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Telling tales

Storytelling in the world of medical communications
Telling tales

The Best Film category at this year's Oscars told us something important: people love true stories. Half of the nominees were films, such as Selma and The Imitation Game, based on real events, and that's been roughly the case for the last three years. This is great news for medical communicators since we have loads of opportunities to tell meaningful, real stories (in person, in print, in video, and through other media) and we should do so!

The world of healthcare is often a maelstrom of facts and data for patients, HCPs and industry alike. Storytelling is a invaluable tool for clarifying and conveying health information in a coherent and accessible form; it's how we make sense of reality and, to my mind, a key part of how we store memories. It is as old as human civilisation, and universal. But it's worth stopping to consider what the term 'story' actually means.

Story
All storytellers have their own (generally similar) definitions of a story. This is mine: A narrative concerning a defined protagonist striving to achieve a defined goal, and confronting one or more obstacles in the course of doing so. How does this figure in medical communications? In my experience, patient and HCP stories are most often presented alongside science writing to illustrate key messages, trends and experiences, or to instruct the audience in best practice. Storytelling can also be used more broadly, eg to demonstrate the journey a pharma company has taken to develop a new product from R&D to launch. Here I'll refer to patient stories, but the principles apply across the board.

Character
First of all, we need a patient - our protagonist, or main character. Ideally your main characters will be real patients that you've spoken to in the course of a project, but they may also be fictional 'typical cases'.

The key to a good main character is empathy. The audience (other patients, HCPs, industry etc) must be able to relate to the character's situation: his concerns, decisions, and actions. The audience must be able to do this on a basic human level, even if the specifics of the character's position are alien to them. This isn't as hard as it sounds - at the heart of most patient stories lie experiences of fear, anxiety, confusion, frustration, joy, relief and love, and most people can get on board with those.

Empathy invests the audience in the character and his experiences. Caring about the character's outcome is the audience's gateway into the story. This is important - if we care about the character and his journey, we'll go through it with him, vicariously. We'll actively engage with the information we're given and so we'll react to the story's content on both an emotional and intellectual level.

Beginning
This journey typically begins with an Inciting Incident: an event which upsets the character's life and creates a goal which he has to pursue. Common inciting incidents in patient films include: the realisation of first symptoms; diagnosis; or the point at which efficacy of treatment drops below required levels.

The inciting incident must push the character into action (if no one does anything, you don't have much of a story) and create a tough but plausible goal that captures the audience's interest. But you have to be careful with how youww frame your inciting incident. It causes the audience to ask “what's going to happen?” and there's an element of expectation management here.

For example, say you're telling a story that illustrates the benefits of Product X. If that product helps to manage the symptoms of an illness but doesn't cure it, then the inciting incident should be the moment when the character's symptoms become unbearable. If your inciting incident is the point of diagnosis, then the audience may expect your product to ultimately offer a cure, and they will be left with a (potentially disastrous) sense of disappointment when the product (and story) doesn't fulfil that expectation.

Middle
You're on your way - your empathetic main character is pursuing a gripping goal. He now goes after that goal via a series of steps (you can also call them events, or scenes).

Each step is an action that the character takes in pursuit of his goal. Each action must (and this is vital to any good story) bring the character up against some form of opposition and conflict. This conflict creates a change in his strategy or situation, and leads on to the next step/action. Conflict can be internal (eg fear, lack of discipline in adherence) or external (eg lack of access to specialists, funding issues, bureaucracy) or a combination of both.

A very basic example: our patient takes Product 1 (action), but experiences strong adverse events (conflict) so they are prescribed Product 2 (change) and start taking that (new action).

This is a brilliantly effective structure for conveying complex information because it shows how disparate elements of a patient pathway/experience (in this simple example) are joined by a logical process of cause and effect. Story can turn a confusing mixture of symptoms, anxieties, tests and treatments into a single, coherent and memorable picture.

If we care about the character's journey we'll go through it with them

Furthermore, the conflict and change found at each step leads the audience to wonder “what's going to happen next?” Asking this, the audience will consider, anticipate and interpret the information they are presented with, assimilating your content.

End
Your beginning asks “what will happen?”, your middle says “all these things”, and your ending says “until, finally, this.”

Your ending, or resolution, is the final step of the journey. It's the end of the line, where the goal created by the inciting incident has finally been achieved (or - rarely in medical communications - definitively forfeited) and the story's concerns have all been tied up.

Crucially, your ending has to answer the questions asked by the beginning of your story or it will leave your audience unsatisfied. Have you ever finished watching a film and been left thinking “but I want to know what happened to X?” Don't put your audience in that position!

If you find that your resolution doesn't match up with your inciting incident (running your story past someone who is unfamiliar with it is a useful strategy to check this) go back and tweak the framing of these things until they correlate. You may need to change your inciting incident so that your character starts with a slightly different goal which you can resolve, or end at a different point which ties things up more neatly.

The beginning/ending balancing act is tricky, but it's worth spending a little time getting it right (and it's good to think about it as soon as you start drawing up your story). A matching beginning and ending lock in a consistent narrative. A consistent story is a coherent story, and a coherent story conveys a clear and memorable underlying message.

Epilogue
I've merely taken a fleeting and elementary look at a vast topic here, but this skeleton is at the core of almost all classically structured stories. As medical communicators we meet so many remarkable patients, HCPs and industry players that we're spoilt for powerful, authentic stories which can help us to convey our messages more effectively. These stories let us prove our points subtly, through demonstration, and so appeal to both the rational and the emotional. The effects can be both tangible and profound.

Wherever you have people you have stories, so keep an eye open for the above framework when talking to patients, professionals and industry. You may not win an Oscar, but your audiences will thank you for the effort.

*It's worth pointing out that storytelling is incredibly nuanced, and that stories take many forms, serve many purposes and come in many shapes and sizes. This summary offers a fundamental starting-point, but don't be surprised if you encounter stories which seem to play around with some of the concepts above.

Article by
Damien Pollard

Medical filmmaker and storytelling consultant. He can be contacted at damien@damienpollard.com or via www.damienpollard.com

26th June 2015

From: Marketing

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