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Sarah Pittock and PWR 91SP: Doctors' Stories

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In Spring 2019, Sarah Pittock taught PWR 91SP: "Doctors' Stories: Communicating Health Sciences."  As part of PWR's elective Science Communication track, the course could count toward the Notation in Science Communication but was also open to any interested student.  Recently, the Newsletter team had the opportunity to interview Sarah about this fasincating class.

PWR: Tell us a little bit about your class, PWR 91: Doctors’ Stories: Communicating Health Sciences. What inspired you to teach this class?

SP: I was part of the lecturer team that drafted the proposal for the Notation in Science Communication, and had always wanted to develop a course for it. I knew I wanted it to involve storytelling, and I wanted it to be in a relatively focused area of science so that the content of students’ projects might intersect. I was ultimately inspired by some of the fantastic journalism and narrative non-fiction that’s been published on medicine, especially Rebecca Skloot’s The Immortal Life of Henrietta Lacks, Anne Fadiman’s The Spirit Catches You and You Fall Down, Paul Kalanithi’s When Breath Becomes Air, and the work of Atul Gawande, who also writes in The New Yorker.

Like most of us, I rely on science journalists to bring me the best medical research accurately, concisely, and in a timely manner. I know that’s not easy. On the one hand, there’s a lot of misinformation about our health, lots of well-meaning folk remedies circulating at the watercooler or the family reunion, and on the other, there are sustained campaigns to discredit the health sciences through the circulation of disinformation. I am dismayed by the ways the vaccine debates have been weaponized on Twitter, for example. I hoped my class might motivate a new generation of writers to craft compelling, responsible communication in the health sciences.

PWR: What sorts of topics did you discuss in class? How did you engage students?

We discussed a lot of health science journalism: some news stories from national publications such as The New York Times, some long form magazine stories from places like The New Yorker, even a documentary, Jennifer Brea’s Unrest about chronic fatigue syndrome. We parsed carefully the story elements—setting, character, plot—while considering when and how we were engaged and what we were learning. We read writing about storytelling to give us a critical vocabulary. I had the class read chapters from Martin W. Angler’s Science Journalism: An Introduction, Jack Hart’s Storycraft, and the Nieman Foundation’s anthology Telling True Stories. We considered the affordances of web texts and the ability to link to published research and then talked about ways to translate that research responsibly into concise, layman’s terms. Finally, we discussed the principles of science writers from the Association of Healthcare Journalists. How do we write respectfully about patients and doctors and the science that brings them together?

PWR: What types of writing and research did students do?

As I prepared for this course, I learned there’s an entire field of medicine known as narrative medicine. One of its most influential theorists is Dr. Rita Charon at Columbia University. I was fascinated by the idea that medicine might be a science that depends on narrative thinking, on stories. But instead of teaching the theory in a sustained way, I decided to teach story genres in the health sciences so that students might produce publishable writing by the end of the quarter. They all produced a news story, a profile, and a magazine story.

I asked students to write on the same topic all semester, to take a deep dive into a topic in the health sciences that really matters to them. For example, one student who suffers from Crohn’s disease was keen to investigate the relationship between gut and mental health; another who identifies as Native American elected to write on the health claims of Natural American Spirit cigarettes, which appropriate Native rhetoric, and their public health threat.

We began the quarter with a news story assignment, one that might appear either in a national news publication such as the New York Times or on a major medical center’s blog. Students had to select a recent, interesting research study and distill it and narrate it for a general reading audience. They also had to get their first phone interview with either the authors of the study or a peer respondent, and elicit an interesting quote to weave into their story.

The second assignment was a profile assignment of a health sciences researcher. I was looking for a second assignment that would help them practice major storytelling elements, but one that might come rather intuitively and set them up to write a successful final assignment. On the very first day of class when I explained the assignment sequence, we discussed Gawande’s “The Way We Age Now,” a New Yorker feature story which includes a profile of a charming gerontologist. So they had a model in mind as they went into the second assignment of how the last two assignments might fit together. I loved the profile assignment because students really got to practice interviewing–they had to meet with the researcher they were profiling–and with rendering character.

Finally, they had to develop a magazine story and consider what additional research to bring to their profiles in order to communicate more of the science and the stakes. Interestingly, most of them decided to put themselves into the story, whether as patients, observers (one student was a medical student), or public health advocates. Their own experiences helped frame the narrative arc of the magazine story.

Throughout the quarter, students reflected in writing on their research and storytelling. What does a narrative help us say about medical research? What is lost? How does story serve doctors and patients? Does it ever do a disservice?

PWR: What were some of the most memorable experiences for you in teaching this class?

The class discussions, the extraordinary peer review, the student research and writing that said so much so well about biochemistry and addiction medicine and the Ebola vaccine, all of these were memorable.

The development of this class was also memorable for me. I had to use all of the curriculum design principles I preach because I was creating an all-new class. I had to think about the learning objectives of the Notation in Science Communication, the genres of my assignments, and then the reading and class activities that would set students up for success. It was a long process from course proposal to finished syllabus—a year!—and I was very happy with the finished student writing.

PWR: What were the collaborations with the Stanford Storytelling Project and the Stanford Medicine Magazine like?

Collaborating with the Stanford Storytelling Project, specifically Jonah Wilihnganz and Christy Hartman, was extraordinary. I went into my first meeting with Jonah and Christy to discuss workshop options and came out realizing just how much I needed to fine tune my assignments. They also came to class to present story elements and interview strategies. Students loved them, and so appreciated when they returned to give individualized feedback on their magazine story pitches.

The visit from the editor of the Stanford Medicine Magazine was enlightening. Rosann Spector shared her professional journey as a science communicator, the process by which her magazine develops stories, and the Magazine’s responsibility to represent the institution. We spent a lot of time with her talking not only about process, but also about audience, exigence, and constraints.

Dr. Seema Yasmin also came to class. We discussed a number of chapters from her biography of an important early AIDS researcher, The Impatient Dr. Lange. She also described her career as a science writer first for the Centers for Disease Control and then for the Dallas Morning News. Her dedication to public health and systemic change was very inspiring to students as was her ability to courageously and brilliantly reinvent herself.

PWR: What were the greatest rewards? What would you do differently?

I loved seeing students grow in their ability to scaffold a story and to render character vividly through detail. I loved teaching and reading a whole new set of genres.

I had hoped we would get to more multi-modal approaches to storytelling and that students might include more visual stories, whether still or video, because so many people get health information online. But we just didn’t have time. It was really a writing class. I had also hoped that students might wrestle with more of the patient perspective on the health sciences–because narrative is so important to our ability to cope with illness and death–but the privacy and legal issues make it nearly impossible for undergraduates to access patients.