Behind The Clipboard: Using Narrative Medicine To Nurture Compassion, Understanding, And Emotional Connection During The COVID-19 Pandemic

by Tien Lam

Coauthors: I express my deepest gratitude to the core mentors and leaders of the CHOC Children's MI3 Summer Internship Program for their wisdom, for their invaluable mentorship, and for inspiring me to continue moving forward.

Pandemic Innovations

Infection control efforts during COVID-19, including face coverings, physical distancing within healthcare sites, limited consultation lengths, and telehealth, among others, have inadvertently impaired the emotional relationship-building founded within clinical settings. In line with this observation is a need to address the presently heightened phenomenon of anxiety, distress, and interpersonal disconnect currently gripping medicine, consequently straining the physical and emotional separation endured by children and their healers. A path towards nurturing meaningful connections may reside through the healing and bonding means of storytelling.

“Behind The Clipboard” is a proposal to capture self-written stories, reflections, experiences, or mini biographies of pediatric patients and providers within a mobile app platform. The project’s name is inspired from the archetypal scene of a patient and their doctor with a clipboard in hand sitting within a room, only for that documentative tool to introduce the uninviting impression that the clinical picture of a patient is what solely matters at hand, an issue pronounced during COVID-19. This project presents an opportunity for children to not just express who they are beyond their condition, but to also understand more deeply who their providers are behind the clipboard and connect over something shared intimately.

Inside the app, the care team and child are invited into a privately restricted storytelling cohort. During storytelling, children may share the experiences of their care, their life, their dreams, who they are, or even what they plan to do after they are relinquished from their care. The platform’s design is centered around the aesthetic of a children’s book. In an imaginative spirit, children may select from an assortment of fonts, colors, child friendly book templates, and are afforded a feature to express illustrations alongside their storybook. Provider’s narratives can likewise be personalized and may be reused or edited to each individual patient. Afforded to all is the customization of a cartoon character, whether it be a fictitious being or their own likeness, to reside within the margins of the story to accompany a reader. When opening someone’s book, the character can emerge and be set to lead with a friendly wave animation, a dance, or the emoting of a favorite hobby to promote an inviting, unique start to the story.

Utilizing storytelling into care does not dismiss important clinical aspects, but rather inspires a path for a child and provider to share an intimacy surrounding lived experiences and who they are. The convenient accessibility of delving into stories outside of encounters through an app additionally tackles the issue of time-compressed consultations and room visits when pandemic precautions have made relationship-building difficult. There is also strong implication for providers to participate in something powerful and fulfilling when delivering care. Importantly, the momentous impact of Behind The Clipboard’s capability as a storytelling space resides in allowing children to feel embraced, to have a voice during their care, to connect with the providers partnering with them to heal, and to have an outlet to therapeutically express their identity beyond their condition amidst the limitations of a pandemic.