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“Frontline medical professionals must collectively share what they experienced as a whole. We must piece together these narratives and unearth commonalities to truly know what happened. Just as we must continue rigorous quantitative research on the virus itself, we must also conduct a qualitative examination. In the peri-COVID era, it will be critical to cultivate lasting empathy for the frontline and process the collective trauma that has likewise claimed lives as the virus itself. Only by establishing widespread, lasting awareness will empathy-driven solutions arise and will continued behavior change (e.g., social distancing, wearing face coverings) persist. The act of storytelling comes with the added bolstering of mental health; it is a means of coming to terms with a challenging and rapidly changing work environment being directly in harm’s way with inadequate protective — both physical and psychological — equipment.”
Vibhu Krishna is a medical student.
She shares her story and discusses her KevinMD article, “The mental health benefits of sharing stories.”
This episode is sponsored by Elsevier Health. Looking to update your personal or professional medical library? Shop Elsevier Health’s Holiday Sale and save up to 35% on your purchase of medical books! Plus, you can take an extra 5% off your order with code KEVINMD at checkout. Take advantage of the biggest sale of the year from Elsevier, the world-leading provider of medical books and reference materials. Shop us.elsevierhealth.com now through December 31.
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Vibhu Krishna. She is a medical student, and she wrote the KevinMD article “The mental health benefits of sharing stories.” Vibhu, welcome to the show.
Vibhu Krishna: Thank you, Kevin. I really appreciate you having me here today.
Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?
Vibhu Krishna: Absolutely. So my story is a little convoluted. I came from a humanities and studio art background, so I’m a practicing artist. I realized the role that art has in the health care space and was driven to this intersection of the humanities and human health, and I ended up in medical school.
I am between my third and fourth year here in Manhattan at Columbia University, which, luckily for me, is a champion of narrative medicine. So it’s been wonderful to be here, and it’s been quite the journey being here throughout the pandemic. I’m currently on a gap year where I’m doing health systems consulting work for about a year or so.
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Kevin Pho: And at what point in your background, in your art education, did you decide to make that turn to medical school?
Vibhu Krishna: Yeah, that’s a great question. I think it’s always been, for me, a little bit of both. I always knew I cared about health. There are a lot of physicians in my family, and it’s been a very important thing to be a woman of science and to maintain my own health. So I think it was a mixture of that plus coming across this idea of narrative medicine and of the medical humanities that made me feel like, “Oh, there is a place for me in medicine.” There is also a place for medicine in art, and so it felt very natural.
Kevin Pho: We may talk about this later on, but how has your background in art helped you as a medical student?
Vibhu Krishna: It helped me so much. I mean, from the simple things, like being able to make anatomy drawings, to the more complex things, like empathy and trying to break down a patient’s story, and some of those skills, like synthesis and clear communication. Clear, concise communication, when your attending gives you 20 seconds to present someone’s history. So I think being able to hone in and zero in on information is one of the tasks of an artist, and there’s just so much overlap there.
And also, looking at a physical exam, finding details, finding physical differences and nuances that require keen and close observation, I think that’s another one that art has definitely helped with.
Kevin Pho: All right, so let’s get into your KevinMD article, “The mental health benefits of sharing stories.” Now, for those who haven’t read that article, can you just walk my audience through it and share the story of why you decided to write it?
Vibhu Krishna: I wrote this article, I think, around May of this year, and at that time the pandemic was still raging in New York City. I was seeing some of my own mentors really feeling like they had nowhere to share their experiences. They were going into this battleground ill-equipped in terms of PPE, coming back exhausted, and then doing it again the next day.
And it was almost this thing where talking to them, hearing them share their stories, and having them share them with me and on a platform I created called Faces of the Front Line proved to be very much a coping mechanism for them. So that was the start of it.
And so the article that I wrote for KevinMD basically tracks that: why people didn’t feel comfortable seeking help, or help wasn’t super available to them, and they were facing burnout and fatigue, seeing people die around them. There was even the suicide of Dr. Laura Breen here in New York, which is extremely tragic, and even witnessing your own colleagues getting seriously ill. And so storytelling is a form of coping for a provider, and it has proved all-powerful at this time.
Kevin Pho: I talk to a lot of physicians and medical students on this show, and they share similar thoughts like you: how important it is to share their stories, how cathartic it is. Now, can you give any tips to them in terms of how to write their stories? How can they articulate some of the stories that they’ve seen? Because some physicians are natural storytellers and some aren’t, so what kind of tips can you share?
Vibhu Krishna: Absolutely. So I think the first thing is knowing the audience, right? If you’re synthesizing information to convey to another provider, that story is going to be different than something that you’re trying to share if you’re doing public health messaging, for example, where you need to create buy-in using evidence but using compelling storytelling to get your message across. So knowing your audience is one.
I think the second thing is actually one thing that providers who have a background in science and stuff might actually be more natural at, which is understanding the neuroscience behind it. You have this auditory, or visual if it’s written, input that goes into the auditory and visual cortex, and then you also have semantic natural language processing, which is in higher orders of the brain. We’ve seen studies, fMRI studies, that show it’s not just this left-lateralized area, Wernicke’s and Broca’s area. It goes well beyond that. There are many higher-order processes involved.
And so when you are recognizing that you are trying to light up the same part of multiple people’s brains, how can I do that? How can I convey this clearly so that what I’m thinking matches what you’re thinking? How can I create this common ground, this common alignment? I think the answer to that is really just having empathy, and it’s so hard, but it is a skill. Some people have it very naturally, and some people have to practice at it. But ultimately, what you’re trying to do is create alignment, and that common ground, I think, is one of the true fundamentals of storytelling.
Kevin Pho: Now, you mentioned that you had a website where you collect the stories from other clinicians and medical students about being on the front lines of the pandemic. Can you share an example of a time where a physician may have shared his or her story and how that helped that doctor?
Vibhu Krishna: Absolutely. So I’ll actually give an example of a nurse in Texas who shared their story. Their name is Huston Colby. Basically, they were an ICU nurse, and they had a patient who was at life’s end, and because of COVID, no visitors were allowed. They sent an image, so this is on an Instagram platform, and the nurse is holding up a sign that says, “I’m just going to stay here for a while, hold his hand for a while. I don’t think he has much time left.” Another nurse took that photo and submitted it to us, and then we have the story of the nurses in that ICU unit and how they’ve basically been working around the clock, going above and beyond to provide this sort of empathy-based care.
In one, these nurses got to honor and acknowledge one another. They also got to be seen by the platform, by the audience who reads this. And then the tertiary level to that is what I was alluding to earlier, which is the messaging. We were getting responses on this, on a single image, saying, “Wow, this is what’s going on.” So people are expressing their sentiments of gratitude. They’re acknowledging this is not a hoax. They are saying this is why we need to wear masks. So we’re even seeing it trickle and transform into behavior change and ideological change, and it all comes from this root story.
Kevin Pho: OK, so if I’m a clinician or a medical student and I have a story that I want to share, what is the next step? What are some platforms that you can suggest where clinicians can consume, and medical students, for that matter, can share their story?
Vibhu Krishna: For one, your platform, Kevin. I think you’re a storyteller. I think podcasting is storytelling, and there are actually some interesting fMRI studies on the brain on podcasts, too. And then there are tons of literary magazines. I think many medical institutions have their own sort of publication. There’s, of course, proximity and those sorts of wider-read platforms.
And then you also have the option of publishing books if you want, so we see Siddhartha Mukherjee doing that. And we see a lot of physicians contributing columns to various newspapers, whether it’s a local one or the New York Times or whatever it is. I think there are many, many platforms accessible to us, and all at different levels of readership and localization.
Kevin Pho: We’re talking to Vibhu Krishna. She is a medical student, and she wrote the KevinMD article “The mental health benefits of sharing stories.” So, Vibhu, after reading so many stories from frontline health care professionals and medical students, is there something that you know now that you wish you knew back before the pandemic started?
Vibhu Krishna: I think if I really had to hone in on one thing, it’s the idea of the collective community, and that is that common ground. I think especially New York, but also America in general, is such an individualistic place. It’s kind of every person for themself, and you can go tooth and nail to get whatever you want and achieve what you want. This is not a time for that, right? This is a time for everyone taking the L on one thing or two things and compromising to create safety for the community.
And so when I hear these stories, and I am so moved by what our frontline workers are doing right now, I look to that sense of collectivism and that community and that sense of real, real alignment that we need as a society to overcome this sort of thing. I hope that stays with us past this pandemic.
Kevin Pho: And my final question: What is your take-home message that you want to leave with the KevinMD audience?
Vibhu Krishna: I’d say my take-home message, I’ll leave you with a quote. Hippocrates once said, “It’s far more important to know what person the disease has than what disease the person has.” And that means that we need to have empathy in our interactions, whether it’s listening to the patient narrative, synthesizing the patient narrative to our colleagues, or, in these times, sending out public health messaging about what is going on, about a crisis.
And all of it is based on this root of cherishing our humanity and then really holding on to it, because ultimately, when you’re stripped down of your health, it’s hard to do anything else. And so, yeah, I just think it’s so, so important to keep the person first.
Kevin Pho: Thank you so much for sharing your time and insight, and thanks again for being on the show.
Vibhu Krishna: Absolutely. Thank you for having me.
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