Stories or numbers OR stories and numbers

 

Numbers, argues Professor Trish Greenhalgh, are no more ‘factual’ than stories. The dichotomy between numbers and stories is false, writes Greenhalgh, instead we should recognise that both can be selected and moulded with the aim of constructing a persuasive narrative.
 
 
The notion of numbers OR stories is a false dichotomy. Stories use numbers, numbers tell stories, numbers can paint pictures – and so on. The skilful story teller crafts the narrative according to what is more likely to persuade their audience.

Constructing the narrative: compelling stories

Recently, I read an article in the Times by a man called Anthony Lloyd, reporting from a temporary orphanage for Ebola victims in Sierra Leone. Lloyd explained that:

Ebola, infests along the transmission lines of human love and kindness, decimates whole families and kills across the generations. As a result, most of the survivors at the orphanage had suffered multiple simultaneous bereavements.

The article included a picture of a little boy called Stevie, who was four years old. Lloyd recounted a conversation he had had with the head social work in the district, Mr Kamara.

“Stevie is very young and very traumatised,” said Kamara. “So much so that he is only just beginning to speak.”

Many children at the care centre, said Lloyd in his article, are classed as ‘double orphans’, having lost their parents and then had their foster parents killed by Ebola too. However, having survived so much already, the children now face a final injustice common to Ebola survivors throughout West Africa: stigmatisation.

Story telling: fluid, dynamic, situational

Like many stories, the one I’ve just told is incomplete, ambiguous, multi-vocal, and pregnant with tropes that suggest (but fall short of proving) complex chains of causation. The story is both personal and political. It’s Stevie’s story, Mr Kamara’s story, Lloyd’s story, Sierra Leone’s story, the Ebola virus story, Rupert Murdoch’s story, my story because I’ve shared it here and now, your story, because it has been shaped with the readers of this blog in mind.

Nobody has ever told that story in quite the same way to the same audience – and nobody ever will again. Readers familiar with academic literature on narrative will probably recognise Bakhtinian framing – everything we write, every word we utter is shaped by the response, or anticipated response, of our audience. [1]

It’s small wonder, then, that ‘anecdotes’ are usually placed at the very bottom of the hierarchy of evidence. Feeling uneasy? Need some hard facts? Let me offer you some numbers. In April 2014 , the World Health Organisation began an appeal to raise $4.8 million to help control the Ebola outbreak in West Africa. By the end of July it revised its target to $71 million, in August it was raised to $490 million. [2] Don’t tell me numbers don’t tell stories.

Numbers are no more ‘factual’ than anecdotes

These numbers aren’t any more ‘factual’ than the statement that Stevie is traumatised. You could find people who would contest the values and dates of the WHO’s fundraising figures just as you would find people who would argue that Stevie is not as traumatised as the social worker claims.

Quantitative ‘data’ aren’t true because they’re quantitative. Numbers, even statistically significant ones, mean very little indeed unless coached in a meaningful story.

The fundamental purpose of a story is to persuade so it’s interesting to ask why these numbers and what is the story the narrator is seeking to tell using these numbers.

The art (not science) of rhetoric

Aristole characterised the art (not science) of rhetoric as combining logos or the facts (the story you want to tell), ethos or the credibility of the speaker and pathos – the appeal to emotions. [3] In the 1960’s Chaim Perelman argued that the audience’s ‘point of departure’, where they are coming from and what their assumptions are, also needed to be considered in order to persuade effectively. [4]

If you look up Ebola, you’ll encounter different perspectives, seeking to use a combination of words, numbers and images to persuade you of their argument:

Personal accounts of doctors and nurses on the front line who want to persuade us that resources aren’t getting through and there is avoidable suffering.

The genetic drift story, highlighting Ebola’s rapidly mutating nature and the risk of mutations that will make it even more deadly. This narrative wants to persuade us of the impending cataclysm and, perhaps, attract a chunk of the expanding Ebola research budget into the genetics industry.

Then there is the social scientist’s story that positions failing health care systems as the underlying cause of the epidemic. Aiming to persuade us that the cure for Ebola will elude us until we’ve strengthen health care systems, tackled corruption and improved leadership.

Stories aim to persuade & present ‘facts’ accordingly

In truth, as I suspect most of us know, there is no text, set of figures, picture or experience that is self-interpreting. That is why all of these stories use both words and numbers. Each story combines these different modalities rhetorically in an effort to persuade the intended audience of the importance and veracity of the account.

 

[1] Bakhtin MM: The dialogic imaginination: Four Essays: University of Texas Press; 2010

[2] Gostin LO, Friedman EA: Ebola: a crisis in global health leadership. Lancet 2014, 384:1323-1325

[3] Lawson-Tancred H: Aristotle:The art of rhetoric. In.:Penguin Group; 1991

[4] Perelman C: The new rhetoric: A treatise on argumentation. 1969

Trish Greenhalgh is professor of Primary Health Care and Dean for Research Impact at Barts and the London School of Medicine and Dentistry. She has written many works including the bestselling ‘How to Read a Paper: The Basics of Evidence-Based Medicine’.

 

@trishgreenhalgh

 

Views expressed are the author’s own and do not necessarily represent those of the Alliance for Useful Evidence. Join us (it’s free and open to all) and find out more about the how we champion the use of evidence in social policy and practice.

 

Interested in reading more? Check out Cathy Sharp’s blog ‘Calling time on ‘anecdotal’ evidence‘.