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There is a long-held belief in the medical field that doctors should maintain a professional distance from their patients. But it’s only human to be affected by one’s everyday experiences—and for professionals who work with serious illness, these experiences can range from distressing to profound. In this episode, a collaboration with Grief Is a Sneaky Bitch, we discover how the Palliative Story Exchange uses storytelling to center human connection and meaning in this setting.

Released on May 22, 2025.

is a social worker, a grief activist, and the founder of Reimagining Grief. She hosts the podcast Grief Is a Sneaky Bitch, and she recently published her first book, Grief is a Sneaky Bitch: An Uncensored Guide to Navigating Loss (University of Texas Press, 2024).

is a palliative care physician at Massachusetts General Hospital, an assistant professor of medicine at Harvard Medical School, and a cofounder of the Palliative Story Exchange. Her work has appeared on CNN, on NBC News, and in the New England Journal of Medicine.

is a palliative care physician, writer, and researcher at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital, an assistant professor of medicine at Harvard Medical School, and a cofounder of the Palliative Story Exchange. He also directs the adult inpatient palliative care consult service and leads the Dana-Farber Department of Supportive Oncology Writing Core. His writing has been published in Cell, the New York Times, and STAT News.

Palliative Story Exchange

Podcast: Grief Is a Sneaky Bitch

Radcliffe Accelerator Workshop Program

Lisa Keefauver Personal Website

Alexis Drutchas Personal Website

Richard Leiter Institutional Website

The Palliative Story Exchange on Instagram

Palliative & Supportive Care: “The Palliative Story Exchange: An Innovative Storytelling Intervention to Build Community, Foster Shared Meaning, and Improve Sustainability”

 is your cohost and the editorial manager at HRI, where she edits Radcliffe Magazine.

 is the multimedia producer at HRI.

 is the executive producer of BornCurious and the senior multimedia manager at HRI.

 is your cohost and the senior manager of digital strategy at HRI.

 is a multimedia intern at HRI and a Harvard College student.

 is a multimedia intern at HRI and a Harvard College student.

 is the production assistant at HRI.

Special thanks to  for their invaluable contributions to the editing of this podcast episode.

Welcome to BornCurious, the podcast from Harvard Radcliffe Institute where we lead with curiosity to explore the work happening here. I’m your cohost, Ivelisse Estrada.

And I’m your cohost, Heather Min. Today we take a peek behind the curtain, so to speak, to learn more about one of our private programs: an accelerator workshop for the Palliative Story Exchange. And to do this, we’re breaking once again with our usual format.

Yes. In this episode, I share hosting duties with Lisa Keefauver in a special collaboration with her podcast, Grief is a Sneaky Bitch.

Lisa is a social worker, a grief activist, and the founder of Reimagining Grief, and she has been working with The Palliative Story Exchange, which we will learn all about today.

Hi, Lisa. I’m thrilled to cohost with you.

Hi, Ivelisse. So lovely to be here with you. I’m so excited to be co-collaborating this episode so that we can bring what I, of course, selfishly believe is a really important conversation to an even broader audience. So I’m really honored to be cohosting with you.

And we are here with two guests. We have Richard Leiter, who goes by Ricky, and Alexis Drutchas. Along with Rachel Rusch, they cofounded the Palliative Story Exchange. Let me tell you a little bit more about them. Alexis is a palliative care physician at Massachusetts General Hospital and an assistant professor of medicine at Harvard Medical School. She’s dedicated to serious illness communication, LGBTQ health, health equity, and the power of storytelling to build community, and Ricky is a palliative care physician, a writer, and a researcher at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, and an assistant professor of medicine at Harvard Medical School. He also directs the adult inpatient palliative care consult service. Hi.

Hi. Good morning.

Hey, thanks for having us.

Yes, thank you.

So what is palliative care—because some of our listeners may not know?

I would say it is an interprofessional specialty that is in the hospital, outside of the hospital that works with patients and families living with serious illness from diagnosis all the way to the end of life that really focuses on a few main pillars, really surrounding the umbrella of quality of life. So that can be physical symptom management of an illness or treatment of an illness. So things like pain, nausea are very common things we treat. Also the emotional aspects of living with serious illness—anxiety, depression, more of the existential distress that patients and families are going through and living with. The second, I think, core main pillar is thinking about overall decision-making, medical decision-making, what matters most, and thinking about how do treatment decisions align with who they are as a person and what matters to them. I think hospice always comes into that, in that it is something some palliative care clinicians do, especially in the hospital. And also it’s a separate field. So many people are trained in palliative care and hospice, but when we say palliative care, we aren’t meaning end-of-life care in hospice.

Actually, a few years ago, I’ve got three little kids, they asked me, “What do you do?” And I was like, “Oh, I’m a palliative care doctor.” And they’re like, “Well, what does that mean?” I was like, “How do I explain this?” And it’s like, “I help people feel better and live better.” And I think that’s the ethos of what we do in palliative care.

Yeah, I love that so much. It is a specialty that has developed over the last 30, 40 years and the principles and practices and ideas of palliative medicine could be practiced by any type of healthcare professional.

I think there’s this real underlying ethos, at least in my work, is that more isn’t always better, and we really need to pause to think about how is it impacting the way you live? How are these treatment decisions impacting you as a person, the life you go back to outside of the hospital, and how can we really pause together to think about what matters to you and what are these treatments?

What’s a good life?

Yeah. All of that I think is 100 percent. And I think in the ideal world, everyone practices palliative care.

Can I assume that there is quite a lot of burnout in palliative care?

So yes. Yes, there is. The data on that are mixed. There’s definitely burnout in palliative care. Some studies will show it’s probably a little bit less than in other fields because we recognize it’s really hard work, there are supports in place there, and it’s growing. And so burnout is growing. Retention across palliative care programs is an issue. So these are all the things that we’re thinking about, definitely.

Every part of medicine is dealing with workforce retention for so many reasons, especially since COVID, but while preceding it. But then there’s this less tangible piece, which is how do you sustain your presence in a career through the long haul when the suffering that you see mounts over time? And I think the part that I often see amongst myself and colleagues is it’s not just about leaving the field or not, but it’s sort of like, “How do I remain happy and have sustained meaning in this over time?” And so I think that’s the other part that’s harder to name and that we’re hoping to really think about and measure because even if you’re not leaving, how do you stay present with the suffering of patients and help them find meaning, help yourself. There’s that gray area too.

And how do you find connection to the broader field? I mean, I think we’re both at very well-resourced institutions, a lot of support for palliative care, huge teams—huge teams—and we know that most people in palliative care are not practicing that way.

Right.

And many people who participate in palliative story exchanges are in very small practices in rural areas. They don’t have a lot of connection with their colleagues. So how do we find them and give them the connection that’s going to help create that meaning and sustainability? So I think all of these things are the things that we’re working on. Previewing more of what we’re going to talk about later on, it is getting to know the patient’s story and the family’s story, and then how is illness interrupting that story, integrating into that story? How do we, in medicine, come alongside that story and support the patients and their families through that? And I think that’s sort of the essence of what we do, and it’s all about what does living well mean to them in this moment, and how do we support that?

And is most of that managing pain?

Every patient, it’s something different. So for some people I’m meeting them and pain is the primary issue, and we’re going to do really, really complicated, cutting edge things with their pain to get it under control. Some, their pain is okay, and it might be other physical symptoms—nausea, shortness of breath, we’re going to do the same thing. Or, like Lisa was saying, it’s existential distress. And then we’re sitting with them. Every patient though, we’re sitting with them, we’re understanding who they are, what matters to them, and really figuring out how we can help. And as you might imagine, every person is different, every family is different, and so we just see this vast array of humanity and lived experience and suffering and different understandings of what even that means. It’s incredibly fulfilling and energizing and difficult in many ways to work.

Yeah.

I think helping to advocate and build and collaborate is another key piece of it too, to help our colleagues build some of these skills and know how to hold these tougher conversations because they’re not easy to go there and our patients are really wanting to. So I think that’s another part of it—so that we can figure out what each other needs, how to work together, how to be a team for our patients, I think is a constant growth edge for all of us too.

So let’s talk about the Palliative Story Exchange then. I think we’re there.

Okay. So we’ll go back in time a few years. I was pretty early on in my faculty career and was sitting on our fellowship selection committee. So I got to interview all of these amazing people applying for our fellowship, and I interviewed Alexis, who had already had an amazing career. It was less an interview than a conversation, and we immediately connected over a shared love of narrative and writing. And a few months later, we’re working together clinically on a weekend, and Alexis said, “Wouldn’t it be great if we could all, in the spring, go to someone’s house, open a bottle of wine, sit outside by a fire, and tell the stories of our work. We see so much, we experience so much. Let’s find a way to talk about it and debrief it and use that to connect.” I was like, “Let’s do that.” It was January 2020. So six weeks later, everything changed. I mean, in many ways, it felt like the world had fallen apart.

So I was leading an embedded palliative care team in the ICU at Brigham and Women’s during the initial surge. It was terrible. And Alexis was over at the end-of-life care unit at Mass General. And so we were separated, but we were texting back and forth all of the time, and at some point, we both came to the realization, “Remember that thing we talked about, those stories? Now’s the time. We’ve got to do this.” Obviously we weren’t going to do it in someone’s backyard or in person, but we decided to do it on Zoom. So it was a Monday night, June of 2020, we got 40 people on Zoom, and we had this incredible night of storytelling. It was remarkable. A lot of tears, a lot of laughter. I think we all felt better coming out of it. We both told stories about what it was like in our respective units as we were working through the pandemic.

Someone told a story about going back to the grocery store for the first time coming out of isolation and how ridiculous it felt—and sort of everything in between. And we started getting messages afterwards from everyone from the trainees to the division chiefs saying, “That thing you did, that was really special. You should do more of that.”

What was cool is that Ricky and I both have an interest and love of writing, but what was different about this is how do you bring that into the open and create vulnerability. In writing groups, there is a positive regard to the writer when you’re reflecting back on their writing, you’re not critiquing it. You’re thinking about, “How do I amplify and understand?” So there was something there we were pulling in and making this community, and I think the number of people that showed up after a long workday when we were still around so much suffering, still helping people say goodbye on iPads, it was horrible. I mean, those words don’t even scratch the surface of it, but there was something about people coming together and not feeling alone that felt so tactile. And people would come up to us after and say, “Are you going to do that again? When are you going to do it?”

And really from there, it grew as a community in Boston between Dana-Farber, Brigham folks, and MGH because we are colleagues in that there’s a fellowship between us and many of us train together and collaborate across town. So it was an already great group to bring together. The stories that we heard allowed us to know each other in a very different, much more vulnerable way. I guess to segue into how did we grow? We started doing quarterly events, where we would send a call out to storytellers: “Here’s the event, here’s the date and time. If anyone wants to tell a story, here’s the sign-up form,” with some language around how would we hope they would think about crafting a story. So we often use the prompt, “What can you not stop thinking about? What are you carrying home with you? What are you carrying into work?” We ask that all stories be written down so that no one has to perform, which really helps, I think, people who are worried already about writing and sharing.

And then over the course of an hour to an hour and a half, we might have four to six storytellers. And then the real bulk, I think, of the community creation and the work is in the reflection in between, which we’ve really honed over time. I think to fast-forward to our growth, at the beginning, we applied to do a workshop at the Montreal International Palliative Care Congress, which happens every two years up at McGill, and that was really our first step, I think, in true transformative growth outside of Boston. Ricky is close friends and colleagues with Rachel Rusch, who’s a pediatric palliative care social worker, now a lead at Colorado Children’s Hospital, and she came in and collaborated with us on that. And since then, I think with the three of our backgrounds, it’s really grown into something that we’ve brought to much larger conferences, like the Annual Assembly of Hospice and Palliative Medicine.

We say we’re data-driven and all of those things. And we are in healthcare, and we think in stories, like all the time. We think in stories; we tell stories. I think the natural inclination is to tell a patient case: “Mr. X was a 55-year-old man. He had this. This is what we went through.” That’s not what we’re looking for. And so as Alexis alluded to, when we send out our call for storytellers, it’s like, “What can you not stop thinking about? What are you bringing home with you at night?” And that has been incredibly helpful. One, it’s very broad, so people can go whatever direction they want to.

Our first couple of story exchanges were sort of COVID related because that’s the world we were living in. And since, they’ve expanded and the stories run the gamut. At the beginning of our Radcliffe seminar, we did a story exchange. So really anything people are holding onto, and that’s the stuff we’re going for. We want people to go deeper than the typical patient case because that’s what’s eating at them, and that’s what they’re grieving, what they’re holding onto.

To add onto everything you said, which is that we’re not given space in medicine to grieve or to really think about, “How is this impacting me?” And again, I’m years out from training now, many years out, so things in some places are moving and shifting—and I can only really speak to medical, like the MD training—but there is a way in which you are very much taught to be a good doctor is to have a very strong boundary, to not cry, to be present in the room, but at a distance enough so that you can be objective. And I think there is part of that that is so true. You can’t go room to room and be so permeable. But that totally overlooks the fact that we are in the room, and we might be caring for someone our same age. We might be caring for someone who is our father’s age or has the same diagnoses as our best friends.

There are ways in which we can’t separate ourselves out from the room, and we aren’t given space for that. And when there is space for that, I think there’s a lot of worry, especially from the physician end—which again is closest to me, so the one I’m speaking to, but I’m assuming there’s this everywhere—that, “Will I be judged for having these feelings if I was sad, if I was angry?” And I think we aren’t given training in that in the same way that I know our social work and chaplaincy colleagues are, and we aren’t given space to do that. And so when we’re back in the fellows’ room in our own offices and we’re talking about cases, we’re not usually doing that work together.

I might be saying to Ricky, “Is this the right dose of methadone you would do?” Or I might say, “That was a really tough family meeting.” But it’s not that we don’t want to do that for each other—we’re not given the training. We don’t have the time. We have a list of 12 patients to see. And so, I think, in so many ways as we’ve been creating this, it feels like at the beginning we’re creating the thing we needed, and then it’s like we’re creating the thing we realize our colleagues needed, and then it’s like, “Oh, we’re creating something our field needs, and how do we maintain the preciousness of that? How are we making meaning together? What are we really doing in this storytelling? What are we really allowing for in a more existential way?” That’s what Radcliffe, and I think Lisa, has helped us bring into the conversation of what are we actually doing here when we’re telling the stories of grief? Because I do think grief is in every story, in a way.

What do you think are the sweet essential foundational principles for the story listeners and the reflectors?

Yeah, I mean I think one of them is universal positive regard, as Alexis mentioned earlier, for the storyteller. And so Alexis, Rachel, and I—usually it’s the three of us facilitating. Sometimes it’s two of the three of us, but either way, we’re up there beside the storyteller to support them, and then we will always kick off the reflection as a way of modeling what we’re hoping people will do. It’s very much like a rapid sense making of the story for us that’s very personal. So if Alexis was telling her story, we would give it a second, let it sit with everyone. And then I would say, “You know, Alexis, that story was so incredibly beautiful, and the way you took us through the patient but your own experience really resonated for me and reminds me of how I struggled in my first couple of years as an attending to understand what is the boundary between me and the patient, or my family and the patient.”

So those are the types of reflections that we would model for the people. So sometimes we’re commenting on the story and the writing itself. We actually try and move away from that a little bit to really be about what does this mean for us? How did this land with us? And I think for the listeners, Alexis, I’d be interested to hear how you think about it, it’s about the deep listening. So: “I’ve really heard you. You, as the storyteller, I have heard you. I recognize what you’re saying and here’s how I’m thinking about it.” We had this incredible moment the other day where someone told a story and one of our story listeners reflected back and said, “I don’t think you wrote it this way, but what I heard in this story was hope.” And everyone was like, “Oh.”

The room was electric.

The room was electric. No one had thought about it that way, but that’s how it landed for her. And it was totally this moment where it was like, “Whoa, we’ve got it. This is what we are going for.”

The most core principle, implicit principle I hear in the work is, “Your job is not to fix the storyteller.” So when they bring their heartache, when they bring their pain, even if their story has some kind of tidy, aha resolution moment, that’s where the pause is so important. How did that story touch you and make you think? Because what we never want to do is to look at a griever or to say to a griever, “Here’s how you can fix the pain that I see,” because it’s so dismissive. So I just love that whether that was explicitly or implicitly intended as you cultivated the story exchange, as it grew, that’s what I’ve really seen and witnessed. Are there other principles that you think are important or invitations to the listeners when we think about how we hold space in a storytelling exchange?

I mean, I think there are the very concrete foundational principles, especially in our political climate, of we really say explicitly freedom of speech is not freedom to share hate. So there’s something very important there about having some concrete foundational principles. So I think that is one that we are much more explicit about, what is allowed and not so that people are very clear. It’s never happened, but that feels important to state out loud. We do talk about the fact that stories can be hard to hear and they can activate some people in the room. And our desire is to allow the storyteller to share the full story and their full experience with it. And if you feel like it’s not landing well with you for whatever reason, it’s activating memories that are hard for you in whatever way, it’s okay to step out.

So I do think we have some foundational principles to just create a safe space for us as best we can, not knowing where everyone is coming from, like a psychologically safe space. I think we do do that, as well as some principles about stepping up and stepping back, so those in the room, us extroverts, aren’t always sharing and people who take more time, are more introverted, that’s okay. So I think there are some very concrete principles that we share. And then I think there’s the—how can we cocreate meaning in the room together? And how can we really help the listener allow the story to resonate with them rather than just hearing it—like we often do in clinical work—which is like, how am I going to write this in a note? What does this mean for their symptom management? It’s like, how do we suspend any of those parts and let the story deeply resonate and reflect back to the storyteller, and then allow that to be in the room to create meaning in our own story through the exchange?

And at the point that we’ve applied for the Radcliffe Accelerator, we have had over 2,000 participants at some really well-renowned conferences around the country. Internationally, we’ve recently had an event with a humanitarian crisis, sort of palliative care group in Kenya. We’re going to be working with the largest palliative care group in Australia. So there is a need for this globally, and we’ve been able to collect some initial data, which I’ll just refer to here. We’ve had a survey that we’ve sent out over the last few years looking at, as best we can, how does this impact participants when they look back on who they were coming into the room, how are they as they leave? And we’ve asked questions about, “Does sharing your story, can it be a tool to foster connection with peers and colleagues? Can sharing your story be a format to increase the meaning you feel in your work before and after?”

So we ask some, “Now that you’ve done this, compared to before,” questions, and each time, we see that after participating, participants are able to say that they feel more connected to the larger palliative care community, that sharing their stories in a facilitated format promote well-being and resilience. There’s a huge leap in how people report they feel after compared to before, and with the number of participants we’ve had, we really have felt like we’re at a threshold of knowing that there’s impact and wondering where to go with it—

What’s next?

Because up until this point, Ricky, Rachel, and I are doing this in our academic time and, really, in a lot of our free time in the evenings. And yet people are constantly coming to this saying, “How can I be trained in this? How can I bring this to my institution?” Every time we get feedback, every single one is always like, “More of this this; more of this. This should have been two hours at a conference rather than one.”

We had been thinking about, “Do we do a facilitator training? Is there a retreat here to build this community in a larger scale over the course of a long weekend, somewhere beautiful?” Really selfish ’cause that’s what I want to do. And so we had been thinking about, “What are our next steps?” I think Lisa had been thinking about, “What would a retreat in this space look like? How could we collaborate? What would be meaningful for participants?” I’m on the Radcliffe listserv because I’m really interested in the speaker series here, and then I saw this e-mail for the Radcliffe Accelerator and that there was a next call for the applications to be open. And I was really struck by how creatively open-ended it was and the real draw for it to be interprofessional, interdisciplinary, and to really be made for teams that are at a threshold of growth, hoping to really get to their next step in whatever creative project they’re in, in a very interprofessional, interdisciplinary way. And I saw that e-mail, and I just had this light-bulb moment of, “Could this be what we apply to? Is that crazy?”

’Cause we had applied for multiple grants before then, and some of them we got a little bit closer, many of them we didn’t. And it was like, “Okay, we’re going to keep doing this, but this feels hard.” And then again, it was like, “Is this something that we could get?”

As a way to really think through what are our next steps and how do we bring in collaborators, creative thinkers from our field, from outside of the field, from research, from palliative care, from social work, from grief, all of these different fields to think about, really deconstruct, “What is it that we’re doing? And if we could dream, how would we grow this? What would we do next?” And I think we were all completely excited and thrilled and humbled and shocked.

I may or may not have cried a few tears when we got the news. Yeah.

But it felt like this ingenious perfect fit in that the grants we’d applied for before were really more research science grants to look at how do we measure the impact of our work, which is so important, but it was clear that for whatever reason, the fit of it just wasn’t there. There was something about the beauty of this Radcliffe Accelerator being creative and open-ended and really built for people to come in with creative projects that can make a difference but are right on that threshold of how do we really make a difference? How do we take this to the next level? That felt like an incredible fit. And I think I feel just so thankful for the opportunity.

I’m so glad that Radcliffe was able to offer this.

There’s something really special about being at a historical women’s college where they had to push the boundary, and it’s still pushing the boundary, and it’s still bringing people together that were told that, “You don’t belong here. Your voice isn’t here.” And it’s saying, “No, that actually isn’t true. We’re going to turn it on its head, and we’re going to bring all of you in from all of these different backgrounds. And it might not make sense to anyone, but it makes sense to us.” There is something beautiful and boundary breaking about that, that I just felt lucky to apply with all of us and so lucky to have that. 

This Radcliffe incubator has just been truly incredible. Listeners might know—to my show, but listeners of BornCurious might know—in my career as a social worker, I started in training in narrative therapy. So the power of narrative and how we tell our stories, the particular stories and ways in which we tell them, the meaning that it offers us, and those who’ve worked with me in grief know that I’m often asking us to interrogate our own stories.

So my entrance in, and I’ll let you both take it from there, was just with this goal of, “I want to get to know these people, learn more about what they’re doing, and see how I might be able to bring something to this really special project.”

I think over the last year planning together, we’ve gone through many iterations of what this could look like because the beauty of it being open-ended is it can be anything, which can be overwhelming.

It was.

And we kept coming back to, “Where are we at? Why did we apply in the first place? How can we bring amazing people together to think about where should we go from here?” And so over many iterations, I think where we finally came to was spending our first day showing everyone what The Palliative Story Exchange is because not everyone has attended. And so we brought in five storytellers who are in the Boston area, all palliative care clinicians. We had a chaplain, I think two social workers, a physician, and a nurse practitioner—all with a variety of stories, as Ricky mentioned before—and we started out the day like that going through what we would do for a palliative story exchange over an hour and a half for this group.

And then we really sat down to have everyone introduce themselves to each other and talk about why they said yes to this and what expertise are they hoping to bring. And we really asked them to share that with us and to not be humble in what do they think they could bring to their room. And then we really spent that first day to deconstruct the various components of the work, which was so helpful for us to almost hear reflected back what the different components are. So we had a panel on storytelling, we had a panel on grief, we had a panel on community, and then we had a panel on ethics and ethics and storytelling and a wrap-up. And that was incredibly helpful.

And I think we’ve had a sense of what we’ve been doing, but what was so powerful was having other people reflect it back to us because they see different things than we’ve been seeing, and we don’t know what we don’t know. And there were all of these moments where we could feel them over and over again, where someone would say something: “You know, when I was sitting in the story exchange this morning, the sense of community was here in those moments of reframing the story in that we heard something different from this reflector.” And everyone was like, “Yes, never thought about it that way. That’s what’s going on here.” And it happened over and over and over again. And so our minds, our hearts, we were all kind of just exploding at the end of day one. There are so many threads to pull on and to weave together.

And the questions that came up that I think we don’t always have to dig into. How do we define storytelling in our group? What is it that we’re really doing here when we’re making community? What are we really asking of the storytellers when we say, “Write down a story, you can’t stop thinking about?” What are we actually doing there? So I think each part was really brilliant.

So we went from that to day two. So day one was all about: What is the Palliative Story Exchange? Let’s deconstruct it. Day two was: Where do we go from here? How do we dream, and how do we plan? So day two, we gave people—and this was Rachel’s brilliance. She’s like, “Let’s let them be creative.” And so we bought all of these art supplies and things, and we split them up into two groups. Again, we’re very intentional about bringing different types of people together in the groups. We went to a different room, and we’re like, “Here are the things we’re thinking about. We’re thinking about facilitator trainings, we’re thinking about making this financially sustainable. We’re thinking about a retreat. But what are you thinking about? Spend an hour and a half thinking together.” So they did that. “And dream, and where could we be?” Joy and holding and—

Swag.

And swag came up. And all of these things. And then in the last half of the second day, it was really about: What do the next three months look like? What do the next six months look like? What does the next year look like for The Palliative Story Exchange? So let’s be concrete. So, how do we fund this? Where do we go? What grants should we apply for? How do we think about a facilitator training? And this was where we were all taking copious notes, and people were just throwing these things out there. Totally allowed us to think differently, and I think we have exactly what we were looking for. We have the dreams, and we have the roadmap for where to go from here.

One of the things that I drew away from, which I wasn’t expecting in it because, of course, some was around, “How do we look at the data we already have? How might we get more data?” Because if you’re going to go for funding, let’s be real. You got to have some data. Michelle Barton, who’s brilliant, this researcher in the business school at John Hopkins, and she just looked at us and said, “You have 2,000 participants. You’ve had X number of storytellers. What if we looked through for the meaning-making that’s happening, the sense-making that’s happening? What if we dig in, because whether you’re taking this to your large palliative team at MGH or you’re taking this to your rural four-person team or maybe collecting a bunch of four-person teams together, we want to know what is the common threads and the sense-making that’s happening.”

Is there a database where you have all the stories that you’ve gathered, or—

I want to be clear for the listeners, we don’t have access to the actual story nor consent to use their stories yet. So of course that would be a really important piece. But we have kept track of who are our storytellers, where are they from? What was their story about? What is their information to get in touch with them? So we have kept track of that as well as what events have we had, how many participants at each? So we have very high-level, not very detailed, information over the past five years about who’s participated. When we were thinking about, “How do we bring this to different groups? Are we bringing this to division leadership? Are people coming to us? How do we grow in a meaningful intentional way?” I think someone had brought up the fact, “You’re working with teams to create community.”

And then we went down a whole rabbit hole. “What does community mean? What are we actually meaning when we say we’re trying to create community?” So that has been such a beautiful part of this. I don’t think we have concrete answers to all of those questions, but I feel like we have a much better sense of what are we bringing and what are people needing and how can we grow from here?

So are we thinking then chapters, Palliative Story Exchange chapters around the country, or—

I think, yeah.

Yeah?

Around the country, around the world.

World.

The world. You said Kenya earlier.

Australia.

Australia, we’re coming for you.

Australia, Kenya, Canada. Yeah. I mean I think that’s what we want. We want people to be able to do this in their communities, in their groups, their divisions, their teams, what have you. And we want to make sure that we have a model that we’ve cultivated and we use and we are studying. And so we want a way to have them use that model. We want some fidelity to the model because we know that that’s working too. And I think that’s important to us.

And that’s part of I think what we’re thinking about this cohort at least and beyond as being advisors or consultants to us. So there’s the fidelity to the model.

So I think we have been pondering for a while now, “What does it look like to have pilot sites? What does it look like to build community?” I think, yes, the question of growth, and really intentional growth, what does that mean? And if we know that this has been so helpful for us and for our participants so far, it’s hard not to want to give that to the larger community, many of whom we’re close to. So I think that brings me to the idea of a larger community, too, that we feel like there is vast energy and need there, not only to have pilot sites or chapters, as you said, but to be able to connect to a larger community that is interested in sinking into storytelling and listening and vulnerability and being in community and having these conversations.

And so we’re also really interested and excited about thinking about a larger community of practice. What does that look like? How do we keep people connected? What would a retreat space look like that brings people together yearly or twice a year into this space that I think gives them that feeling that everyone walks out of the smaller exchange with? How do we do that on a larger scale?

And how do we track the long-term ripple effect of that?

Yeah.

Yeah.

So it’s an intervention, but it’s an intervention of such a different kind of experience and quality that I think we need to better understand what’s the long-term impact of it.

I love that, as an intervention, it’s one that builds humanity. That’s what it’s really about. Just embracing your humanity rather than shutting it off in order to do the work.

And figuring out a way to do that really with anybody listening to the show who’s been a caregiver in their personal life or a professional caregiver knows that there are ways and spaces in which we cannot be drinking from the fire hose all the time, but how do we mindfully pause and shut down? Digesting a story is a way to sort of keep you in the game, as it were, to keep you in the common humanity and community.

I mean, we say it and we think it, you feel it in the Palliative Story Exchange, and I think we’ve been lucky to go into some of these larger spaces, international conferences, and we’ve had people tell stories from—someone told a story from Nigeria, and then someone told a story from Oregon. And the content of the stories were very different; the feelings of the stories were not. And it was incredible because we’re like, “Oh, yes, I feel that too. I don’t have the lived experience you have. I will never have the lived experience that you’ve had. And yet both of us working in this space, even in very different places, very different cultures, different languages, those feelings are there.” And that’s powerful for people. They walk away saying, “I feel less alone in my work. I feel less alone in my professional identity. I am part of this larger community of people, of practitioners, of healers.” And that in itself, I think, brings meaning and connection and joy.

And compassion. I want to say common humanity is the key. When we think about Kristin Neff’s work around compassion and self-compassion, seeing your common humanity, so that you can have self-forgiveness and self-care and care for others, is critical. And this work is a compassion driver.

You mentioned earlier the power of storytelling, and I mean that’s it, right? This is it right here.

That we are actually so much more alike than we are not, and that sounds cliché, except we know from these experiences that it’s absolutely true—and why it matters to lean into that—is because of the ripple effect we all walk away with in terms of it.

I mean, we know from life.

We know from life, yes.

That people don’t consider that enough: how alike we really are, how we have all the same wants, needs, desires.

I think being in community when you’re witnessing suffering—and I don’t mean to say that all palliative care is suffering or grief, there is a lot of funny, there’s a lot of joy, there’s a lot of meaning—

And those stories come out.

And those stories do come out, and I think that we need the processing though for the grief, and even what does it mean to have fun when there’s grief? There’s a lot there. But I think the idea of being in community and knowing you’re not alone is such an essential part of this and I think speaks to our desire to have a larger community here. I think the other piece alongside storytelling and deep listening is what does it mean to go back to the work when you’ve seen a colleague of yours make meaning and find a story in something you might not have made meaning or find a story in? There’s something there, too, in this idea of the writer’s eye and seeing the world really intentionally through this lens of story. If you are someone who sees the world through the lens of a poet or a writer, you are always going to find that little moment. I walked out of the neuro ICU having a really sad family meeting for a young patient dying, and there is an area of bamboo at MGH, and I was in a spot of, “How am I going to go see the next patient after that?” It was really sad.

And all of a sudden, there was a cardinal in the bamboo in the middle of winter. It was so strikingly red and green, and the sky was gray, and I was like, “Oh, my God.” And within a second the cardinal was gone, but there was something about noticing that and then thinking to myself, “This could be an essay called ‘The Cardinal in the Bamboo.’” And all of a sudden my day was different. I think even seeing how someone has taken a really difficult patient situation and turned it into a story and found meaning in it can even change the way you see your work when you walk through your day.

And maybe that’s part of this too, is helping people not only with the narrative—like yes, with the narrative—and what that does is that helps people start to look for the meaning and then find it, and that gives them some sort of healing and sustenance.

Yeah, and that’s not to say, I think I’m sure everyone here has dealt with their own personal illness, family illness, and you never want someone to say, “Oh, the silver lining here is this meaning you can find.” Like F that. I am not saying any of that. Things are unfair. You are never going to walk out of the room of a 35-year-old parent who’s saying goodbye to their three-year-old, and think, “I’m going to find meaning here.” So I am by no means saying that at all.

I agree. I agree.

My sister lives with heart failure. When I go to see someone in the CCU, despite the fact that I’ve—it is still hard, so I’m not at all saying that, but I think there is something about trying to really dig in, like, what am I really seeing here? What am I feeling? And allow that to percolate. You might not find any sense of meaning in it weeks or months from now. Some of the stories that we all write are years later, but I think there’s something to hold onto there to not let it be just a binary. It’s not just one thing or that. Can we let it resonate? Can we hold onto it? Can we allow it to resonate with our personal selves and find a story in there, find meaning, or find that through listening to our colleagues?

Well, and I think it really speaks very much to curious—since this is a co-collaboration of Grief is a Sneaky Bitch and BornCurious—as I hear you telling that, we say, and I think it was even said in the room the other day, literally everything we do, feel, everything we say is a story. Our entire lives is a story. Humans are storytellers. Things happen, and then we build a story. This is the work I do with my clients all the time. “Notice the story. How is this story making you feel? Is there an alternate story?” And this all requires such deep, profound self-compassion and deep curiosity.

While you’re talking about all these things, I’m just thinking, it seems like what we’re doing is going toward a model of healthier processing, healthier processing of grief—

Integration, metabolizing, yeah.

Yes. But is that even a thing? Is there such a thing as healthy grieving?

I don’t know if I would say there’s healthy grieving because again, that’s a binary black and white way of thinking. If you just do it this way, you’re good. Most of the myths that we have in our culture that are problematic, try to tell that story. You move through the five stages—which by the way isn’t a thing—and you just get to a year and you’re done. I do think there’s healthier, and I also think there’s integrating. We often talk in social work, maybe even in medicine, maybe even in the Palliative Story Exchange, that we integrate our story, and I think our practice in life and in the wake of loss in our grieving journey, as we often refer to it, is learning how to accept and be present to both and to navigate in between the two.

And just hearing you describe all of that makes me think of the work that Palliative Story Exchange is doing. I mean, that’s what it’s doing exactly, right? But just in a specific context.

Yes.

Yes.

:
Holding the duality, together.

Yeah, absolutely.

As you’re talking about the idea of healthy grief versus healthier grief and these binaries, I think we thought a lot the past two days about a safe space here, because when you’re opening that container to a group that doesn’t always have the knowledge of how to grieve together, that are coming in from different phases of where they’re at in their career, what has happened in their personal lives, what are they seeing? I think we’ve thought about this idea as we do a call for storytellers: “Write from your scars, not your wounds.” How do we try to be intentional about that in terms of what the space can provide therapeutically and what the space cannot provide, especially if you’re at the beginning of someone’s workday or in the middle of someone’s workday.

Similarly, audience members are coming in with all different experiences. We’ve had people whose parent just died. Just your idea of what’s healthier and what’s healthy is bringing up that idea that I don’t think we have answers to, but certainly Radcliffe has helped us really interrogate more, “What are we doing? How do we be intentional about this? How do we create a space that is safe and healthy to the best of our ability?”

Knowing that that goalpost will move and change in each iteration that we arrive to.

Yeah. No, I mean, it makes me think of what Michelle Barton has told us over and over again in her work. She’s like, “Resilience is not something that you have or something that you are. It is something that you do.” And resilience in medicine and healthcare is a complicated, loaded term, given all the systems factors that lead to burnout and exhaustion and staff attrition and all of those things that, from our level, we’re not going to fix it. We’re going to advocate, and we are going to fight like crazy to make things better. But there are systems factors at play, and yet, there are ways that we can help people. If resilience is a thing that you do, we can help them do that with the Palliative Story Exchange, with thinking about healthier grief, with thinking about telling their stories—and that’s the space we really want to be in.

Yeah. This notion that you just said, Alexis, which is one of the many benefits of our experience here at Radcliffe over the past few days, was the luxury of being able to interrogate, “What are we doing? What does make a safe space? Is it in the doing or the being? And then how do we distill that into something that we can communicate so that it doesn’t just have to live with the walls of the four of us or the places that we can go, that it can live beyond?”

I’m going to ask you now: What can’t you stop thinking about? What are you taking home from the Palliative Story Exchange?

Oh, good one. Yeah.

I think the thing that I’m coming away with is the wisdom of creating a deep container for the deep reverence of the human experience. And then how do we, as we scale with intention, make sure that we are creating a deep container that allows for the reverence of the full human experience.

I think for me, I have these two sides to the coin that I keep coming back to, which felt so heartwarming and fulfilling. The idea that this is precious in and of itself. Storytelling is not unique. Every human has done it forever. But this particular way to bring people together, especially in palliative care, to do it and how people feel in it, that that altogether is precious and doesn’t need to be anything more than it is. The other side of the coin is if we love this work and we love our colleagues, how can we not want to grow and expand it? But those things are sometimes at odds. As you get bigger, the preciousness changes, and so I’m really holding that. And how can we use all the principles and questions and curiosity that came up to really be intentional about how to teach this and how to grow it in a scalable sort of small-step-by-small-step way, but holding this tension between keeping a preciousness and growth.

I think someone said, “You have to be aware that as it grows, you will lose something, but if you keep 80 percent, is that enough? Is that good enough?” I think I’m deeply holding that and thinking about how to take everything that we learned and felt and how to create a model that makes sense.

So if our listeners wanted to hear more about Palliative Story Exchange, where could they find more information, other than our show notes, of course?

Yes. Yeah, so we have a website. It is pallstoryexchange.com. On there, we have a whole history of places we’ve been, different conferences we’ve been to. There’s a link to stay in touch, to send us an e-mail, or to get on a Listserv if you want to hear about future events or connect because you’re interested in bringing this to your own institution. We also have an Instagram page now at @pallstoryexchange.

We have a paper that we published, if you’re so academically inclined, in the journal called Palliative & Supportive Care. It just came out a few months ago. You can find a link to it on our website as well. There we break down the science of what we’ve done and our program evaluation data that we talked about, too.

Great.

Ivelisse, I don’t know about you. It’s been such a treat to cohost a show with somebody different. I know you have a usual cohost.

Yes!
I know you have a usual cohost.

I do. Shout-out to Heather Min.

Shout-out to Heather Min. Thank you, Heather, for letting me step in here. It’s been such a treat to be able to be with you today and to be curious around this topic. And Ricky and Alexis, thank you so much for joining us.

Oh. Thank you, both, so much.

Thank you for doing this work here. I mean, just the storytelling aspect of it, again: we talked about it—the power of it—and I’m so glad you’re bringing it to your corner.

And more corners to come.

And more corners to come.

Exactly.

Yeah. Thank you.

Thank you, everyone. 

Thank you. 

Thank you, Lisa.

That concludes today’s program.

BornCurious is brought to you by Harvard Radcliffe Institute. Our producer is Alan Grazioso. Kevin Grady, Anna Soong, Lily Roberts, Emerson Prond, and Cabin 3 Media provided editing and production support. Many thanks to Jane Huber for editorial support. And we are your cohosts. I’m Ivelisse Estrada.

And I’m Heather Min.

Our website, where you can listen to all our episodes, is radcliffe.harvard.edu/borncurious.

If you have feedback, you can e-mail us at [email protected].

You can follow Harvard Radcliffe Institute on Bluesky, Facebook, Instagram, LinkedIn, and Threads. And as always, you can find BornCurious wherever you listen to podcasts. Thanks for learning with us.

Heather Min:
And join us next time.