful. You know, it's, you know, title and subtitle. I'm familiar with the, you know, I'm familiar with that myself a little bit. But, you know, I'll make sure I put a link to Amazon to your book in the show notes. But, you know, it's not surprising that someone drawn to storytelling would use storytelling to, to make their point. And so you give us a strong glimpse into your own personal journey and struggles with this, which you just, you know, certainly alluded to a few minutes ago. But you do get into some of the science behind the idea that the stories can help with actual healing. So recognizing this is not a scientific podcast, I'm just wondering if you can give our listeners a little bit of a taste on the findings in this regard.
- [16:16]
Dr. Annie Brewster
Sure. Well, I'll say first that initially I really sort of resisted the science because when I started to bring sort of my health story collaborative programming or tried to bring it into the hospital setting where I worked, I kept getting hit with, well, what's the data? What's the data? And it sort of irritated me initially because I thought it's, well, it's so obviously beneficial to, and people Want to tell their stories. Patients are hungry to tell their stories. And it felt like, you know, if I were an artist doing this, no one would be like, where's the data? I had a mental block. It also felt like I don't want to study people. I want to be creating programs that help them. I am here to be of service, not to, I don't know, felt exploitative in a way. So I resisted it, but I had like a mental block against it. Then I met Jonathan Adler, who is a PhD psychologist who works with Health Story Collaborative, really since 2012. And he's just amazing and has taught me so much about the science of stories. And what I love about his field, it's narrative psychology, is that he would say it's like a bottom up science rather than a top down meaning it's starting sort of in the messy experiences of people's individual stories and then sort of trying to find connections from looking, seeing what arises out of those, instead of taking a hypothesis and imposing it down on and trying to prove that. So it's really sort of bottom up. Anyway. It's grounded in this concept called narrative identity, which really makes sense to me. And that's the belief that who we are, our identity is shaped by the stories that we tell about ourselves. So the stories that we tend to remember, obviously we don't tell stories about everything that happens to us in our lives because we can't possibly remember every tiny thing. It tends to be sort of the standout moments, the high points, the low points, the turning points. And those stories sort of form the scaffolding of our identities, this narrative identity. Our stories kind of make us who we are. And while our stories are, I mean, while our identities are fairly stable over time, they're not static. So we're constantly sort of constructing and reconstructing the stories of our lives. And our identities shift. And for me, that feels freeing that, that we're not stuck. It's not static. And I think the piece that really resonates with me as a patient is that it turns out that our mental health is impacted by how we tell stories and that not all stories are created equally. When it comes to positive health benefits, some stories do a better job, but it doesn't have anything to do with. It doesn't have. It's not solely due to sort of what happens to us in our lives, the events of our lives. It actually has more to do with the meaning we make of what happens to us. So we play an active role in how we decide to make that meaning. And so, again, for me, that's empowering to realize. Okay, you know, obviously our stories are grounded in the events of our lives, but it's up to us how we find the meaning, where we parse the chapter breaks. And that has an impact on our mental health, it turns out. So. So in going deeper into Dr. Adler's work and this whole field, really, there are certain narrative themes that are actually linked to mental health or are associated with mental health. There are so many of them, but sort of the key ones that we work with at Health Story Collaborative are the theme of agency. So agency is really about feeling like you have some control over what's happening to you, to you or to your story, that you're not just being batted around by fate. And the more themes of agency that show up in stories, the better the mental health of the person. Another is communion. So that's sort of more themes of feeling close and connected to others. That's linked to positive mental health. Another is redemption, and that's sort of more about how things change in a story. So redemption is when, like, something that's negative or hard or a bad experience turns positive. Those themes of redemption are linked to positive mental health. The flip side of that is contamination. Like when something good in a story, like, turns bad, and that's bad for our mental health. That's not to say that everything's redemptive. And Dr. Adler always makes a point like that. We're in our culture in particular, we love redemptive stories. So we're not. No story is all redemptive. Some stories just don't have redemptive elements in them. But there's always, you know, seeds of redemption or threads like, even if someone's terminally ill, you can still have some redemption. Maybe that is deepening relationships at the end of your life, saying things that needed to be said, whatever it is. So there are always some threads you can find of redemption, and then the other is accommodative processing. And that's when that's about meaning making. So meaning making is really an important piece of our stories. And when something happens to us and how we make sense of it, we can either do what's called assimilative processing or, you know, that's when a small thing happens. We sort of assimilate it into our existing story versus accommodative processing. That's like something bigger happens. We can't really just assimilate it. We have to actually change our stories. And that's really good for us. It Turns out, even though it's hard. So when illness happens to us, or trauma or loss, what is it? Whatever it is, we can't necessarily just assimilate that experience. We have to change our stories. But that process of making meaning is productive, even if it isn't always easy. So these are sort of the themes that we work with at Health Story Collaborative based in this science of, like, when we're working with people to tell their stories, we're not necessarily saying give us more agency, but we're asking questions that help might help people explore or find their agency or develop new agency. Same with all of the themes communion to. And just by going through this process with us, they're doing accommodative processing. So we always have this sort of grounding and research that we're thinking about as we're helping people to narrate their stories. And I always want to make clear to people, it's like it always has to be an authentic story. We're never sort of trying to make people tell happy stories out of something that's really hard. It's not that at all. It's about finding the meaning. It's about telling authentic stories. It's about looking for these themes where they do and they don't exist. And we all have. In any story, all of these themes are there in varying degrees. And we're just trying to help people think about them. And we do that by asking, you know, questions and probing and helping people. And so we're sort of just guides as people work through their stories. We do have the whole narrative guide that's sort of grounded in this research that we help that people write to, or they can do it orally with us and go through this process of sharing their stories. But sort of grounded in this science.
- [23:23]
Ray Spadoni
Well, maybe any. Let's go right to that. In terms of the ongoing and maybe future work of the Health Story Collaborative, we'll jump to that. You mentioned you started some number of years ago with some simple recording equipment and you began capture. It's come far since then. What is the work of the Collaborative now, and do you have a sense of where it's headed?
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Dr. Annie Brewster
Yeah, so I. We have a lot of. We have an online forum for storytelling. So we have a lot of online content. But I'd say our two main programs are one that are called Healing Story Sessions, and these are live or live virtual storytelling events where we usually have two storytellers, sometimes three, side by side on a stage, or sometimes it's on zoom more since the Pandemic. And we have an audience and we have live storytelling. We have worked with these people in advance. So there's like a long preparation leading up to these events where the storytellers work with us independently using our narrative guide that's grounded in the research I was just talking about. And write to the prompts. And then we edit, and we usually go through, you know, multiple drafts. And then John Adler, actually, in addition to being a scientist, is a theater person. So he works with them to prepare to share their stories live. And then they do that in front of an audience. And so that is sort of one of our main programs, the Healing Story Sessions. And it is something magical that happens. I think, you know, it's beneficial for the storytellers to engage deeply in their stories like that and to have somebody really work with them through it. And then it's just magical to have an audience. And I think, you know, some people ask, do I have to share my story? You absolutely don't. You can still get benefit from. Not if you just want to write your story. But I think there's something really magical that happens with the sharing, with being witnessed, with standing up and being received, and then also, you know, having the audience respond to you. I always say sort of like no stories in a vacuum. So we're all in this web of stories. And so when someone is sharing their story, it's going to impact the listener and how they might tell their story next time or understand their own story. And back and forth. There's this whole. So it's magic what can happen in an audience. It's also like if someone shares vulnerable stuff, it's an opening for others to be vulnerable. So it invites us all into this space that I think above all else, health story collaboratives have been, is about sort of deliberately creating this space for story exchange, which does not exist in health care. And it really doesn't exist that often in our world either. So just really creating this space where there can be story sharing and listening and connecting on that deep level. So we do the. The Healing Story Sessions program a lot. And then our other main project is called the Opioid Changing Perceptions through Art and Storytelling. And that's about using stories for social change. And, you know, we've done other projects around stories and social change. So just to add to the research, there's this. There's this concept in this field of narrative psychology called master narratives, that the belief that, like, we all have our individual narrative identities as people, but we all live in this web as I said of other stories and a lot of different master or dominant cultural narratives. There's a dominant cultural narrative of our family, of our workplace, of our ethnicity, of our gender, all sorts of things. And some of these are constraining and can limit the stories that are available to us to tell. But the way that we can change these perceptions and these dominant cultural narratives is by telling more different stories one story at a time. So specifically, I'll give you the example, the opioid project. It's working with people around the opioid epidemic. We started. I work with a visual artist, and we run workshops where she collages with them. I audio record their stories, and then we have community events where we have the stories, the art, and then you can scan a QR code and listen to the story. We started with people who'd lost a loved one to overdose, sort of as remembrance. They're talking about the person they lost and creating art about it. The goal there is to change this sort of dominant cultural narrative about sort of who is, quote, unquote, an addict. Right? There's all these assumptions and stigma. Addicts are bad people. Addicts steal. This is about, like, let's actually contextualize the stories of these people's lives and bring them to light and then have these community events to try to decrease the stigma. So these stories are all about who were these individuals as human beings, complex human beings, beyond their addiction. And, you know, we've expanded that project now. We've done it with people who are in recovery and with first responders and also with, like, people in recovery and first responders together. So that's our other major project, which is around the opioid epidemic and just using storytelling for social change, but, like, related to both. I'll say. Like I just said that one of the workshops we did with the opioid project was first responders and people in recovery together. And that's an example of how we can use stories to sort of heal relationships, too. So in that world, many people who have overdosed, who have opioid use disorder, other substance use disorder, have been treated poorly by first responders because the first responders are burnt out. They see the same people over and over again. They're tired, and they are also in pain from feeling overworked, like they can't help, like they can't fix it, like they keep. So to bring these groups together and have them hear each other's stories and talk together about and really see the humanity of both sides is really powerful. And same with The Healing Story Sessions program, like, we have one model where we have patients and providers share side by side. So a patient and a provider who are in an existing relationship as patient and provider, we work with them each separately. They share their narratives and then stand up and hear each other. And again, it's playing with those boundaries that's sort of taboo in medicine to think we'd ever learn anything personal about our provider. But it's playing with it in a safe way, in a contained space, and it's really trying to showcase the humanity of both patients and providers. I mean, healthcare is a mess right now, right? Providers are so burned out, and patients are not happy either. So to bring them together and to have them really celebrate the humanity of both and then also insert something new into that relationship going forward, I think is really powerful. So, like, our annual event this year is all about patient and provider stories. And it's April 6th, but it's. And it's really because in response to sort of where we are right now in healthcare at this, I think a tipping point of, I don't know, it's becoming increasingly corporate. Primary care doctors are very frustrated and leaving in hordes, and patients aren't getting what they wanted and healthcare is getting more and more expensive. So there's this tension, and stories can really break through that and humanize. And so that's another. Yeah, healing, collective healing.
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Ray Spadoni
That's. That's an incredible amount of very impactful work. The first responder story is not one I've heard and frankly thought about. And so I think that's probably, probably many people could make that statement, which is why I think it's so important that you're doing this work. That's great. And the healing of the relationships between the first responders and those whom they respond to is a side of this that's, I think, interesting and something to think about. I think probably there are corollary and similar examples in other areas as well that run through criminal justice and healthcare and lots of other places. But you've leaned a bit into the system side of this, and so maybe we can talk a bit about that. And we're complicated, multidimensional. You ran through many of the various sort of dimensions to the stories and to the work. And as I listened to your audiobook, I heard you describe the notion of the importance of an integrated approach. I hear a lot of integration in your work and in the work that Jonathan Adler does as well. But our system is often very much fractured. Dots don't connect together in an effective way. I suspect you agree with that. Can you talk a little bit about what you've seen as a physician in terms of the challenges of being in such a fractured system and what that results in for your patients?
- [32:46]
Dr. Annie Brewster
Yeah, I mean, it's so painful. It really is. Because I think, I mean, I'm speaking as a primary, a past primary care doctor and somebody who still talks with a lot of primary care doctors and most doctors, I think in general would want to really offer a more holistic healing environment where it was about psychological health, spiritual health and physical health, but the system just doesn't allow for that. Right. So because of the time constraints and the way we're trained, it's really about sort of diagnosing and then more thinking about like curing, can we cure this? And there's less of a focus on sort of healing in a more general way, more holistically. And you know, as I spoke about, like with the diagnosis that is life changing and that the system really isn't set up to help us with that piece of like, oh, what do I do now? I leave your office and I have no idea what to do or how do I integrate this? And it takes, it's a long process and it takes time. And I'm not saying that physicians can do all of that, but I think the health care system could do a better job of having more programs to help people with those pieces. And so Health Story collaborative in a way, is trying to address some of these gaps. I also think, you know, just. I like the word fractured that you used. You know, the system is so fractured. If you look at all the different sort of siloed specialties. So you're a patient in the hospital and you might have like, you know, four different specialties involved in your care and they're not necessarily talking amongst each other. And you know, it's rare where there's like a team approach where everyone's unified. We did a story once with people who a kidney donor and a kidney recipient that was really interesting. But one thing they were talking about is how actually the transplant community is one that's quite holistic. Like there is you feel more held patient and provider and they care about your psychological well being and it's just much more comprehensive. And some cancer centers have that, but some don't. So I think that fracturing where you can start to feel like a body part rather than a person in the hospital and your lung doctor might be an expert in your lungs, but they're thinking about your lungs, they're not thinking about your mind. And primary care doctors are the ones that are supposed to hold this all together and be the, you know, gathering the different opinions and seeing all of you. But they're just way, way, way too overextended right now. So that can't happen the way the system is. So something needs to change, but I, I don't know how to get there, but. So we're trying with Health Story Collaborative to create some opportunities for other types of healing. But, yeah, I wish the health care system could do more. I think it is going to have to change. I don't know, you know, way more about this than I do, Ray, about how systems can change, but it's very broken right now and it is very fragmented.
- [35:54]
Ray Spadoni
Well, you know, this is the, this is a matter for, you know, policymakers, politicians, you know, economists and, you know, there's a lot of, there's a lot of world building associated with solving this problem in a lasting manner. But let's bring it down to the issues of. You mentioned. Physicians are way overworked. There's a growing shortage of clinicians, especially primary. You use the term burnout several times, and this is a big and important problem. Some folks look at the pandemic we've had and felt as though that was. That exacerbated the problem, and it probably did, but it didn't cause it. This had been brewing for a while.
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Dr. Annie Brewster
Yeah, absolutely.
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Ray Spadoni
Yeah. Bigger issues at play in terms of how we finance healthcare and so forth. So you and I aren't going to solve this problem today. And things like the Health Story Collaborative may solve them as you motivate the hearts and minds of people who see what happens when you can integrate the whole person together and put them together and support them in ways that, that bring about their benefit and true healing. But let's talk about those high schoolers and college students who are thinking about going to medical school and, you know, because these issues exist and they're not going to be resolved by the time they get to medical school or come into practice. What advice do you have for them so that they can have their eyes wide open so that they can be successful? What do they need to retain the proper amount of balance in their lives so that they can engage in this work and do it in a way where they don't end up? Another statistic of someone who did her for a while and then left for greener pastures.
- [37:52]
Dr. Annie Brewster
Right? That's a great question. I don't want young people to be discouraged away from a career in healthcare, I do still think it's like a wonderful job and as I said at the outset, like a unique privilege to really be invited into people's turning point moments. I always say I teach medical students and I always say to them, like, remember when you go in the room with your patient, you are going to become a character in that story and potentially a very big character. And so how you are in those moments matters. So that's like a huge responsibility, but it's also a huge opportunity and privilege. So anyway, I say, I'd say it's still a career worth pursuing, even if it's in a mess right now. And maybe the fact that it's in this tipping point moment is an opportunity for change. Something's, you know, and the people going into the field are going to be involved in that change. So I guess my main advice would be like, think, don't forget about the relational aspects of care. Like that to me is the number one thing. We've become so much about efficiency and diagnostic accuracy and all those things are super important. But I think what has been lost is sort of the relational aspect of medicine. And I think that's going to sustain physicians from whether you call it burnout or it's also been called moral injury because they, they want that meaning and that connection and it's also going to be better for the patient. So that would be my biggest advice is like, just remember the relational aspects of care. Do not forget about that. And things are going to push you away from that and you're going to be so busy. But we need to make healthcare more relational. We need and, and providers need to be talking amongst each other more and cre. There needs to be space built into the system for the, for them to share stories together and for them to have time to listen. We just need to hear each other's stories more. We need more time for that. We need more relationship building. I don't know. Again, it's a systems issue, but I think going in with those things top of mind, I think will help people who are entering the field and this is an opportunity for them to make change, because it has to change.
- [40:02]
Ray Spadoni
I completely agree. It's a relational issue. And we live in an age where we've never been as connected to each other through technology. But the pace of our lives, the pace of information that's coming at us and how much we have to process and the ways that we actually do have relationships with each other has changed quite a bit through the years. And in many ways that increasingly are being found as unhelpful. And storytelling slows us down. I mean, you have to commit to, to hearing someone's story. And our initial instinct, based on how we've been, you know, our behavior has. We've acclimated to the, to the pace, into the world. Our. Our instinct might be not to listen, but to hear the story. Not only slows us down, which is good for us, but it. It helps us to contemplate at a deeper level issues of meaning that, you know, we're all just skating across the surface, unfortunately. And I. This all resonates with me because storytelling changes the pace and invites us not just to skate, but to go down deeper.
- [41:17]
Dr. Annie Brewster
Absolutely. Absolutely. And, you know, I think your point about, like, we're more connected than ever in some ways, but. But it's very superficial. Like, those aren't narratives, the, like the text or the, you know, whatever digital platform it is, they're curtailed and we're racing through them and we're not really absorbing. So it is creating that time and space for deeper sharing and deeper listening and reflection that I think is really at the heart of what we're trying to do and just really fighting for that space. We have to. And I think everyone benefits if they slow down, but I just think it's hard to find that time and space in this day and age.
- [42:00]
Ray Spadoni
Yeah. And that might be the response to the question that I want to ask you, which is based on who listens to this podcast. So it's pretty much current and emerging leaders of healthcare and other types of social service organizations that are mission driven, and it's folks who are inclined towards wanting to help improve the lives of the folks who are served by their organization. Sometimes it's as a volunteer, members of governance, those who contribute financially, and of course, those who work at those organizations. Do you have a perspective or maybe any advice for them so that they can be more powerful or rather more effective and impactful in their work?
- [42:46]
Dr. Annie Brewster
I think, number one, I would say listen, be a good listener. And again, our culture doesn't always support that because we're so, like, action oriented and we think that listening is passive, but it's not. And I think there's nothing more empowering than feeling like someone is really listening to you, seeing you, hearing you. So in terms of relationship, it's going to really strengthen a relationship if someone feels like you're really listening. And we just don't do enough listening today. Even if we're in conversation, often we're thinking about the next Smart thing we're going to say before the other person's done instead of like giving time to pause and really hear it and respond to it. So I think listening is key. And then I'd also say, like, risk. Don't be afraid to risk vulnerability. I think if you open up yourself and share, obviously to the degree that you're comfortable about who you are as a person, it invites others to do the same. So it's going to deepen any conversation and it's going to deepen trust and I think it's going to make things more effective. So I think those are the two things I would say that's great.
- [44:03]
Ray Spadoni
I love that. And I think a willingness to share the story is, in my own experience, surprisingly a good starting point to invite someone to share their story. You know, it's, it can be a little bit of these, you know, like, who's going to go first? And, you know, let's just keep it, let's just keep it on the professional level and we're just doing what we're doing. But when someone is willing to share this story and their vulnerabilities and what they've learned, you know, I am often surprised at how that becomes the initiation of a better conversation for everybody beyond simply the storyteller. But the ones who hear then want to share their stories.
- [44:45]
Dr. Annie Brewster
Absolutely. Absolutely. And sort of related to that, I'd say, like, as a culture, we're really bad at asking for help. We are so independently minded that, that we think we can't ask for help. But I think asking for help is another way of sharing vulnerability and it opens everything up and it makes the other person feel really good and feel like they can give back in a way. It just, I think it's just a really good thing to do. I'm, I'm, I have a lot to learn. I'm not very good about asking for help. I'll admit that I'm good at being vulnerable about certain things, but it's hard for me to ask for help. So that's something I'm striving for too, is like, it's actually an opportunity for others to say, hey, I actually can't do it all myself.
- [45:28]
Ray Spadoni
Yeah, well, I, you know, I was very much struck when I read your book and we had had an earlier conversation by something that I've already mentioned in this podcast, which is how integration is such an important part of this. So you're a physician and you're a patient and you are a scientist who has collaborated with Jonathan Adler that has brought forth the research into this piece of it. But he's also into theater, and that has helped folks get their audience. And, you know, visual artists often say that until you exhibit something, it's not really art. And so what becomes of a story once you give the storyteller an audience? It takes on a very different form. And this, again, sort of, this theme of how pieces come together is, I think, unique today, and I think it is very, very powerful.
- [46:25]
Dr. Annie Brewster
Thanks, Ray.
- [46:26]
Ray Spadoni
Yeah, I really appreciate that. Yeah. And I. And I appreciate you, Annie, and the fact that you're willing to tell this story, and I am. In the show notes, I'm going to give folks a way to get in touch with the Health Story Collaborative and a link to your book. You know, there's so much to this, and this podcast has been, you know, my attempt to be an introduction. I have a feeling that there are folks who are going to hear this episode and click on those links. That said, you know, any closing thoughts or any remarks you'd like to leave our listeners with, and then I'll finalize the whole thing by saying, if people do want to learn more beyond the Health Story Collaborative or. Or your book, what's the best way that folks can get in touch with you?
- [47:18]
Dr. Annie Brewster
Yeah, so the best way to get in touch is through our website and it's www.healthstory collaborative.org. and you can find my email there. You can find just our information email, but it will get to me. So that's a good way. I guess my final thought would be just to encourage people to think about sharing their stories and that that's. There are a lot of different ways to do that. So the book I wrote, because it has all of our prompts and they're all there, and it talks about the research and people can use that and do that independently if they want to at home. But I would say I still do think there's something really beautiful about the sharing, but you don't have to share. It can be really helpful to have somebody else be a reader, at least to help ask you probing questions and. And deepen the process. But you can do it on your own. Also, I'll say that we've done this even though the Healing Story Sessions model is pretty writing heavy, we've also done it with people who are not literate, and we've done it just all orally. So you don't have to write. And if you are going to write, you don't have to be, quote, unquote, a writer like Anyone can do it. We really, you know, hold your hand through the process and we do it in audio, just audio storytelling sometimes. So there are a lot of different ways to do it. I have a program I'm doing right now with a place called the Boston Homes in Boston, which is for people with neurologic disorders. And we've been doing healing story sessions there. We have a grant and we've had to adapt a lot because people have a lot of limitations. Not everyone can write on their own. So we've found other ways to work around that. So there are lots of ways we can do it. Most importantly, we don't want it to be limiting to anybody. So it doesn't all have to be one way. We also have a blog people can share there. We have, you know, we love art as a way to share. So there are lots of different ways to share. So I would just encourage people to dig into your stories a bit. Some people say, oh, I don't really have a story, but everybody has a story and it's meaningful. So great.
- [49:22]
Ray Spadoni
Well, thank you so much for your time. I would for sure encourage listeners of the podcast to check out those resources. There's a lot there. And you know, much of this can be useful to work groups, can be useful to the organizations where our listeners are working or supporting, but there's also a personal dimension to this that can be very fortifying and healing as well, because storytelling is very important to healing and I believe that myself. And I know you do. So thank you so much for your time.
- [49:59]
Dr. Annie Brewster
Thank you, Ray. I will. Can I add one more thing? We do, we do do trainings for organizations too. We do like a train the trainer model. So I should have said that because I think there are a lot of ways this can be integrated into work environments. So.
- [50:13]
Ray Spadoni
Excellent. Yeah, super glad you mentioned that. That is. I'm actually going to check that out myself in a little bit more detail because I think that would be a very useful thing. So again, Annie, thanks so much.
- [50:26]
Dr. Annie Brewster
Thank you so much, Ray. It's been a pleasure.
- [50:28]
Ray Spadoni
Awesome. Thanks for listening. I hope you'll consider leaving a five star review on Apple Podcasts or your platform of choice that will help others find us here. My mission is to help empower organizations that matter by supporting those who lead them. Feel free to learn more about me and my work atredsale advisors.com.