An updated version of my presentation at the WHO European Health Communications Network gathering on Effective Environment and Health Communication, Chisinau, Moldova, June 2000
“Tell me a story!” The very expression drips with comfort.
Whether it is a child requesting a cosy bedtime tale, or loved ones seeking entertainment, the story is a time-honoured intimacy emerging from myths and legends, through songs, sagas and poetry to the novel, the newspaper and magazine, radio drama, film and television soap operas.
In Ireland, the land of my ancestors, the story-tellers or seannachai were the most welcome guest at the fireside, weaving the history, genealogy and traditions of the community into compelling narratives of wit and wisdom which also offer a wry commentary on human behaviour.
We often forget that stories are the way so many of us learn the basics of social intercourse. The folk and fairy tales of our youth leave an enduring impression.
Most of us can remember still the stories that warned us of the dangers lurking around every corner on the twisting road to adulthood. Those of us who are parents will have found fables or created stories to help our children understand the complexities of life and protect themselves from the bully and the child molester, the drug pusher, and the myriad anxieties that plague us about their health and well-being.
The French scholar Hilaire Belloc, who wrote in English during the early part of the twentieth century, provided my father’s generation, with splendid collections of ‘Cautionary Tales’ which appalled and delighted us as children. The story of ‘Henry King’ was used to frighten us from putting things into our mouths – especially chewing gum which, we were assured, would strangle our hearts if we swallowed it.
The chief defect of Henry King
Was chewing little bits of string.
At last he swallowed some which tied
Itself in ugly knots inside.
Physicians of the utmost fame
Were called at once; but when they came
They answered as they took their fees,
“There is no cure for this disease.
Henry will very soon be dead.”
His parents stood about his bed
Lamenting his untimely death,
When Henry, with his latest breath,
Cried: – “Oh, my friends, be warned by me,
That breakfast, dinner, lunch and tea
Are all the human frame requires…”
With that the wretched child expires.
It sometimes takes many years to undo the inaccurate stories that fill our brain when we are young and suggestible. My brothers and sisters and I were regularly scolded as children for making faces and crossing our eyes. ”You will stay like that for ever if the wind changes,” went the ‘old wives’ tale’ with which we would be warned. Yet my optician recently told me he thinks it is a good idea for people to practise crossing their eyes as a form of exercise to strengthen their capacity.
I suspect we all learn more about health care from the anecdotes we pick up at work and from the neighbours’ stories about people we know who are suffering from an illness. We pay more attention when it is something happening close to us, and to which we can put a human face.
When I was very young I heard about someone killing themselves by connecting a hose to a car exhaust, so I convinced myself that I might die if exhaust fumes touched me. I made every effort to avoid them. But the actual dangers of lead pollution from car exhausts were brought home most forcibly to the British public when parents began campaigning outside schools where children were found to be suffering from the consequences of inhaling heavy traffic fumes nearby. Their actions made it onto the TV news and suddenly environmental pollution made headlines. Everyone was talking about it.
I was once approached by a community group puzzled about why the media were not taking up their campaign against industrial pollution from a chemical factory in the area. They had been submitting technical reports and petitions to local journalists, but to no avail. Having gently reminded them that it is not the journalist’s job to handle public relations for pressure groups, I suggested that what was missing was the human face. Where were the stories about how it was affecting individuals? They explained, quite properly, that their campaign was designed to prevent the situation deteriorating to the level at which people would be directly affected.
And then suddenly they got their headlines. An elderly neighbour of the factory that was dumping industrial waste took his cat to the vet. It had been acting strangely, and he was told it had been poisoned. In fact the cat had absorbed chemicals from its habitat, and could die. Its plight made a front page story which all their earnest campaigning with its technical details had failed to achieve.
And why? Because here was a tragedy that caught people’s attention, and which journalists could dramatise without feeling they were being persuaded by vested interests.
In most societies the print and broadcast media have taken over from those consummate story-tellers – the priests, mullahs and rabbis whose job is to enthral us with tales of good and evil to encourage an appreciation of moral values for the health of our souls.
We journalists are always looking for the human angle that will help to explain the complex issues we have to report about. It is the oldest communication technique – illustrating information by giving it a human face – someone that our readers, viewers and listeners can connect with.
Journalism is all about story telling. We actually describe news events as ‘stories’. We may not construct the stories along the lines of conventional narrative, and we may insist that our material is factual and objective, but we always try to humanise each event with actual quotes from real people to demonstrate that there are witnesses to actual events. We illustrate the facts through our use of language and imagery, just as effective politicians who will always try to explain their policies by justifying them through the personal experience of real people they have met.
Think about how you communicate with your friends through gossip and good humour and shocking tales of bad behaviour. We all rely on similar communication techniques, but often forget about them when we are faced with a professional duty to deliver a message.
Communicating health messages is not about dumping jargon-filled reports on journalists’ desks and hoping they will plough through them and find something worth repeating. There are as many ways of getting the message across as there are opportunities to stimulate a narrative.
Writers of TV soaps do not need much persuading to develop relevant story lines that will explain about safe sex, or noise pollution from neighbours, or domestic violence, or the value of immunisation.
The medical profession has an abundance of stories it can tell, and most of them start with the experiences of individuals – from the startling discoveries of the medical researcher to the tragedy of the dead child, or remarkable changes that exercise can bring to those of us who haven’t looked after our bodies. All the worthy documentation and learned research in the world is not much use if no-one gets the message.
A friend told me about listening in on a dinner conversation among surgeons about the intricacies of sewing back on a severed penis. The doctors were engrossed in the technicalities of their trade, but her main concern was far more human.
“Did it function properly afterwards?” she asked, much to her male companions’ embarrassment. No doubt the poor man was relieved to discover that his organ was nearly as good as new after the operation, but the incident neatly illustrates the simple point I want to make.
My friend’s curiosity was perfectly natural, and she left the table better informed and fascinated by the possibilities of modern micro-surgery – and all without breaching patient confidentiality.
If we want to communicate health messages all we have to do is respond to people’s natural curiosity. When a nuclear facility goes into meltdown people want to know what effect it will have upon their lives. When soil erosion or irrigation schemes begin to change the landscape people want to know what they can do about it. And when diseases strike, people want to know why and how they can prevent their own family from being struck down.
There are a wealth of media to choose from – tell them, show them, in as many different ways as you can. Keep the message consistent and make sure the illustrations are relevant to their experience.
But just remember that health communication must constantly find ways of reinventing itself and telling stories that are fresh and compelling. Repeating the same old mantra is counterproductive; and, like gossip, it can be dangerous. As the story goes around it is embellished with new details at every retelling – like ‘Chinese whispers’ it becomes distorted out of all recognition.
The key to effective health communication is to root the human story in authoritative reliable and consistent information, and to convince your audience that you can be trusted.
That is the genius of the traditional story-teller, who earns a living by sharing knowledge. However the story is dressed up, it boils down to basic truths that stand the test of time. That should be our aim in our efforts to build a healthier environment for our children.