See story elements at work in this health care narrative
How do you organize a dramatic narrative?
Model this piece written for Saint Luke’s Health by Wylie Communications’ head writer and senior writing coach, Loring Leifer. It has all of the elements you need to craft a compelling case study.
Start with a feature head. A good narrative deserves a creative headline. Alliteration works beautifully for this one.
A cascade of mysterious, mind-altering conditions led Daniel Stoner to the brink of death
Show instead of tell with a feature lead. Feature leads are concrete, creative and provocative.
Find a poster person. Characters drive your story — not organizations, products, services or programs.
Start with the snake. Lead with the problem. The inciting moment — aka the desk-pounding moment — gets the action started. So look for the moment of pain, change, crisis or decision that started your subject on his journey. Begin as close to the action as possible.
And make it a moment, not a condition. Notice that this doesn’t start with a month of Stoner feeling poorly, but with the moment he couldn’t ignore his problem any more.
Daniel Stoner couldn’t walk in a straight line, but not for the reasons those around him suspected.
Stoner was running errands last August when he lost track of where he was. He pulled his car to the side of the road and started phoning people from his past.
When a policeman asked him to get out of the car, he fell down trying. After Stoner failed a field sobriety test, the officer took him to an area hospital, where he wound up in a substance abuse ward.
End sections with external transitions, like the one in the second sentence in the following paragraph. External transitions propel the story forward, rather than summing up what’s already happened. Think of external transitions as cliffhangers designed to pull the reader through the piece at a natural stopping point: the end of a section.
A blood test soon determined that he was completely sober. It would take a team of doctors and some of the most sophisticated medical technology in the region to determine what was wrong … and, more important, what was not.
Body: Section one
Develop the problem in more detail in the first section of the body. Here, Loring introduces new obstacles to Stoner’s health.
The hospital sent Stoner home with a diagnosis of stress and a bad reaction to a prescription medication.
The following week, after a swim at the gym, Stoner was headed toward the whirlpool when he dropped to the floor in a seizure. An employee found him staring and non-responsive.
The Emergency Department at the same area hospital now suspected he had suffered a stroke. The doctors started him on a stroke medicine and transferred him to the Saint Luke’s Brain and Stroke Institute.
Forget name, title and company in the first paragraph. The fact that Stoner’s a personal trainer doesn’t matter in the lead. But here, where he can’t move his arm or feel his feet, it provides a startling contrast that shows how far he’s sunk.
Stoner’s next memory is waking up 36 hours later at Saint Luke’s Hospital Intensive Care Unit. A personal trainer and wellness instructor usually full of energy, he was lethargic and nauseated. He couldn’t move his left arm, felt weak on his left side, and couldn’t feel his feet. He also had trouble understanding what people were saying.
It’s the problem, silly. One of my respected colleagues in the health care communication business tells his writers to “get the patient to the hospital.” In fact, it’s the problem, not the solution, that moves readers in case studies like this one — no matter what the industry. Plus, the more fully you develop the problem, the more brilliant you show the doctors who finally solve it to be.
Expertise in strokes enabled Saint Luke’s doctors to quickly rule out one in Stoner’s case. Doctors ran a cerebral angiogram, which mapped the blood vessels in his brain with dye. It came back normal. So did a CT perfusion scan. One of only a few in the region, this scan measures blood flow and can pinpoint strokes.
“He was profoundly altered, but his exam wasn’t consistent with stroke,” said Suzanne Crandall, D.O., a neurologist on staff at Saint Luke’s Hospital.
Find the antagonist. Notice how Loring treats Stoner’s health issue as the villain in this piece. Villains don’t have to be people: They can be diseases, hurricanes, political movements — anything that keeps the hero from achieving his goal.
With one culprit eliminated, she launched a full-scale investigation. Blood tests eliminated West Nile, several other viruses, and fungal infections.
“Anything that bothers the brain on one side can manifest on one side of the body and cause stroke-like symptoms,” Dr. Crandall said.
She ordered an MRI to eliminate a tumor and found lesions of inflamed brain tissue. A spinal tap confirmed abnormalities in his spinal fluid consistent with viral encephalitis, a severe inflammation of the brain.
Body: Section two
Develop the solution in the second section of the body.
Brain boot camp
Stoner’s infectious disease specialist, Paul Jost, M.D., sent him to Saint Luke’s Neurorehabilitation Services. There, he began a program of physical, cognitive, speech, and occupational therapy to regain functions damaged by the inflammation.
Pile on the problems. A series of conflicts and resolutions makes up the body of a good dramatic narrative.
Even after his acute symptoms subsided, Stoner slurred his words. His left hand curled, and he had trouble commanding his left side to move. The lesions were in a part of the brain that affected his emotions, too.
“I stopped feeling emotionally connected to friends that I knew I had been close to before,” Stoner said.
He had always been physically active and had been able to distract himself from trauma by working out, going out in the garden, or reading.
Write sound bites, not quotes. Blah-blah-blah corporate quotes sound even more ridiculous in dramatic narratives.
“There weren’t a lot of things I could do to escape mentally or physically from my situation,” Stoner said. “As they say in the South, I had to set in my stuff.”
He was amazed at how Brad Steinle, M.D., a physiatrist, and the team of therapists worked together to help him regain what he had lost.
“Everyone understood that I wasn’t at this moment the person I was or considered myself to be,” Stoner said. “They held that place open for me.”
His therapists would introduce him by saying, “This is Daniel, he’s a personal trainer,” always referring to his work in the present tense.
String the beads on the necklace. Look for moments of success, as well. Specific moments in time are the pearls in the necklace of a dramatic narrative.
Stoner marveled that Dr. Steinle stayed current on his breakthroughs. When Stoner finally straightened his hand during therapy; Dr. Steinle knew about it before his next visit.
All subjects should be as expressive as Stoner. If yours is, feel free to pile on the lyrical sound bites like these. Most of the time, however, it’s better to paraphrase.
“All of my doctors and therapists worked in concert, and I never had to spend time updating them,” Stoner said. “They would shine the light on the path ahead of me instead of needing me to tell them where I had been.”
Here’s another nice external transition.
But, one more consequence of his condition would set back his progress.
Body: Section three
In this section, Loring introduces and resolves another obstacle — the final plot point in the hero’s journey toward recovery.
Here’s another solid moment in time.
In the months following his stay at Saint Luke’s, Stoner was plagued with headaches again. He dismissed them as residual effects of the encephalitis. Then, he felt a lump on his scalp. His temperature spiked to 104 degrees.
That brought him back to Dr. Jost, who quickly determined that Stoner had a massive scalp abscess. It covered almost one third of his head. Had Stoner delayed seeking treatment for another 24 hours, Dr. Jost told him, he might not have survived. Toxins from the abscess were entering his blood stream.
A hairline crack in his sinus cavity, which occurred when he hit his head during the initial seizure, may have allowed bacteria to escape, causing the abscess.
Stoner underwent a three-hour surgery to drain it. He also underwent six weeks of intravenous antibiotics.
Here, Loring wraps the story up — with more specific moments, successes and sound bites.
Once again, Stoner’s indomitable spirit rallied with help from a nurse’s aide taking him for a shower.
“My head was bandaged like ‘The English Patient’; I hadn’t shaved in 10 days; I had plastic bags over my head and arm; and the nurse told me, ‘You look like Mel Gibson,’” said Stoner.
“I said, ‘I’ll take the compliment.’ Everyone I encountered seemed to know not just how to make me get better, but how to make me feel better.”
Their efforts are paying off. Stoner is working again; the lesions are fading; his left hand responds to commands; and he’s feeling emotions again.
Tops among them: his tremendous gratitude to Saint Luke’s for negotiating a course through his complex conditions.
How can you craft an extended narrative like Loring’s?
Get the word out with clear, compelling copy
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