Doctor Turned Author Shares How Story Principles Helped With Treating Refugees

Science vs Art

When Martina Scholtens (Byl, ‘96) was a student at Trinity Western, she felt like she needed to choose between her love of art and science. At first, she didn’t see how the two could mix, so she decided to pursue the dream of becoming a writer.

Her first year was filled with artistic pursuits. But when she encountered a dorm mate who wanted to be a missionary doctor, Scholtens felt her perspective change. Medicine completely resonated with the science part of her mind. For a time, her dream of being a writer would take a backseat.

“I figured if I pursued science, I could also do art on the side,” says Scholtens. She couldn’t see how it would be possible to do it the other way around.

A Return to Writing

After graduating from Trinity Western, she went on to medical school at UBC. But by the end of her first year, she found herself writing again.

“I kind of felt like something was missing for me, with such a heavy science load in medical school,” says Scholtens, who decided to return to writing poetry. Scholtens says it was the experience of working on a cadaver in her first year that really stirred her heart back to writing.

“There’s this whole other kind of profound human, spiritual, emotional experience to dissecting another person’s body that wasn’t really acknowledged,” says Scholtens. “So I wrote about it.”

The resulting poem was so well-received, it was published in the Canadian Medical Association Journal.

Medical Care that Cares

One day, while reading a medical journal, Scholtens encountered a concept called Narrative Medicine. She was instantly captivated by the concept of clinical practice marked by narrative competence—listening to the story of a patient and using that to help inform their care.

“If you’re thinking about the importance of story, and look at how the patient tells it to you, not only is there factual information, but there’s symbolism, recurring characters, different themes that emerge as you know a patient over time,” says Scholtens. “These story elements give you information if you’re open to it.”

After attending a workshop in New York, she knew she’d found her perfect fit, and decided to incorporate Narrative Medicine in her practice.

When Scholtens was introduced to Bridge Refugee Clinic—the only refuge clinic in B.C.—she felt she was really able to use what she’d learned.

“Narrative Medicine really tied into that kind of work,” says Scholtens. “We saw one to two thousand patients a year, most from refugee camps, so their stories were important to their care.”

Scholtens was offered a position at the clinic in 2005, and worked there as Medical Coordinator and Family Physician until 2015.

Working with Refuges

“It really was a great place to work,” says Scholtens. “The patients’ stories were fascinating. And I really liked the people I worked with. My colleagues were all very committed, unconcerned with recognition or money. It’s really satisfying work. The suffering was so great, but I had training to offer some relief to those problems.”

Being able to do meaningful work like this gave her purpose. But it was very consuming. Because of the intensity of the job, the burnout rate is high. Hearing stories from refuges about the horrors they encountered takes a toll. One way Scholtens found to deal with this was through writing about these experiences.

“So many thought-provoking things happened every day. I knew if I didn’t jot them down, I wouldn’t remember,” says Scholtens, who really struggled with the stories of horrible things humans would do to one another. She also struggled when faced with the disparity in wealth between patients and clinic staff. Many of her patients struggled with basic needs, like keeping their families fed.

It was these early notes that formed the bulk of what would eventually become her first book, “Your Heart Is the Size of Your Fist.”

Your Heart is the Size of Your Fist

Photo taken by David P. Ball, from a story at https://thetyee.ca/News/2012/06/19/Refugee-Health-Cuts/

Scholtens started putting this book together after she left the clinic in 2015. She says the title came from an expression she regularly used with patients. Not only is it true of the human anatomy, but it also serves as a beautiful symbol.

“A raised fist can have two meanings,” says Scholtens. “A fist can be a sign of aggression, or a sign of strength. What I saw in my patients was strength. It takes a lot of reliance and strength to flee their country to get here. I liked that imagery, that the fist reflects different states of your spirit.”

The book was released in 2017, and has gone on to receive critical acclaim beyond what she’d ever expected.

What’s Next?

Amidst her busy schedule post-publication, Scholtens completed her Master of Public Health degree at UBC in December, 2017. Her time since has been filled with doing interviews about her book and speaking at a variety of events. She decided to take a short break, but it seems to be short-lived. A new opportunity has already presented itself.

Scholtens will be starting at the Royal Jubilee Hospital in Victoria in the fall of 2018, working as a psychiatry resident.

“Mental health was where I saw the most suffering at the refugee clinic, and I plan to focus on that area of medicine going forward,” she says.

The variety of experiences at the refugee clinic, as well as her extensive studies in Narrative Medicine and Public Health, have provided Scholtens with precisely the tools she needs to thrive in her new position, and she couldn’t be more excited to enter this new season.

 

Martina Scholtens was selected to receive The 2018 Alumni Achievement Award. Click here to get tickets to attend the award gala.