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This busy piece, The Gore family with George,
3rd Earl Cowper, by Johann Joseph Zoffany, ca.
1775, is used by Dr Braverman to teach observational
skills
Painting: Courtesy
of the Yale Centre for British Art, Paul Mellon
Collection
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Art and medicine are at opposite
ends of the academic spectrum. But more and more physicians
are touting the benefits of a well-balanced education.
"Here's an art/science perspective," says Dr Robert Norman,
a Tampa dermatologist and artist, photographer and writer.
"Consider the patient encounter as performance. The first
act introduces the characters, and the second act is problem
solving. The exam room is the stage, and getting the story
down is the theater. The sights, sounds, smells, touch
and tastes all add to the action."
Dr Norman's ideas are not unique.
The use of art to help mould and refine the skills of
doctors-to-be is gaining steam. Dalhousie University
leads the pack with a comprehensive medical humanities
program and many US med schools are now incorporating
art education into the curriculum.
"It was my strong feeling that
we needed to have a balance," says Dr Jock Murray, a
professor emeritus at Dalhousie and the founder of the
university's medical humanities program. "A lot of criticism
pointed to a lack of humanism among doctors." Dr Murray
felt that the humanities — art, literature, history,
music and philosophy — all had to play an important
role in medical education.
FOR
ART'S SAKE
Traditionally, med schools have shied away from teaching
the humanities. "When I went through medicine, a student
who wanted to pursue an interest in history, art or
music would have been thought to be frivolous —
that they weren't very serious about their medicine,"
recalls Dr Murray.
Dal's medical humanities program
— launched in 1992 — spans many disciplines
and includes unconventional classes. "What we didn't
want to do was to take something like history or literature
and then teach it the traditional way — telling
the student to sit down and we would tell them what
they needed to know — that has always tended to
fail," he explains. Students are encouraged to take
on individual projects and to incorporate the humanities
into all aspects of their medical education. An annual
art exhibit based on a medical theme (like Alzheimer's
disease) and the artist-in-residence, a joint program
of the Faculty of Medicine and the Canada Council, are
some of the cornerstones of the program.
LEARNING
TO LOOK
In the US things are being done very differently. Instead
of promoting a more humanistic approach to medical education,
profs in the States are using art to help hone essential
skills. "The premise behind our project," explains Dr
Irwin Braverman, a dermatology professor at Yale and
one of the leaders in the art-meets-medicine field,
"is that years ago physicians used to spend a great
deal of energy and effort looking and listening to patients
because we didn't have fancy lab tests." He says that
with the advent of medical imaging and other tests,
docs no longer have to rely as heavily on observation
to make their diagnosis. MDs are able to pinpoint disease
earlier, but the relationship with patients gets lost
in the process.
"The thought occurred to me, if
you were to show a student a foreign object and ask
them to describe it they would probably be able to describe
everything," he says. "But if I were to ask them to
tell me what they see in a patient, they'd only be able
to visually describe the person."
ATTENTION
TO DETAIL
In his course, which has been adapted by over a dozen
other American med schools, students are divided into
small groups and assigned a painting. At Yale, a selection
of 18th and 19th century British art is used. Students
look at the work of art and describe what they're seeing
to their classmates. "By the time they finish looking
at and describing the painting the invariable comment
is 'wow, I'm looking at this differently now'," says
Dr Braverman. Early tests of the curriculum found that
even a brief two-hour session improved students' attention
to detail. "As I often tell students, when you see a
patient, think of him or her as a painting in a frame.
Just concentrate on what's inside it."
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