Erica Wrightson reflects on Sayantani DasGupta's workshop on narrative humility and medical listening in oral history. This talk took place on Thursday, October 16, 2014.
“When was the last time you felt truly listened to? Not just heard, while somebody was texting, but deeply attended to….That sort of relational moment—that sort of being seen and being heard and being made to understand that we matter in this world—that is one of our fundamental human needs.”[1]
Medical humanities educator and writer Sayantani DasGupta has thought a lot about paying attention. When DasGupta was in medical school she was taught bedside manner in a class without an instructor. Instead, students watched a prerecorded video in which a white-coated physician seated at the end of a long table explained how to listen. As technology has improved and increased in clinical settings, the nature of communication between doctor and patient has changed. Back in the day, a doctor would set out with his black bag in hand to visit a patient in their own home, but these days there is so much technology between doctors and their patients that sometimes a doctor will not have physical contact with his patient in the course of an appointment, but instead make his diagnosis from behind a screen.
Speaking to a packed room for the 2014-2015 Oral History, Medicine, and Health Workshop series at Columbia on October 16, 2014, DasGupta discussed the role of oral history in narrative medicine, a medical approach and master’s program at Columbia that aims to change the way care is given and received by valuing the stories and experiences of patients and caregivers. If you want her short answer to what it means to be a narrative medicine instructor, Sayantani will say, “I teach people how to listen.”
DasGupta’s mantra is “stories matter,” and this, she explained, has to do with the fact that “stories are also about power” and they demand that we ask questions regarding stories, such as “Whose story counts? Who owns the story? What voices or stories go unheard? Who gets to speak and who is perpetually spoken for?” But while stories should be valued, DasGupta emphasized the importance of not getting too precious about storytelling. “Stories aren’t inherently magical or healing or just,” she said. Quoting writer Chimamanda Adichie, DasGupta reminded us that stories can dispossess and malign as much as they can be used to empower and humanize and that “people should be able to define and not define their bodies as they will.”
DasGupta believes that we need spaces for intersection of storytelling and medicine and that all clinical trainees should be trained in oral history. To teach medical listening through oral history, which she describes as a form of qualitative research, she encourages her students to interview someone with an embodied condition that they’re willing to talk about and to focus on life history, not clinical history. The oral history approach is effective, said DasGupta, because it doesn’t ask people to talk about their illness; patients are encouraged to speak about themselves and their lives as they wish.
It’s not only important to learn to listen to others, but to listen well. Oral history methodology is useful to medical professionals because it teaches humility, sensitivity, and attention to nuance. “Listening is not a one-size-fits-all activity,” she said, and being sensitive, adaptable, and responsive is crucial. She arrived at her concept of narrative humility through oral history, which teaches us that stories are “relational events, with real live people on both ends of them!”
“We have a perspective of stories as fixed objects that don’t change in time,” she said. “We think of stories as immutable, non relational facts to fixed repositories of truth, like statures we carry around.” According to DasGupta, “bad historian” is actually a term doctors use for patients they don’t want to talk to, people they’d rather analyze through numbers and medical records instead of firsthand accounts of self. It’s important for people to feel that they can be trusted to tell their own stories, that they are reliable narrators, and that they will be believed. Oral historians privilege memory and experience over fact, valuing even the narratives of “bad historians.” As the great oral historian Alessandro Portelli has said, oral history allows us to see "through and beyond facts to their meanings.”[2] A former student of OHMA professor Mary Marshall Clark, DasGupta claims “oral history has taught me so much about this demand for narrative truth.” “Instead of teaching people how to look like they’re listening, let’s teach them to listen.”
To find out more about doctor, writer, and educator Sayantani DasGupta, see her website.
For information about our upcoming discussions, see the 2014-2015 schedule here.
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[1] See DasGupta’s TEDxSLC talk "Narrative Humility: Listening as Social Justice."
[2] Alessandro Portelli, “The Death of Luigi Trastulli: Memory and the Event,” in The Death of Luigi Trastulli, pp. 1-26; quote from p. 2.