Tag Archives: medical humanities

Barbara Sibbald, News and Humanities editor for the Canadian Medical Association Journal, reads the CMAJ Humanities Encounters article "Cathartic narratives for chaotic thinking" (subscription required). The article is written by Dr. Richard Hovey, associate professor in the Division of Oral Health and Society with the Faculty of Dentistry at McGill University.

In the article, Dr. Hovey speaks from personal experience about life with severe chronic pain.

Listen to the article reading:

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Stuart Kinmond reads the CMAJ Humanities Encounters article "He was a boy with a name". The article is written by Dr. Nicholas Batley, associate professor in the Department of Family Medicine at the American University of Beirut Medical Centre in Lebanon.

The article tells the true story of Dr. Batley’s encounter with a young Syrian refugee on the streets of Beirut. The patient’s name and personal details have been changed to protect his identity.

Full article (subscription required): www.cmaj.ca/lookup/doi/10.1503/cmaj.160530

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Daniel Bierstone

Daniel Bierstone

University of Toronto

Class of 2016


On the first day of my Social Paediatrics elective, I accompanied a nurse on a visit to a family shelter. I entered the single room and noticed a healthy newborn girl, sleeping peacefully in an old crib. The room consisted of a bed, a table, two chairs, a fridge, and a microwave. There was no stove, no kitchen sink. Clothes, toiletries, dishes and bottles were strewn everywhere. The floor was dirty and there was graffiti on the wall. One of the parents was present, but the other was out looking for work. It was my first time in a shelter, and I was stunned that a family with a newborn was living in such conditions.

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Rabea ParpiaRabea Parpia
University of Toronto
Class of 2019

His voice is warm and soft, each sentence running into the next, broken up only by gravelly laughter and the occasional cough. The honey that coats his voice obscures his jarring story, the suffering hidden beneath the evenness of his tone. He tells me about his injury, rating his pain on a scale of one to ten, and describes its quality and radiation. I ask him for his previous medical diagnoses and he pauses briefly. ...continue reading

cmaj blogs photoSumedha Arya, Outgoing Editor-in-Chief

"Literature adds to reality, it does not simply describe it. It enriches the necessary competencies that daily life requires and provides; and in this respect, it irrigates the deserts that our lives have already become." – C. S. Lewis

Taken into a new context, I believe that this quote illuminates an image of medical education without the influence of the humanities: it can be a desert. Hostile and sweat-provoking in its unrelenting pressure to consume information hurtling from screens to cerebral cortices with inexorable speed. Alienating in its jargon and strictures on daily routine. Conducive to cultivating a homogenous species well equipped to survive in a very particular environment. ...continue reading

Barb_photoBarbara Sibbald is Editor, News and Humanities, at CMAJ

 

Long billed as a symposium for arts, humanities and the social sciences in the education of health professionals, the fifth iteration of Creating Space has seemingly taken its mission to task, with a substantial integration of the latter at its Vancouver conference, Apr. 24-25.

“How can we get more social scientists to come to Creating Space,” asked the University of Toronto’s lead in humanities, Dr. Allan Peterkin in the opening address. His query was echoed and answered by numerous presenters.

Dr. Andrew Clarke, who works in the physician health program at Doctors BC, said self-awareness, through building reflective capacity – one of the primary goals of the humanities – and scholarship are both essential. ...continue reading

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TomlinsonJonathan Tomlinson is a general practitioner in London, UK, and a NIHR In Practice Research Fellow at the Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry

Kate Granger, a young doctor with cancer, recently wrote a book called 'The Other side'. It's a book for doctors ‘to be better able to understand exactly what being the patient is really like …” Other medical writers have also been motivated by the shocking realisation that medical education and clinical practice had taught them so little about what it’s like to be a patient, the particular problems that doctors themselves have in coping with illness and the health risks associated with their profession; loss of identity, shame and stigma, the need to be treated as a person and an acute awareness of mistakes were common themes of narratives.

Inspired by their stories, I have been leading teaching seminars with medical students, GP trainees, GP trainers, GP retainers, medical humanities students and the public and learned a few more lessons along the way.

Doctors’ illness narratives have a particular power ...continue reading

Moneeza cropMoneeza Walji is CMAJ's editorial fellow 2014-15

Some would say it is strange to remind physicians or health care workers of the humanity of medicine, I would argue with the onslaught of new drugs, new research, and new technology to make medicine a faster evolving machine… we have sometimes forgotten the art of interacting as humans. So when Dr. Abraham Verghese gave a talk at TEDMED 2014 on metaphor and medicine (and language and medicine more broadly) it struck a chord.

During my medical school training I had often heard (sometimes from older and wiser physicians) that the art of the physical exam was dying with the increase in tests that allowed us, at times, to not touch or even see patients before making a diagnosis, let alone speak with them. One physician said we were losing the intimacy in medicine that allowed us to really listen to what was needed from those in our care. Much of what I gleaned from Dr. Verghese’s TEDMED speech was similar, we needed those moments of communication.

Dr. Verghese is Professor of the Theory and Practice of Medicine and Senior Associate Chair of the Department of Internal Medicine, at Stanford University Medical School. He is also a best-selling author, having written fiction and non-fiction throughout his career. So when he asked “What is a metaphor?” I found I really wanted to hear his answer. ...continue reading

Pat_Harrold_photoPat Harrold is a family physician working in County Tipperary, Ireland

It had been the worst snap of cold weather for many years. An elderly farmer had gone missing and a body had been discovered. I was the general practitioner on call for the night so I found myself in the back of a police car speeding through the darkness to a mountainside in a remote part of Ireland. I was glad I was not driving, the snow had fallen thickly and it was glittering in a hard frost. The moon was bright and it was as cold as it could get.

At last we reached the spot where several local men in high-viz jackets were waving torches. The car could go no further. A hearse pulled in alongside us and a portly undertaker, incongruous among the farmers and police in his suit, overcoat and city shoes, introduced himself. Then we all set off up the mountain at a fearsome pace.

The moon was so bright that we had no need of the farmer's torches. Before long I could hear the police panting for breath. These local lads were fit. At last we stopped at the place where an elderly man lay, literally frozen in a snowy field. One arm was lifted, as if to wave goodbye, and his open eyes gazed at the starry sky.

There was not much for me to do. I placed a hand on his icy wrist, took note of the time and, pronounced him dead. But nobody moved .The ring of men waited silently staring at me. What else was I supposed to do? There was no family member to comfort. The police would contact the coroner. Still they waited. What did they know that I did not? Was I expected to pray?

At last, the police sergeant spoke: "How would you say, Doctor, did he die?”

I must have looked even more at a loss as I stared at him, speechless.

"Can you not tell by the look on his face?"

Just then the Undertaker arrived, puffing noisily. He came to the rescue. He first circled the body. Then he doffed his hat, squatted   and stared long and solemnly into the man's eyes. He stood and declaimed:

“He was walking and fell. He tried to get up. He felt a chest pain and suffered a massive heart attack. Then he died. ”

That did the job. Amid nods of acknowledgement and rueful head-shaking the body was lifted on a stretcher and the swift pace was resumed.

Twenty years later, I still don't know what it was all about. I have asked several GPs in rural areas if they had ever heard of anything like it. Nobody had. It must have been a peculiarity of the place, a tradition started by a doctor with a sense of drama in the days before post mortems were commonplace. I have never had the nerve to try saying it myself. "From the look on his face I would say…....."

 

by Barbara Sibbald, Editor, News and Humanities, CMAJ

Educational standards for physicians in Ontario originally included eight roles. When these morphed into the CanMeds physician competency standards there were only seven. The one lost competency was ‘physician as person’, said Dr. Brian Hodges in a keynote to 120 attendees at the Creating Space IV Symposium in Ottawa, Apr 25–26.

Proponents of the medical humanities, a burgeoning movement aimed at restoring the art, to the art and science of medicine, is all about that lost role.

Hodges leads the AMS Phoenix Project, A Call to Caring, an initiative to rebalance the technical and compassionate dimensions of health care. “Phoenix is trying to leverage change in education and the health care system to balance compassion and technical components,” said Hodges, who is a professor in the faculties of medicine and education at the University of Toronto, Ont. AMS supports the Hannah History of Medicine Chairs, fellowships, innovative projects and scholarly endeavors (including the Creating Space IV Symposium).

Hodges was speaking to an audience of the converted at the symposium, which was associated with the Canadian conference on medical education, but raised extensive discussion when he asked whether the medical humanities makes a meaningful contribution to health care and improving the lives of patients and health care providers. The consensus seemed to be yes, but it could do so much more if it was embedded into core curriculum, instead of being an elective, which de facto has less importance and credibility.

Medical humanities must be a department, like the department of neuroscience or orthopedics, said Dr. Jeff Nisker, another keynote speaker. Nisker, a professor at Schulich School of Medicine and dentistry at Western University in London, Ont., said first year students should get 200 hours in humanities beginning in the first week.

At least two attendees seemed to doubt that humanities would ever gain a place in the core curriculum due to lack of funding and lack of will. “How do we get health professionals to come out and play?” asked Hartley Jafine, who uses theatre to teach communication and team work to health professionals.

Inserting medical humanities into the core curriculum undoubtedly presents challenges including, breaking down barriers to other faculties, improving pedagogy and developing a robust research agenda.

But it’s essential, said another keynote speaker, Alan Bleakley, an internationally recognized expert in medical education and humanities, otherwise, we’re “just playing around the edges and it’s bad luck to those who don’t take it up.” Bleakley started a core integrated medical humanities program at Plymouth University in the UK, and is now a professor of medical humanities at Falmouth University in Cornwall.

Humanities are necessary, said Bleakley, to help cope with symptoms such as the increase in errors, moral erosion and poor self-care. Sensibility lies at the core of Humanities. By this, Bleakley means how we use our senses and how we develop a sense of what is useful, ethical and what is pleasing or disturbing. “Medical students have been rendered insensible,” said Bleakly. “They can’t think or sense for themselves. They are told what they should pick up when they go on a ward round or in the classroom.”

“Why shouldn’t patients or students talk back to the system and say this isn’t right?” Bleakley tries to teach medical students to be dissenters, to provide other options.” He said the major role of medical humanities and the arts is, in Jerome Bruner’s words, to allow people to “traffic in human possibilities, rather than settled certainties.”

The two-day symposium also featured sessions on writing, reflection and curriculum, and brought the arts to participants through writer- and poet-in-resident activities as well as a field-trip to the National Gallery to explore visual thinking strategies.

Creating Space V Symposium will be held next Apr. 25–28, 2015 in Vancouver, British Columbia as an associated event with the Canadian Conference on Medical Education.