Listen. Using Narrative Medicine and Radical Listening to Become a Better Writer

Much of my girlhood was spent waiting for my dad to finish a conversation—at Butch’s convenient store where he was “just running in to buy a pack of smokes,” at the mechanic’s shop long after the oil had been changed as he analyzed the previous night’s Kentucky basketball game with another customer, at a car dealership where men gathered to chat and where I was gifted an ice-cold grape Nehi for my patience. My family waited for him after church in a stuffy car, my belly growling and ready for the pot roast cooking on low in the oven at home. He’s never met a stranger, my mom would say.

Verbosity is genetic. I have a 14-year-old daughter who has been willing and able to carry on a conversation with any person she encounters since the age of three. Throughout her life, people have commented that they’ve never met a child so adept at conversing with adults. Teachers report that she talks with anyone and everyone around her, whether it’s a fellow classmate or the lunch lady.

I am the loquacious genetic link between generations. I too appreciate a good chat. Give me a warm body, and I am ready to start a conversation. It’s what made me fall in love with Ireland, a country that I found rife with talkative folks. It’s why my husband told me to not be so chatty when we met with a lawyer to draw up a will. “We’ll be charged by the minute,” he warned.

My family may be predisposed to talkativeness through DNA, but we’re culturally influenced as well. Southern Appalachia has a rich storytelling tradition stemming from the confluence of Scots Irish, African, and Cherokee heritages. I won’t make the overarching statement that all people in Appalachia are avid storytellers—taciturn Appalachians do exist. However, no gathering of family and friends in the mountains is complete without at least one person telling a good story. That story should be long, full of rich detail, and end with high emotion, whether it be laughter, fear, or scandal. It’s informally accepted that the story may blend fact and fiction as long as there is truth somewhere within it. Each year I attend the Appalachian Writers’ Workshop, a nearly 50-year-old gathering of Appalachian writers. We sit late into the night exchanging stories. It’s been dubbed porch-sworpin’, my favorite part of the week.

In the fall of 2025, as a way to augment my career as a physician, I completed a certificate in Narrative Medicine. The field originated under the guidance and vision of Rita Charon, an internal medicine doctor with a PhD in English. Dr. Charon asserted that analyzing and digesting stories in the way she’d learned to do while studying the humanities could help health care providers better understand and communicate with their patients. Dr. Charon realized that knowing a patient’s story is an important element of treating their disease, that the human experience of living with illness cannot be separated from a disease’s physiologic and anatomic effect on the body. Through workshops, narrative medicine trains medical practitioners to read poems with discernment, study the details of paintings, and listen deeply to music as a way to hone similar skills of attentiveness and mindfulness in the clinical setting. Charon prioritizes listening in the practice of narrative medicine. She calls it “radical listening,” allowing a person to relay their story without interruption and without judgment.

After a lifetime of talking, I now realize that listening, truly listening, is what fosters genuine communication. Though my first inclination is to share my own stories, I am learning to sit back with silent lips and listen. It’s not easy for me. I am a person who is eager to tack on to others’ anecdotes—Same! That happened to me once! Oh, you should hear about the time I did that too. In the past, this is how I’ve connected in conversation, but the practice of narrative medicine teaches me differently: Listen closely. Listen without bias. Listen without the need to insert myself. I work as a dermatologist subspecialized in Mohs surgery, a technique used to excise skin cancers. The procedure spans several hours with multiple encounters with the same patient. It ends with a surgical repair, during which the patient is awake. The long and intimate nature of the surgery affords me ample time to converse with my patients, to listen to them, something I treasure.

Not only has narrative medicine helped me be a better physician, but it has also helped me be a better writer. Though the act of writing is telling a story, the skill of good writing begins with listening. Writers are called to pay attention to the world, to note the particulars of our environments, the mannerisms of the people around us, and to listen to others’ stories. We do not write from a vacuum, but from a web of interconnected observations woven from our own experiences and the experiences of the people we have encountered. I like to imagine a writer’s web not as the elegant, tightly woven, homogenous silky webs of spiders, but spun with threads of varied fibers, sizes, and colors, chunky knots holding everything together.

In my novel, But For Fortune, the protagonist Corinth muses about the importance of story in relation to her grandmother’s secretive past. She thinks, “That’s why stories are called yarns. They are what holds everything together, what links the past to present.”

A writer’s web is just that, a vibrant, textured collection of interwoven yarns linking stories, our own and those of other humans, truth to truth. The act of weaving stories, the act of bearing witness to all stories is an act that fosters empathy. Empathy is the crux of human connection. Human connection empowers art. As the poet-physician William Carlos Williams said, “When asked, how I have for so many years continued an equal interest in medicine and the poem, I reply that they amount for me to nearly the same thing.”

The same holds true for me. The task of caring for the human body and the task of embodying human stories, if we genuinely listen, are wholly intertwined.

Rita Charon labels powerful narratives as “stories that work on us.” I still think about one such story told to me by an elderly woman in my operating chair years ago. I started our conversation with a question I commonly ask, “Tell me about your family. Do you have kids?” I have learned during my years of medical practice that a simple question can often lead to uncomfortable answers. She told me she’d had a daughter, but that she’d died in a car accident as a teenager. “I’m so sorry,” I said, “How awful.”

The woman was silent for a moment, then told me that she’d left the girl’s bedroom unchanged since the day she died. She said that still, decades later, there are days she sits on her daughter’s bed and grieves for her. I had to excuse myself from the surgery. I couldn’t see through the fog of tears. Her story worked on me that day and still does. Over the years, I’ve filled in details—a pink bedspread with eyelet trim, a Partridge family poster on the wall, an eight-track player that still works, a wicker hamper half full of dirty clothes with a pair of Jordache jeans slung over the edge, a white vanity table with a hairbrush, blonde strands still tangled in its teeth, and tubes of lipstick hardened with time.

It’s not my own story, despite the added details, but it’s become part of my web. It’s a story that I hold as part of my own experience, though I don’t tell it as my own; I’d never do that. But I still pull it out from time to time and listen to it, listen closely to it—a story of grief and a mother’s love, a story that was graciously shared with me, a story that works on me, a story that I will carry with equal measure of honor and empathy.

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