Improving Medicine With Art

http://www.nytimes.com/2017/03/11/arts/improving-medicine-with-art.html

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AUSTIN, Tex. — Some doctors are so inundated with the business of medicine that good bedside manner has become a lost art. As a preventive measure, the new Dell Medical School, part of the University of Texas at Austin, is challenging students in its inaugural class to embrace their feelings by examining the fine arts.

In late January, about 20 first-year Dell Medical students met in a gallery at the university’s Blanton Museum of Art for a two-hour lesson on empathetic communication, the final session in a three-part program. In addition to focusing on ways that doctors treat their patients through empathy, the program aimed to develop observation skills and address how doctors treat themselves, through a session on mindfulness and self-care.

“One of the things that we’re struggling with in medicine right now is the immense level of burnout,” said Dr. Jonathan MacClements, an assistant dean at Dell and a student mentor. “The reason why we go into medicine is forgotten. We’ve just become so focused on the day-to-day activities that the human side is sometimes lost. I’m hoping this will help us refind and re-identify within ourselves what made medicine such a special profession.”

The students’ principal guide for the program was Ray Williams, the museum’s director of education and a veteran of the emerging practice of using art as medicine of sorts for medical professionals, pioneered by Columbia and Yale. Before coming to the Blanton in 2012, Mr. Williams worked at the Harvard Art Museums, where he partnered with Brigham and Women’s Hospital in Boston to foster teamwork. Mr. Williams, who developed the curriculum for Dell, likens interpreting art to interpreting a patient.

“I’ve rescued them from their domain that is driven by crisis and the mastery of information, and embedded them in a process where they’re not experts,” Mr. Williams said of the students. “They don’t know about art. But they know how to look and think and talk together.”

Mr. Williams, joined by the museum educator Siobhan McCusker, welcomed the class with quotations by the actress Meryl Streep describing empathy as a key to her success. Then Mr. Williams presented David, as conveyed in the French painter Claude Vignon’s circa 1620 work “David With the Head of Goliath.” This take on Caravaggio’s classic depicts David, a sword-bearing teenager after his first kill, as forlorn and androgynous.

Mr. Williams doesn’t tell his students the titles of pieces and discourages their reading the labels. For this piece, he started by asking the students to capture the mood in one word and say it aloud.

“Pain.” “Innocence.” “Sad.” “Pensive.” “Oops.” “Heavy.” “Exhausted.” “Murder.” “Light.” “Regret.”

He challenged the students to delve into the psyche of the young hero, or to cast their “empathetic imagination” upon him, at this life-changing moment. Then he flipped the exercise back on the students.

“I wonder if you can think of ways in which this story and the image relates to your own experience today,” Mr. Williams said. “Do you feel any connections?”

“I personally worked very hard to get to med school,” one female student said. “But now that I’m here, I’m like: ‘Whoa, do I really want to do this? This is a big change.’ So there’s lots of time for introspection, and a little bit of regret.”

Mr. Williams and Ms. McCusker also drew from the museum’s Latin American art collection. Ms. McCusker used two 55-inch-by-92-inch paintings from “The Strangest Fruit” series, made in 2013 by the San Antonio artist Vincent Valdez, to illustrate the point of not judging a book by its cover.

One painting depicts a man wearing plain jeans and a long-sleeve top; the other shows a shirtless man in baggy jeans with a huge tattoo on his back. Ms. McCusker asked the students to rate their empathy for the two men, seemingly suspended in air, on a scale of 1 to 10. After she revealed the artist’s personal connections to his subjects and explained his portrayal of them in a “hanging” manner as homage to the Latinos lynched in Texas in the 19th and 20th centuries, some students increased their empathy scores.

Later, Mr. Williams showed the students a fiberglass sculpture about 10 feet tall, “Border Crossing (Cruzando el Rio Bravo),” made in 1987 by the El Paso artist Luis Jiménez. The work depicts a man with a woman on his back, holding a small child to her bosom. It elicited conversation about illegal immigration and how doctors ultimately decide who gets health care.

The effectiveness of a program like this is hard to measure. It is more about process than product. But Dr. MacClements, who attended medical school in South Africa during the H.I.V. outbreak in the late 1980s, saw tremendous value in the experience.

“This whole exercise has reconnected me with my spiritual side,” he said. “It has reinvigorated how I practice medicine.”

Toward the end, the students were divided into three groups, each paired with a painting. Each student was to compose a sentence in response to the work and then as a group arrange those lines in order, like a poem, to be read aloud.

Aghogho Evuarherhe was part of the group that examined “The Land of the Free,” a 1900 piece by William Gilbert Gaul that depicts a Sioux woman who has hiked to a mountaintop to mourn. Reading the sentences the students assembled, Mr. Evuarherhe said: “This is my home. I’ve climbed so high but I’m still so alone. I worry about my family’s future. I wonder what the new year will bring. The world has something for me. Strength isn’t how much, but how far.”

For Mr. Evuarherhe, these “magical” moments at the Blanton were a nice counterbalance to his studying. He especially liked sharing perspectives on the art with other students.

“We thought of her journey to get there,” Mr. Evuarherhe said. “There were probably regrets walking up that mountain, and there were probably challenges. That’s how I feel our journey is right now. But we just keep the big picture in mind. When we finish our medical training, and we’re standing on top of that mountain, it’s going to be this beautiful moment where we realize we made it.”