“I don’t want to tell you what happened. I want to tell you how it felt.”

That is the first sentence of Namwali Serpell’s 2022 novel The Furrows. What I appreciate about this is that she announces from the start that this story won’t just report — it will transmit. In a conversation on the LARB Radio Hour Podcast, Serpell described literature not as a vehicle for messages or ideas, but as an experience through which you come to think and feel about things. To Serpell, the story doesn’t summarize life. It puts you inside it.

I keep returning to that line because it names something public health hasn’t learned to want.

Our field is very good at documenting what happened. Rates, risks, trends, statistics. What we haven’t built is a way to capture how it felt to live through something. The texture of it. What it meant to the person inside it.

Qualitative work gets close — interviews, community testimony, ethnography. But in most public health institutions, these still get treated as background or color. As the human detail we add before returning to the “real” findings.

That distinction is a statement about whose knowledge counts.

Other fields don’t make that distinction. And public health rarely looks at them.

UX research — the discipline that studies how people experience products and systems — is a field where qualitative methods drive decisions. A dozen interviews can redirect a product worth billions. A small diary study can determine whether an app survives. Executives who ignore data dashboards will lean forward for a single user story. In tech, this kind of evidence is considered essential. Not soft.

Oral history has long treated a recorded voice as part of the archive. Interviews preserved in the Library of Congress or in StoryCorps aren’t treated as anecdotes — they’re the historical record. Oral historians have developed careful, rigorous methods for gathering and preserving memory as a form of truth. They treat testimony with the same seriousness as any other source. Public health has stories just as urgent, but we rarely treat them with the same care.

I came to Toni Morrison in high school — long before I knew what public health was. I was a reader first. In college, studying Africana Studies, I took literature seriously as a way of knowing the world. Morrison’s novels were taught not just in literature classrooms but in law schools and sociology departments, because people across disciplines recognized that she was documenting something about American life that no dataset could reach.

I carried that understanding into public health with me. And the longer I’ve worked in this field, the more I’ve felt the distance between what story can hold and what our methods typically allow.

That distance is what I’m trying to close. If you want to see what that looks like in practice, it’s what this Substack is building.

The mercy isn’t in the data. It’s in the telling.

©2025 La’Quana Williams, MPH · A Mercy in the Telling

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

You are welcome to share or adapt this work for educational and community purposes, with clear attribution to the author. Commercial use requires written permission. Any adaptations must be shared under the same license.

This essay is part of Frameworks & Method — on the case for narrative as rigorous knowledge in public health practice.

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Public health often treats story as illustration, a preface, a quote, a case example.
The Story-Based Evidence Framework (SBEF) repositions story as evidence itself.

Developed alongside my narrative case study series A Mercy in the Telling, SBEF offers a way to translate lived experience into insight that informs systems change, not just sentiment.

The Three Layers

Narrative as Evidence
Lived experience, memory, and story reveal truths data alone cannot.
This layer honors the knowledge held in daily life and how people make sense of health, harm, and care.
It treats stories not as embellishment but as rigorous forms of data that carry emotional precision and contextual depth.

Systems Mapping
Stories become structural when we trace how policies, environments, and institutions shape health.
This layer connects the personal to the systemic, revealing how individual experiences expose the design and the gaps of our public health frameworks.
Through story, patterns emerge that data tables often hide.

Justice Claims
Analysis without action is not enough.
Each case points to what repair and equity demand, asking how we honor the evidence that stories provide.
This layer insists that interpretation must lead to accountability, ensuring the use of story moves toward justice, not extraction.

SBEF bridges creative and structural ways of knowing. It invites practitioners to see how evidence can emerge from memory, relationship, and resilience, expanding the field’s imagination for what counts as valid, rigorous, and actionable knowledge.

SBEF is not only a framework but a practice. It asks practitioners, educators, and storytellers to build evidence differently — to listen, interpret, and act in ways that honor the communities at the center of every story.

This post accompanies the Prevention Institute podcast episode on Uplifting Contextual and Experiential Evidence (UCEE), where I shared how SBEF complements that framework by positioning story as rigorous evidence for public health action.

To explore how SBEF takes shape through story, read:

• Practice, Not Pastime

• A Mercy in the Telling

This work continues through A Mercy in the Telling and my broader practice, Thatch, where I support public health teams in translating lived experience into strategy, policy, and action.

Reach me at laquana@thatchconsulting.com to start a conversation.

-Q

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©2025 La’Quana Williams, MPH · A Mercy in the Telling

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

You are welcome to share or adapt this work for educational and community purposes, with clear attribution to the author. Commercial use requires written permission. Any adaptations must be shared under the same license.

But these case studies are not just “creative stories.” They are narratives. Stories tell what happened; narratives reveal why it matters and how it connects to larger systems. In this work, I treat stories as the building blocks of narrative—individual accounts that, when held together, reveal patterns and meaning. In my first Series, Mira (Mirror) Work, I write through Mira’s losses, memories, and moments of resilience not only to describe a single life, but to uncover the patterns that shape many lives. In this way, the case studies become narrative evidence, linking the intimate and the systemic, the personal and the political.

The truth is, public health as a field and discipline has always been in the business of proving legitimacy. Public health has spent decades working to show that it is “serious” and “scientific.” We’ve clung to numbers as the only legitimate evidence, borrowing authority from medicine and biomedical models. We’ve professionalized with degrees, certifications, and accreditation standards. We’ve staked our very worth on technical fixes to crises or on speaking the language of policy and economics just to be heard at the table.

Those strategies gave us credibility in some spaces. But they also narrowed the field, excluding the forms of knowledge communities hold most tightly. Too often, what matters most—loss, resilience, memory, silence—is absent from what we call “evidence.”

Public health loves its charts, reports, and evaluation tools. At the same time, it is often suspicious of story, especially when the voices telling those stories don’t echo the dominant chamber. And when the field finally does speak—no longer hiding its hands behind its back—it is too often speaking about Black and Brown communities, to a profession that remains largely white and female.

This has never sat well with me.

I have decided it’s time to give my narratives shape, contours, parameters, a FRAME-WORK, if you will. I created it to show that this is practice, not pastime, and it rests on three commitments:

Narrative as Evidence: Lived experience, memory, and story reveal truths data alone cannot.
Systems Mapping: Stories become structural when we trace how policies, environments, and institutions shape health.
Justice Claims: Analysis without action is not enough. Each case points to what repair and equity demand.

At the center is the work I’m building through A Mercy in the Telling: case studies that invite us to see, analyze, and act differently. They also speak directly to the people I most want to reach, in a language and rhythm they recognize. A reclamation, flipping what’s often used to exclude into a way to affirm and include. A knowing nod (the chin up kind), a quiet way of saying, this is for you. A familiar chord, humming with recognition only if you’ve lived it.

These case studies are not only literary, they are functional. They can be taught, discussed, analyzed, and applied in classrooms, trainings, and health department practice. They are designed to sharpen skills, deepen reflection, and expand what counts as evidence.

These narratives are not just illustrations, they are evidence. They carry the power to reshape how public health understands its work, and who gets to define what counts as knowledge. And still, I want them to read with the cadence and richness of the narrative fiction I love—that’s the creative part. I like to think that beauty and rigor can live together here.

My hope is that as you read, you will not only sit with these stories but also practice seeing them as evidence, usable, rigorous, and alive. This is how we expand what public health can be.

As James Baldwin once wrote, “I love America more than any other country in the world and, exactly for this reason, I insist on the right to criticize her perpetually.” I feel the same way about public health. It is because I love this field, because I want it to be worthy of the communities it serves, that I insist on critiquing and expanding it.

-Q

©2025 La’Quana Williams, MPH · A Mercy in the Telling

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

You are welcome to share or adapt this work for educational and community purposes, with clear attribution to the author. Commercial use requires written permission. Any adaptations must be shared under the same license.

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I spent a lot of time in Houston, Texas, in 2023. I worked hard during the day, but at night, I’d hit the town or linger for long weekends. I met so many amazing Black people there, the kind you meet on a Thursday who say, Hey, come with me to a lounge tonight. I’d say sure, expecting to never hear from them again (that’s how it usually goes in California). But by 7 p.m., I’d get a call from that “stranger” telling me to be ready by 9. They’d pick me up and take me all over the city: lounges, cigar bars, restaurants, sometimes even their homes.

Looking back, it was almost an anthropological quest. I was heavy in my Zora Neale Hurston bag! In our conversations, people would often pause mid-story to tell me I wasn’t like most L.A. folks they’d met. Then, without fail, they’d launch into stories about my city. How it was full of “lost souls,” always on fire, running out of water, rattled by earthquakes. And then the gut punches came — that most of it was man-made.

Ah, yes, global warming! I’d say.
No, “they’er” controlling the weather patterns, even the sun. You gotta get out of there!

I wrote a version of this in Brick Red:

“Don’t nobody talk about what’s in that air,” her husband said once, eyes fixed on the morning sky. “You know they over there changin’ the weather patterns.”
“They got big turbines that push air from the peninsula—”
He meant it. He’d started saving articles, showing her headlines between bites of toast.

At first, I was deeply annoyed by those conversations. Sometimes I’d push back gently, trying not to be dismissive with my science. Other times, I’d just get really quiet and still, listening for where the truth might live. (I’ve harnessed both of these strategies at Christmas and Thanksgiving dinner tables over the years.)

Slowly, it became more clear to me: these weren’t just casual conspiracy theories. They grow in the same soil as something much bigger, the long history of being lied to, ignored, and left to piece together the truth ourselves.

I thought about those Houston conversations this weekend, watching the newest Katrina documentary, Hurricane Katrina: Race Against Time. I have been fascinated by Katrina for years: the storm, the aftermath, the resilience, the storytelling (read Salvage the Bones by Jezmyn Ward if you want a deep dive in narrative fiction on Katrina). Since the doc came out, social media has lit up with posts saying: It’s time to stop sugarcoating. The levees weren’t broken, they were blown.

Here’s the thing: I don’t know for sure if that’s true. What I do know is that I believe Black folks. I also know that in the weeks after Katrina, when the official record was slow, incomplete, and untrustworthy, people filled in the blanks. And they didn’t do it out of thin air. They did it from lived experience. From a memory bank filled with Tuskegee and Flint, and a hundred other moments where the “official truth” arrived too late, incomplete, or not at all.

This is why I write my case studies. A Mercy in the Telling isn’t simply about crafting beautiful stories. It’s about showing the field what we’re truly up against. When public health fails to speak with clarity, honesty, and urgency, the void doesn’t stay empty. It just fills with the kind of narrative that grows from survival, suspicion, and history, stories that, for all their sharp edges, have been lifelines in the absence of truth.

And here’s the truth public health needs to face: this isn’t “misinformation” in the shallow sense. It’s the product of generations of institutional betrayal, and of generations finding ways to survive in spite of it. It’s the knowledge that what’s in the report is rarely the whole story, and the wisdom to keep telling it anyway.

Black folks have always had to be our own record keepers. Not only out of necessity, but as an act of brilliance and care. Our stories are the GIS maps, warnings, public comment, testimony, and sometimes the only archives we have, holding our history intact when nothing else would.

When you don’t tell the story, the story will tell itself. Black folks are the canaries in the coal mine. I implore you to believe us too.

-Q

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