Medical Students and Storytelling: HIV Out Loud By Yolanda Crous and Joshua Carrasco

Medical Students and Storytelling: HIV Out Loud

By Yolanda Crous and Joshua Carrasco

Ihave always believed in the power of stories. I was an English major in college, and I spent my first career as a magazine editor in New York. So, when I began to consider my job to go to medical school, I turned to the place I’ve always gone for life advice: the bookshelf. While I was shadowing physicians and volunteering in hospitals, I was also devouring tomes by physician-writers like Paul Farmer, Rana Awdish, Abraham Verghese and Elizabeth Ford. Page after page, story after story, I searched for a line or a moment that would signal to me that applying to medical school in my 40s was not an absolutely disastrous idea. (Spoiler alert: It was the best decision of my life.)

What I did not know then was that I would never think more deeply about the power of storytelling than I have as a medical student. I owe this gift to HIV Out Loud, a storytelling project dedicated to creating and preserving the oral history of HIV in South Texas, and a National Endowment for the Humanities-funded collaboration between the End Stigma End HIV Alliance of San Antonio (ESEHA) and the Center for Medical Humanities and Ethics (CMHE) at UT Health San Antonio.

In November 2019, Dr. Barbara Taylor, an infectious disease physician who was co-chair of ESEHA at the time, invited students to a live HIV storytelling event at the historic Guadalupe Cultural Arts Center. The theater was packed, but all conversation stopped the moment the first storyteller walked onto the stage. As a first-year medical student who still spent more time in the lecture hall than with patients, I was struck by how each narrator centered their story not on illness or the virus but on how living with HIV had reframed the way they were seen by the community—and the way they perceived themselves.

That night, those stories, jolted me into an awareness of how profoundly a single sentence or gesture by a physician or staff member can change the trajectory of our patients’ lives and health. A growing body of research indicates that even subtle or unconscious judgmental tones when discussing a patient’s sexual history or lecturing a patient about missing a clinic appointment can negatively affect the patient living with HIV and can reduce the likelihood a patient will adhere to a lifesaving antiretroviral medication regiment.

In the months and years since that storytelling night in November, ESEHA and the Center for Medical Humanities and Ethics have joined forces to expand ESEHA’s storytelling program into HIV Out Loud, an oral history of HIV in South Texas. Under the leadership of pediatrician and writer Rachel Pearson, the project has three main goals: 1) to create new spaces where those in the HIV community— not only people living with HIV, but also their loved ones, their physicians, HIV advocates and anyone whose life has been touched by HIV—can tell their stories how they wish them to be told; 2) to ensure that these stories are preserved and easily accessible by the public, especially by those living with HIV; and 3) to establish an HIV Out Loud medical-school elective, co-led by the CMHE and people living with HIV, that will train students in oral-history interviewing techniques. It is our hope that this elective will not only sustain the oral history project but help reduce HIV stigma in health-care spaces and encourage compassionate, collaborative patient-centered care among our future physicians.

The elective has not yet begun but HIV Out Loud has already trained two cohorts of medical students. We held our first mobile storytelling session at World AIDS Day in December, and several members of the HIV community generously took time out of the event to entrust their stories and memories with us—an honor we do not take for granted. We are actively looking for members of South Texas HIV community to interview, so if you are interested in sharing your story for the oral history project, please reach out to HIVOutLoud@gmail.com.

As for me, I still hit the bookshelf when I need guidance on big life questions. But when it comes to figuring out what kind of physician I want to be one day, nothing will ever teach me more than the stories of my patients—and the stories of HIV Out Loud.

For ESEHA’s Anti-Stigma Guidelines, go to endstigmaendhiv.com/resources.

Yolanda Crous and Joshua Carrasco are medical students at the UT Health San Antonio Long School of Medicine, Class of 2023. They are leaders of the HIV Out Loud project.