Notes from the field of visual health mapping
It’s been awhile since my last update, and I want to share some more nuggets of insight I’ve gained while conducting the business of Pictal Health — helping people visualize and share their health histories. Let us jump in.
Visualizing daily functioning
In a couple of recent cases, I’ve come up against the limits of the two major forms of visualization I’ve been using — a health history timeline, and a symptom map.
These are helpful when people need to show what happened over time or illustrate their bodily symptoms — two common needs — but recently a few clients have wanted to bring to life their ‘limited daily functioning.’
For example, I worked with a person with memory and cognition symptoms, and his wife told me a number of anecdotes that really illustrated how difficult daily life was for both of them. I struggled with how to represent these, and then decided to draw some rough comic panels. Here are a few examples:
As you can see, I didn’t spend a lot of time trying to perfect the visuals and kept the drawings very basic. This was for practical reasons, as I didn’t have a lot of time to spend, but fortunately this style also happens to align with the drawings I’ve done elsewhere for Pictal Health. Regardless of their simplicity, the drawings build on the text to help set the scene.
All together, these comics felt like they got to the heart of their lived experience, and it was a more emotional way to visualize their story. We also put together the usual health history timeline and combined it with these comics to give a holistic view of this person — the timeline showing the facts of how the illness unfolded, and the comics illustrating the narrative of daily life.
Looking back on difficult or traumatic events
For people with very complex histories or those who’ve had a specific traumatic event, I have felt concerned that seeing their story will bring focus to the difficulties they’ve experienced and make them feel depressed. So far that hasn’t actually happened. On the contrary, people seem to have a sense of wonder at ‘seeing’ where they’ve been. One client I worked with, who had a very complex and full health history, said “look at how hard I’ve been working” — she wanted to show her doctors just how many treatment directions she’d been pursuing, and how they hadn’t made a difference. A few other clients with PTSD have been able to look back on their life and gain a new understanding of their life as a whole, including the traumatic event.
I still feel cautious about this, and I think I have more to learn about how to support those who may be disturbed at seeing their life journey. But I have learned that I need to quiet my own anxiety around these types of situations and follow the patient’s lead.
Helping doctors get to know patients and make them memorable
As I start to work directly with more doctors through this process — namely Sunjya Schweig of the California Center for Functional Medicine and some local VA doctors I’m currently collaborating with — I’m learning more about how this process helps them. Aside from the obvious (things like making appointments more efficient and saving them time digging through the medical record), I’ve recently heard that the visuals make patients’ stories more tangible and memorable:
“It makes my intake easier, and even more interesting to me is the way the patient’s case is much better retained in my memory. For the two cases who came in during the last couple weeks with visualizations, I can still remember the story in detail. This is not the case for my normal patients where everything blends together and I don’t retain the details as well when not looking at the chart.”
This makes sense. The visuals provide an additional modality that helps doctors commit to memory what they’ve learned about the patient. I’ll quote this article from Psychology Today:
“A large body of research indicates that visual cues help us to better retrieve and remember information. The research outcomes on visual learning make complete sense when you consider that our brain is mainly an image processor (much of our sensory cortex is devoted to vision), not a word processor. In fact, the part of the brain used to process words is quite small in comparison to the part that processes visual images.”
In addition to helping doctors remember their patients better, it also helps them better understand their patients ‘as people’:
“I’m finding these really helpful for getting to know patients better, especially with regard to work and social history.”
For the three veterans I’ve worked with so far, it’s been helpful to map out their work history. I don’t do this with most people, but it felt significant to their story. Two of them had long-term work-related chemical exposures that seemed potentially related to their cognitive and memory loss symptoms.
Two also had impressive careers that involved building and making things; they love working with their hands and solving problems, and have continued to do so into retirement. For both of them, their health has interfered with their ability to do this work, which has left them feeling depressed and unfulfilled. I made sure to articulate this in their story and pass this along to their doctors. As doctors try to help mitigate the pain of illness, it’s helpful for them to understand not only physical sensations but psychological impacts and losses; that way, they can hopefully be more effective in helping to improve patients’ quality of life.
It is always a pleasure to learn from the people who have entrusted me with their health histories. Thanks to them, and also to you for reading. I’d love to know what you think — feel free to leave me a comment below or learn more at pictalhealth.com.