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MEDICAL YEAR
IN REVIEW

Medical Students and Storytelling:

HIV Out Loud

By Yolanda Crous and Joshua Carrasco

I have always believed in the power of stories. I was an English

major in college, and I spent my first career as a magazine editor
in New York. So, when I began to consider my job to go to med-
ical school, I turned to the place I’ve always gone for life advice: the
bookshelf. While I was shadowing physicians and volunteering in hos-
pitals, I was also devouring tomes by physician-writers like Paul Farmer,
Rana Awdish, Abraham Verghese and Elizabeth Ford. Page after page,
story after story, I searched for a line or a moment that would signal to goals: 1) to create new spaces where those in the HIV community—
me that applying to medical school in my 40s was not an absolutely not only people living with HIV, but also their loved ones, their physi-
disastrous idea. (Spoiler alert: It was the best decision of my life.) cians, HIV advocates and anyone whose life has been touched by
What I did not know then was that I would never think more HIV—can tell their stories how they wish them to be told; 2) to ensure
deeply about the power of storytelling than I have as a medical stu- that these stories are preserved and easily accessible by the public, es-
dent. I owe this gift to HIV Out Loud, a storytelling project dedicated pecially by those living with HIV; and 3) to establish an HIV Out
to creating and preserving the oral history of HIV in South Texas, and Loud medical-school elective, co-led by the CMHE and people living
a National Endowment for the Humanities-funded collaboration be- with HIV, that will train students in oral-history interviewing tech-
tween the End Stigma End HIV Alliance of San Antonio (ESEHA) niques. It is our hope that this elective will not only sustain the oral
and the Center for Medical Humanities and Ethics (CMHE) at UT history project but help reduce HIV stigma in health-care spaces and
Health San Antonio. encourage compassionate, collaborative patient-centered care among
In November 2019, Dr. Barbara Taylor, an infectious disease physi- our future physicians.
cian who was co-chair of ESEHA at the time, invited students to a live The elective has not yet begun but HIV Out Loud has already
HIV storytelling event at the historic Guadalupe Cultural Arts Center. trained two cohorts of medical students. We held our first mobile sto-
The theater was packed, but all conversation stopped the moment the rytelling session at World AIDS Day in December, and several mem-
first storyteller walked onto the stage. As a first-year medical student bers of the HIV community generously took time out of the event to
who still spent more time in the lecture hall than with patients, I was entrust their stories and memories with us—an honor we do not take
struck by how each narrator centered their story not on illness or the for granted. We are actively looking for members of South Texas HIV
virus but on how living with HIV had reframed the way they were seen community to interview, so if you are interested in sharing your story
by the community—and the way they perceived themselves. for the oral history project, please reach out to
That night, those stories, jolted me into an awareness of how pro- HIVOutLoud@gmail.com.
foundly a single sentence or gesture by a physician or staff member can As for me, I still hit the bookshelf when I need guidance on big life
change the trajectory of our patients’ lives and health. A growing body questions. But when it comes to figuring out what kind of physician I
of research indicates that even subtle or unconscious judgmental tones want to be one day, nothing will ever teach me more than the stories
when discussing a patient’s sexual history or lecturing a patient about of my patients—and the stories of HIV Out Loud.
missing a clinic appointment can negatively affect the patient living For ESEHA’s Anti-Stigma Guidelines, go to
with HIV and can reduce the likelihood a patient will adhere to a life- endstigmaendhiv.com/resources.
saving antiretroviral medication regiment.
In the months and years since that storytelling night in November, Yolanda Crous and Joshua Carrasco are medical
ESEHA and the Center for Medical Humanities and Ethics have students at the UT Health San Antonio Long School
joined forces to expand ESEHA’s storytelling program into HIV Out of Medicine, Class of 2023. They are leaders of the
Loud, an oral history of HIV in South Texas. Under the leadership of HIV Out Loud project.
pediatrician and writer Rachel Pearson, the project has three main

26 SAN ANTONIO MEDICINE • December 2022