Narratives

Stories can be the heart of your essay, if you handle them effectively. Below are some tips on how to maximize their value.

How to Incorporate a Narrative

Integrating your story effectively ensures that it flows well within the essay and has a strong impact. Failing to do so could lead to choppiness or confusion on the reader's part. Here are some possible approaches, but what you ultimately use depends on your content:

1. The Origin. The most common approach is to start from the beginning. Everyone has a story to tell about his or her early interests in medicine. This tactic can be an effective way to grab the reader's attention and offer insight into your fundamental attraction to the field. You should be aware, however, of two concerns: a) if it has been done many times before, and if your basic idea is about "realizing the power of medicine," then you won't stand out; b) most early stories revolve around passive observation and therefore offer limited insight into your character and abilities. Despite these concerns, there is still much potential in this approach if you have a compelling, original story to tell.

2. The Flash Forward. Sometimes your essay's main focus will be showing the progression or growth of your interests and abilities. That doesn't mean, however, that your essay must start from the beginning. Often it can be effective to open with a more recent episode to accomplish three purposes: a) establishing a clear context for the rest of the material; b) demonstrating a strong interest in medicine from the beginning; c) bringing to the forefront a significant experience with depth you could not have achieved in an earlier stage. It's the last point that distinguishes this approach from the previous one. Using a Flash Forward opening enables you to highlight your strongest points, as in the Hierarchy of Evidence structure, but then move backward to show your growth process.

3. The Bookend. Like the first two, this approach involves using a story in the introduction, but it leaves that story unfinished until the conclusion. For example, you might stop within the story to reflect on how you found yourself in that position. The body of the essay would then be a flashback to the experiences that led you to the place of the introduction, and the conclusion would return to complete the story. Another possibility would be a story that involved two distinct phases; the body of such an essay might discuss what you learned between the phases, and the conclusion would show how you applied what you learned to the second phase. Again, the precise approach depends on your content, but the Bookend method can be a very effective way to create a flowing, coherent piece.

4. Within the body. Regardless of whether you choose to open with a narrative, you may find opportunities and reasons to insert a story within the body of the essay. This is the approach for which you have to worry most about integration. Unlike introductory anecdotes, you should not jump right into these stories without preface. You will need at least one sentence to make the transition from the previous paragraph and briefly hint at what themes your story will illustrate. Actually beginning your story will usually require some introductory phrase, such as the following:

"One memorable incident involved..."

"I recall one patient who..."

After the story, you should have some significant insight with which to conclude to justify the story's inclusion. This line should not be a mere repetition of the transition from the beginning of the paragraph, because you now should have more concrete details from which to draw more in-depth conclusions.

What to Include

The basic rule here is the same as always: include specific details. The purpose of using stories is to illustrate your points with concrete evidence, thereby giving your ideas force and context. Telling one specific story enables you to achieve depth and convey personality beyond what you could achieve in brief, isolated descriptions. It's not enough, however, merely to decide to include a story. Some writers will start on the right track but end up conveying nothing meaningful. For example, they might name a specific personal incident and then jump to generic conclusions without demonstrating anything substantive about their character. Here are some more specific tips that have come up in other contexts but are especially important for stories:

1. Show active contribution. Many people tell stories in which the payoff is a lesson learned. While this can have some value, it does not say as much about your character because you are only responding passively.

2. Emphasize the process. Don't set up a problem and jump to the solution. Show us the process of reaching that solution. Give details about your approach and your reasoning.

3. Paint a vivid picture. Try to draw the reader into your story by including details that bring the story alive. One effective way to accomplish this is to think visually. For example, if you're meeting a patient in the story, describe the color of his hair or the expression on his face. Of course, you should not get carried away and go down tangents or become monotonous. For example, if you're recalling a conversation, don't bother recounting all the pleasantries with which it began.

Gleaning Insights

Anecdotes should serve some clear purpose, but you have to be careful about sounding contrived. One common mistake is to start citing lessons before you've finished the story. This kind of interruption adulterates the force of the story itself. Be careful that your insights flow naturally from the details of your anecdote: stay close to your personal story and avoid making grand pronouncements based on a minor episode.

An Example

To put the above suggestions in more concrete terms, we will analyze one actual essay from a critical perspective. First, this applicant chose to incorporate his story into the body of the essay, but it could have been used as an introduction and would have been more engaging than his current, somewhat dry opening. There is nothing in the current introduction that provides essential context for the story, and the insight it offers, such as the final sentence, would have more force after the concrete evidence has been laid out.

The writer uses the following transition: "While I had many meaningful encounters, one in particular stands out." Although this is functionally sufficient, it relies on the vague term "meaningful." A stronger transition might have looked like the following: "While I had many meaningful encounters, one in particular reinforced my sense of purpose in devoting my career to medicine." This hint then paves the way for the insight that closes the paragraph: "Seeing Scott's smiling face, I realized that my future must revolve around instances like this one, and that true fulfillment comes from helping another person heal. My summer at the Ontario Cancer Institute taught me that patience, compassion, and sensitivity are just as crucial as scientific skills for medicine."

Now let's evaluate the paragraph on the strength of its details. He shows his active contribution as follows: "Sensing that Scott desperately needed to be cheered up, I initiated a conversation with a soccer joke." It's a minor gesture, but it's a tangible act. Note also how the writer draws the reader into the situation with vivid details: "Scott quietly sipped orange juice while tugging on his baseball cap, trying to conceal his balding head, the unmistakable sign of chemotherapy." He does not simply tell us that Scott looked nervous or self-conscious; he describes an image that the reader can picture in her head.

Finally, note that he allows the story to unfold naturally without forcing conclusions on it, until he makes the transition: "I felt intensely satisfied, although I had done nothing for the boy's physical condition." The flow from story to insights drawn is smooth and fitting.

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