In a bookshop frequented by Grumpy Midwife there is a sign, propped up on a table piled high with the lives of sports personalities, politicians and pop stars:
Do not read history, read biography – because biography is life without theory (Benjamin Disraeli)
Or, to paraphrase very loosely: Read the lives of people because it is people and their stories that help make sense of life, the universe and everything.
In another persona, Grumpy Midwife is Grumpy Novelist and a Great War geek. She really does know a ridiculous amount about trench warfare and Tommies and Haig’s twisted thinking during the Battle of the Somme. And the source of all this knowledge? Stories. The stories of individual men and women. Diaries. Letters. Dramas. Novels. Biographies. Because without stories, quite frankly, the theory (to channel Mr Disraeli) is actually rather boring.
And so it is when we think about healthcare.
It’s all so big. So complicated. So messy. What’s an STP, for goodness sake? And what does CQUIN stand for? Or STEIS, for that matter? 697,852 live births in England and Wales. 1.82 children per woman. CS rate 27%. So what?
Four years ago Grumpy Midwife (ahead of the curve and first in the Costa queue as usual) wrote an essay for some academic course or another on the power of stories shared by midwives and obstetricians. Sprinkled with impressive references (available on request) this was the gist of what she wrote:
Stories … enable us to share events and give meaning to those events as if we were ourselves participants. Stories also help capture the complexity of practice and provide opportunities to share tacit aspects of practice. Stories … can offer serendipitous glimpses into the world of others. Stories add humanity; a story told against the teller engenders feelings of warmth and trust towards her.
So imagine GM’s smug grumpiness when she read recently (courtesy of The Health Foundation) of the transformative power of story telling; how when we listen to someone telling their story we begin to “see the world as they see it, walk in their shoes”. We start to empathise; we experience “narrative transformation” – and stifle sobs as Bambi’s mother dies on screen. Neurologists blame oxytocin for narrative transformation; oxytocin makes us more compassionate, more sensitive to social cues, more willing to help those in need.
According to The Health Foundation, we are also more likely to remember a message embedded in a story than the same message presented in facts and figures; “Statistics and data have an important place in monitoring … but the right story can have the power to motivate and change minds.”
Which all helps explain why stories are useful tools for quality improvement in healthcare; to identify problems, motivate staff, and celebrate success.
So next time you really want to know what a woman thinks about her antenatal care, set aside your F&F cards and your feedback forms and smiley face touch pads and sit down beside her and ask her to tell you her story.
Don’t interrupt. Don’t explain. Just listen.
And then go away and decide how you will use her story to change things.