Empathy, Neurochemistry and the Dramatic Arc

The emotionally charged story recounted at the beginning Dr. Paul Zak’s film—of a terminally ill two-year-old named Ben and his father—offers a simple yet remarkable case study in how the human brain responds to effective storytelling. As part of his study, Dr. Zak, a founding pioneer in the emerging field of neuroeconomics, closely monitored the neural activity of hundreds of people who viewed Ben’s story. What he discovered is that even the simplest narrative, if it is highly engaging and follows the classic dramatic arc outlined by the German playwright Gustav Freytag, can evoke powerful empathic responses associated with specific neurochemicals, namely cortisol and oxytocin. Those brain responses, in turn, can translate readily into concrete action—in the case of Dr. Zak’s study subjects, generous donations to charity and even monetary gifts to fellow participants. By contrast, stories that fail to follow the dramatic arc of rising action/climax/denouement—no matter how outwardly happy or pleasant those stories may be—elicit little if any emotional or chemical response, and correspond to a similar absence of action. Dr. Zak’s conclusions hold profound implications for the role of storytelling in a vast range of professional and public milieus.

Hello, I am your patient…

We are creating a chapter in my life. You control a large part of this part of my life’s story. For the time being you and I are co-authors of me and of my experience as a patient in your care. Let’s get started.

Any story has the following elements.

1. Setting: You control most of the setting in this story.

Please listen to me. I may not be a nurse or a doctor, but I know how I normally feel. I don’t feel normal, so I came to you. Help me, but please listen to me first.

2. Characters: Obviously you and I have a starring role in this story, but there are many others.

Some I will never meet face to face, but they can control my destiny in this story, just as much as you. I want to believe that the only villain in the story is what is making me sick. I need heroes. I need the kind of hero that takes the time to listen, to ask and to respond quickly and kindly.

3. Conflict: I most certainly have conflict; otherwise, I would not be here. Ironically, as your co-author, I might not fully understand the conflict raging inside me. Norman [...] continue the story

When It Doesn’t Make Sense

May 16, 2012

As doctors in training, we learn to think in patterns of symptoms and can often use “clinical judgement” to fit a patient’s presenting symptoms into a diagnosis. This generally works well, until we are presented with an unfamiliar pattern. For example, in the early 80’s I saw a 60 year old shoe salesman with fatigue and a low grade fever. He had general malaise and some muscle weakness. His exam and initial blood work was unrevealing except he was mildly anemic and his sed rate was elevated. A search for cancer and infection unrevealing. So my next thought was polymyalgia rheumatica, an autoimmune illness associated with inflammation of medium sized arteries. I sent him to a surgeon for a temporal artery biopsy which was negative.

About this time he started to get a cough and the chest X-Ray showed a hazy pattern of change. I knew the symptoms yet had not yet encountered HIV. He was one of the first cases in our State, but likely we had all missed the boat with similar patients. Our pattern thinking generally works clinically, but it isn’t a very good way to ferret out a new or unexpected disease. I never thought [...] continue the story

Tig Notaro and Breast Cancer

A message from Louis CK: Tig is a friend of mine and she is very funny.  I love her voice on stage.   One night I was performing at a club in LA called Largo.  Tig was there.   She was about to go on stage.   I hadn’t seen Tig in about a year and I said how are you?   She replied “well I found out today that I have cancer in both breasts and that it has likely spread to my lymph nodes.  My doctor says it looks real bad. “. She wasn’t kidding.  I said “uh.  Jesus.  Tig.  Well. Do you… Have your family… Helping?”. She said “well my mom was with me but a few weeks ago she fell down, hit her head and she died”.  She still wasn’t kidding.

Now, I’m pretty stupid to begin with, and I sure didn’t know what to say now.  I opened my mouth and this came out.  “Jeez, Tig.   I.   Really value you.  Highly.”.  She said “I value you highly too, Louie.”.  Then she held up a wad of note-paper in her hand and said “I’m gonna talk about all of it on stage now.  It’s probably going [...] continue the story

The Tom Green Show – Cancer Special: Part 1

In March of 2000, unconventional MTV personality and Comedian Tom Green was diagnosed with testicular cancer. On May 23, 2000, MTV aired a one-hour special episode of the Tom Green Show. The special followed Tom through his treatment and included graphic footage of the surgical procedure during which doctors removed Tom’s right testicle. Tom uses humor to educate!