The Journey of a Patient Volunteer as a Hero’s Journey

May 20th is International Clinical Trials Day, a day to recognize the efforts of all those involved in clinical development since James Lind conducted the very first controlled trial, a study of scurvy, in 1747.

Those involved in research and development know that bringing a new treatment or cure to those in need is an epic journey with many challenges and setbacks along the way. To be successful, clinical trials require the ongoing commitment and resourcefulness of many contributors, including sponsor researchers, investigators, study coordinators and, of course, volunteers.

So on this important date in history, how might these roles map to the roles found in the epic journeys shared throughout human history, from Homer’s Odyssey to the Lord of the Rings?

Common ‘archetype’ roles were identified and documented in the seminal work “The Hero with a Thousand Faces” by Joseph Campbell. George Lucas credits this work as a key inspiration for the Star Wars series. In this work, Campbell identifies commonalities among the great hero characters across cultures and throughout history, referred to as the Hero’s Journey. In short, the hero leaves the everyday world, crossing into the unknown and returns with great gifts for fellow man.

The following are the stages of the Hero’s Journey:  

The archetype roles found in the Hero’s Journey have clear analogs in the world of clinical development:

• The Hero embodies self-sacrifice and growth (in fact, the word "hero" comes from a Greek root that means to protect and serve). For reference purposes, the hero character from the original Star Wars series is Luke Skywalker.
  • In clinical research, the hero is the patient volunteer. Despite the myriad burdens, patients participate in studies for many reasons but, consistently, the most common reason cited is to advance science. Their self-sacrifice and willingness to undertake the challenge of clinical research aligns perfectly with Campbell’s Hero persona.
• The Herald issues a challenge or announces coming change.
  • The doctors that both diagnose the patient’s condition (the change) and share the opportunity to participate in clinical research (the challenge) serve as the best analog for the Herald.
• The Villain, the antagonist in the journey, represents the dark side and challenges the hero. Darth Vader is the perfect embodiment of this role.
  • In clinical R&D, the Villain is obvious: the disease or medical condition
• The Wizard is the wise and enigmatic teacher and gift-giver.
  • So who is the Obi-wan Kenobi or Yoda of R&D? We find the answer in those who dedicate their scientific talents to eradicating disease. For many, the miracles that come from these Wizards is health, happiness and, sometimes, life.
• The Allies/Helpers support and aid the hero.
  • While there are many potential players filling this role including the patient’s own family, friends and caregivers, site staff including physician investigators and study coordinators best fit Campbell’s description of Allies.

While patients’ individual journeys are far from fictitious like many of the epic journeys found in literature, the parable of the Hero’s Journey may help to recognize the magnitude of their contributions.

Much has changed since the first clinical trial in 1747, but two things remains constant: the brilliance of researchers and heroic commitment of patients.