Storytelling for health care workers: “If you aren’t scared, you can’t be brave”

Laurel Braitman, PhD, leading a writing workshop for the Stanford University School of Medicine's clinical students at Soul Food Farm in Solano County, California. In 2020, Braitman started a virtual writing workshop for health care workers.

Courtesy of Laurel Braitman, PhD

A couple dozen squares populated the Zoom room on a Saturday morning in July 2024. Several were blank, showing only the names of the participants. Others revealed the faces of the health care workers logging in from their living rooms, backyards, and offices across the United States, and even across the Atlantic Ocean.

Laurel Braitman's square lit up as she welcomed the attendees and reminded them of the guidelines for participating in Writing Medicine, a virtual writing workshop for health care providers and their loved ones.

"Kindness before all things, and no apologies allowed," she said.

Braitman then encouraged the attendees to allow themselves to step out of their comfort zones as they embarked on the one-hour session.

"If you aren't scared, you can't be brave. So, if you feel uncomfortable at any point during this hour or on your own when you are trying to engage in creative practice, just know that's doing it perfectly," she said. "Getting stuck is a rite of passage. Getting stuck is often the very feeling of writing itself. I tell this to my students all the time."

Braitman, who holds a PhD in history, anthropology, and science, technology, and society from the Massachusetts Institute of Technology and is the director of writing and storytelling at the Stanford University School of Medicine's Medical Humanities and the Arts Program, teaches creative writing classes for clinical students, medical trainees, physicians, nurses, and other health care professionals. She's also written two books of her own: Animal Madness: Inside Their Minds and her memoir, What Looks Like Bravery: An Epic Journey Through Loss to Love.

Although the sciences and the humanities are often relegated to separate university departments, many medical schools offer courses in the arts and humanities and encourage students and faculty to express themselves and expand their talents in these areas.

In fact, a 2018 report by the National Academies of Sciences, Engineering, and Medicine, a committee entrusted with examining the effect of integrating the sciences and humanities, found that integrative approaches in higher education showed promise for improving communication skills, problem solving, ethical decision-making, empathy, and personal enrichment.

The AAMC also provides resources for medical schools to support incorporating the arts into curricula through the Fundamental Role of the Arts and Humanities in Medical Education (FRAHME).

But Braitman created Writing Medicine, the Zoom writing workshop, to reach beyond the students and faculty in her program and be available to health care workers and their families everywhere.

She started the virtual community in the early days of the COVID-19 pandemic.

"It was back in the Tiger King and sourdough-bread stage of the pandemic, when we all thought it was going to be just a couple of weeks," Braitman tells AAMCNews.

Her idea was to offer a free workshop for health care professionals and their loved ones every Saturday morning, to help participants connect and cope in a time of isolation, fear, and grieving. Although she barely advertised, Braitman recalls that around 150 people logged on to the first Writing Medicine session in March 2020.

"Frankly, I wanted to feel useful, and I am not a frontline health care professional, but I wanted to figure out a way that I could support them," she says. "And those were really scary days, when there was no PPE, a lot of health care professionals were getting really ill, people were dying, there was triaging in the parking lots. So, people were coming on [to the Zoom meetings] and it was a place for them to hear other people's fears and to share their own."

Over the years the workshop has fostered friendships, cultivated writing that has been published in a range of outlets - from the Journal of the American Medical Association (JAMA) to McSweeney's, a satiric online publication - and has amassed a regular attendance that has pushed Braitman to continue hosting it after the pandemic passed.

Braitman has thought about winding down the program, but she's often reminded about how valuable it is, especially for health care workers, who she says "are on the frontlines of the human experience." She offers them a welcoming place where they can be vulnerable about the struggles that come with their profession.

"I'd say that the average feedback I get is just, 'God, I needed this!' and 'Thank you for giving us a protected space to be able to share some of these things with people who get it and understand,'" Braitman says.

Although the workshop is no longer free (Braitman asks for $25 per session but offers free registration for those who have a financial need) and it is now twice-monthly rather than weekly sessions, it continues to draw about 30 regulars, as well as a few new participants.

On that Saturday in July, about two dozen attendees joined: one a third-year psychiatry resident fresh from treating her first psychotherapy patient, another a physician calling in from her office at the hospital, and still another, a second-year medical student attending the workshop for the first time.

They listened as Braitman shared several tips for getting out of a creative slump:

1. Remind yourself that even great writers struggled. Braitman quoted The Grapes of Wrath author John Steinbeck's journal entry: "I have been remiss and lazy, my concentration I have permitted to go under the line of effort. If this had been the first time, I should be very sad. But I am always this way."
2. Go see someone else's finished work, whether that be a museum exhibit, a poetry reading, or a live concert.
3. Move your body; it helps the mind. Braitman said she sometimes gets her best storytelling breakthroughs while walking without checking her phone.
4. Change your font or writing medium (from computer to paper or notecards, for example). Small changes can spark creativity and get the mind unstuck.
5. Try a writing prompt: a question or topic to start the words flowing.

Over the next 45 minutes, Braitman led the group through a series of writing prompts and reflection activities. The first was to write a prayer to the higher power of their choosing.

Maria Shibatsuji, DO, a psychiatry resident at Loma Linda University in California, volunteered to read hers aloud:

"God, here is my chaos. The intense emotions, the endless to-do lists, and all the adulting tasks in between. I am tired, frustrated, stressed, and in need of emergency chocolate and a nap. Help me step away from the storm and let me be present to my patients in their moments of darkness, joy, and aloneness. Help me be the vessel for healing. Help me reflect your love and compassion. May they feel less isolated and their hearts be filled with hope, connection, and belonging. Amen."

"'God, here is my chaos.' Oh my goodness," Braitman reacted. "Your current patient and future patients are so lucky to have you … and please keep writing. Everyone here has heard me say this many times, but nothing is going to hit like the things that you do for the very first time. There's a future version of you that's really going to want your notes and your stories before all of this becomes routine and not scary. Please keep writing. That was delightful."

The next prompt was, "If I weren't scared, I'd write X." After seven minutes of quiet scribbling, Michael Eselun, who is the Dr. John Glaspy Chaplain in Oncology Care at the Simms Mann University of California Los Angeles Center for Integrative Oncology, read his piece about his husband, Scott, aloud:

If I weren't scared about sounding like an asshole, I would write about Scott's Parkinson's Disease.

I am not the person I want to be, imagined I'd be, thought I was... I am this guy. Who barks with such ferocity at Scott who is lost and confused … losing control. Such ferocity that I must break my tether to the chair. I need to stomp around the house, unable to contain my rage in the chair, as I scream at him through the phone. "NO, Scott! I just told you! Ask someone nearby which direction is Wilshire!" "Excuse me," I hear him say to a passerby, while his phone is out of his earshot, impervious to my screaming. "Which direction is the beach?" "NO! Scott! Scott! Scott! Not the beach! Wilshire! Which direction is Wilshire!" He can't hear me. So, he gathers new information from the stranger that only confuses him more. It doesn't keep me from screaming or stomping. It only becomes more urgent. Marching from room to room seems the only way I can slowly detonate the time bomb I carry. I live with. We live with.

Eselun's voice broke, and he began to cry.

"Michael, it's almost too much to bear," Braitman said. "This is a many-decades love letter you're writing. And it's so real. It's so painful. It's so brave of you to share. I think you're making so many other people feel less alone. I just can't thank you enough. I wish we could help."

"You did help, by letting me share it," Eselun said.

Others shared their writing and their grief. One attendee spoke of the fresh sorrow from the death of a colleague. Another wrote about his fear of losing his humanity in his pursuit of becoming a physician.

As the hour drew to a close, Braitman left the attendees with a prompt for their homework and encouraged them to keep expressing themselves through writing.

"We only have three minutes left, which is just terrible. I've had every feeling today. I don't know about you," she said. "I feel exhausted, but also better."