In “The Wounded Storyteller” (ISBN 0-226-25993-5) Arthur Frank describes his study of how patients talk about their illnesses, where he identified three major “genre” of narrative which we use to talk about illness – the “restitution story”, the “chaos story” and the “quest story”. I thought that was such an interesting insight and such a wonderful ideal to aim for.
Most patients tell the restitution type of story. It goes along the lines of “I’m broken, please fix me”. Our whole health care system seems created around this idea. Patients present their broken bits for fixing, the fixing is the outcome or target to be delivered cost-effectively, doctors are seen as the fixers and the process of health care is experienced as a passive one by the patient.
The chaos story is also very common. Frequently we become overwhelmed by not only the illness, but also the diagnosis and the treatments. In a chaos story a patient is lost in an ocean of suffering, confusion and distress. As they tell their story it comes tumbling out in all its complexity and it can be very hard to see the person who is suffering from the vast intense collection of symptoms and problems. Indeed, even the storytellers can’t find themselves any more in the middle of this terrible experience.
Frank proposes a beautiful alternative genre of story to tell – the “quest story”. A quest story has certain clear elements and they are the ones you find in “hero stories” in all cultures around the world. The “hero”, he proposes, is the patient. Their quest is health. The adventure is the illness. As the patient encounters various investigations, diagnoses, symptoms and treatments, they are experienced as challenges which need to be met in order to gain “boons”. It’s the gaining of these boons which grows the hero into the person who can attain the goal of the quest. (Think of the traditional tale of the prince who wants to marry the princess but first is told he needs to slay the dragon, overcome the wicked witch, and so on, before he can become the man worthy of the princess’ hand in marriage).
One of the best examples of this is Lance Armstrong‘s autobiographical “It’s not about the Bike” (ISBN 978-0224060875). Lance is a professional cyclist who was a great sprinter but when he tried the Tour de France he found he didn’t have the stamina for it. He developed testicular cancer with widespread metastases and was given only a slim chance of survival. He underwent surgery and chemotherapy successfully, became depressed by the whole experience, then got back on his bike. A year later he entered the Tour de France and won it. He went on to win it eight times in a row – more than any man has ever done before. In his book he says if he’d had to choose between cancer and winning the Tour, he’d choose cancer every time. That shocked me when I read it. He went on to explain, cancer and dealing with it made him the man who could win the Tour de France. That’s a quest story! (let me be clear – he’s not advocating cancer as a good thing, something to be welcomed, or worse, sought – he’s telling the story of how dealing with a serious illness can actually grow us, ultimately changing our lives for the better)
The challenge, I think, is to find a way to live, which is a quest story in it’s own right……to become heroes, not zombies.
[…] of Generosity” (ISBN 978-0226260174). Many years ago I read and was hugely impressed by his “The Wounded Storyteller”. It’s a great small book which is an important contribution to the struggle to create a […]
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[…] is a crucial part of health care, which is sadly, all too frequently absent. The “restitution narrative” of quick fix, sort out the broken or troublesome part, reigns supreme. Yet illness remains […]
[…] of the first books I read which impressed me about the importance of stories in medical work, was Arthur Frank’s “The Wounded Storyteller”. In this book, which is the product of years of research, Frank claims that there are two very […]
[…] tell us and what the person is experiencing. A person’s experience can be communicated to us by their telling of their story – which has the additional benefit of allowing us, together, to make sense of what is […]