The passion and the peril: storytelling in medicine.

Medical caregivers are always telling stories because stories provide meaning to much of their working lives. Although there is surely an element of shock value in the stories that medical professionals choose to share, the compulsion to tell a story is largely motivated by the profound emotions kindled by the clinical experience. This impulse needs to be recognized by the profession, even nurtured. However, as Wells and colleagues highlight in this issue, social media adds a new twist to storytelling. Exponential amplification combined with lack of space for nuance is a toxic brew. This needs to be explicitly emphasized with medical trainees. Although privacy rules already exist, the meaning of professionalism is to cleave to the spirit of the law, not just the letter of the law. Caregivers' primary duty is toward patients, not to writing careers or to online following. Consent should be obtained wherever possible. Identifying characteristics must be changed. Any story that might be damaging, hurtful, or embarrassing to a patient does not belong in the public sphere. Nevertheless, those in medicine need to recognize that the impulse to tell a story is innate in the human race, especially so in the caregiving professions. Experienced caregivers need to help students understand that stories provide depth and meaning to medicine but, when broadcast inappropriately, can cause harm.