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  • 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)

  • Laurel Braitman: Physicians' 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, what 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.

  • LB: 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.

  • LB: 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.

  • LB: 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.

  • LB: 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 [where] 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.

  • LB: 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 the 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)

For the last few years,

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医療従事者のためのストーリーテリングの精神衛生上の利点|ローレル・ブレイトマン (The mental health benefits of storytelling for health care workers | Laurel Braitman)

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    林宜悉 に公開 2021 年 01 月 14 日
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