Write About a Time You Changed the Way You Think

One of the activities I’ve been engaging in more with medical friends and colleagues is reflective writing. How it works: You propose a narrative medicine prompt. Set a timer for 5 minutes. Then, write. The focus is not on the grammar or the writing; it’s the reflection, the introspection, the idea. After the 5 minutes are up, you go around and share your answers. This exercise forces you to think deeply. It’s also enlightening to hear other people’s experiences. The goal isn’t polished writing. It’s about reflection and introspection.

This particular narrative medicine prompt is not easy. It encourages you to think about your own biases. It’s hard enough to own up to your own personal biases to yourself, but to talk about them openly in front of others? However, I think it’s essential to acknowledge that we all have areas for improvement.

Using these reflective writing exercises can teach the softer side of medicine. It’s the quiet awareness of how our identities, experiences, and blind spots affect how we practice medicine. Can these qualities be taught, or are they innate? I often wonder.

“Quiet Confidence,” oil on canvas, 9 X 12, 2024.

In this post, I’ll share some of the responses for this narrative medicine prompt—paraphrased and anonymized. Hope you enjoy!

Write about a time when you changed the way you think.

“My patient brought his paper bag full of medications and inhalers to the appointment. I could tell he struggled to manage his lung disease. I thought, “He just needs help organizing his medications!” So, before he left the appointment, I spent 30 minutes typing out a one-page outline of which medicines he should take and when. I was feeling quite satisfied with myself because I thought, ‘I solved the problem.’ But when he came back three months later, he was still not taking his meds correctly. I was frustrated. I assumed he hadn’t even looked at the list. The nurse saw my frustration. She quietly whispered to me, “The reason he didn’t follow your written instructions is because he can’t read.” I hadn’t even considered that this was the issue.” -Pulmonologist

“I once worked with a nurse who had a strong Southern accent. One night, a young man in his 30s came into the ER. He had advanced testicular cancer that had spread to his femoral vein. Blood oozed down his leg, and his blood pressure was dangerously low. He was really sick. His parents insisted we do everything possible. But we knew, even with aggressive treatment, the outcomes wouldn’t change. It would only delay the inevitable. I tried to explain this, but felt like I couldn’t get through. Then the ICU doctor also tried to explain this, but also couldn’t get through. Finally, the nurse asked if she could try. She softened her voice, leaned in, and spoke in her thickest country accent, “Junior wouldn’t have wanted to live like this.” At that moment, something clicked. Her words resonated in a way ours hadn’t. His parents finally understood. He passed peacefully soon after. That night I realized: What you say matters, but how you say it can make all the difference.” -ER physician

“For years, I cared for a couple facing a possible diagnosis of amyloidosis. His wife always did the talking at our appointments. She was sharp, well-informed, and up-to-date on the latest studies and trials. Her husband, the actual patient, would sit silently beside her, not saying a word. His chart mentioned ‘early dementia,’ so I assumed he wasn’t following much of what we discussed. One day, after an hour spent mostly talking with his wife, I was getting ready to wrap things up. Just then, the husband spoke up, asking, “So is this what Muhammad Ali had?” I realized that he had been listening the whole time. I had unintentionally overlooked him, even though it was his health we were discussing.” -Neurologist 

“In nursing school, we were taught to follow the hierarchy in medicine: don’t bother the doctor, don’t ask questions, figure it out yourself. But when I started working, I found it was different. Doctors respected me. They listened to my opinions. On tough cases, they even asked, “What do you think is going on here?” That’s when I realized medicine is about teamwork and collaboration, not hierarchy.” —ER Nurse

“I used to sigh when patients came in for things that had just started. Like, ‘I threw up once’ or ‘I’ve had a fever for two hours.” Then one day, my 4-year-old suddenly started vomiting across the entire room. I panicked. I called my husband and yelled, “Something is wrong!” and rushed to the ER. Once we got there, the nurse gave him some medicine and a popsicle. By the time the doctor walked in, my son was smiling and looked completely fine. The doctor asked how long the symptoms had been going on. I looked at the clock and sheepishly said, “…um, two hours.” This was the day I stopped judging people for coming in early. Because when it’s your loved one, two hours can feel like forever.” –Family Medicine Physician

Read similar narrative medicine posts.

Write about a time when you felt like a doctor

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