tag:theconversation.com,2011:/au/topics/medical-humanities-14613/articlesMedical humanities – The Conversation2024-01-05T13:46:39Ztag:theconversation.com,2011:article/2173572024-01-05T13:46:39Z2024-01-05T13:46:39ZLiterature inspired my medical career: Why the humanities are needed in health care<figure><img src="https://images.theconversation.com/files/564561/original/file-20231208-17-e51tzu.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1998%2C1494&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Medicine is as much about the human experience as it is about biology.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/two-hands-connected-by-a-dramatic-graph-royalty-free-image/545248093">Jonathan Knowles/Stone via Getty Images</a></span></figcaption></figure><p>While there is a long history of doctor-poets – one giant of mid-20th-century poetry, <a href="https://poets.org/poet/william-carlos-williams">William Carlos Williams</a>, was famously also a pediatrician – few people seem to know this or understand the power of combining the humanities and medicine.</p>
<p>As a <a href="https://www.tremblingpillowpress.com/orogeny">published poet</a> and <a href="https://med.virginia.edu/biomedical-ethics/people/irene%E2%80%8B-mathieu/">scholar of the health humanities and ethics</a>, I have a foot squarely planted in each field – or perhaps more accurately, I stand in what I perceive as the overlapping field of healing and poetic practices.</p>
<p>Literature has had a large role in helping me define the kind of physician I strive to be – one who is not only empathetic and a good listener but also a fierce advocate for changing the sociopolitical forces that affect my patients’ lives. I think literature can do this for other health care providers, too.</p>
<h2>Narrative competence in medicine</h2>
<p>Despite having physicians for parents – or perhaps because of it – initially I had no interest in medicine. It seemed too clinical, too sterile. The work stories my parents shared over the dinner table were intentionally devoid of the personal details that would have interested me.</p>
<p>I was preoccupied with characters in the books I read – who lived in conflict zones, who as children were working instead of playing, who had struggles I couldn’t imagine – and wondered why I had my life and not theirs. What intangible forces shaped their lives in ways different from my own? Now I can directly trace my early infatuation with the written word to my chosen career as a pediatrician and public health researcher.</p>
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<figcaption><span class="caption">Medicine is a confluence of scientific and literary thinking.</span></figcaption>
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<p>Narrative medicine is the practice of close reading and reflective writing to build <a href="https://doi.org/10.1001/jama.286.15.1897">narrative competence</a>. Physician and narrative medicine scholar Rita Charon describes narrative competence as “the ability to acknowledge, absorb, interpret and act on the stories and plights of others.” </p>
<p>Narrative competence, then, could inspire a person to pursue a career in health care and possibly make them a better clinician. In fact, studies of narrative medicine programs have demonstrated that they tend to not only increase students’ <a href="https://doi.org/10.3352%2Fjeehp.2020.17.3">empathy and communication skills</a> but also their <a href="https://doi.org/10.1007/s11606-017-4275-8">tolerance for ambiguity and self-confidence</a>. They also improve their <a href="https://doi.org/10.3390%2Fijerph17041135">open-mindedness, ethical inquiry</a> and <a href="http://dx.doi.org/10.1136/bmjopen-2019-031568">perspective taking</a>.</p>
<p>Books introduced me to the breadth and diversity of human experiences and perspectives, as well as to searing inequalities in life outcomes. I wanted to positively change those outcomes in some way – a desire that led me into the arms of medicine, despite my initial misgivings about it.</p>
<h2>Using the humanities to address health inequity</h2>
<p>Might narrative competence also expand clinicians’ understanding of health disparities and urge them to act in ways that lectures full of statistics couldn’t?</p>
<p>The burgeoning field of <a href="https://doi.org/10.1097/acm.0000000000002871">critical health humanities</a> theorizes that stories and art can help clinicians understand the unequal realities of different people’s lives and make clinician-patient relationships more therapeutic. It can do this by cultivating clinicians’ awareness of the power differences and structural forces that affect their patients and themselves.</p>
<p>Defining features of this field are collaboration between disciplines – such as between medicine and literature – and a broad understanding of narrative medicine beyond the clinical encounter. Understanding not only human biology but also fields like the history of medicine, queer and disability studies, critical race theory and <a href="https://doi.org/10.1097/acm.0000000000002871">other forms of knowledge</a> can inform and improve clinical practice. </p>
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<a href="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clinician in scrubs sitting on a table between library shelves, reading a book" src="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564566/original/file-20231208-15-3bb3il.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Medical trainees often aren’t given the space to engage with the humanities.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/female-intern-finds-quiet-spot-in-library-to-study-royalty-free-image/1434731417">SDI Productions/E+ via Getty Images</a></span>
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<p>For example, a clinician might turn to research from the social sciences to learn about the experiences of people with disabilities. This could lead her to make her practice <a href="https://adata.org/factsheet/accessible-health-care">more accessible to her patients</a> – an action that would improve equity in health care for people with disabilities.</p>
<p>Before ever meeting my first patient, I gained an expanded knowledge of the diversity of human experience from the books I read. It made me curious about my patients’ stories. And when I felt this curiosity flagging because of stress, exhaustion or burnout, refocusing on the stories seemed to help.</p>
<p>However, medical students are inundated with information about the human body in their training and <a href="https://www.aamc.org/news/medical-schools-overhaul-curricula-fight-inequities">barely have time</a> to learn about the nonmedical aspects of patient experiences. This negates the fact that disease and health happen in varied and disparate social, cultural and political contexts.</p>
<p>For example, <a href="https://doi.org/10.2337/dci20-0053">diabetes is a very different illness</a> for a patient experiencing homelessness and racism compared with a wealthy patient who doesn’t experience racism. A patient’s access to resources and their <a href="https://theconversation.com/how-racism-in-us-health-system-hinders-care-and-costs-lives-of-african-americans-139425">interactions with health care staff</a> affect their ability to get the care they need and the degree to which their basic needs are being met. Rarely are these nuances discussed in a medical school’s endocrinology lecture about diabetes.</p>
<h2>Fitting in health humanities education</h2>
<p>I believe that physicians must find ways to practice their humanity – perhaps using the humanities – if they wish to be effective healers. But how might they actually do this? </p>
<p>There are ways to fit in more health humanities in all the busyness and bustle of notoriously grueling medical education. As a senior resident, I often distributed poems to my team, printing and posting them above the computers in our cramped hospital workrooms or attaching them to email updates about patient care. Once, during a rare quiet moment in the pediatric ICU, with permission from my colleagues, I read a couple of poems out loud. I remember watching my colleagues’ eyes close and their bodies visibly relax as the words washed over them.</p>
<p>Since then, I have shared poems – my own and others’ – in talks at my institution and across the country. I’ve also led other health care providers in creative writing exercises during workshops, lectures and classes. Many institutions host book clubs, story slams, film screenings and other opportunities for medical learners to engage with the humanities.</p>
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<span class="caption">Exposing clinicians to the breadth of human experience through the humanities can help them better understand where their patients are coming from.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/male-nurse-examining-baby-girl-with-stethoscope-in-royalty-free-image/1309071117">The Good Brigade/Digital Vision via Getty Images</a></span>
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<p>While poetry can be intimidating to some, many contemporary poems provide approachable emotional experiences.</p>
<p>Pieces like Safiya Sinclair’s “<a href="https://www.triquarterly.org/issues/issue-150/notes-state-virginia-ii">Notes on the State of Virginia, II</a>” viscerally illustrate how a place that seems innocuous or even beautiful to some can be haunting and traumatic for others. </p>
<p>Monica Sok’s “<a href="https://www.poetryfoundation.org/poetrymagazine/poems/144805/abc-for-refugees">ABC for Refugees</a>” powerfully paints a portrait of a young child caught between languages and cultures – a reality that many pediatric patients face. </p>
<p>“<a href="https://www.poetryfoundation.org/poems/155120/ode-to-small-towns">Ode to Small Towns</a>” by Tyree Daye upends common assumptions about rural life and demonstrates the meaning of place in hymnlike vernacular. </p>
<p>In “<a href="https://verse.press/poem/medical-history-7786213513888859947">Medical History</a>,” Nicole Sealey shares a many-layered patient perspective on a part of health care that, for many of my students and colleagues, has been reduced to a series of check boxes on a computer screen. </p>
<p>These and other poems – not to mention short stories, novels, personal essays, films, podcasts and comedy shorts, among other genres of storytelling – provide fertile ground for enhanced understanding of the human condition, as well as inspiration for a clinician’s own potentially transformative reflective writing.</p>
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<img alt="A square box with the words 'Art & Science Collide' and a drawing of a circle surrounding a lightbulb with its wire filament in the shape of a brain." src="https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567788/original/file-20240103-23-yg479z.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Art & Science Collide series.</span>
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<p><em><strong><a href="https://theconversation.com/us/topics/art-in-science-series-2024-149583">This article is part of Art & Science Collide</a></strong>, a series examining the intersections between art and science.</em></p>
<p><em>You may be interested in:</em></p>
<p><a href="https://theconversation.com/art-and-science-entwined-this-course-explores-the-long-interrelated-history-of-two-ways-of-seeing-the-world-210250">Art and science entwined: This course explores the long, interrelated history of two ways of seeing the world </a></p>
<p><a href="https://theconversation.com/art-illuminates-the-beauty-of-science-and-could-inspire-the-next-generation-of-scientists-young-and-old-168925">Art illuminates the beauty of science – and could inspire the next generation of scientists young and old</a> </p>
<p><a href="https://theconversation.com/visualizing-the-inside-of-cells-at-previously-impossible-resolutions-provides-vivid-insights-into-how-they-work-195873">Visualizing the inside of cells at previously impossible resolutions provides vivid insights into how they work</a></p>
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<h2>Melding literature and medicine</h2>
<p>The possibilities for collaboration between literature and medicine are wide open. In a country that <a href="https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going#">spends more per capita on health care</a> than economically similar nations yet continues to have extreme inequalities in outcomes, it’s clear that the U.S. needs to do things differently. </p>
<p>I believe <a href="https://doi.org/10.1186/s13010-023-00149-1">all clinicians have a role</a> in recognizing and grappling with how everyone has been shaped by an inequitable society. The history, sociopolitical context, imaginative perspective and reflective practices the humanities offer may improve the practice of medicine.</p>
<p>Through understanding others’ experiences and reflecting critically on their own, every clinician can move closer to being the kind of healer they intend to be.</p><img src="https://counter.theconversation.com/content/217357/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Irène Mathieu, MD, MPH is an iTHRIV Scholar. The iTHRIV Scholars Program is supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers UL1TR003015 and KL2TR003016.</span></em></p>While medical school may teach students about how the body works, it often neglects the social, political and cultural factors that determine health and disease. The humanities can help.Irène Mathieu, Assistant Professor of Pediatrics, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2022292023-08-22T12:24:50Z2023-08-22T12:24:50ZThis university class uses color and emotion to explore the end of life<figure><img src="https://images.theconversation.com/files/539631/original/file-20230726-21-o8a1by.jpg?ixlib=rb-1.1.0&rect=20%2C5%2C1096%2C656&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An imaginative watercolor drawing by Madison Zhao inviting students to enter the 'Schools of Color.' </span> <span class="attribution"><span class="source">Madison Zhao/Courtesy of Marcia Brennan</span>, <span class="license">Author provided</span></span></figcaption></figure><figure class="align-right ">
<img alt="Text saying: Uncommon Courses, from The Conversation" src="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/topics/uncommon-courses-130908">Uncommon Courses</a> is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.</em> </p>
<h2>Title of course:</h2>
<p>“The Colors of Life and the End of Life”</p>
<h2>What prompted the idea for the course?</h2>
<p>For many years, I’ve <a href="https://profiles.rice.edu/faculty/marcia-brennan">worked as a literary artist</a> at the University of Texas MD Anderson Cancer Center and the Hospital of the University of Pennsylvania. In both contexts, I work with advanced oncology patients and with <a href="https://www.collectiveinkbooks.com/axismundi-books/our-books/heart-hereafter">people at the end of life</a>.</p>
<p>During the hospital visits, I ask people about images that are close to their heart. As people speak, I write down their words verbatim and put their phrases into successive lines, like poetry – a gift for the patient and their loved ones.</p>
<p>Then, a year and a half ago, I was offered an opportunity to consult on an animation project in Hollywood. After decades working with university students and people <a href="https://doi.org/10.1007/s11089-012-0477-5">facing the end of life</a>, I found myself working with people at the beginning of life – with children.</p>
<p>The themes converged, and I was inspired to write a children’s book and teach a related university class about how art can help us understand major life insights and experiences, especially the wisdom that emerges at the end of life. </p>
<h2>What does the course explore?</h2>
<p>Classes pair original literary artworks that I produced with people at the end of life with related texts and images from philosophy, ethics, biomedicine, literature – including my new children’s book – and the fine arts. Together, we read everything from 15th century texts about <a href="https://www.loc.gov/item/49038880/">the Ars Moriendi</a>, or “the art of dying,” to contemporary writings by figures such as <a href="https://www.poetryfoundation.org/poetrymagazine/poems/57745/the-chart">the physician-poet Rafael Campo</a> and <a href="https://atulgawande.com/book/being-mortal/">the surgeon Atul Gawande</a>.</p>
<p>To organize key themes, each week we focus on one color and related thematic elements. In addition to the seven primary colors, the class examines pink, silver, gold, and black and white. The “orange” class, for example, centers on readings about creativity and communication, while the “green” class looks at issues of balance, continuity and people’s relationship to the natural world. During the “red” week, as we discuss strength and perseverance, we also examine debates about <a href="https://www.nytimes.com/2023/03/14/health/end-of-life-care-hospice.html">aggressive medical interventions</a> at the end of life.</p>
<p>Students also produce their own narrative artwork, drawing on a meaningful encounter with another person – preferably, a statement that incorporates the wisdom of an elder.</p>
<h2>What’s a critical lesson from the course?</h2>
<p>The end of life is all about life itself and the many different types of love that we experience as human beings. The wisdom that can emerge at this time is vital, not just for those facing the end of life but for all of us. </p>
<p>“The Colors of Life” explores how art and color can provide a way to express and discuss experiences that <a href="https://press.uchicago.edu/ucp/books/book/distributed/L/bo25034444.html">can otherwise be hard to put into words</a>. These can be deeply personal thoughts, and often, spiritual ones – especially in the face of death, suffering and uncertainty.</p>
<h2>What will the course prepare students to do?</h2>
<p>The class provides a window into a vital aspect of life that is often overlooked and avoided – namely, serious illness and the end of life.</p>
<p>While the class focuses on themes that are relevant to everyone, the course is particularly appropriate for students planning to enter into the medical and health care professions, or who will one day serve as caregivers. The emotions we explore engage some of <a href="https://students-residents.aamc.org/applying-medical-school/article/core-competencies">the core competencies</a> in pre-medical and medical education, from resilience and perseverance (red) to compassion and care (pink) to the ability to see multiple perspectives at once (black and white).</p>
<p>By focusing on color, this class also gives a concrete way for STEM-oriented learners – those in science, technology, engineering and math – to engage social, emotional, creative and humanistic themes.</p>
<p>I hope that all my students will draw on these skills and insights throughout their education and well beyond, within both their professional and personal lives.</p><img src="https://counter.theconversation.com/content/202229/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marcia Brennan is the Carolyn and Fred McManis Professor of Humanities at Rice University, and she is affiliated with the MD Anderson Cancer Center, the Hospital of the University of Pennsylvania, and the nonprofit organization COLLAGE: Art for Cancer. </span></em></p>Exploring colors can help discuss abstract, challenging topics in concrete ways – especially experiences doctors and caregivers may encounter caring for people at the end of life.Marcia Brennan, Professor of Religion and Art History, Rice UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1336822020-03-18T14:53:16Z2020-03-18T14:53:16ZApocalyptic fiction helps us deal with the anxiety of the coronavirus pandemic<figure><img src="https://images.theconversation.com/files/320956/original/file-20200317-60915-1gqzbg2.jpg?ixlib=rb-1.1.0&rect=0%2C5%2C4000%2C3994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Dystopic science fiction provides a reference points for our anxieties during a time of global change.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Masked people standing six feet apart. Empty shelves in the supermarket. No children in sight outside the school during recess.</p>
<p>The social upheaval caused by COVID-19 evokes many popular dystopian or post-apocalyptic books and movies. Unsurprisingly, the COVID-19 crisis has <a href="https://www.thestar.com.my/lifestyle/culture/2020/03/13/7-chilling-books-about-virus-outbreaks-you-should-take-a-sniff-at">sent many people rushing</a> to <a href="https://www.vanityfair.com/style/2020/03/an-epidemic-novel-for-every-kind-of-reader">fiction about contagious diseases</a>. Books and movies about pandemics <a href="https://www.wsj.com/articles/readers-are-bingeing-books-about-pandemics-really-11583944988">have spiked in popularity over the past few weeks</a>: stuck at home self-isolating, <a href="https://www.usatoday.com/story/entertainment/books/2020/03/09/stephen-king-decries-comparisons-between-coronavirus-and-the-stand/5002066002/">many people are picking up novels such as Stephen King’s <em>The Stand</em></a> or streaming movies such as <a href="https://www.rollingstone.com/movies/movie-features/contagion-most-urgent-movie-of-2020-964532/">Steven Soderbergh’s <em>Contagion</em></a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/4sYSyuuLk5g?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The 2011 movie <em>Contagion</em> looks at the spread of a deadly virus.</span></figcaption>
</figure>
<p>Yet no one seems to fully agree on why reading books or watching movies about apocalyptic pandemics feels appealing during a real crisis with an actual contagious disease. Some readers claim that <a href="https://www.vulture.com/2020/03/contagion-coronavirus-pandemic-fiction.html">contagion fiction provides comfort</a>, but others <a href="https://www.nytimes.com/2020/03/10/movies/contagion-movie-coronavirus.html">argue the opposite</a>. Still more <a href="https://twitter.com/katiek_wanders/status/1238124517530222594">aren’t totally sure why they these narratives feel so compelling</a>. Regardless, stories about pandemics call to them all the same.</p>
<p>So what, exactly, does pandemic fiction offer readers? My doctoral research on contagious disease in literature, a project that has required me to draw from both literary studies and health humanities, has taught me that a contagious disease is always both <a href="https://us.macmillan.com/books/9780312420130">a medical and a narrative event</a>.</p>
<h2>Art reflects life</h2>
<p>Pandemics scare us partly because they <a href="https://doi.org/10.1353/con.1997.0006">transform other, less concrete, fears</a> about <a href="http://www.jstor.org/stable/41371530">globalization</a>, cultural change, and <a href="https://doi.org/10.1215/9780822385271-008">community identity</a> into tangible threats. Representations of contagious diseases allow authors and readers the opportunity to explore the non-medical dimensions of the fears associated with contagious disease.</p>
<p>Pandemic fiction does not offer readers a prophetic look into the future, regardless of what some may think. Instead, narratives about contagious disease hold up a mirror to our deepest, most inchoate fears about our present moment and explore different possible responses to those fears.</p>
<h2>Station Eleven</h2>
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<a href="https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=882&fit=crop&dpr=1 600w, https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=882&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=882&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1109&fit=crop&dpr=1 754w, https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1109&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/320953/original/file-20200317-60889-1m8biow.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1109&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘Station 11’ is set in Toronto, Ont., and looks at what happens to human relationships as a pandemic threatens civilization.</span>
<span class="attribution"><a class="source" href="https://www.harpercollins.ca/9781443434867/station-eleven/">Harper Collins</a></span>
</figcaption>
</figure>
<p>One novel that has grown in popularity over the past few weeks is been Emily St. John Mandel’s <em><a href="https://www.harpercollins.ca/9781443434867/station-eleven/">Station Eleven</a></em>. Mandel’s novel follows a troupe of Shakespearean actors touring a post-apocalyptic landscape in a North America decimated by contagious disease. </p>
<p>Mandel’s novel serves as a test case for understanding the cultural response to COVID-19. The current pandemic sharpens fears about the relative instability of our communities (along with posing an immediate threat to our health, of course). </p>
<p>Coverage of <em>Station Eleven</em> <a href="https://www.vulture.com/2020/03/glass-house-station-eleven-emily-st-john-mandel.html">claims</a> <a href="https://pen.org/literature-in-the-time-of-coronavirus-reading-list/">that</a> the text is uniquely <a href="https://electricliterature.com/12-books-about-pandemics/">relevant</a> to the COVID-19 situation. This response treats Mandel’s novel as through it predicts what will happen as a result of the COVID-19 crisis. Some news outlets even call the novel a “<a href="https://www.vulture.com/2020/03/contagion-coronavirus-pandemic-fiction.html">model for how we could respond</a>” to an apocalyptic pandemic.</p>
<p>This is not the case. <em>Station Eleven</em> draws from apocalyptic literature, a <a href="http://doi.org/10.1093/oxfordhb/9780199856497.013.027">narrative form that tells us more about the present than the future</a>. Mandel herself has called <em>Station Eleven</em> more “<a href="https://www.bustle.com/articles/37200-emily-st-john-mandel-talks-station-eleven-shakespeare-and-sentimentality">a love letter to the world we find ourselves in</a>” than a handbook for a post-apocalyptic future Indeed, <a href="https://twitter.com/EmilyMandel/status/1237807751620853762">Mandel herself publicly suggested that her novel is not ideal reading material for the present moment</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1237807751620853762"}"></div></p>
<p>In fact, <em>Station Eleven</em> spends almost no time focused on the actual epidemic. The vast majority of the novel takes place before and after the outbreak. The medical details of the disease are less important than the rhetorical impact of the destructive virus.</p>
<p>Those fears in <em>Station Eleven</em> coalesce in scenes where communities must shift how they understand their relationship to one another. Characters stranded in an airport hangar, for example, must work together to build a new society that accommodates their shared traumatic experience. The pandemic in Mandel’s novel dramatically emphasizes to the characters not how to respond to a virus but, instead, how powerfully interconnected they truly are — the same thing COVID-19 is doing to us right now. Part of what pandemic fiction illuminates is how fears of invasion and the perceived threat of outsiders can diminish our humanity.</p>
<h2>Fear of outsiders</h2>
<p>A virus crosses the boundary of your body, invading your very cells and changing your body on an incredibly intimate level. </p>
<p>It is unsurprising, then, that scholars see a strong relationship between contagious diseases and community identity. As anthropologist Priscilla Wald puts it, contagious disease “<a href="https://www.dukeupress.edu/contagious">articulates community</a>.” Pandemics emphasize how our individual bodies are connected to our collective body. </p>
<p>Left unchecked, the rhetorical implications of these narratives can lead to <a href="https://www.jstor.org/stable/3568026">discriminatory behaviour</a> or <a href="https://www.nytimes.com/2020/03/14/opinion/Racism-coronavirus-asians.html">racism</a>. </p>
<p>In <em>Station Eleven</em>, the villain — a cult leader prophet — continually denies his fundamental connection to those around him. He claims that he and his followers survived the epidemic because of their divine goodness and not because of luck. As a result, he engages in violent, abusive behaviours intended to quash the fear associated with interdependence — <a href="https://www.jstor.org/stable/3568028">a common response to this fear</a>.</p>
<p>The prophet in <em>Station Eleven</em> does not survive the novel; the surviving characters are the ones who accept that they cannot extricate themselves from connection to other people. </p>
<p>Contagious diseases — both in fiction and in real life — remind us that the social and cultural boundaries we use to structure society are fragile and porous, not stable and impermeable. </p>
<p>Although these works of literature cannot prophecize an imminent post-apocalyptic future, they can speak to our present.</p>
<p>So if reading a book about a pandemic appeals to you, go for it — but don’t use it as an instructional manual for an outbreak. Instead, that work of fiction can help you better understand and manage how the virus amplifies complex, diverse and multi-faceted fears about change in our communities and our world.</p><img src="https://counter.theconversation.com/content/133682/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katherine Shwetz's dissertation research has received funding from the Social Sciences and Humanities Research Council and the Ontario government.
She is a member of the NDP political party.</span></em></p>Pandemic fiction is more popular than ever – but what these books and movies offer us isn’t as straightforward as you might think.Katherine Shwetz, PhD Candidate and Course Instructor, University of TorontoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/704842016-12-15T19:26:43Z2016-12-15T19:26:43ZFriday essay: can looking at art make for better doctors?<figure><img src="https://images.theconversation.com/files/150254/original/image-20161215-2529-19hnetw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Students ponder the meaning of Jinamoom by Peggy Griffiths at the Ian Potter Museum of Art.</span> <span class="attribution"><span class="source">Jodie Hutchinson/Ian Potter Museum</span></span></figcaption></figure><p>In 1984, artist Jon Cattapan’s sister Adriana died in a car accident. His painting, titled Sister, and some accompanying drawings, were a response to this tragedy.
Sister depicts a grey-shrouded body lying on a bright red structure. Behind it are five figures in two separate groups. One represents living relatives and friends; the other, the spiritual world. </p>
<p>Sister’s distorted figures reflect Cattapan’s interest in primitivism and animism. Its colours and twisted forms project his anguish, and express the heightened intensity of the state of grieving. Cattapan has written about the disorientation experienced in grieving and also how the “topsy-turvy” space in all the Sister images represents his sister’s schizophrenia. </p>
<p>One day, a few months ago, a group of third year medical students spent a long time looking at these works, which were on display at the Ian Potter Museum of Art at Melbourne University. </p>
<p>They were encouraged by the Museum’s Academic Programs Curator to describe aspects of the painting as objectively as possible - its style, colours, content. Then they began to share their personal interpretations of the narrative. </p>
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<a href="https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=423&fit=crop&dpr=1 600w, https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=423&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=423&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=531&fit=crop&dpr=1 754w, https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=531&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/148385/original/image-20161202-25656-18ogewd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=531&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Jon Cattapan, Sister, 1984 (oil on canvas). The University of Melbourne Art Collection, Gift of Jon Cattapan 2008.</span>
</figcaption>
</figure>
<p>Was the prone figure in the foreground dead or dying? What elements were more powerful? The Christian iconography and emotion on the figures’ faces? Their gestures? The insistent vibrancy of the colours? Or the apparently chaotic mix of formal elements? How did their interpretation change when the examination shifted to the Sister Drawings, hung alongside the painting, which are like snapshots of aspects of the story?</p>
<p>And how did the students’ initial gut reaction to the painting compare to the feeling it conveyed after 20 minutes of close, shared attention? </p>
<p>The aim was not to reach a consensus on what was going on in the artwork; rather it was to explore multiple alternative meanings. This was a practical demonstration of the medical method called differential diagnosis and the problems of rushing to a premature conclusion. </p>
<p>In response to the experience, one student wrote: </p>
<blockquote>
<p>Objective things can have a number of different subjective meanings. People can have different perspectives. There is a lot of empathy required in order to extract these thoughts.</p>
</blockquote>
<h2>Teaching empathy</h2>
<p>Healthcare professionals - doctors, dentists, physiotherapists, audiologists, optometrists - are now expected to have cultural, social and technical competencies that reach far beyond their biomedical training. And some clinical teachers have observed that graduates lack the capacity to demonstrate empathy or the skill of visually differentiating and prioritising what is important.</p>
<p>Can empathy be taught to these students? How can we ensure that they pay full attention to “the whole person” rather than just the disease? </p>
<p>Over the past two decades, there has been growing interest in the use of the humanities as a way of raising students’ awareness of emotions and the ethical dimensions of health care. Known as the “Medical Humanities”, many programs across the US and elsewhere engage students with theatre, literature, film and dance, as well as the creative arts. </p>
<p>The University of Melbourne began a pilot program at the gallery in June 2012 for six students in their Palliative Care rotation at Peter McCallum Hospital. It now provides programs to over 1000 students a year over 13 different areas in the health sciences, including Medicine, Dentistry, Optometry, Physiotherapy, Audiology, Nursing and Clinical Teaching. Unlike most such overseas programs, engagement is compulsory. </p>
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<figcaption>
<span class="caption">Most healthcare students entering the gallery are immediately out of their comfort zone.</span>
<span class="attribution"><span class="source">Jodie Hutchinson</span></span>
</figcaption>
</figure>
<p>Medical students visit the gallery in First Year, and again in Third Year, when they are studying and doing hospital placements in areas such as Geriatric Medicine, Rehabilitation Medicine, Palliative Care and Psychiatry of Old Age. Over three hours, they work on attentiveness, interpretation, reflection and consideration of their emotional response.</p>
<p>Medical students particularly, and health students generally, tend to believe that there is a right and wrong answer to everything. This comes from their early training in pathology, anatomy and physiology, which is delivered under the bio-medical model, as compared to the bio-psycho-social model that the art museum sessions address. </p>
<p>Most healthcare students entering the gallery are already out of their comfort zones and in a state of alert curiosity. Their experience there, and particularly the diversity of perspectives that emerge in group conversations, demonstrates that you can have different interpretations of the same thing, without either of those positions being “wrong”.</p>
<p>Their teachers hope that students are beginning to realize that medicine is not black and white, but many shades of grey. The museum sessions are designed to get these students thinking about the importance of a diagnosis that is not just based on physical symptoms, but also on the larger narrative that informs a patient’s health story.</p>
<h2>Moral imagination</h2>
<p>Final year Physiotherapy students, for instance, were asked to draw upon their visit to the gallery to explore the question of ethics in healthcare provision, and develop what’s known as “moral imagination”.</p>
<p>The idea is for students to increase awareness of their emotional reactions to ethical issues, through looking at art, and enhance their capacity to recognise the moral dimensions of clinical experiences. </p>
<p>Students then write assignments based on their visit, incorporating both an analysis of ethical principals and reflection on their emerging professional identity. </p>
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<a href="https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149553/original/image-20161211-31383-7gft4h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Julia Robinson,
Twitch, 2012 (boiled wool, thread, timber, press studs, and fabric).</span>
<span class="attribution"><span class="source">courtesy of the artist and GAGPROJECTS | Greenaway Art Gallery, Adelaide</span></span>
</figcaption>
</figure>
<p>After looking at the sculpture Twitch by Julia Robinson, which takes the form of a pair of soft, cream-coloured Long Johns with one apparently mis-shapen, exposed wooden leg, one student wrote:</p>
<blockquote>
<p>There was no right or wrong way of deciphering the art piece and for once that was freeing. I left the museum somewhat changed…</p>
</blockquote>
<p>Responding to a ceramic artwork by Stephen Bird – depicting a hand pointing to a bird on a branch accompanied by the inscription, “Singing not allowed!” – another student wrote:</p>
<blockquote>
<p>The innocent looking bird, perched on a branch and trying to sing in its natural environment prompted me to think about a patient I saw lying in bed, calling out to medical staff, only to be dismissed as they are told that they are ‘doing fine’ or ‘need to continue with their course of treatment’. </p>
<p>This made me feel a little uncomfortable, as we are taught to practise with a patient-centred approach, listening to what others have to say and respecting their autonomy. What if the bird too, was singing out for help, only to be silenced? </p>
</blockquote>
<h2>Indigenous perspectives</h2>
<p>Cultural understanding, particularly in the context of indigenous health, is vital for graduating doctors. Students are aware that they need this knowledge, but they sometimes consider the teaching to be guilt-laden. They have challenged us to provide more innovative ways to engage with this part of the curriculum. </p>
<p>One medical student, Mahesha Dombagolla, noted that</p>
<blockquote>
<p>…a unanimously held sentiment by medical students is that we would find it valuable to gain some practical advice on how to provide care for Indigenous patients. Perhaps we can use Indigenous art to better understand their values and how we can incorporate these values when treating Indigenous patients? </p>
<p>For example, what are the Aboriginal perspectives on death/palliative care, caring for the elderly, women’s health, mental health, community and family, what things are respectful or disrespectful…?</p>
</blockquote>
<p>In our programs, we now explicitly address Indigenous health, drawing upon Indigenous art to prompt discussions around cultural understanding and cultural determinants of health.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149765/original/image-20161213-25492-pl8lc8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Looking at My Life My Family (2013) by Shirley Purdie.</span>
<span class="attribution"><span class="source">Jodie Hutchinson</span></span>
</figcaption>
</figure>
<p>In recent months, we were able to engage students with the touring exhibition In the Saddle - On the Wall, which included both visual art and digital stories of Indigenous Elders from the Kimberley. </p>
<p>What students might assume as homogeneous experience of Aboriginality, and a “sameness” in life stories, was turned on its head as they explored the diverse life experiences of the 13 artists in the exhibition, and the different ways they expressed their life narratives and culture through paintings and interviews.</p>
<p>Our sessions focused on “other ways of seeing”, and the power of place in health and wellbeing. One painting the students examined,<a href="http://kimberleyaboriginalart.com.au/view/photo-gallery/20091006185121/inTheSaddleGallery.html"> My Life My Family</a> by Gija artist Shirley Purdie, gave a rich context for these conversations. A large square artwork created with natural ochre and pigment, it depicts aspects of the life of the painter, her parents and grandparents. </p>
<p>The visual narrative moves from the top right in a clockwise direction. A series of vignettes trace the violent events that caused Purdie’s family to move from Violet Valley Station to Mabel Downs station in the Kimberley, where they eventually settled and created a more peaceful life. </p>
<p>The work is testament to the agency and survival of Purdie’s family in a brutal, colonial world. The power of this story can only be unpacked by students through long and careful attention to both the artwork and the artist’s accompanying digital story. This is a great parallel to the care and attentiveness needed to provide professional, compassionate, and culturally appropriate care in Indigenous health contexts. </p>
<p>This narrative painting was in great contrast to many others that depicted Dreamtime stories and lore. Most students found these more abstract works harder to understand and interpret.</p>
<p>Looking at these paintings, students talked about the need to be patient, attentive, and to learn how and where to ask appropriate questions. While practising these skills with the artworks in group discussions, students considered their wider application in healthcare settings.</p>
<p>In contrast to the visual complexity of many of the artworks, the personal stories of the artists in the digital narratives were delivered in “matter of fact” style. This contrast prompted students to consider the different communication styles of people of different backgrounds - which will be relevant in their professional lives.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149371/original/image-20161209-31367-1ocx1x9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Students drawing their idea of ‘place’ at the end of a session.</span>
<span class="attribution"><span class="source">Jodie Hutchinson</span></span>
</figcaption>
</figure>
<p>Students’ reflective essays give us great insights into the transformational experiences they had while viewing exhibition. One student said it “challenged
my assumptions”. Another said the experience:</p>
<blockquote>
<p>…enriched my knowledge about the hardship and troubles Indigenous Australians encountered. Whilst I was aware of the discrimination, abuse, and abduction, among other things that have occurred, it was still difficult to process these events, especially when hearing it from those who experienced it firsthand. I found it challenging to comprehend how the events happened and how these artists coped, as their lives are polar opposites to my own…</p>
</blockquote>
<p>The combination of digital audio stories and paintings was especially powerful for the Audiology and Optometry students. One student observed that the way an artist spoke about his work was very different to the emotions expressed in his artwork.</p>
<blockquote>
<p>… The artist I chose was discussing his childhood working on cattle stations and how it was a time of purpose and fulfilment for him. However, his body language in the video and the emotion in his artwork conveyed a more melancholy nostalgia. He talked in depth about how it gave him a purpose in life but skimmed over how he had to leave his family to do so. This example illustrates how in our profession we have to really listen (to verbal and non-verbal cues) to get the more personal information because people are not naturally comfortable opening up to strangers… </p>
</blockquote>
<p>This exhibition also challenged students’ conceptions of ageing and agency by showing the influence the Elders exert both within their communities and beyond, in contexts that include health, welfare, and culture.</p>
<p>As one of the Mental Health Nursing students later tweeted, </p>
<blockquote>
<p>Every painting is like every patient … they all harbour a story which we need to explore to better appreciate & understand them. </p>
</blockquote>
<h2>How effective is it?</h2>
<p>While we know that museums can be agents of social change, there is as yet very little research around the pedagogical utility of art museums in intercultural understanding. Program evaluation is essential to convince academics and students alike that there are tangible as well as intangible benefits to their art museum visits. </p>
<p>At the Ian Potter Museum we have begun three ethics-approved research projects. The first is in Special Needs Dentistry, where we sought to develop students’ capacity to pay closer and more empathetic attention to patients, “beyond the tooth”.</p>
<p>Our research sought to identify any changes in empathy in the students, with tests done before and after the museum intervention. It found that the second year dental students had significantly high levels of empathy and generally perceived the art museum session as a worthwhile experience in terms of widening the scope of core clinical skills including observation and empathy.</p>
<p>Whilst the intervention itself did not alter empathy levels at a single time point, the findings did highlight the need for further investigation into dental student empathy over the course of their studies, and opportunities for increased targeted humanities interventions.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149554/original/image-20161211-31383-cijuzm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Students at the In the Saddle - On the Wall exhibition.</span>
<span class="attribution"><span class="source">Jodie Hutchinson</span></span>
</figcaption>
</figure>
<p>A qualitative survey of medical students’ experience of the program in the year following their gallery experience included interviews with museum and health practitioners about their perception of the educational value of these encounters. </p>
<p>Student responses in this study showed they valued the opportunity to learn observational, critical thinking and intra/interpersonal skills, but acknowledged difficulties in incorporating the humanities into the heavily scheduled and bio-medically-focused curriculum. </p>
<p>Another project in Medicine records students’ immediate responses after gallery sessions, followed by an online survey a few weeks later, exploring Indigenous health contexts as well as engagement more generally. Results from this study will be explored by a fourth year Medical student in 2017.</p>
<p>Clearly, for the majority of students, the experience is seen to be a valuable and memorable one. Fourth year Medical Student Kim Pham wrote that her sessions at The Ian Potter Museum of Art taught her about “taking the time to observe”. They also enabled critical discussion, which is essential to science but “often ignored during a packed medical curriculum”. </p>
<blockquote>
<p>I left feeling more capable of engaging with the emotional narrative of my patients and being more open to their perspective.</p>
</blockquote>
<p>Other universities around Australia are now creating their own programs for health students using their art collections. Flinders University, for instance, is teaching psychiatry students utilising works that include those in their rich collections of Indigenous art. </p>
<p>But in a crowded curriculum, sceptics might ask, is a visit to an art museum really a good use of students’ time? </p>
<p>We can’t yet prove conclusively that it is, but let’s end with more words from Kim Pham. Art, she says, has, </p>
<blockquote>
<p>a capacity to make us critical and deep thinkers, using our capacity to observe to the full extent. And this should be a defining part of university education.</p>
</blockquote>
<hr>
<p><em>This article was written with the assistance of A/Prof Eleanor Flynn, A/Prof Clare Delany, A/Prof Mina Borromeo, Ms Bronwyn Tarrant, Dr Caitlin Barr and Ms Anthea Cochrane, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, all of whose students participated in engagements at The Ian Potter Museum of Art.</em></p><img src="https://counter.theconversation.com/content/70484/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Gaunt works for The Ian Potter Museum of Art at the University of Melbourne, where the programs described take place. She is currently an Advisory Team Member with Flinders University Art Museum, Adelaide, on an Australian Office of Learning and Teaching Grant.
</span></em></p>Can empathy be taught to students in the healthcare professions? A groundbreaking project is using visual art to ensure they pay attention to the whole person, not just the disease.Heather Gaunt, Curator of Academic Programs at the Ian Potter Museum of Art, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/561602016-03-17T04:02:22Z2016-03-17T04:02:22ZPhysiotherapy students have much to learn from the humanities<figure><img src="https://images.theconversation.com/files/114836/original/image-20160311-11288-1ffcvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A little girl in Sudan gets treated by physiotherapist Fatima Mohamed.</span> <span class="attribution"><span class="source">Reuters/UNAMID/Albert Gonzalez Farran/Handout </span></span></figcaption></figure><p>Undergraduate physiotherapy students spend most of their time learning about the basic and clinical sciences. This has a certain pragmatic appeal, but a person is more than an assemblage of body parts. Our students learn anatomy and biomechanics – the idea of bodies as machines – and then explore what can be done to those bodies in order to “fix” them. Universities pay lip service to the idea that patients require holistic management. But not much in the curriculum signals to students that it <em>really</em> matters.</p>
<p>Research has confirmed what seems intuitively true to many: <a href="http://www.ncbi.nlm.nih.gov/pubmed/15203476">empathy</a> is critical in developing medical students’ professionalism. The humanities, and particularly literature, are considered effective tools for increasing students’ empathy. There is also <a href="http://www.forbes.com/sites/robertglatter/2013/10/20/can-studying-art-help-medical-students-become-better-doctors/#2f0232f51b3f">some evidence</a> that health professionals who are trained in the humanities and liberal arts are better at caring for themselves and their patients.</p>
<p>In addition, a relationship between emotion and learning has been <a href="http://www.ibe.unesco.org/fileadmin/user_upload/Publications/Educational_Practices/EdPractices_24eng.pdf">well established</a>, with findings from multiple domains supporting the idea that emotion is intimately <a href="http://onlinelibrary.wiley.com/doi/10.1111/mbe.12099/pdf">intertwined</a> with cognition, serving to guide learning, behaviour and decision making. This suggests that introducing concepts from the humanities when educating health professionals can do two important things: develop students’ emotional responses and their empathy; and simultaneously improve their overall learning.</p>
<h2>Examples from other disciplines</h2>
<p>The <a href="http://www.hopkinsmedicine.org/medart/">medical</a> disciplines have started <a href="http://my.clevelandclinic.org/services/arts_medicine">to embrace</a> the role that the humanities and the arts can play in developing empathy in their graduates. In the US, Johns Hopkins Medical School has a <a href="http://www.hopkinsmedicine.org/medart/">department</a> of art as applied to medicine and Stanford School of Medicine has a <a href="http://bioethics.stanford.edu/arts/">programme</a> for medical humanities and the arts. These are two of the world’s <a href="http://www.topuniversities.com/university-rankings-articles/university-subject-rankings/top-medical-schools-2015">top</a> medical schools. Elsewhere in the world, South Africa’s University of Cape Town’s medical school chose the theme <a href="https://www.uct.ac.za/dailynews/?id=8957">“Medicine and the Arts”</a> for its first ever Massive Open Online Course.</p>
<p>In an editorial explaining Stanford’s stance, the medical school’s dean, Lloyd B Minor, <a href="http://www.stanforddaily.com/2014/04/06/the-humanities-and-medicine/">wrote</a>:</p>
<blockquote>
<p>The specificity of scientific interventions does not account for the messiness of human life … We as physicians heal best when we listen to and communicate with our patients and seek to understand the challenges they face in their lives. The perspectives on illness, emotions and the human condition we gain from literature, religion and philosophy provide us with important contexts for fulfilling these roles and responsibilities.</p>
</blockquote>
<h2>Physiotherapy lags behind</h2>
<p>There is little evidence that physiotherapy and other health professions are following these medical schools’ innovative approaches in undergraduate education. Some physiotherapy researchers have explored how concepts from the humanities could be <a href="http://www.sciencedirect.com/science/article/pii/S0031940605658658">integrated</a> into clinical practice. But this has tended to focus on the impact on professional practice among qualified therapists, rather than on students and their learning. </p>
<p>The reasons for this are unclear, though several factors may be at play. Physiotherapy is conservative by its nature and tends to privilege <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2009.03418.x/full">positivist methods</a> in general. It favours quantitative measurements of progress as the standard against which impact is measured. Our students are taught how to address physical impairments in a patient’s anatomy and biomechanics, using joint range of motion, strength and fitness as indicators. This is important but also tends to sideline approaches that are more interpretive in nature. For example, it’s good to know how to treat back pain from a purely physiological point of view – but it’s also important to know how to respond to a patient who believes his or her pain is <a href="http://www.bodyinmind.org/wp-content/uploads/Madden-et-al-2013-JCHS.pdf">the result of witchcraft</a>. </p>
<p>These differences in perspective may be what limits the potential for the humanities to have much impact on curriculum change from the point of view of the clinical therapist. My own teaching experience, though, suggests that physiotherapy students benefit hugely from practices and ideas that are influenced by the humanities. </p>
<h2>Putting theory to the test</h2>
<p>About three years ago, as an experiment, I started applying some of these ideas in the professional ethics module I teach at a South African <a href="https://www.uwc.ac.za/Faculties/CHS/physiotherapy/Pages/default.aspx">university</a>. Initially the module’s emphasis was on human rights, but I started foregrounding empathy and the development of empathy instead.</p>
<p>Over the past few years my students have explored the humanities – art, literature, theatre, music and dance – in their assignments for this module. This has helped them to develop a sense of awareness of empathy in the context of clinical education. </p>
<p>Students can interpret the assignment in any way they want as long as they integrate concepts from the ethics module with their own experiences in clinical practice. They must also express their work through “creative” means: they write <a href="http://www.mrowe.co.za/blog/2014/08/eleven-hundred-hours-poem-by-a-student/">poems</a>, draw pictures or cartoons, film video diaries or re-interpret popular songs. Two of my students have even filmed themselves using interpretive dance to try and embody what it might be like to live with a disability. Others have completed <a href="https://photovoice.org/">PhotoVoice</a> assignments (such as the image below). Here, they photograph people in community or clinical contexts, and then reflect on how those experiences and interactions informed their personal and professional development as ethical practitioners.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/114834/original/image-20160311-11302-1y2xej7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An example of a photograph taken by a fourth-year student in the author’s professional ethics module.</span>
<span class="attribution"><span class="source">Sarah Manig</span></span>
</figcaption>
</figure>
<h2>Students’ response</h2>
<p>Many students were initially worried about the assignments, telling me they were “not creative” and would prefer to write an essay. I suspect that they were simply feeding off my own hesitation in the early days. Now that I provide literature to support the assignment design, give examples from previous students and am fully committed to the process, far fewer students express these concerns. </p>
<p>They are also starting to open up in much more interesting ways. They draw from their own very deep emotions and personal experiences, and are more willing to share and discuss their work in class.</p>
<h2>Building empathy</h2>
<p>Creativity does not naturally decrease over time. Instead, higher education systems place less and less emphasis on creative expression as students move through the system. If universities want to graduate physiotherapists who have an increased awareness of patient suffering, and an associated empathic response, maybe the key is to provide them with learning tasks that encourage their creative expression through humanities and the arts.</p>
<p><em>This article was adapted from a post that first appeared on the author’s <a href="http://www.mrowe.co.za/blog/">own blog</a>.</em></p><img src="https://counter.theconversation.com/content/56160/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Rowe receives funding from the National Research Foundation. </span></em></p>Many medical disciplines have started encouraging their students to embrace lessons from the arts and humanities. Physiotherapy is lagging behind.Michael Rowe, Senior Lecturer in Physiotherapy, University of the Western CapeLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/469182015-09-01T19:49:52Z2015-09-01T19:49:52ZHow Oliver Sacks brought readers into his patients’ inner worlds<figure><img src="https://images.theconversation.com/files/93567/original/image-20150901-13392-1oy94dy.jpg?ixlib=rb-1.1.0&rect=0%2C191%2C752%2C490&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Oliver Sacks died of cancer this past week.</span> <span class="attribution"><a class="source" href="https://c2.staticflickr.com/4/3078/3256398629_019f3444aa_b.jpg">Joshua Wanyama/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>Oliver Sacks achieved global public renown because his writings melded two particular traits that cut across his dual role as doctor and writer: his focus on single patients rather than large populations and his profound empathy.</p>
<p>These unique characteristics underpinned the distinctive contribution that the famed neuroscientist – <a href="http://www.nytimes.com/2015/08/31/science/oliver-sacks-dies-at-82-neurologist-and-author-explored-the-brains-quirks.html?_r=0">who this week died of cancer at age 82</a> – made to the public’s understanding of medicine. </p>
<p>Like no other writer, he showed readers how a compassionate doctor can treat the most misunderstood and marginalized patients by accessing their mysterious inner worlds.</p>
<h2>People over data</h2>
<p>Scientists who study neurological conditions such as Parkinson’s will often study the condition across hundreds or thousands of patients, searching for common traits that will lead clinicians to the core of the disorder.</p>
<p>The more patients in a study, the stronger the evidence for scientists to draw general conclusions about the condition. One case is viewed as the <a href="http://www.ncbi.nlm.nih.gov/pubmed/12897592">weakest form of evidence</a>. (Old joke: what is the plural of anecdote? Data.)</p>
<p>But Sacks, in contrast, saw the nature of neuroscience written in the lives of single patients. And he rendered those lives in vivid prose.</p>
<p>Dr P, the eponymous character in his bestselling collection of essays <a href="http://www.lrb.co.uk/v05/n09/oliver-sacks/the-man-who-mistook-his-wife-for-a-hat">The Man Who Mistook His Wife for a Hat</a>, was not a generalized abstraction. He was a charming man, a singer and music teacher. </p>
<p>But, wrote Sacks, a massive tumor or degenerative process in the visual parts of the brain meant he could not recognize objects in the world. When asked by Sacks to put on his hat, he reached and grabbed his wife’s head. </p>
<p>Through a step-by-step process of observation and reflection, Sacks shows readers how Dr P used music to navigate the world: he could only perform tasks, like getting dressed, while singing quietly to himself.</p>
<p>Sacks’ focus on the detailed description of single cases also differentiated him from other scientist-writers. Stephen Hawking’s <a href="http://www.amazon.com/Brief-History-Time-Stephen-Hawking/dp/0553380168">A Brief History of Time</a> and Richard Dawkins’ <a href="http://www.amazon.com/The-Ancestors-Tale-Pilgrimage-Evolution/dp/061861916X">The Ancestor’s Tale</a> are examples of books that presented sweeping narratives, taking place over eons. </p>
<p>Sacks, instead, went for vivid description of the single life. </p>
<p>For Sacks, it was both a scientific method and a literary device. Its wider consequence was that popular science books became ways to transmit original, compelling scientific evidence and ideas to mainstream audiences.</p>
<h2>Penetrating the mind</h2>
<p>The second characteristic that underpinned his success as a doctor and writer was his uncanny empathy. </p>
<p>As Sacks wrote in <a href="http://www.amazon.com/An-Anthropologist-Mars-Seven-Paradoxical/dp/1480530360">An Anthropologist on Mars</a>: </p>
<blockquote>
<p>The realities of patients, the ways in which they and their brains construct their own worlds, cannot be comprehended wholly from the observation of behavior, from the outside.</p>
</blockquote>
<p>In order to do this, he needed to infiltrate their consciousness. He needed to see the world as they did. He needed to understand them from the inside.</p>
<p>In one chapter, Sacks introduces readers to Dr Carl Bennett, a surgeon with Tourette’s. Sacks travels to Bennett’s house and hospital in British Columbia, where he witnesses the surgeon’s incessant tics and twitches at home – but flawless composure in the operating room.</p>
<p>Sacks shows readers how the manifestations of Tourette’s vanish once Bennett assumes the role of surgeon and engages in the rhythmic routine of surgery.</p>
<p>On a personal level, I identified with this technique, and in a way, <a href="http://bigthink.com/age-of-engagement/diagnosing-a-migraine-how-popular-science-helped-a-writer-cope">Sacks diagnosed me through popular science</a>. Browsing in a bookstore as a student, I flipped through Sacks’ <a href="http://www.oliversacks.com/books-by-oliver-sacks/migraine/">Migraine</a>, first published in 1970. I read descriptions of patients with the condition. I saw in its pages drawings by migraine sufferers showing how their vision was disturbed at the onset of a crippling headache. </p>
<p>For years, I’d had the same (then unexplained) headaches, the same visual disturbances – zigzag lines in front of my face, half my vision blurred. </p>
<p>Sacks had described my experience perfectly – from the inside. </p>
<p>The New York Times once <a href="http://www.nytimes.com/1990/04/01/books/good-books-abut-being-sick.html?pagewanted=2">called Sacks</a> “a kind of poet laureate of contemporary medicine.” But that description, for me, does not fully describe Sacks’ distinctive ability to move between the roles of doctor and writer, putting the individual at the center of medicine and understanding one single patient at once objectively and subjectively.</p>
<p>The preface to An Anthropologist on Mars describes his work best. There, Sacks explains that he gave up much of his hospital work in order to visit patients where they lived their lives, offering “house calls at the far borders of human experience.”</p>
<p>His distinctive sensibility as a doctor-writer explains why one million copies of his books are still in print in the United States – and will continue to be read and used as models for future forays by other writers into the human condition.</p><img src="https://counter.theconversation.com/content/46918/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Declan Fahy does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sacks was able to communicate the fascinating workings of the brain in ways that evoked understanding and compassion.Declan Fahy, Lecturer in Communications, Dublin City UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/373162015-03-16T09:39:20Z2015-03-16T09:39:20ZHealthy songs: the amazing power of music therapy<p>When I was a child, on most Fridays, my dad, mom, brother and I would travel to Cape Cod to visit my grandparents. For my father, this drive would come after a long day of work, during which he had already commuted from our home, an hour outside of the city, to Boston, where he worked as an accountant, and back home again. He was an intense man, and during these drives to the Cape we were often silent, on edge – unsure how to interpret his sullen and grave demeanor. </p>
<p>After we arrived, my grandmother would typically begin playing a mix of classical music, folk songs and pop songs on her spinet piano – and I would watch my dad’s face transform: his jaw would slacken, while the lines between his eyebrows softened, lifting the intensity of thought that always seemed to burden him. </p>
<p>This was my first experience of the power of music.</p>
<p>Nearly two decades later, I learned of music therapy as a profession. I was a rising junior in college and, without hesitation, I switched my major to learn how to clinically wield music’s ability to transform and heal – a power I had observed years earlier. </p>
<p>Music therapy has grown from relative obscurity to a practice that is becoming fairly mainstream, largely due to the advocacy of colleagues in the field, along with media coverage of the burgeoning profession. Jodi Picoult came to Berklee College to study music therapy to develop the main character – a music therapist – of her novel <a href="http://www.amazon.com/Sing-You-Home-Jodi-Picoult/dp/1439102732">Sing You Home</a>. Meanwhile, following the gunshot injury she sustained, Representative Gabby Giffords underwent rehabilitation efforts that <a href="http://abcnews.go.com/Health/w_MindBodyNews/gabby-giffords-finding-voice-music-therapy/story?id=14903987">included music-based interventions</a>. Although she initially couldn’t speak, she could sing, an ability that was used to further her speech recovery. And films about music’s capacity for healing and improving quality of life include the recent releases <a href="http://www.aliveinside.us">Alive Inside</a>, <a href="http://nickreedent.com/about/">The Lady in Apartment 6</a>, <a href="http://www.landfillharmonicmovie.com">Landfill Harmonic</a> and <a href="http://www.amazon.com/Music-Never-Stopped-J-K-Simmons/dp/B004QL7JTE">The Music Never Stopped</a>.</p>
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<figcaption><span class="caption">The trailer for The Lady in Apartment 6. ‘My world is music,’ said the film’s subject, 109-year-old Alice Sommer. ‘I am not interested in anything else.’</span></figcaption>
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<p>Doctor-writer Oliver Sacks’ essay collections, like <a href="http://www.amazon.com/Musicophilia-Tales-Revised-Expanded-Edition/dp/1400033535">Musicophilia</a>, introduced stories to the public that explained the ability of music to promote skill learning and/or recovery in the face of severe disability and trauma. Research in neuroscience has backed up many of Sacks’ observations. For example, people who have suffered strokes or have been diagnosed Parkinson’s disease <a href="http://www.jstor.org/discover/10.1525/mp.2010.27.4.263?uid=3739696&uid=2&uid=4&uid=3739256&sid=21105624714671">are better able to walk while listening to rhythmic music</a>. In the case of strokes, people who can’t talk can often sing. Singing is then used to facilitate recovery of speech. This has been the case of Representative Gabby Giffords.</p>
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<img alt="" src="https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=779&fit=crop&dpr=1 600w, https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=779&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=779&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=979&fit=crop&dpr=1 754w, https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=979&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/74681/original/image-20150312-13502-1nplyt3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=979&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Oliver Sacks’ essays – like those in the collection Musicophilia – have helped promote the benefits of music therapy.</span>
<span class="attribution"><a class="source" href="http://upload.wikimedia.org/wikipedia/commons/b/b6/Oliversacks.jpg">Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
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<p><a href="https://www.questia.com/library/journal/1P3-862998781/music-therapy-with-premature-infants-research-and">Another study showed</a> that premature babies in the neonatal intensive care unit left the ICU, on average, 11 days earlier if they used a device that played lullabies triggered by their sucking. And children who have had orthopedic surgery will report lower levels of pain <a href="http://www.researchgate.net/publication/244921013_The_Effects_of_Music_Entrainment_on_Postoperative_Pain_Perception_in_Pediatric_Patients">when doctors offer post-operative music therapy</a>. </p>
<p>In my practice as a speech language pathologist and music therapist, I’m able to use music to serve a variety of patients with an array of needs. Children with autism tend to be more attentive to musical sounds than speech sounds (especially when they’re very young), so I’ll use music to foster their linguistic and cognitive development. In my work with hospice patients, I’ll use quiet music that has a lulling rhythm to help even out their ragged breathing (which is sometimes very difficult for families to watch). </p>
<p>For cancer patients, I’ll use songs of hope and resilience. And by pairing music with imagery, such as relaxing nature images, I’ve helped patients preparing for surgery achieve a state of tranquility that can decrease their need for anesthesia and pain medication. I’ve used the same protocol to decrease the use of anti-anxiety medications among hospice patients I’ve served. Ultimately, carryover is the endgame: we help patients take the tools they’ve learned in music therapy and apply them to their everyday lives.</p>
<p>As a professor of music therapy at the Berklee College of Music, I’m preparing the next generation of music therapists to work in a variety of settings: early intervention programs, public schools, hospice and palliative care, cancer clinics, nursing homes and private practice. For many students, it’s an attractive opportunity – a chance to use their artistry to make the world a better place.</p>
<p>Every week, our Berklee students Skype with a group of child soldiers in Uganda. These young adults have suffered a great deal: forced to kill as children, they often started with their own family members and neighbors. They’ve emerged from the bush traumatized and without purpose. We’re teaching them to use meditative practices in music to calm their minds and to infuse meaning into their lives. As our students share therapeutic practices with the child soldiers, they, in turn, perform and share their music and dance for our students.</p>
<p>It’s this fusion of what many consider two distinct, incompatible entities – art and science – that ultimately elevates both; and the two, as one, can more readily accomplish their shared purpose: the healing and betterment of humanity.</p><img src="https://counter.theconversation.com/content/37316/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kathleen Howland does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>From serving newborns to treating hospice patients, music can be used in medical and psychological treatment with surprising – and real – results.Kathleen Howland, Professor of Music Therapy, Berklee College of MusicLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/359812015-01-28T06:26:30Z2015-01-28T06:26:30ZWhy popular culture is mad for medical fiction<figure><img src="https://images.theconversation.com/files/70206/original/image-20150127-17625-111w44y.jpg?ixlib=rb-1.1.0&rect=0%2C3%2C2334%2C1635&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Helen Macdonald, winner of the 2014 Costa Book of the Year.</span> <span class="attribution"><span class="source">Marzena Pogorzaly</span></span></figcaption></figure><p>Whatever your opinion of book prizes, they remain a useful tool for understanding what is popular in the literary world. The Costa Book of the Year, awarded this year to Helen Macdonald for her book <a href="http://www.theguardian.com/books/2014/nov/04/samuel-johnson-prize-helen-macdonald-h-is-for-hawk">H is for Hawk</a>, provides one such example. </p>
<p>H is for Hawk is grief-tinged, part memoir and part nature book, Macdonald’s account of training a goshawk as a way of dealing with her father’s death.</p>
<p>Another of the category winning titles, Emma Healey’s “dementia detective story” <a href="http://www.theguardian.com/books/2014/jun/08/elizabeth-is-missing-review-emma-healey-impressive-debut-dementia">Elizabeth is Missing</a> also concerns illness. And last year’s Costa award went to Nathan Filer’s <a href="https://theconversation.com/nathan-filers-stunning-debut-wins-costa-book-award-22416">The Shock of the Fall</a>, which explores mental illness. </p>
<p>So there seems to be a growing trend towards fictional and factual writing about the experience and effects of illness. </p>
<p>A cursory glance at contemporary culture confirms that this is not confined to books. Films, TV shows, and other media all frequently use medicine in their narratives. The soon-to-be released <a href="http://www.imdb.com/title/tt3316960/">Still Alice</a> features Julianne Moore struggling with Alzheimer’s, while <a href="http://www.imdb.com/title/tt1306980/">50/50</a>, starring Seth Rogen and Joseph Gordon Levitt, managed to take a darkly humourous yet moving look at cancer. </p>
<p>In TV, the success of <a href="http://www.imdb.com/title/tt0412142/">House</a> has made Hugh Laurie an A-list star. Elsewhere, graphic novelists and cartoonists such as <a href="http://www.makingwaves.org/news/brick-s-graphic-novel/">Brick</a> and <a href="http://davidsmallbooks.com/">David Small</a> seek to represent the experience of illness in visual art. And there are many first-hand accounts of real-life experience dedicated to the representation of physical and mental illness. </p>
<p>Many universities now offer courses in Medical Humanities, the academic study of medicine, illness, and the arts. Certainly the academic and popular appreciation of medical narratives in relation to life writing and autobiography has increased in recent years, something that academic <a href="https://books.google.co.uk/books?id=1jX3_RyedfcC&printsec=frontcover&dq=leigh+gilmore&hl=en&sa=X&ei=ja7HVMjqCajW7QbA_oGwCQ&ved=0CCIQ6AEwAA#v=onepage&q=leigh%20gilmore&f=false">Leigh Gilmore</a> has attributed to a greater tendency towards introspection around the turn of the millennium.</p>
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<p>Critics have suggested, <a href="https://books.google.co.uk/books?id=1g3iaku6QY0C&printsec=frontcover&dq=Illness+as+Narrative++By+Ann+Jurecic&hl=en&sa=X&ei=KMXHVKSlJqTn7gaCyYCoDA&ved=0CCIQ6AEwAA#v=onepage&q=Illness%20as%20Narrative%20%20By%20Ann%20Jurecic&f=false">as Ann Jurecic notes</a> that this interest in illness is, like the “misery memoir”, another fashion. Illness is this decade’s hot literary topic, or an academic fad. But I would disagree. When the <a href="http://www.wellcome.ac.uk/">Wellcome Trust</a>, the foremost funding body in the history of medicine, hosts a series of public exhibitions and their own <a href="http://wellcomebookprize.org/">book prize</a>, I think it’s clear that this is a trend which is well entrenched in the public sphere. </p>
<h2>More than a fad</h2>
<p>It is tempting to see the growth of cultural interest in medicine as a modern development. It could indicate greater social acceptance of illness, or a willingness to share what once would have been kept largely private. Virginia Woolf once wrote: </p>
<blockquote>
<p>Considering how common illness is … it becomes strange indeed that illness has not taken its place with love, battle, and jealousy among the prime themes of literature. </p>
</blockquote>
<p>So is the prevalence of medical literature in book prizes evidence that we’re more open and sensitive than past generations? No. This is as fictitious an idea as any hospital drama.</p>
<p>Despite the recent rise in medical-themed writing, the history of medicine and literature goes back much further than this modern interest (or Virginia Woolf). There are medical themes in Western literature dating back to the epics of ancient Greece. </p>
<p>And across time, representations of illness have altered repeatedly to reflect the diseases of the day. In that sense, these texts provide a good barometer of the particular problems of an era. For example, illness and disease were used within fiction to explore anxieties over morality and class in the 19th century, such as in Charles Dickens’ <a href="http://www.theguardian.com/books/2011/sep/23/charles-dickens-favourite-dombey-son">Dombey & Son</a> (1848). In the Cold War, illness allowed writers to fictionalise fears of nuclear conflict, such as in the post-apocalyptic society of Richard Matheson’s <a href="http://www.theguardian.com/books/2012/apr/03/i-am-legend-vampire-novel-century">I Am Legend</a> (1954). More recently, writers have used illness to consider terrorism, as in Margaret Atwood’s trilogy of novels beginning with <a href="http://www.theguardian.com/books/2003/may/10/bookerprize2003.bookerprize">Oryx & Crake</a> (2003). </p>
<p>Many specifically, modern reasons have shaped fictional and factual medical narratives over the past 25 years. In our own time, concerns over the UK’s ageing population, the NHS in crisis, or the widespread diagnosis of certain conditions (particularly mental health conditions) might all be increasing interest in medical fiction and illness experiences. </p>
<p>I also have a hunch that reflecting on our own mortality through the illness narrative is a response to the superficiality of the modern world. In a life lived through smartphones and in the virtual spaces of social media, the illness narrative might be a way of tapping into raw emotion once more. If modern life feels dispersed and inauthentic, illness is tangible. </p>
<p>Literature academic <a href="http://books.google.co.uk/books?id=-NuQbmau__AC&printsec=frontcover#v=onepage&q&f=false">Miriam Bailin suggests</a> that in the Victorian period, illness helped create bonds between people in a period of great social tension due to political upheaval. Applying this to our own time, perhaps medical literature and illness narratives are performing a similar process – illness possesses a strong power in emphasising a shared humanity that cuts across the divides of a multicultural and multi-faith society.</p>
<p>Whatever the reason, it’s clear that the fever for the medical narrative is not about to break any time soon.</p><img src="https://counter.theconversation.com/content/35981/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sam Goodman has received funding from The Wellcome Trust (for previous research projects).</span></em></p>Whatever your opinion of book prizes, they remain a useful tool for understanding what is popular in the literary world. The Costa Book of the Year, awarded this year to Helen Macdonald for her book H…Sam Goodman, Lecturer In Linguistics, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.