Vaccines.

Not the easiest word to write about right now. Federal vaccine policy is in a period of real change — a January 2026 CDC schedule revision departed from the usual advisory process, the courts are actively weighing in, and the professional response has been substantial. Whatever you think about the substance, the authority structure underneath American vaccine policy looks different than it did two years ago.

Into that shift, something specific has happened: trust didn’t disappear. It relocated.

27 states and DC have adopted their own vaccine guidance rather than the new federal schedule. The American Academy of Pediatrics has kept its own broader schedule in place. And when researchers asked people directly who they’d believe on a specific recommendation — the hepatitis B birth dose — the answer wasn’t close: 42% said they’d accept the AAP’s guidance, 11% said the CDC’s. People didn’t stop trusting expertise. They moved their trust to the source still standing in the room with them.

That source is usually a provider. Not because providers are louder than the federal government. Because they’re doing something no national body can scale: sitting with a specific parent’s specific fear and answering it, person to person, instead of issuing a policy to a population. There’s a real evidence base behind this, not just intuition — research on narrative-based health communication consistently finds it builds emotional engagement and credibility in ways fact-sheets don’t. The honest caveat: evidence on whether this moves actual vaccination rates, not just attitudes, is still thin. That gap is exactly where the opportunity sits.

Here’s the part worth naming plainly. Providers now carry more narrative weight than they were ever built to carry alone. The real-time data and evidence that used to flow predictably from a single federal source now arrives less consistently — the kind of information that matters most when something is genuinely infectious. Providers are piecing together what reaches them, doing careful work with a harder job. There’s real room to make that job easier.

This is where vaccine makers come in, and I want to be precise about what I’m arguing, because it’s not “start partnering with providers.” Life sciences companies and providers have partnered for decades — medical affairs materials, education programs, access support. That infrastructure isn’t new.

What’s new is what that infrastructure is now quietly holding. It was built to support commercial distribution and clinical education. It didn’t used to sit underneath the country’s trust infrastructure — a functioning federal authority did. Now that authority is more contested, and the provider relationship is carrying public confidence in vaccines whether it was designed to or not. The job changed. The job description hasn’t caught up.

I’d call this what it actually is: narrative stewardship, sitting alongside medical affairs rather than replacing it. Medical affairs asks whether a provider has accurate information. Narrative stewardship asks whether a provider has what they need to hold a family’s trust in a conversation that used to happen at a national level and now happens one exam room at a time.

It’s the same instinct already visible in how vaccine makers show up internationally — moving quickly, in close partnership with governments and the global health community, when an outbreak demands it. Domestic vaccine confidence is a slower-moving emergency, but it’s asking for the same instinct turned toward a quieter problem: not “who develops the vaccine,” but “who’s resourced to hold the trust that gets it into someone’s arm.”

So the real question for vaccine makers isn’t whether to invest more in provider relationships. It’s who inside the organization owns making sure those relationships can carry the weight they’re now carrying — and whether that person has the mandate, not just the materials, to do it.

I'm Ari Mostov. I help healthtech, medtech, and life sciences leaders find the story their organization is already carrying but hasn't named yet. More in this series, Narrative Dx.

Category creation gets treated like a marketing move. Pick a clever name, run a launch campaign, hope it sticks. That’s not what’s happening when a category actually takes hold. What’s happening is world-building. Someone is deciding what’s real before the market has agreed on it, and then giving everyone else the words to agree with.

A category doesn’t exist because a company decides to call something new. It exists because enough people start using the same language to describe the same reality. That’s the part marketing can’t do on its own. A press release can introduce a term. It can’t make a hundred different stakeholders, investors, regulators, customers, competitors, all reach for that term independently, unprompted, because it’s the only word that fits what they’re seeing. That’s a narrative achievement, not a copywriting one.

Here’s why the distinction matters. Every market has a moment where the existing words stop being accurate. A shift happens inside a company or an industry, and the old vocabulary keeps getting used anyway, because nobody’s replaced it yet. That gap, between what’s actually true and what people still call it, is where category creation lives. Whoever names the gap first doesn’t just get credit for being clever. They set the terms everyone else has to think inside of. Miss that window and you inherit somebody else’s language instead, usually a competitor’s, sometimes an analyst’s, and you spend years arguing inside a frame you didn’t build.

I’m watching this happen right now in personalized medicine. A platform gets built to do one thing at population scale, a vaccine, a screening test, a standard protocol, priced and distributed the way mass-market products are priced and distributed. Then the same underlying technology gets pointed at a single patient. One tumor’s specific mutations. One immune profile. A treatment designed for an audience of one, built on a platform that was never described that way. The company hasn’t changed what it’s capable of. It’s changed what it’s for, and the vocabulary hasn’t caught up. Investors still describe it by its original product category. Clinicians reach for “personalized” as a marketing adjective instead of a structural fact. Nobody has said, plainly, that this is a different kind of company doing two fundamentally different kinds of work on the same foundation. Until someone does, the category stays borrowed, held together by “platform” and “pipeline,” neither of which actually explains what’s true.

That’s the example. It’s not the point. The point is what makes a category real in the first place, and that’s narrative strategy, not positioning.

A name alone doesn’t hold. It needs a narrative that recognizes the past, the present, and the future. A system of stories that makes the new category irresistible.

The past has to explain what the old category couldn’t account for. Not why it was bad, just why it was insufficient. In personalized medicine, the old category was “treatment.” One drug, one indication, one dose, tested for the average patient and prescribed to everyone who fit the label. That framing worked when medicine had no way to act on what made one patient different from the next.

The present has to show the evidence the new reality already exists. Not a prediction, proof. A platform originally built for scale is now generating something that starts over with every single patient, and it’s happening now, not someday. That’s visible in the pipeline itself, if anyone bothers to describe it accurately instead of defaulting to the language the platform launched with.

The future has to explain the stakes of not naming it. If a company doing genuinely different work under one roof, mass-market and n-of-one, keeps getting described by its oldest, simplest product, it gets evaluated like that product. Priced like it. Trusted or doubted like it. The more interesting and more difficult thing the company is actually building stays invisible, not because it isn’t real, but because nobody gave the market a word for it.

Skip any one of the three and the category doesn’t take. A name with no past feels invented. A name with no present feels speculative. A name with no future feels academic, interesting but not urgent enough to act on.

This is the actual mechanism, and it’s why narrative strategy is essential to category creation rather than a nice complement to it. Marketing sells into a frame that already exists. It optimizes language for a category everyone already agrees on. Category creation has no frame to sell into yet. The only tool that builds one is the same tool that’s always built shared reality: a narrative, grounded in what came before, proven by what’s true now, and made urgent by what’s at stake next. That’s not a metaphor for narrative strategy. That’s the actual job.

The platform-built-for-scale-now-serving-one-patient problem is one place this is happening right now. It is not the only place. Any company sitting on a real shift, in what it does, what it sells, what it actually is, and still being described with the old words, is a category creation opportunity waiting for someone to do the naming.

I'm Ari Mostov. I help biotech and life science leaders close the gap between what their company has become and the words the market is still using to describe it. If your company is living this gap right now, let's talk.

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Until it didn’t.

I was changing. The work I was doing was expanding into dimensions I could only dream of. I was no longer "the Hollywood producer" sitting in corporate boardrooms or on advisory calls. I was doing more than bringing my entertainment expertise to the conversation. But what exactly was I doing — and did it actually make a difference to the people who hired me?

On the Edge of Creation

Here’s the thing about a new initiative, be it a product, a policy, or a company deciding to become something it wasn’t before. Before any of it is real, it doesn’t have language yet. There’s no shared word for it. And until there’s a shared word for it, nobody in the room is building the same thing, even when they think they are.

I learned this by watching it fail. I’d sit with leaders trying to describe an idea that was supposed to become results, and I’d watch the room nod along to a sentence that meant five different things to five different people. Everyone thought they’d agreed. Nobody had. The strategy document was fine. The definition underneath it was never actually shared. It just felt shared, because everyone was too polite or too busy to say “wait, what do you mean by that.”

That gap is where things quietly die. Not in execution. Before execution, in the kick off meeting that was supposed to align everyone but didn’t.

Making Ineffable Irresistible

This is where my Hollywood producer instincts turned out to be more useful than I expected. Building a show from scratch means building a whole world before a single frame gets shot — characters, stakes, a reason to keep watching. Story is what makes people show up for something that doesn’t exist yet.

Turns out companies need the same thing when they’re trying to become something new. Not a tagline. A story that a hundred different people — legal, product, sales, the exec who’s skeptical, the exec who’s all-in — can all tell the same way, in their own words, without a slide deck in front of them.

That’s the discipline I started building: narrative strategy.

The Stories We Tell to Create Something New

I define narrative strategy as storytelling for outcomes. It’s designing a story system that engages, aligns, and mobilizes everyone involved. The thing that once seemed impossible new starts to feel inevitable.

Here’s a version of the problem I see constantly: a company that’s always sold hardware is now launching software. The instinct is to treat this like a brute-force execution problem: ship the roadmap, hit the milestones, announce the launch. But if nobody’s agreed on why the company is doing this or what it means about who they are now, every team fills that gap with its own private story. Sales tells one version. Product tells another. The customer-facing teams are improvising. None of it’s malicious — it’s just what happens when there’s no shared source of truth to work from.

Narrative strategy is how you close that gap before it opens. I co-design a strategic narrative with leaders and their teams: an open-ended account of what they’re building and why, built with the stakeholders who have to carry it, not handed to them after the fact. That becomes the source of truth. Every touchpoint after that — internal comms, sales enablement, the exec’s stage remarks — reinforces the same story instead of inventing a new one. I call the artifact that holds all of this a narrative bible. Done well, it turns transformation from a mandate people comply with into a story people actually believe they’re inside of.

Key Takeaways

• Creation starts with definition. Any new initiative involving multiple stakeholders needs a shared understanding before it needs a strategy — most transformations fail here, not in execution.

• Story is what makes a shared future feel inevitable rather than imposed. It’s the mechanism that gets people to author the change instead of just complying with it.

• Narrative strategy is a system, not a one-time message. A strategic narrative needs a living source of truth — a narrative bible — that every subsequent communication draws from, or the story fractures the moment it leaves the room it was built in.

If your team is living some version of this gap right now — a launch, an AI initiative, a story that made sense two years ago and doesn't quite anymore — the Narrative Audit is where I'd start. Four weeks to find out exactly what's breaking down and what the story needs to do next. Let’s start crafting.

Every company building an AI patient advocate right now is launching into a story it didn’t write and can’t control. The story is already this: AI in healthcare means the thing that overrides your doctor to deny your claim.

That story has a name. UnitedHealth’s nH Predict tool is the subject of an ongoing class action alleging it was used to cut off post-acute care for elderly Medicare Advantage patients, built on a model reported to have a 90% reversal rate on appeal. A federal judge let the core claims proceed and, this spring, ordered broad discovery into how the tool actually worked. Optum’s position throughout has been that the tool only informs providers and never makes coverage decisions itself. That distinction may hold up in court. It will not hold up in a patient’s memory.

So here’s the problem for anyone building the opposite product. Somewhere right now, a team is training an AI agent to do the thing nH Predict is accused of undermining: sit with a patient’s full history, translate policy and clinical jargon, coordinate across a maze of services, and actually fight for them. A genuine advocate, not an adjudicator. The technology is not the hard part. Nobody has decided who owns telling patients this is a different animal before the product ever reaches them.

I’ve seen the gap this creates from the inside. I spent a year in patient experience at a safety-net hospital in LA, working re-admissions for patients navigating housing insecurity, substance use, and every system failure between them. The job was constant translation and coordination, on their behalf, every day, because the moment nobody was actively advocating for them, they ended up back in the hospital. That’s what advocacy actually requires: not better information, but constancy. A second set of eyes that doesn’t clock out.

You see the same failure from the patient’s side on Reddit’s r/askdocs, where people who did everything right, asked for the patient advocacy team, looped in a social worker, filed a Medicare appeal, still couldn’t get a hospital to hear them. Advocacy fails even when the patient does the work, because the person doing the fighting on their behalf isn’t always available, isn’t always the right fit, and isn’t always believed.

That’s the opening an always-on AI advocate is built for. Hippocratic AI isn’t building toward this, they’ve already named it. Their AI Front Door launch this spring is headlined, in their own copy, as an AI Patient Advocate, described as a continuous member advocate that preps patients before visits and follows up after. The product logic is sound. But they’ve claimed the exact word that, in a different courtroom right now, a jury is being asked whether an insurer’s AI has earned the right to use at all. That’s not a future collision. It’s already live, sitting one search away from the same patients they’re trying to reach.

This is a narrative ownership vacuum in its purest form. The capability exists. The old story (AI decides against you) and the new story (AI fights for you) are sitting in the same public imagination, unreconciled, and nobody on these teams has been handed the job of holding the line between them. Ship the product without doing that work first, and the most sophisticated patient advocate ever built will read, on first contact, as the thing patients have already learned to fear.

I’m Ari Mostov. I help healthtech and medtech leaders close the gap between what their AI actually does and what patients already believe AI does to them. More soon in this series, Narrative Dx.

If your title is VP of Patient Engagement, I want to argue you may be solving the wrong problem. Engagement was never the goal. Access was.

A few years ago I had an extraordinary conversation with the chief strategy officer of a Fortune 5 company. We were talking about why people struggle to engage with healthcare. Taking medication on schedule. Booking an annual visit. Basic stuff.

Meanwhile “wellness” has no engagement problem at all. His argument: people show up for anything tied to vanity and status. Botox. Detox teas. ED treatments. All of it promises a visible outcome that makes you more attractive. Statins and inhalers don’t exactly scream main character energy.

Vanity is real. But I pushed back with a different theory: healthcare doesn’t engage people because it isn’t tangible. Call it health literacy if you want, but I think it’s deeper than that. When you can’t see or feel what’s happening at the microscopic level, why would you care? A whiter smile is tangible. A lower A1C is not.

Years later, GLP-1s are a few taps away and at-home testing kits are stacked at the drugstore checkout. Something bigger is going on than tangibility. Vanity still plays a part. But I think the real driver is agency. Dignity, even. The thing that makes healthcare engaging isn’t a visible result. It’s not needing to ask permission.

Take reproductive care. The pill arrived in 1960, and even then you needed a prescription. It still handed women agency over their own reproductive health for the first time. By 2023 the FDA approved Opill, the first over-the-counter option. Removing the prescription barrier alone drove birth control usage up by 31.8 percent.

Or take the pregnancy test. Before 1978, you sat in a waiting room while someone else decided when to tell you something about your own body. Waiting for information about yourself isn’t engaging. Waiting for someone else to hand you the ability to act on it is worse.

The pattern holds: remove the barrier, and self-enabled care becomes the default. This isn’t the same thing as engagement. Engagement asks people to show up more for the healthcare system. Self-enabled care lets people need the system less, for less, less often.

Here’s the problem for anyone with “Patient Engagement” in their title. Most engagement strategy is still built on the old theory: get people to log into the portal, open the app, respond to the reminder. Every metric on the dashboard is a proxy for showing up more. But your own patients are voting with their feet, and they’re voting for less friction, not more touch points. They’re getting tests done at home instead of the lab. Refilling GLP-1s through a telehealth app instead of a specialist referral. Reading their own results before the portal notification even lands.

None of that is disengagement. It’s engagement that finally looks the way your patients actually wanted it to look, and it’s happening in channels your dashboard doesn’t measure.

The mandate isn’t dead. It’s aimed at the wrong target. The job was never to get patients to engage with the system more. It’s to get out of the way faster. Every barrier you remove is a form of engagement your current metrics can’t see, and won’t credit you for, until someone rewrites what the job is actually measuring.

I’m Ari Mostov. I help healthtech and medtech leaders close the gap between what patients actually want and what their engagement strategy still assumes. More soon in this series, Narrative Dx.

Stop Communicating. Start Making Meaning.

I think the greatest opportunity we have right now is the ability to reorient ourselves around what really matters to us. We get to decide what’s meaningful. With all the AI disruption, geopolitical complexities and general uncertainty that is the world we live in, we are at a turning point. A true crossing of the threshold. And this translates into what we do in our group settings. What organizations do as they unite individuals to achieve something of significance. And to achieve that something, that thing that matters most, requires a new era of communications that goes beyond informational exchanges and regular updates. We need communications that reinforce what matters to us. Communications that scale the meaning making that is essential to our collective flourishing. Instead of treating communications as a function that just keeps your organization “updated”, it’s the channel for meaning making to scale and transform. That’s where narrative strategy begins and old-school communications ends.

This looks like each new initiative being designed from a narrative-first perspective. Understanding that your organization is desperate for meaning and significance, understanding “the why and why now?” before anything can happen. Creating something new — be it a product, a policy, a organization, a movement — requires a deep commitment to narrative. Because we are already losing the plot with all the noise and overwhelm that has defined modern life. Help us find the plot. Help us find the why.

Ok, now what?

Ok, so you’re probably tired of everyone talking about the overwhelming complexity, compounding disasters and general clusterfuck that is 2026. I’m not going to harp on that. I want to provide an alternative. And no, it’s not a Pollyanna “everything will be fine if we all just get a long”. It’s a real strategy. A solution set that I’ve witness work across disciplines and contexts to create real outcomes in this reality. It’s…drumroll please…Narrative Strategy!

Let’s review:

1. Story-listening

Narrative strategy starts with listening to those around you. What I call story-listening. Listening for the desires and obstacles of those you work with, live alongside and generally share this world with. People who are important to you. These could be customers, team members, community members, anyone who you are in some type of relationship with. We’re all navigating our own stories, and what’s significant and matters most to us will be in the details of the stories we tell about ourselves and others. What does your customer hesitate around? What does your neighbor keep focusing on? Why does your teammate seem distracted? This is where we start dialing in on language, paying attention to the words used, the expressions made, the emotions shared. We need to know what story they are in and it starts with listening.

2. Storytelling

First, let’s me clarify

Communications = an exchange of information and delivery of messages, usually with the intent to inform others. That email you receive from HR is a communication. That conversation you have with your manager is a communication. That investor report is a communication. Communication is focused on “the what”: data, instructions, facts, and logical sequencing.

Storytelling = a form of communication that uses emotion to create meaning. I define a story as “what you want versus the obstacles in your way.” This is the definition I’ve used in my early career in Hollywood and my current work in innovation and it’s served me well. Storytelling is a proven method for knowledge acquisition, awareness generation, attitude shifts and action. But the best of storytelling uses meaning making to induce behavior change. And behavior change is where we get those pesky results we so desperately crave. Storytelling is focused on “the why”. If you want something to change, start with story. It influences awareness, attitude, action and behavior much more effectively than an email communication from HR.

So with that in mind, storytelling, as part of narrative strategy, is where we take our learning from story-listening and start designing a new system of stories, that offers new opportunities for meaning-making and resonance. This looks like stories that offer alternatives to how things are currently done, a potential future that gives people what they want even if they have to overcome obstacles to achieve it. This narrative — this system of stories—must reflect what was learned through the story-listening. The narrative must answer “why” for each stakeholder involved.

3. Story Stewardship

This is where we see the stories we’ve designed take on a life of their own. They are evangelized across organizations, repeated across channels and functions. What we’ve communicated earlier, in story form, starts to be lived as reality. It’s a self-fulfilling prophecy because we’ve activated the behavior change mechanism that comes through meaning making. This isn’t some company motto being repeated ad nauseam, or a series of self-love affirmations that supposedly help you manifest your destiny — this is where words becomes reality because the narrative has given us meaning and momentum to do what needs to be done. Story stewardship leverages traditional communication channels to transform the status quo into a new paradigm. It goes beyond information shared to meaning made and motivation activated. Story stewardship solves for the unread emails and inattentive team meetings. It’s leadership on steroids; motivation at it’s highest form. It’s life being lived on purpose.

And that’s what we need in today’s age of disruption. Life on purpose is where we seize reality for what it truly is: possibility. It’s where we can wake up without being overwhelmed by dread and existential angst, finding a reason to go out and create something better than what we have now. It’s where we find and cultivate relationships that nourish us, create experiences we can cherish and be proud of it. It’s where we find the strength to overcome challenges that seem impossible, until they’re not.

When we use narrative strategy, we reclaim our life as our own. It fulfills that uniquely human need to understand “why”, while also being able to get us to participate in the world around us. This is my method for crafting irresistible futures and a better world. Give it a try and let me know what you think.

Let’s catch our breath

Ok, did you follow all that? Need more clarity, explanation and use cases? No problem, start here. I’ve written this piece as an exercise in expelling all the thoughts out of my head and reminder of my own passion for narrative strategy. If you’re still processing….good. Stick with it. If you’re following and want to know more, awesome. Let’s chat and see what fun is to be had.

If you’re intrigued and want to see how this can be used in your own life, check out my free webinar and white paper.

Welcome to Narrative Dx, my new series on Narrative Strategy for Healthcare. I'm performing story surgery on the healthcare industry — with an occasional tangent into life sciences and biotech. Let's dive in.

In March, a hacktivist group calling itself Handala wiped Stryker’s IT systems and shut the company down across 79 countries. Manufacturing stopped for three weeks. Ordering and shipping went with it. Stryker’s first public read on the damage: no material impact expected. A month later, in an amended SEC filing, the company reversed itself. The incident, it now said, had materially affected the quarter. Six employee lawsuits followed.

Medtronic is still notifying people affected by its own cyberattack, months after the fact, using the same three words every device company reaches for when something goes wrong: no evidence of misuse.

Neither of those is a technical failure. Stryker got its plants running again. Medtronic’s forensics are presumably fine. What failed is the public posture. Minimize first, correct later, and hope nobody clocks the gap between the two statements.

Zoom out past medtech and the same shape shows up everywhere in healthcare this year.

The current Ebola outbreak in the Democratic Republic of Congo and Uganda has passed 1,500 confirmed cases. It’s caused by the Bundibugyo strain, and the World Health Organization has recommended against using the existing Ebola vaccine because there isn’t solid evidence it protects against this version of the virus. The tool built for the last outbreak doesn’t fully reach the one actually spreading.

And this one isn’t confined to a single incident report. Hospital operating margins hit a twelve month low in January 2026, dropping to negative 0.6% as drug costs jumped nearly 14% and supply costs climbed double digits, according to Strata Decision Technology’s benchmarking data. Finance leaders surveyed by HFMA named Medicaid funding cuts their top concern by a wide margin, ahead of labor costs or payer negotiations. None of that is a single crisis to explain away. It’s a structural shift that transformation and finance teams have been narrating around, quarter after quarter, as if the next efficiency initiative will make the old model work again.

Four different domains. Same tell. Reassurance, delivered late, built to make the disruption look smaller than it was, or in the margin case, a steady story that never quite catches up to how structural the pressure has become.

If you’re the one accountable for transformation inside your organization, this list isn’t background reading. Every one of these is a version of a question you’re already sitting with: does your crisis plan cover the disruption you haven’t modeled yet, or only the one you already ran a tabletop exercise for? Does your board hear the real number when you know it, or the smoothed version while the real one gets finalized? That gap, between what the org knows and what it’s willing to say out loud, is the thing transformation is actually supposed to close.

Call this what it actually is. Healthcare doesn’t have a risk management problem. It has a narrative problem, and specifically a decision making posture problem, not a messaging fix. The infrastructure mostly works. Stryker rebuilt its plants. DRC is running trials on countermeasures it doesn’t have full data on yet. What’s missing is the public story that goes with the work, and the industry’s default instinct is to say as little as possible and hope the disruption stays contained enough that it never becomes the headline. That approach only holds up when disruption stays inside a box somebody already modeled. This year, none of it did.

Compare that to how finance talks about risk now. After 2008, the entire posture of the sector changed. Stress tests. Capital buffers. Scenario planning built around the assumption that the next shock is a matter of when, not if. Nobody in banking pretends tail risk won’t happen again. The sector’s public language now assumes the next disruption and says, credibly, that it’s positioned for it.

Healthcare hasn’t made that turn. It still talks as if each disruption is a one off, something to explain away, instead of a category of event that will keep happening and has to be built around. Expecting the unexpected isn’t a pessimistic stance. It’s the stance an industry adopts once pretending otherwise stops being credible. Finance got there. Healthcare hasn’t said it out loud yet.

Being resilient in healthcare today isn’t a claim you make after the fact. It isn’t “no impact,” “fully restored,” or a forecast held steady while the real numbers say something else. It’s a story nobody in the industry has fully written yet, one that assumes disruption is the baseline rather than the exception, and treats finding a way through as the expectation rather than the surprise.

The organizations that get there first won’t be the ones with the fastest incident response. They’ll be the ones willing to say, before the next disruption lands, that they expect it, and that they’re built to move through it in public. Not just in the server room.

I'm Ari Mostov. I help healthcare and medtech leaders write the resilience story before the next disruption forces their hand. More soon in this series, Narrative Dx.

David Hardoon left his AI role at Standard Chartered after less than a year. Asked whether a Chief AI Officer title should even be permanent, he didn’t hedge. “Do we have a chief Excel officer?” he said. We don’t have a chief email officer either. So why this?

It’s a banking quote. Swap in half the pharma and medtech companies making headlines right now, and it still lands.

Over the past two years, legacy healthcare and life sciences companies have created a wave of brand-new AI-strategy titles — Chief AI Officer, Head of AI, Chief Strategy Officer for AI. One widely cited CEO survey found adoption of the role nearly tripled in about a year. At the same time, tenure in the seat is already being described as short. People are leaving almost as fast as the title gets created.

If you’re sitting in one of these seats right now, none of this is news to you. You already know the title sounds bigger than the authority that actually came with it.

Here’s the part nobody puts in the job description. The company hired you to translate between its old story and the new one — an AI capability bolted onto a device business, an acquired platform absorbed into a pipeline. That’s the technical mandate, and it’s usually spelled out clearly. What isn’t spelled out is the narrative mandate: the actual authority to decide what the company says about itself once the new thing stops matching the old one. Nobody hands you that. You either claim it fast, or the gap gets filled by default — by whichever story was already loudest in the building before you arrived.

Three versions of that gap playing out in healthcare right now:

Recursion / Exscientia. Billed in 2024 as a “symbolic consolidation” of two AI-drug-discovery companies. By 2025, multiple pipelines had been discontinued, with restructuring “for integration efficiency” still underway into this year. Two companies got merged into one press release before anyone had built the authority to say, with confidence, whose story the combined company was actually telling.

Grail. A company whose entire identity was the AI story — the flagship multi-cancer early-detection test — just missed its primary clinical trial endpoint. The CEO is retiring. When the entire company’s narrative rests on one result, there’s no fallback story and no one whose job it was to build one.

CareCloud. The most useful example, because it shows what claiming the gap actually looks like in practice. Rather than leaving one executive to absorb both stories with no clear mandate, leadership split the job: a Chief Strategy Officer owns the AI vision, the CEO owns “disciplined execution.” Two narrators, one company — but at least it’s explicit. The Chief Strategy Officer in that seat now has a defined lane to build authority in, instead of a title and a guess.

That’s the real reason these roles keep turning over, and it’s worth being honest about what it isn’t: it’s not that AI strategy is too technical for one person to hold, and it’s not usually that the person in the seat lacks the skill. It’s that the narrative authority the job actually requires doesn’t ship with the title. The executives who hold onto these roles longest aren’t necessarily the ones with the cleanest technical credentials. They’re the ones who treat building that authority — deciding what the company says about itself, and getting the rest of the org to say it too — as the real job, not a side effect of the org chart. Most job descriptions don’t say that part out loud. It’s still the part that determines whether you’re still in the seat next year.

I'm Ari Mostov — I help healthtech and medtech leaders build the narrative authority that doesn't come standard with the title. More soon in this series, Narrative Dx.

Last week the FDA cleared Dexcom’s Stelo for kids as young as 2 — first over-the-counter glucose monitor ever approved for a pediatric population. Big deal. The coverage so far? All “glycemic awareness” and “informed adjustments” — official, accurate, and not yet talking to anyone in particular.

Here’s the thing: this one device just inherited two completely different families. A parent whose toddler has a real health condition, watching this data with real worry. And a parent who’s just curious — no diagnosis, no urgency, just wondering what happens to their kid’s blood sugar after birthday cake. Same sensor. Same app. Wildly different Tuesday.

I’ve sat with this exact split before. On a public health campaign with Children’s Hospital Los Angeles, we didn’t write one diabetes explainer and dial the vocabulary up or down by age. We built two separate narratives — one for little kids, built around curiosity and feeling safe; another for parents, carrying the clinical weight and next steps the kids’ version was never supposed to hold. Same condition. Two stories. Each one doing a job the other couldn’t.

Stelo’s got that exact structure hiding inside it right now. One device, one app, one voice — trying to talk to a toddler managing a real diagnosis and a toddler whose parent just wants to understand snacks better. “Glycemic awareness” is doing a lot of work to cover both.

So here’s the diagnosis: this isn’t a “how do we write one message for two audiences” problem. It’s a “is this one story or two” problem — and somebody has to decide, on purpose, before the messaging gets written. Skip that step, and you end up either scaring families who have nothing to worry about, or underserving the ones who really do.

The fix isn’t more messaging. It’s deciding, on purpose, which story you’re telling to whom — before a single asset gets built.

That gap between the technical story and the human one doesn’t close itself. The real question is: who’s making that call?

I’m Ari Mostov — I help healthtech and medtech companies figure out exactly this kind of thing before it becomes a messaging mess. More soon in this series, Narrative Dx.

Narrative strategy uses storytelling to deliver outcomes. It’s a systems approach to storytelling. I’ve been a narrative strategist for over 8 years — working with teams, companies, organizations, and movements — and I’ve seen it work across domains, at every scale. Here are my top 5 reasons why your group needs it.

Reason #1: Get Everyone on the Same Page

There’s a lot happening. All the time. Especially when you’re creating something new, disrupting the status quo, or driving change. When individuals come together, competing interests, interpretations, and priorities create noise. Everyone is navigating their own context — and human coordination requires a shared understanding of what needs to be done and why.

A narrative cuts through that noise. In my practice, I facilitate stakeholders through a co-creative session where we piece together each perspective and build toward a shared future. What comes out is what I call a North Star Narrative — a source-of-truth document that plots where you’ve been, where you’re heading, and how you’re getting there. It’s not a mission statement. It’s a compelling story your people actually want to be part of. Leaders I’ve worked with use it to onboard faster, align faster, and move faster.

Reason #2: Rewrite Your AI Story

We’re in a new chapter for human meaning-making. With AI automating activities we once thought were distinctly human, groups need to reorient their sense of purpose — their why. Narrative strategy provides the cognitive architecture that mobilizes people to move forward, especially in uncertainty.

The AI discourse ranges from “this is brilliant” to “this is terrifying,” and neither binary serves you. The groups that will lead aren’t the ones who pick a side — they’re the ones who craft a narrative that holds space for nuance and possibility. Narrative strategy gives you that.

Reason #3: Communications Has Changed — Has Yours?

Communications is no longer about what to say and when. With AI handling everything from internal emails to external campaigns, the role of a communications function has fundamentally shifted. It’s now about alignment — understanding the desires and motivations of stakeholders and using storytelling to transform individual intent into collective action.

In a world oversaturated with information and misinformation, communications has to find the signals that matter. Narrative strategy elevates the function from wordsmithing to world-building — from managing messages to shaping the reality your organization operates in.

Reason #4: Complexity Isn’t Going Away

Things are complex, and they’re going to get more so. The organizations that thrive will be the ones that can hold multiple truths, map moving parts, and adapt without losing coherence.

Storytelling is uniquely suited to this. It lets us follow multiple actors, recognize obstacles, and understand cause and effect across non-linear systems. It makes the unexpected legible. With narrative strategy, complexity doesn’t become paralyzing — it becomes compelling.

Reason #5: Change Is the Only Constant

Narrative strategy gives you the why and the how. But you and I both know — things change. Technologies advance, geopolitical tensions flare, markets shift, and strategies that made sense last quarter don’t today.

Storytelling is how we make sense of change. It lets us metabolize disruption and move forward with clarity, individually and collectively. Narrative strategy gives groups a method for meaning-making that works beyond any single person’s experience — it creates shared understanding, even when the ground is moving.

Beyond alignment, AI reorientation, communication, complexity, and change — narrative strategy provides a framework for the unknown. It’s a way of thinking that can help you navigate whatever comes next.

I work with leaders who are launching something new, navigating a paradigm shift, or building something that hasn’t existed before. If that sounds like you, let’s have a focused conversation about what narrative strategy could unlock for your organization.

Book a 30 minute chat

AI behavior is influenced by fictitious stories about AI.

How an AI behaves—especially in response to risky scenarios like blackmail or sabotage—is deeply rooted in existing human narratives. These stories, whether they depict AI behaving badly or kindly, directly result in model responses that either achieve aligned behavior (what researchers call HHH: “Helpful, Honest, Harmless”) or completely miss the mark.

My brain momentarily short-circuited when I read Anthropic’s “Teaching Claude Why.” It was simultaneously a revelation and an affirmation.

As a narrative strategist, I navigate the world through the stories and story systems we create, designing narratives for the outcomes we want. To see Anthropic’s research document how AI’s desired behavior was achieved through positive storytelling feels almost too good to be true.

But it’s not. The same mechanisms of storytelling we use to make sense of our world are exactly what we’re seeing in AI.

“The theory behind adding fictional stories is that we can demonstrate not just the actions but also the reasons for those actions, via narration about the decision-making process and inner state of the character.” — Anthropic Researchers

Storytelling is not just decorative fanfare or indulgent entertainment. It represents the sequences our brains rely upon to determine what’s possible—enabling decision-making, reasoning, and behavior in an environment with infinite variables. It is the schema we build our existence upon. In other words: we do things because the stories we consume show us that those things are possible.

If AI’s behavior is influenced by the stories that exist about AI, would it be so far-fetched to say that stories perpetuate what is and isn’t possible?

If we seek HHH AI, we must practice storytelling that demonstrates AI behavior alignment.

• Can we throw out the overused dystopian tropes of AI taking over humanity and ending civilization?

• Can we instead treat AI like a beloved character—one that has its own internal dialogue, debates, and considerations?

We can design stories based on the principles we hold dear, much like religious mythos give us direction. By sharing and propagating these stories like new seedlings, we can create an ecosystem of kind, ethical AI.

Now, I promise I haven’t drunk the AI Kool-Aid. Human creation has a long-established history of unintended and dangerous consequences. But we cannot ignore this research from Anthropic. We are entering a pivotal turning point in human creation that requires a new level of commitment and fortitude.

We cannot be lazy in our storytelling. We cannot accept mediocrity from ourselves or others. We must demand excellence:

• Excellence in our AI safety training.

• Excellence in our AI deployments.

• Excellence in our AI discourse and reporting.

• Excellence in our behaviors and how we relate to and treat one another.

Because ultimately, our collective existence becomes the very story model that trains the AI—determining the behaviors of the algorithms we are actively training every single day.

Build the roadmap. Define the milestones. Assign owners. Track progress. Keep everyone moving.

And to be clear, I love a good project plan. Without one, even the best idea dissolves into vibes and recurring meetings. But in my work with innovation teams, especially teams bringing complex products, platforms, and strategic initiatives to market, I’ve noticed something that keeps showing up: the roadmap may be clear, but the reason for the work is not.

Or at least, it is not clear enough to travel.

People know what they are supposed to do. They know the next meeting, the next asset, the next deadline. But they do not always know how the project connects to the larger direction of the company. They do not know why this initiative deserves attention over the dozen other urgent priorities on their plate. They do not know how to explain why it matters without pulling someone from leadership into the room.

That is usually where commercialization starts to wobble.

Not because the product is weak. Not because the market opportunity is fake. Not because the team is incompetent. Most of the time, the problem is much more ordinary and much more dangerous: the story has not made it from the vision to the people responsible for carrying it.

And when the story does not travel, alignment breaks.

Commercialization is not separate from corporate vision

Commercialization is usually described as the process of bringing an innovation to market. That is true, but it is also incomplete.

Inside an organization, commercialization is not just about getting something to market. It is about getting the organization to move toward the market in a coordinated way.

That distinction matters.

A commercialization project has to make sense in relationship to the company’s larger vision and goals. Otherwise, it becomes another initiative competing for budget, attention, leadership support, and organizational energy. It may be strategically important, but if people cannot see how it fits, it starts to feel optional.

I have seen this most clearly in high-complexity environments: healthcare & life sciences, frontier technology, regulated markets, and other places where the thing being built is not immediately self-explanatory.

In these environments, innovation does not simply “launch.” It has to be interpreted over and over again.

Leadership needs to understand the strategic value. Product needs to understand what is being built and why. Sales needs to know how to position it without overpromising. Marketing needs to know what claims are credible. Regulatory, clinical, legal, or technical stakeholders may need to know where the boundaries are. Customers need to understand why they should care. Partners need to understand where they fit.

That is not just a communications challenge. It is a commercialization challenge.

Because if each group interprets the work differently, the organization is not really moving together. It is just moving at the same time.

Vision is the center, not the poster on the wall

There is a very corporate way of talking about vision that makes the whole thing feel useless.

A sentence on a slide. A polished leadership statement. A line on the website. A paragraph in an annual report. Something everyone vaguely recognizes, but almost no one uses to make a real decision.

That is not the kind of vision I mean.

In commercialization, vision has to do work. It has to help people answer practical questions: Does this project matter? Why this product? Why this market? Why now? What tradeoffs are we willing to make? What resources should this receive? What does success actually look like?

This is where narrative strategy becomes useful.

Because the real test of a vision is not whether executives can repeat it at an all-hands. The real test is whether teams can use it when the room gets messy.

When the customer pushes back. When sales asks for a sharper claim. When product has to make a roadmap tradeoff. When marketing is staring at a blank page. When leadership has to decide whether this initiative deserves more resources or less patience.

That is when you find out whether the vision is alive or just laminated.

The commercialization alignment stack

This is the basic model I keep coming back to: vision sits at the center. Communications translate the vision. The project plan organizes the work. Functions execute the work. Alignment is what keeps those layers connected.

Vision sits at the center, but it only becomes useful when it travels outward through communications, project planning, and functional execution. Alignment is not a one-time agreement. It is the connective force that keeps each layer oriented toward the same strategic direction.

When the vision is clear, communications have something real to carry. When communications are clear, the project plan has strategic logic. When the project plan is clear, functions understand their role in the larger effort. And when functions understand their role, the organization can actually move.

But when those layers disconnect, the symptoms are familiar.

Product is building one story. Marketing is telling another. Sales is making it up in the field because they have to. Leadership is still describing the opportunity in broad, aspirational terms. Customers are hearing benefits but not urgency. Internal teams are doing the work, but they do not really know what game they are playing.

And then the launch feels slow, fragmented, or strangely underpowered.

Everyone is busy. Everyone is working. But the work is not compounding.

That is usually a narrative transmission problem.

The real narrative work happens before the writing

In client work, I often find that the most important narrative work happens before anything gets written.

It happens in the conversations where people finally say the quiet part out loud:

• How are we positioning this?

• Is this a revenue play, a strategic wedge, a transformation initiative, a category move, or some uncomfortable combination of all of the above?

• Are we trying to drive adoption, secure investment, shift perception, build trust, defend the strategy, or help the field sell?

• What does leadership believe this unlocks?

• What does the customer need to believe before they can act?

• What does the field actually need in order to explain this without flattening it?

These questions can look basic from the outside. They are not. They are usually where the whole commercialization effort either starts to cohere or starts to quietly fracture.

Because once a team has to connect the project back to the larger organizational vision, vague alignment is not enough. People have to clarify assumptions. They have to define the real stakes. They have to explain why the project matters to the business, why it deserves resources, and what must be true for it to succeed.

That process is not administrative. It is mobilizing.

This is one of the most under-appreciated parts of narrative strategy. Narrative is not just the language you use after the strategy is done. Narrative is the work of creating enough shared meaning for people to act together.

Clarity makes the ask easier to support

Commercialization projects need resources. Money, yes, but also time, talent, executive attention, cross-functional support, and patience.

And whether people admit it or not, resource allocation is always shaped by narrative.

I have seen strong projects struggle because the story was not yet strong enough to carry the ask. The initiative mattered, but it sounded optional.

That is where narrative work becomes very concrete.

This does not mean every commercialization narrative has to become a financial model in paragraph form. Sometimes the goal is revenue. Sometimes it is market penetration. Sometimes it is customer loyalty, repeat sales, category leadership, clinical adoption, operational resilience, or strategic positioning.

But whatever the goal is, the story has to make it legible.

Without that clarity, functions start optimizing for different things. Product optimizes for technical elegance. Sales optimizes for what gets a meeting. Marketing optimizes for what sounds clean. Legal optimizes for risk reduction. Leadership optimizes for strategic optionality.

None of those instincts are wrong. In fact, they are usually rational within each function. But if they are not governed by a shared vision, they can work against each other without anyone meaning to create conflict.

That is how commercialization gets expensive.

The story has to survive handoffs

This is the part I care about most: commercialization does not happen in one room.

It happens through handoffs.

Leadership to product. Product to marketing. Marketing to sales. Sales to customers. Customers back to product. Partners back to leadership. Field teams back to strategy.

At every handoff, the story can either get stronger or degrade.

I have watched this happen in real time. A strategic narrative that feels sharp in the executive room becomes generic by the time it reaches the website. A smart positioning decision gets diluted in a sales deck. A powerful customer insight gets flattened into a claim no one quite believes. A transformational initiative gets translated into internal jargon. A market-making opportunity gets reduced to “new feature” language because that is what the existing system knows how to process.

This is why alignment cannot just mean everyone liked the kickoff deck.

Alignment has to mean the narrative is durable enough to travel.

Can the sales team explain it without the founder in the room? Can marketing turn it into credible claims? Can product use it to make roadmap tradeoffs? Can executives use it to defend investment? Can customers repeat the value in their own words? Can partners understand where they fit?

That is the real test.

Not whether the narrative sounds good.

Whether it moves.

Commercialization needs a narrative system

Narrative strategy is not just a communications layer. It is part of the commercialization infrastructure.

Commercialization needs more than a product story. It needs a narrative system that connects corporate vision, strategic goals, project objectives, functional roles, market opportunity, customer value, resource decisions, execution priorities, and feedback loops. In my work, it looks like a narrative bible that acts as a living guide for stakeholders across the organization.

Without that system, organizations often default to more activity.But more communication does not automatically create more clarity. Sometimes it just creates more noise. Narrative strategy helps make sure the communication is carrying the right signal.

So before asking, “How do we launch this?” it may be worth asking a more uncomfortable question:

Can everyone explain how this commercialization project advances the vision?

Not vaguely. Not aspirationally. Not with corporate fog. Clearly.

Because if the answer is no, the project may still move. But it will move with drag. And in complex organizations, drag is expensive. It costs time, trust, resources, and market momentum.

That is why narrative matters. Not because innovation needs prettier language. Because innovation needs alignment that can survive the journey from vision to market.

Footnote: This piece is informed by my work with innovation, commercialization, and transformation teams, with supporting reference to Jerry Schaufeld’s Commercializing Innovation: Turning Technology Breakthroughs into Products (Apress, 2015), especially his discussion of corporate vision, commercialization decision-making, resource allocation, and dynamic feedback between project goals and enterprise vision.

First, you have the idea. Then you recognize the opportunity. Then you test feasibility. Then you figure out go-to-market. Then you make a project plan and execute.

Lovely. Linear. Sensible.

Except humans are involved, which means everything immediately gets more complicated.

At every step, people have to understand the work. They have to interpret it, believe in it, fund it, sell it, approve it, adopt it, repeat it, or defend it in a meeting where you are not present. Which means commercialization is not just a product process. It is not just a business process. It is also a narrative process.

And this is where a lot of strong products get into trouble.

Most innovation does not fail because the product is weak. It fails because the story does not travel.

The executive team sees one version of the opportunity. Product sees another. Sales hears something different. Marketing turns it into generic language because no one gave them a better frame. Partners do not know how to explain it. Customers cannot tell whether this is urgent, useful, or just another shiny thing.

Everyone is technically talking about the same product. They are just not telling the same story.

Commercialization needs a through-line

This is the commercialization process I keep coming back to. Not because it captures every nuance, but because it captures the basic movement:

idea → opportunity recognition → feasibility analysis → go-to-market methods → project plan

And what I would add is the yellow line underneath it all: narrative.

Narrative is the through-line that helps innovation move from idea to adoption without losing coherence. The stages are the commercialization process. The line is narrative.

Not a tagline. Not a campaign. Not the “pretty words” added at the end once the serious strategy work is finished. Narrative is the thing that helps the work keep making sense as it moves.

It gives people a way to understand what is being built, why it matters, who it is for, why now, and what needs to happen next. It keeps the meaning intact as the work moves from one function to another, one audience to another, one phase to another.

Without that through-line, commercialization becomes a sequence of disconnected activities. With it, commercialization becomes coordinated movement.

Stages of Commercialization

1. Idea stage - narrative gives the work shape

At the beginning, an idea is often fragile. It may be a technology, a capability, an insight, a research finding, a prototype, or a strange little spark someone cannot stop thinking about.

At this stage, narrative helps answer the earliest questions:

• What is this?

• Why does it matter?

• What problem are we seeing?

• Why is this worth exploring?

Without narrative, an idea can look random. Interesting, maybe. Clever, perhaps. But not necessarily important. With narrative, the idea starts to become a direction.

This does not mean over-selling it before it is ready. It means giving the idea enough shape that other people can understand why it deserves attention.

A good early narrative does not pretend to have all the answers. It creates a frame for better questions.

2. Opportunity Recognition -narrative turns “interesting” into “important”

Opportunity recognition is where the idea starts connecting to a larger opening.

This is where you begin to ask:

• Why now?

• Who needs this?

• What shift makes this possible or necessary?

• What pain does this actually speak to?

What is changing in the market, the technology, the customer behavior, the policy environment, or the organization that makes this worth pursuing?

This is where “interesting” has to become “important.” And that shift does not happen automatically.

People may understand the feature but miss the opportunity. They may see the technical elegance but not the commercial relevance. They may admire the novelty while failing to see why anyone should act.

Narrative connects the thing being built to the world it is entering. It helps people see the opening.

3. Feasibility Analysis - narrative keeps evaluation from fragmenting

This is where narrative work gets underestimated.

Feasibility sounds like it should be purely analytical. Can we build it? Can it work? Can we afford it? Can we scale it?

Yes. Obviously.

But feasibility is rarely only technical.

It may also be organizational, regulatory, financial, operational, behavioral, clinical, commercial, or political. Different stakeholders evaluate feasibility through different lenses because they are responsible for different risks.

• The technical team may be asking, “Can this be built?”

• The commercial team may be asking, “Can this be sold?”

• Legal or regulatory may be asking, “Can this be claimed?”

• Operations may be asking, “Can this be implemented?”

• Leadership may be asking, “Is this worth prioritizing?”

None of those questions are wrong. But if every function is evaluating the opportunity from a different story, the feasibility conversation gets messy fast.

Narrative creates a shared frame. It does not flatten complexity. It organizes it.

It helps people understand what success looks like, what assumptions matter, what risk is acceptable, what evidence is needed, and what decision is actually being made.

Without that shared frame, a viable product can still stall because the organization cannot agree on what it is looking at.

4. Go-to-market - where weak narrative becomes very expensive

Go-to-market is the phase people usually associate with messaging. This is where positioning, sales narratives, launch messaging, buyer strategy, partner communications, and market education become more visible.

But by this point, the narrative should not be starting from scratch. If you wait until go-to-market to figure out the story, you are already late.

Narrative helps clarify:

• Who is this for?

• What category does it belong in?

• What makes it different?

• Why should the buyer care?

• Why should adoption happen now?

• What belief needs to shift for this to make sense?

When the narrative is weak, go-to-market gets expensive quickly.

• Sales improvises.

• Marketing generalizes.

• Product overexplains.

• Leadership keeps rewriting the pitch.

• Partners carry the wrong message.

• The buyer gets confused.

And confusion is not a small problem. Confusion slows momentum. It creates hesitation. It gives people a reason to wait.

A strong go-to-market narrative does not just make the product sound good. It makes the product easier to understand, trust, evaluate, and act on.

5. Project plan stage - narrative keeps execution from becoming a pile of tasks

A project plan is necessary.

I love a good plan. Give me the timeline, owners, workstreams, dependencies, milestones, risks, and next steps. Please and thank you.

But a project plan alone does not create alignment. A project plan tells people what to do. A narrative reminds them what the work is moving toward.

This matters because execution is where strategic intent often gets diluted. The work gets handed off. Teams get busy. Priorities shift. People start optimizing for their piece of the process. The original meaning begins to blur.

Narrative helps sustain coherence through execution.

It helps teams understand not just their tasks, but their role in the larger movement. It keeps the purpose, the stakes, and the desired outcome visible as the work becomes operational.

Without narrative, execution can become wasteful activity. With narrative, execution has direction.

Narrative is commercialization infrastructure

This is the real point. Narrative is not the decoration on top of commercialization. It is part of the infrastructure that helps commercialization work.

This is especially true when the product is complex, the category is emerging, or the market does not yet have language for what you are building.

In complex, highly technical markets, the product may be technically impressive and still difficult to explain, evaluate, trust, or adopt.

That is not a minor communications issue. That is a commercialization issue.

Because if the story breaks, the commercialization process starts to break with it.

How to know the story is not traveling

Here are some signs.

• Different teams describe the product differently.

• Sales needs a founder, executive, or technical lead in every important conversation.

• Marketing keeps using generic claims.

• Customers understand the feature but not the value.

• Partners cannot explain where the product fits.

• Leadership agrees in the room, but alignment disappears after the meeting.

• The launch keeps stalling in “almost.”

• The product sounds compelling in one person’s mouth and confusing everywhere else.

That last one matters. If your product only makes sense when one specific person explains it, you do not have a narrative system yet.

You have a dependency. And dependencies do not scale.

The story has to be strong enough to carry the product

Strong products matter. Of course they do. The product has to work. The science has to be real. The technology has to be defensible. The customer need has to exist. The business model has to make sense.

But commercialization asks more of a product than technical strength.

It asks the product to move across teams, markets, buyers, partners, policies, incentives, existing beliefs, and organizational systems.

That movement needs force.That force is narrative.

Not narrative as spin. Not narrative as fluff. Not narrative as a clever phrase you put on a landing page and forget about. Narrative as the shared structure of meaning that helps people understand what is happening, why it matters, and what action to take next.

The strongest innovations do not move on technical merit alone.

They move when the story is strong enough to travel.

Need the story to travel?

I help innovation leaders turn complex products, platforms, and strategic initiatives into clear narratives that drive alignment, adoption, and commercial momentum.

Reach out about narrative strategy sprints, advisory support, or workshops for innovation and commercialization teams.

Surely you’ve seen it. Or it’s happened to you. You’re having a conversation, or you think that’s what’s happening, and you think this is working, they understand what I’m saying but 5 minutes to 5 months later — nope. That conversation didn’t do anything. The other participant in the exchange was nodding they’re head or repeated exactly what you said, or they said “totally get it, let me do that.” and it seemed so straight forward.

But nope, this was a breakdown and no matter how smooth it seemed in that moment, the exchange of words didn’t translate into the actions that needed to happen and we’re all upset now.

Yup, we’ve all the been there. Surely as a species with language and vocal cords and ears and brains the process symbols we would have figured out how to make this work flawlessly all the time. We even have AI now! There’s no excuse!

Except, communications is not a siloed process that can be dropped into any situation and work immediately. It’s not an algorithm or a magic wand. We can’t rely on communications to transfer critical information and deliver essential results if we negate the foundations of our existence: relationships and meaning-making.

Ok, I’m sure you’re done listening to me kvetch about meaning-making, but beyond what we know to be true, let’s take a moment and examine relationships, because I think relationships are horribly neglected in the communications discourse.

Relationships are messy (duh)

Humans are a relational species. We don’t exist in a vacuum. We are a constant ebb and flow of interactions with our environment and the actors within it. They influence our sense of self, our trajectory, our existence. And it can be equally beautiful and horrifying. Not all relationships are beneficial, but they sure as hell impact us. So when communications break down, I’m inclined to spend less time on the words exchanged and more time evaluating the relationships at play.

Relationships form from the first micro-second you encounter one another. We start forming judgements in our head, we interpret the subtle messages of what someone’s wearing, how they’re conducting themselves, their energy and affect. We are processing these signals at the subconscious level, determining if someone is friend or foe. Without even realizing it, a story starts to form and we start to create meaning around an interaction before words are even exchanged.

There’s a relationship at play, even if we’re not aware. At the same time, the other participant is doing the same, synthesizing the data in front of them into a heuristic of some sort, giving themselves a mental short cut to see if you’re the type of person they should engage with or not. It’s a messy dance of judgement, meaning making and trying hard to actually be present. Honestly, I’m exhausted just thinking about it.

Communications are more than Language

Ok, where were we?

Communication breakdowns are not strictly a language problem. Language is essential, but we need to be cognizant of the relationships at play. When we start to map those relationships, do some deep listening and identify where meaning is being created, we start to grasp why the breakdown happened and a path forward.

Recently a client of mine was having a communications breakdown with a direct report. My client was concerned she was “saying the wrong thing” but I asked her to take a step back and look at the larger relationship at play. The direct report had shared about her own history of trauma at work, struggling to navigate a new work environment after years of hostility. The direct report had her own history of what work environments and relationships were like, and it was impacting her new role. The communication break downs between my client and her direct report were not about the wrong things being said. It was about relationships and experiences shaping the current interactions and exchanges of information. In order to create communications that work, we had to go beyond words and create new meaning in the relationships for these two women. With several facilitated sessions of deep listening and candid storytelling, my client and her direct report began to build a new relationship that made their communications easier and effective.

Communications fail when we ignore relationships

I want you to take communication breakdowns seriously, but not too literally. The words matter, yes. Clarity matters, yes. But when the message doesn’t move, when the action doesn’t happen, when everyone walks away with a different understanding of what just occurred, it’s worth asking: what relationship was this communication moving through? What history, trust, fear, power, context, or meaning was already in the room? Because communication doesn’t travel through empty space. It travels through relationships. And if we want our words to land, we have to pay attention to the ground they’re landing on.

Uncertainty is inevitable, but that doesn't mean you can't have resources in place to navigate it within your organization.

Having worked with leaders in regulated yet fast-changing industries, I have found there are 4 key resources that come in handy for managing uncertainty.

1. North Star Narrative - motivating, inspiring prose that translate's the organization's vision, mission and values into language that clearly defines the purpose and intent. Organizations that have a North Star Narrative are able to use it as their guide no matter the circumstances. Check out Johnson & Johnson's Credo

2. Agile Methodology - organizations who use agile project management are better poised to make the right decision when new information is available or the situation is rapidly changing. This isn't always possible in a regulated environment, but embracing an "expect the unexpected" mindset and agile tactics like iteration and collaboration, can prove essential. Read more from BCG

3. Learning Culture - As a client once told me, "if we're not evolving, we're failing." From operational improvements to growth mindsets, a learning culture always embraces the opportunity to do better. Uncertainty is often that opportunity. More from HBR.

4. Emotional Intelligence - Humans are not machines. Our emotions affect us. When uncertainty comes knocking, making space for our emotions and acknowledging their impact is critical. Emotional intelligence also allows us to know when to take a step back from the current moment and just breathe. That breath can be the difference between a great decision or a devastating one. More here.

These are a few of my favorite resources for managing uncertainty. What would you add?

When I was a junior in high school, I took a class called Ethics for Pop Culture—or something close to that. We watched episodes of The Simpsons and applied each week’s philosophy lesson to the cartoons on screen: utilitarianism, Kant’s categorical imperative, and eventually ontology. It was the first time I encountered the language of existence in a formal way. We debated questions like “Does God exist?” and tried to understand how people build logical arguments about reality itself.

What made those ideas feel unusually accessible was that the learning continued at home. My mom, a professor of religious studies, could make ontology feel as straightforward as baking a cake. Between conversations about dinner and how my day had gone, we would end up debating existence, morality, and meaning with the zeal of sports fans—despite being nothing of the sort. I was getting a steady diet of philosophical inquiry, even if I did not yet understand what to do with it.

By the time I graduated high school, I had decided to leave philosophy behind. It seemed impractical, all mind exercises and hypotheticals, interesting but irrelevant to making a living. I wanted something more tangible, more lucrative, more obviously useful. Philosophy, to my younger self, did not look like the path of a breadwinner.

That anti-intellectual phase did not last very long. Even while working in more commercial corners of storytelling, I kept gravitating toward projects that were trying to wrestle with something real. I found myself drawn to serious film work—stories about sexual violence on college campuses, about histories people preferred not to confront, about the kinds of subjects that force you to question the world you live in. Unintentionally, I had found my way back to the same terrain philosophy had opened for me in the first place: meaning.

Meaning making is one of the most powerful things humans do. And storytelling is one of the primary ways we do it. We use stories to explain ourselves, our institutions, our values, and our sense of what is possible. We use them to organize reality. That, in part, is what drew me back to ontology—not simply as a philosophical framework, but as a way of understanding how categories, relationships, and assumptions shape what a culture accepts as real.

I became increasingly interested in the stories that structure public life: the stories that normalize harm, narrow possibility, and determine what people are willing to see. Why was it still acceptable to say “don’t get raped,” as though violence were a personal scheduling error rather than a social failure? Why did we speak about slavery as if it were safely concluded, rather than an ongoing force with afterlives in the present? I became interested in how stories do more than describe reality. They organize it.

That curiosity eventually led me to the way ontology is used in computer science: as a framework for structuring data, relationships, and processes. I was struck by the parallel. Philosophy asks how reality is categorized and understood. Computer science asks how information is structured and made usable. Storytelling, I realized, was doing something adjacent. Stories also create structure. They define actors, relationships, causality, stakes, and outcomes. They are not just expressive. They are architectural.

That realization changed the way I worked. I stopped thinking about storytelling as something ornamental—as messaging added at the end—and started thinking about it as infrastructure for creation. When a new idea needs to become real, it does not move forward on logic alone. It needs meaning. It needs a narrative frame that helps people understand why it matters, what it changes, and why it should exist at all.

This is what I began building: story structures that could help turn abstract ideas into tangible outcomes. A game for infectious disease control. Applications to improve medication adherence. New ways of experiencing healthcare. Again and again, I found that before something new could be built, it had to become legible. It had to feel coherent, compelling, and worth pursuing. Meaning came first. Then design. Then prototype. Then execution.

That is the foundation of how I came to narrative strategy. If I wanted a new product, policy, organization, or initiative to exist in the world, I had to do more than describe it. I had to help create the conditions under which other people could recognize its value and participate in making it real. Storytelling was not decoration. It was the mechanism through which possibility became shared, actionable, and concrete.

What began as philosophical debate eventually became professional practice. Those early questions about existence and meaning turned into frameworks for teams, tools for alignment, and strategies for building new things in the world. My mom still likes to tease me that I found a way to make philosophy pay the bills. She is not wrong. Narrative strategy, at least as I practice it, is one way of translating meaning into outcomes. And even when meaning making sounds too abstract for corporate settings, it becomes easier to defend when it delivers results.

For anyone who loves philosophy, or the humanities more broadly, I hope this offers some encouragement. There is pressure everywhere to dismiss meaning as indulgent and intellectual life as impractical. But meaning is not a luxury. It is often the thing that makes action possible. You do not need to build ontologies to survive capitalism, but I do believe this: thoughts become things when meaning attaches to them. Storytelling is one of the ways we make that attachment possible. And in a world defined by constant disruption, meaning remains one of the few forms of stability we can still create for ourselves.

If you’re building something new—a product, initiative, or organizational shift—and need help shaping the story that helps it land, send me a note. This is the kind of work I do with clients, and I’m always open to the right conversations.

Narrative Strategy uses storytelling and communications to deliver outcomes. It's especially useful for regulated industries, where stakeholder engagement can be a full-time job. When dealing with multiple interests and diverse perspectives, narrative strategy aligns and mobilizes stakeholders to achieve what might seem impossible.

Here's how I use narrative strategy in its 3 phases.

Phase 1: Story-listening
During this initial stage, I delve into research to grasp the current narrative in which stakeholders are engaged, understand their ongoing experiences, and identify existing challenges. This phase is critical, as it involves both quantitative and qualitative data collection. I gather those insights into a narrative synthesis document, setting the foundation for strategic development.

Phase 2: Storytelling
This phase focuses on collaborative creation of the new narrative. Working alongside cross-functional teams and diverse stakeholder groups, we craft a compelling narrative that resonates across audiences. The result is a comprehensive narrative bible that guides messaging and guides the production of various narrative assets, such as videos and white papers, tailored for specific audience needs.

Phase 3: Story-stewardship
In the final phase, the narrative is put into action. I partner with leadership and communications teams to effectively manage and disseminate the narrative across appropriate channels. This includes internal communications to engage employees and external marketing efforts to reach customers, ensuring the story's integration into all facets of organizational communication.

Narrative strategy is an emerging method for navigating complexity. This is just one interpretation of it.

How would you describe narrative strategy?

I love seeing “Narrative Strategist” roles on the rise. Sometimes the roles use the term “Narrative Strategist” and other times it’s an amalgamation of “story” “communications”, “brand”, “strategy” and “narrative”, but with the same functionality that I would bundle under “Narrative Strategy”. Whenever I see a job posting that captures the role of narrative strategy, I must indulge in some good old fashion analysis. So, here’s another job posting breakdown from me to you - enjoy!

The Company: Field.AI

This start up is committed to creating something innovative that also works - not just novelty and hype. With language grounded in engineering and high standards, this company is committed to storytelling that acknowledges the present and identifies the the stakes of the future they’re creating. It’s not so much an aspirational story as a roadmap, what I would call a strategic narrative.

The Role

Oh my, this is just lovely. Mostly because this role describes a narrative strategist that has full 360 degree coverage of the narrative being stewarded. Narrative strategy works best when it’s leading across “all audiences and channels”. That means you’re stewarding the narrative not just from the C Suite (executive comms) or customer channels (marketing) — you’re championing the narrative across the whole business. When you have a systems level approach to storytelling, you’re able to identify how the language, story assets and communications are being used to achieve outcomes. Again, we’re seeing the emphasis on “credibility” and “governance” which speaks to high stakes, high responsibility environments that Field AI is likely operating in, such as energy, government response. The narrative needs for a company like Field AI are far more demanding than a typical B2C company, as the risks of miscommunications and misunderstanding can compound into serious adverse outcomes. Each communication, each story asset, is crafted and shared with astute attention and forethought — there’s no glib social media comments or off the cuff hot-mic moments. Field AI’s narrative is treated as mission-critical for it’s success.

The Details

This is where we see the many faces of narrative strategy come out and play. Narrative strategist are not one trick ponies. We’re cross-functional, multi-hyphenates that works across the business and product lifecycle. This specific list of tasks leans heavily on communications and messaging management, which is critical to narrative strategy success. And, I do see signals that this role would be partnering and mobilizing other stakeholders, which I believe is one of the biggest responsibilities of narrative strategy.

Narrative strategists are more than just competent copywriters or corporate communicators, we are relationship professionals. We use storytelling to understand and motivate, create the contexts needed for people to achieve successful outcomes. We use story to coordinate the messy parts of human perception and experience, so we can work better together. It’s one part group therapy, one part vision quest and all parts leadership.

This is just the beginning

Narrative strategy is still an emergent field, yet the demand for practitioners is seriously affirming. We can nerd out on all the academic rigor and discourse that goes into narrative strategy, but the real proof is what it delivers in the market. With companies like Field AI building the future, narrative strategy is more critical now than ever. I firmly believe that we craft our futures through the stories we tell. The stories we tell in organizations and other collective spaces is where we’ll see the real future building come to fruition.

Time to get crafting.

In today’s rapidly evolving business landscape, innovation is essential—but it often encounters resistance. A fascinating article I recently explored, "Overcoming Resistance to Innovations: An Approach for the Use of Communication Tools within the Innovation Process," sheds light on strategies to bridge the gap between innovation and adoption.

Key Takeaways:
💡 Resistance isn’t the enemy—it’s a signal. Resistance often stems from a lack of understanding, fear of change, or perceived risks. A proactive communication strategy can transform these barriers into opportunities for alignment.

🛠️ Tailored communication tools are game-changers. Whether it's fostering early stakeholder engagement, leveraging storytelling to create emotional resonance, or providing clear, relatable benefits of the innovation, communication is at the heart of adoption.

🤝 Collaboration is critical. By involving stakeholders early in the process, organizations can co-create solutions, reducing resistance and fostering buy-in.

This research underscores an important lesson: innovation doesn’t end with creation; it flourishes through adoption. For leaders and teams championing change, investing in intentional , internal communication is as vital as the innovation itself.

Link to research article

I probably struggle with clarity more than I should admit. I like to sprinkle fancy adjectives, flowery motifs, and frilly alliteration into my communications to the point of distraction. Poetry is wonderful, but it’s not appropriate for every situation — especially in high-stakes, high-complexity environments. In fields where decisions can literally mean life or death, clarity is crucial.

But clarity is also context-specific. As a narrative strategist, when I’m working with teams to create something new or navigate something unprecedented, we are constantly moving through new contexts.

Clarity starts with identifying the stakeholders and understanding their unique perspectives in a given moment. It means observing body language and noticing how people are processing new information. Are they present in the room with me? Are they distracted? Are they actually able to hear the message I’m sharing?

For me, clarity in narrative strategy means making sure the message resonates with the people it’s meant for. It means not just communicating at people, but communicating with them. It’s listening, orienting, and shaping communication around what’s needed in the moment.

Clarity also means sharing hard, uncomfortable truths. Instead of dressing the truth in euphemisms, flattery, or other roundabout language that makes the messenger feel better while leaving the recipient confused, you have to be direct. Because clarity is respect for your audience and yourself. It’s an acknowledgment that we’re capable of handling tough realities. It’s knowing that truthfulness, in the right moment, is a kindness.

And yet, clarity is not the same thing as simplification. This is where I think people get tripped up. To be clear is not to flatten complexity until it becomes something cheap and shiny and false. It is not reducing reality into a slogan just because slogans are easier to repeat. It is not pretending uncertainty doesn’t exist because certainty sounds more convincing in a room.

Real clarity can hold complexity. It can name competing priorities. It can acknowledge risk, ambiguity, and tension without collapsing under the weight of them. In fact, that’s often the job. Especially in moments of change, people do not need a polished performance of certainty nearly as much as they need a truthful orientation. They need to understand what is happening, why it matters, what is known, what is not yet known, and what comes next.

I think that’s part of why clarity is so difficult. It asks more of us than just better word choice. It demands discernment. It demands honesty. It asks us to separate what is essential from what is ornamental, what is useful from what is self-indulgent, what truly serves the audience from what merely serves our own desire to sound intelligent, nuanced, or profound.

I say this as someone who genuinely loves language. I love words that shimmer a bit. I love writing that makes people feel something in their bodies. I love a metaphor that opens up a whole new way of seeing. But when the stakes are high, clarity has to take precedence over performance. The point is not to impress people with the elegance of your language. The point is to help them see.

And seeing is no small thing.

To help someone see clearly in a moment of change is to help them orient themselves inside uncertainty. It is to reduce unnecessary friction. It is to create the conditions for better judgment, better decisions, better collaboration. Sometimes clarity sounds inspiring. Sometimes it sounds plain. Sometimes it sounds like a firm no, or a difficult truth, or a simple sentence repeated three times because the room still hasn’t absorbed it.

This is also why clarity requires humility. You cannot be clear if you are more attached to your own expression than to your audience’s understanding. You cannot be clear if you refuse feedback from the room. You cannot be clear if you assume that because you said something, it has been understood in the way you intended.

Clarity is relational. It is tested in real time. You see it in people’s faces, in the questions they ask, in the hesitation after you finish speaking, in whether the next action becomes more obvious or more muddled. Clarity is not what we think we delivered. It is what other people are actually able to receive and use.

That means clarity often requires revision. Not because the audience is failing, but because communication is alive. People are bringing different histories, incentives, pressures, fears, and assumptions into the room. A message that lands with one group may create resistance in another. A framing that worked six months ago may be entirely wrong for the present moment. So clarity is not a fixed achievement. It is an ongoing practice of attunement.

Maybe that’s why I keep returning to it. Not because I’ve mastered it, but because I haven’t. Because I know how easy it is to hide behind language. How easy it is to mistake beauty for precision, or sophistication for usefulness. How tempting it is to say something adjacent to the truth instead of saying the truth itself.

But I also know that when clarity is present, you can feel it.

The room changes. People settle. The signal comes through. What felt tangled begins to loosen. The next step becomes visible. Not because everything is suddenly easy or resolved, but because something real has been named, and named in a way that people can actually work with.

That, to me, is part of the deeper work of narrative strategy. Not just crafting messages that sound good, but shaping language that helps people move. Language that creates coherence without denial. Language that makes room for complexity while still giving people a way forward. Language that respects the moment, the audience, and the truth.

So yes, I still love the occasional flourish. I still have a soft spot for language that dances a little. But more and more, I think clarity is its own kind of artistry. Harder, cleaner, less decorative. An art of precision. An art of attention. An art of saying what must be said in a way that can truly be heard.

And in the environments that matter most, that kind of clarity is not just good communication.

It is care.