The Consultation That Changed Everything
Ana entered the office expecting the standard 15 minutes: symptom description, prescription, goodbye. She had been treating migraines for five years with different medications. They worked for a while, then stopped.
But this time was different.
The doctor started with an unusual question: “Tell me about a typical day for you.”
Over the next three hours (yes, three hours for the first appointment), he wanted to know about:
- Her work routine
- Sleep quality
- Nutrition
- Family relationships
- Sources of stress
- Moments of joy
- Past traumas
- Dreams for the future
Ana left without a prescription that day. She left with a comprehensive care plan that would change her life.
What Is Narrative Medicine?
Narrative medicine is an approach developed by Dr. Rita Charon that recognizes: each patient is a unique story, not a set of symptoms.
Pillars of practice:
- Attention: Deep and present listening
- Representation: Documenting with narrative richness
- Affiliation: Genuine doctor-patient connection
Why Does Storytelling Heal?
Neuroscience of narrative:
- Telling your story activates brain areas of emotional processing
- Naming experiences helps regulate emotions (neuroimaging confirms)
- Coherent narrative = fewer PTSD and depression symptoms
Studies show:
- Patients who write about traumas have:
- Fewer medical visits in following months
- Better immune function
- Better control of chronic diseases
- Greater treatment adherence
Three Types of Illness (That Traditional Medicine Confuses)
Medical anthropologist Arthur Kleinman distinguishes:
1. DISEASE
- The biological pathology
- What appears in tests
- Technical medical language
2. ILLNESS
- The lived experience of disease
- How the person feels and interprets
- Impact on identity and daily life
3. SICKNESS
- Social dimension of disease
- How society/culture sees and responds
- Stigma, social roles, cultural meanings
Practical example:
- Disease: HIV positive (test result)
- Illness: “I’m afraid to tell my family”
- Sickness: Social discrimination, job loss
Medicine Is Forgetting to Listen
Alarming data:
- Average time before doctor interrupts patient: 18 seconds
- Average consultation time in public health systems: 7-10 minutes
- Percentage of doctors who make adequate eye contact: 30%
- Patients who feel they were truly heard: 40%
Consequences:
- Incomplete diagnoses
- Non-adherent treatments
- Patients who “wander” between specialists
- Excessive medicalization
How to Be the Protagonist of Your Health Story
Prepare for consultations:
Before:
- Write your “health timeline”
- Major medical events
- Life context when they arose
- Patterns you notice
- Identify your “essential question”
- Not just “What do I have?”
- But “How does this affect who I am?”
During:
- Start with: “I’d like to contextualize my symptoms…”
- Use analogies and metaphors: “The pain is like…” “I feel as if…”
- Talk about impacts: “This changed my ability to…”
After:
- Write your understanding of the consultation
- Note questions that arose
- Reflect: “Was I heard? Does the plan make sense for MY life?”
Therapeutic Writing Tools
Exercise 1: Letter to your illness (20 minutes)
- “Dear [disease/symptom]…”
- What do you want to say to it?
- What might it be trying to teach you?
Exercise 2: Expressive writing (James Pennebaker technique)
- 15-20 minutes, 4 consecutive days
- Write about difficult health-related experience
- Explore deepest thoughts AND feelings
- Don’t worry about grammar, no one will read it
Exercise 3: Rewriting the narrative
- Version 1: “I am a victim of [disease]”
- Version 2: “I am facing [disease]”
- Version 3: “I am learning to live with [disease]”
- How does each version change your sense of agency?
Finding Professionals Who Listen
Signs of good narrative practice:
✅ Asks open questions: “Tell me more about that” ✅ Uses your words back: “You said you feel ‘trapped’…” ✅ Asks about context: “What was happening in your life when this started?” ✅ Validates emotions: “I imagine how difficult this must be” ✅ Explores meanings: “What does this disease represent to you?”
Warning signs: ❌ Constantly interrupts ❌ Only looks at computer ❌ Dismisses complaints: “It’s just stress” ❌ Only uses medical jargon without translating ❌ Rushed, irritated, disinterested
Ana’s Story (Continuation)
Remember Ana and her migraines?
Through narrative, the doctor discovered:
- Migraines started after mother’s death (unprocessed grief)
- Intensified before visiting mother-in-law (family conflict)
- Improved when painting (had abandoned this hobby)
Integrated plan:
- Grief therapy
- Family mediation
- Resume painting 2x/week
- Mindfulness to deal with triggers
- Medication only in acute crises (not daily preventive)
Results in 6 months:
- 70% reduction in crisis frequency
- When they occur, less intense
- Feeling of “getting her life back”
Conclusion: You Are More Than Your Symptoms
Narrative medicine reminds us: you are not “the diabetic in bed 3,” “the fibromyalgia patient,” or “complex case.”
You are a person with history, context, relationships, dreams, and unique meanings.
And this story matters—not just to humanize care, but because it may be the key to your healing.
Is your health story being heard?
If not, perhaps it’s time to find someone who knows how to ask: “Tell me your story.”