“He’ll make a good story”.
The attending’s observation claimed my attention in two ways. First – “He’ll make a good story”.
Notice how often we use the word ‘good’. ‘Good’ is frequently part of the etiquette as we pass each other – “Good morning” . . . “Have a good day” . . . “Have a good one”. ‘Good’ is also heard in conversations about our work – “Last night was a good night” . . . “Good job” . . . “We’re a good team” . . . “That’s a good patient mix” . . . “She’s a good candidate”.
When I hear ‘good’, I find myself wondering about the criteria. When appropriate, I ask – “What do you mean by ‘good’?”
What do we reveal about our values, our priorities, our goals when we call a day, a shift, an action, an experience, a position, a colleague, a candidate, a patient ‘good’? How often do our criteria include the ethical dimensions of patient care – e.g., trust, respect, honesty, gentleness, privacy, fairness, empathy, advocacy, integrity, . . .
Second – “He’ll make a good story”.
It seemed obvious the attending did not mean a good case presentation. A good case presentation is organized, concise, informative, orderly, clear, objective. A good case presentation maintains format, gives “just the facts”, highlights relevant details, does not wander, clarifies “the big issue/s”, leads to “the plan for today”. A good case presentation answers the question – “What do I/we need to know?” You learn quickly (sometimes painfully) – “If your summary takes more than one breath, it’s too long”.
A good story has plot, angle of vision, suspense, theme, humor, texture, memorable characters, feeling, rhythm, place. A good story entertains, educates, preserves, tantalizes. A good story ‘draws you in’, stirs the imagination, has punch, calls for a verdict. A good story is hard to forget.
Patients are stories. They rarely come to us with good case presentations in hand. They, their families, their friends draw our attention to what is unique, special, more about them – e.g, “She was a nurse for forty years” . . . “He was only fifteen” . . . “She’s a classy lady” . . . We become part of their stories – most of us behind the scenes, some of us as named characters.
Patient stories have to be reduced to a series of case presentations and notes in a chart. We select a few patient encounters to tell as stories from our perspective. Which ones? why? to whom? when? where? how?
