Strong at the Broken Places

The Paradox

“The world breaks everyone, and afterward, many are strong at the broken places.”

– Ernest Hemingway, A Farewell to Arms

Ernest Hemingway built his literary legacy by writing unflinchingly about pain, loss, and resilience. His novels and stories – often drawn from his experiences in war and personal turmoil – present characters who face brutality and despair yet persevere with quiet strength. His signature style was spare, minimalist, and brutally honest, laying bare the human experience in all its vulnerability.

Hemingway's protagonists endure with a kind of grace forged in hardship. From the disillusioned expats of The Sun Also Rises to the aging fisherman in The Old Man and the Sea, his characters remind us that pain is not the end of the story. There is something starkly beautiful in how they continue on, imperfect and changed, but not undone. His idea of being "strong at the broken places" perfectly captures this paradox: the brokenness remains, but so does the strength.

It’s this very tension that underlies the work of whole-person care. Because real healing isn't just about curing disease. It's about honoring the complexity of each person’s story—including the parts that have cracked.

Golden Lines: Kintsugi, Trauma, and Resilience

In Japan, the art of kintsugi repairs broken pottery with gold. Rather than hide the cracks, it highlights them, restoring the vessel with shimmering seams that make it more beautiful than before. The result is not perfection, but transformation. Kintsugi is often cited as a metaphor for emotional and physical healing: our scars are not shameful. They are proof that we have endured. In a culture that pushes us toward concealment and polished surfaces, kintsugi offers something gentler and truer: brokenness acknowledged, held with care, and re-shaped into something new. In healthcare, this metaphor feels especially potent. We see people at vulnerable moments. Their pain isn’t always visible, and their healing rarely linear. If we approach their stories with the same reverence that kintsugi artisans show for broken vessels, we might help shape something resilient and unexpectedly beautiful.

That’s particularly true when it comes to trauma. For many, the most enduring wounds are not visible on a scan or test result. The Adverse Childhood Experiences (ACE) studies revealed how early adversity – such as abuse, neglect, or growing up with substance use or mental illness at home – predicts long-term health outcomes. The data is sobering: over two-thirds of adults have experienced at least one ACE; about 1 in 6 have experienced four or more. Each additional ACE correlates with higher risk for depression, heart disease, diabetes, and even early death. Trauma literally reshapes the developing brain and nervous system, creating a heightened stress response that, over time, wears on the body like a crack under pressure. In the landmark 1998 study by Felitti et al., researchers found a 2.4-fold increase in the risk of hepatitis and a 12-fold increase in suicide attempts among those with four or more ACEs. Later research showed how toxic stress alters brain architecture, hormonal regulation, and immune function (Garner et al., 2015; Teicher & Samson, 2016).

But here is the hopeful part: trauma-informed care acknowledges those invisible cracks and responds with compassion rather than judgment. It offers not just treatment, but the beginning of restoration. When providers are trained to recognize trauma’s impact, they can create a safe, empowering environment for healing. As the CDC notes, preventing ACEs or mitigating their impact could reduce up to 21 million cases of depression and eliminate a large share of future chronic disease burden.

Just as kintsugi fills broken pottery with gold, trauma-informed care fills those invisible cracks with empathy, trust, and time. We may not undo the past—but we can help people become strong, and whole, at the broken places.

Story as Medicine: The Promise of Narrative Care

Modern medicine is excellent at gathering data, but sometimes it forgets the story. Narrative medicine is the practice of restoring the patient's story to the center of care. It asks us to slow down and listen—not just to symptoms, but to meaning. Dr. Rita Charon defines narrative medicine as developing "narrative competence" – the ability to understand and act on the stories of others. This isn’t just poetic; it’s practical. Research shows that storytelling reduces patient anxiety, improves coping, and increases trust between providers and patients. It also helps clinicians retain empathy, find meaning in their work, and avoid burnout. In a world increasingly driven by speed, narrative medicine insists that healing takes time. It takes presence. It takes joining someone in their story, not just charting their symptoms. That kind of care doesn’t show up on a spreadsheet, but it often changes outcomes.

What AI Can’t Do: The Limits of Technology

Artificial intelligence has rapidly become a valuable tool in healthcare. It can analyze labs, predict deterioration, and suggest treatments. But it cannot understand context. It cannot notice the quiver in a patient's voice or the cultural significance of a silence. It cannot hold a hand or sit in quiet witness. AI has the potential to expand capacity and improve the efficiency of diagnostic workflows, particularly in radiology and pathology (Jiang et al., 2017; Topol, 2019). But it cannot replicate the human experience of empathy. The architecture of AI must be designed with careful boundaries. Even when care can be delivered more rapidly, the process of understanding a patient’s full context—emotional, psychological, cultural—should not be rushed.

We now have a rare opportunity: to let AI do what it does best (supporting diagnostic accuracy, summarizing data, and flagging clinical risks), and to preserve the human domain for what it alone can offer—listening to the story, witnessing its meaning, and guiding a person through their healing narrative. Narrative medicine has a place both before and after diagnosis. AI can make care more informed; only humans can make it more humane. Clinicians who spend more time face-to-face, rather than screen-to-screen, offer something irreplaceable: human empathy. At Storyline, we believe AI should support clinicians—freeing them from administrative burdens so they can focus on what truly heals: being present, being curious, and being kind.

Empathy as Intervention: The Science of Presence

Compassionate care isn’t just nice—it’s measurable. In their book Compassionomics, Dr. Stephen Trzeciak and Dr. Anthony Mazzarelli synthesize over 1,000 scientific abstracts to demonstrate that compassion measurably improves clinical outcomes. Their work shows that when healthcare professionals offer compassion, patients experience less pain, better adherence to treatment, improved quality of life, and even lower healthcare costs (Trzeciak & Mazzarelli, 2019).

For example, diabetic patients under the care of highly empathetic physicians have better control of their blood glucose and fewer complications. Studies have also shown that chronic pain patients report improved functionality and reduced discomfort when they feel emotionally supported. Empathy has been associated with decreased patient anxiety and reduced levels of the stress hormone cortisol, supporting the physiological underpinnings of compassionate care.

In a field obsessed with metrics, we must remember: some of the most powerful interventions are not procedures or pills, but relationships. Sitting. Listening. Remembering. Offering a space where someone feels seen. Science of Presence

Compassionate care isn’t just nice—it’s measurable. Studies show that clinicians who demonstrate empathy improve outcomes. Diabetic patients with empathetic doctors have better control of their blood sugar. Patients with chronic pain show greater functionality when their providers validate their experience. Presence reduces cortisol levels. Trust improves adherence. Kindness improves healing.

In a field obsessed with metrics, we must remember: some of the most powerful interventions are not procedures or pills, but relationships. Sitting. Listening. Remembering. Offering a space where someone feels seen.

Whole-Person Healing

Whether it’s Hemingway’s spare prose, a mended ceramic bowl, or a survivor sharing their ACE score, one truth holds: healing is not about erasure. It’s about integration.

Whole-person care acknowledges both the wound and the wisdom that grows around it. At Storyline, we sit with the hard parts of your story—not to fix them, but to honor them. We believe healing happens when patients are not reduced to diagnoses, but supported as people. You are not just your chart, your symptoms, nor your diagnoses. You are someone with a story. And often, it is in the broken places that your greatest strength takes shape.

References:

• Hemingway, E. (1929). A Farewell to Arms.

• Felitti, V. J., Anda, R. F., Nordenberg, D., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258.

• Garner, A. S., Forkey, H., & Szilagyi, M. (2015). Translating developmental science to address childhood adversity. Pediatrics, 135(2), e224–e231.

• Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241–266.

• Charon, R. (2001). Narrative medicine: A model for empathy, reflection, profession, and trust. JAMA, 286(15), 1897–1902.

• Haidet, P., et al. (2010). Medical Education’s Role in Promoting Empathy in Clinical Care. Academic Medicine.

• Verghese, A. (2009). A Touch of Sense. Health Affairs Blog.

• Topol, E. (2019). Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Basic Books.

Jiang, F., Jiang, Y., Zhi, H., et al. (2017). Artificial intelligence in healthcare: Past, present and future. Stroke and Vascular Neurology, 2(4), 230–243.