The Hero’s Journey of Patients and Health Professionals_
Think of 3 of your favorite books or movies.
What narrative elements do they have in common? The transformation of the main character after facing unknown and threatening situations? The encounter with a teacher, guide or philosophy that makes him rethink his identity? Various acts of bravery and leaps into the unknown? A battle or confrontation against external or internal dragons? Coming home with a renewed personality?
It is very likely that you have answered YES to several or all the questions. This is not a coincidence. The essence of the stories that resonate with us follow a predetermined pattern that has been dubbed “The Hero’s Journey.”
The Hero’s Journey, or monomyth, is a term coined by anthropologist Joseph Campbell to define the basic model for many epic, mythological, or artistic accounts of civilizations throughout human history. From biblical narratives, stories of creation, and myths, to the basic archetype of almost all Hollywood movies: from Star Wars to The Matrix, from Toy Story to Harry Potter.
The fact that these films or stories (and I mean all films in general) resonate with us and “change our lives” is because these narratives -which although they seem fantastic or fictional-, really are a reflection of those of us watching from this side of the screen. The characters and stories in these movies are constantly whispering in our ears: “This is your time to do what you’ve always wanted to do.”
The Hero’s Journey is not a metaphor for how life works; it is a description. And as such, all of us have gone through various Hero’s Journeys throughout our lives. Every crisis, every fall, every loss, every illness, have been moments to rethink the story we are telling ourselves. And, after a few battles that required us to reach places that we previously thought impossible, we managed to re-invent ourselves and realize that we have always carried that potential within us. Furthermore, once we have passed these battles and lessons, we can now return to our community and empower our fellow humans in their own personal, professional, spiritual, or health journeys.
Because Health is also a Hero’s Journey. For patients as well as health professionals.
The Patient’s Hero’s Journey
We all are and have been patients of different diseases. Some illnesses, such as acute episodes, usually do not require a Hero’s Journey to heal because they can usually be resolved with medications, surgeries, or short-term treatments.
On the other hand, chronic diseases such as obesity, diabetes, asthma, depression, hypertension, arthritis, cancer, and many others, are multi-causal diseases that are intimately interrelated with our identity and the way we perceive ourselves. And because these diseases can last a lifetime, the way we interpret the disease and the degree to which we feel empowered to integrate it into our life, are inflection points in the type of life that we can have, not “despite”, but “thanks to” the particular ailment we carry.
If you are a health professional: How many benefits could your patients obtain if you make them see that their disease is putting them on a Hero’s Journey where they can live in the epic story of their lives?
1. Life before health problem: It is the world of the patient before his diagnosis, treatment, accident, medical condition, or search for a healthier life. The patient is unaware of subtle unhealthy circumstances that will accumulate overtime. Or, although the patient is aware that certain behaviors are not exactly health-promoting, the consequences will not present themselves until later on, so there is no urgency change now.
2. Call to restore health: Something happens, and the patient realizes that he has a problem and that a difficult journey awaits him. This usually happens after a diagnosis or the loss of a loved one.
3. Refusal to seek medical help: Fear, self-doubt or anxiety prevent the patient from accepting their reality or committing to a path of recovery. The patient continues in a stage of denial or negotiation so as not to have to take charge of his health.
4. Meeting with the health professional: The doctor or any other health professional can play the role of the “wise old man” who encourages and helps the patient at the beginning of his journey. The problem is that many times the patient is not sure who is the “wise old man” that he should follow and oftentimes he begins by following the one who proposes an easy, fast, and cheap solution, and not the one who will accompany him in the rugged challenge of self-transformation.
5. Commitment to diagnosis: The patient accepts his condition and realizes that he has a lot to do to regain his health. He makes the first commitment to voluntarily begin his journey towards wellness.
6. Treatment: The “new” world presents many challenges that test the strength, courage, and consistency of the patient. He makes allies on his way to recovery (family, friends, other patients, and health professionals) who offer their support and guidance.
7. Approaching the biggest test: The patient faces setbacks in the treatment or action plan, which often requires profound changes in his personality and his habits. The patient hesitates and looks for quick solutions because he is not yet ready for the most arduous test of all, which is imminent.
8. The biggest test: The patient faces death or faces the greatest fear that he has been trying to avoid all along. The tools of his “old” self are no longer useful, and he has no choice but to get new ones, which requires an enormous amount courage and energy. He is unsure about his own capabilities. The greatest test is precisely the need to stop being the person he was and become someone new. After this deep confrontation with external and internal forces, there is a rebirth, and the patient manages to overcome the burdens and limitations that made him ill in the first place.
9. Reward: The patient celebrates the success of his journey, but the threat has not been completely removed.
10 and 11. Road back and resurrection: The patient sets on his way back to a new reality, where he finds that his new personality still has a lot of adjustments to do. Oftentimes the patient faces a final test before returning to a new normal. (For example, a diabetic patient may face temptation of the old lifestyle; a rhinoplasty patient may face his inner demons (self-esteem, confidence); a cancer patient may face the challenges of staying in remission.) However, these challenges are integrated with greater awareness and responsibility, and there is a renewed confidence in oneself and in life. The disease is re-interpreted, but it is still part of the patients´ journey.
12. New normal: The patient returns to his daily life with a physical and mental reminder of his journey and has a new story to tell himself and the world. The patient shares his newfound confidence, healthy mindset, and wisdom with his peers. His transformation is complete, and he is ready for new adventures.
The Health Professionals’ Journey
Not only as patients but as Health Professionals (HP), doctors, psychologists, and nutritionists, have also lived and are living their own Hero’s Journey. Many times, they must embark on the journey when they themselves come face to face with illness and had to find their own way to redefine their life because of it. And, once they return to “normal,” they share what they’ve learned and newfound insights with their patients.
But, regardless of whether a Health Professional (HP) has had an episode with a disease of their own, many of them face the Hero’s Journey because they are very disappointed with the outcomes of their chronically ill patients. In other words, the HP is dissatisfied with her work because she has not had the tools to help his patients in an effective and lasting way. This makes the HP confront her own identity, as well as the expectations that culture and institutions have imposed on her for years as a HP.
Thus, in a world where the paradigms that dictate the “correct way” to practice their profession are changing, the HPs find themselves at various crossroads where their academic training and the canon of their profession are confronted with the need to really empower their patients to thrive and not just cope with illness.
In the same way as with the patients’ Hero’s Journey, HPs also have transformation voyages that can be described through the monomyth narrative. In doing so, the HP can redefine, not only the role that the disease will have in her life, but the role of the “wise old woman” that she may play with her patients. But to become “wise,” the HP has first to go through her own transformation story.
1. Life before the problem: It is the world where the HP studies and prepares academically. This period also covers the first years of her clinical practice (although sometimes these first years can be many). The HP establishes long-term relationships with her patients, although in many cases patients keep returning with complications derived from the same underlying problems.
2. Call to expand the clinical toolbox: The HP intuits that with her current knowledge and way of practicing, she is falling short in restoring health. For a long time, she has seen herself as someone who is there when the patient brings new problems, but she is not dedicated to empowering them to prevent those problems from happening in the first place. The HP wishes she could help her patients more but realizes that she is not prepared because her profession has not given her the tools for it.
3. Refusal to seek help: Fear, self-doubt, and inertia built up from so many years prevent her from accepting the reality or cause her to remain in a vicious cycle of blaming the way in which her profession was taught or her patients for not adhering to her advice.
4. Meeting with the “wise old woman”: Usually a colleague who had a similar academic preparation to that of the HP, but who continued to study and learn from other unconventional sources, serves as the “wise old woman” to show that another path is possible. This path, however, is a path that each HP must find for herself and there is no a-priori proof that her efforts will bear fruit. The “wise old woman” can also come in the form of a lecturer, author or even an institute that teaches the profession from a different perspective than the conventional one. This new possibility resonates strongly with what the HP is looking for and is excited about the possibilities that lie ahead.
5. Commitment: The HP accepts her limitations and makes the first commitment to begin her journey of transformation. Oftentimes this involves stretching her schedule even further so as not to lose what she already has and at the same time preparing and training in new programs and certifications.
6. Multivariate learning: The “new” world presents obstacles and challenges that test the strength, courage, and consistency of the HP. Her agenda is full because she continues seeing patients and simultaneously prepares to re-invent her clinical practice. The new things that she is learning are exposing several essential contradictions in he way “health,” “wellness,” and a private practice are defined. The HP makes allies with colleagues and friends who are in similar pursuits and feels at “home” with other HPs who are also questioning the paradigms of the past and are daring to create new ones.
7. Approach to the most important test: The HP faces setbacks of many kinds, among them the constant criticism and ridicule from colleagues and friends who do not understand why they are going off the rails of the conventional path. In addition, the new things she’s learning are demanding profound changes in her personality, habits, and in the way she relates to others. She still does not know how to calibrate times, how much to charge for new services, and with whom to partner. The HP hesitates and looks for quick exits and magic solutions because she is not yet ready for the great test that lies ahead.
8. The greatest test: The HP faces her greatest fear that has been avoiding all along: she has to announce to the world that her way of working is different from the expectations that were set on her. The tools of her “old” self no longer work and she has to retool. This requires an enormous amount of energy and courage. Out of this situation, there is a rebirth and the HP manages to legitimize herself and begins practicing in a way that resonates much more with her new identity and with her ideal of what a HP can be.
9. Reward: The HP celebrates the success of her journey, but the threat has not been completely removed. There are many lessons that she must continue to learn. Many economic models are yet to be resolved, and she has to be patient with her patients to see results.
10 and 11. The path of return and resurrection: The HP sets out on the path to establish this new way of working and to establish it as a new routine. Many times, she faces a final test before returning to a new normal. (For example, she must quit her job and start a practice of her own, or she has to reduce her income for a while because the new model is not yet consolidated) However, these challenges are integrated with greater awareness and responsibility and there is a renewed confidence in oneself and in life. Professional practice is re-interpreted, and this fills her with hope.
12. New normal: The HP achieves a new daily stability with a physical and mental reminder of her journey, and shares her new confidence, mindset, and wisdom with patients and colleagues. The transformation is complete, and she is ready for new adventures.
The Hero’s Journey
The only difference between being a victim and being a hero is the story we decide to tell ourselves. Every journey of transformation (and therefore of Health) begins with a dream that seems fictitious at first, but once the obstacles are faced, the dream becomes a reality.
Whoever your hero is, Michael Jordan, John Lennon, Marie Curie, Buddha, Mark Hyman, your mom, or Patch Adams, they are your heroes because of the courage and determination with which they lived their lives. Telling a patient that he or she is a potential Hero is perhaps the greatest gift that a HP can give. And, as HPs, believing that we are heroes is the best way to change our paradigm of disease to a paradigm of health. We do this by what Joseph Campbell calls BLISS:
“If you follow your bliss, you put yourself on a kind of track that has been there all the while, waiting for you, and the life that you ought to be living is the one you are living. Wherever you are — if you are following your bliss, you are enjoying that refreshment, that life within you, all the time. “ — Joseph Campbell.
What’s the next step on your Hero’s Journey?