The Fine Art of Doctoring
Years ago, Caltech advertised some of its research meetings with artsy posters of surreal scenes filled with brains, vertebrae, strands of DNA. Caltech also has a fountain designed to resemble a DNA helix, and a scientist working there has a stained-glass window in the shape of a fruit fly’s eye. (Fly eyes are jolly pretty when you look at ‘em up close.) I even know of a woman who’s composed music based on the electrical firing rhythms of leech nerves.
The aforementioned items aren’t included for totally gratuitous reasons. The common (albeit tenuous) links to what is to follow: art and biomedicine.
There’s a bit of a movement, we learn, to bring arts into medical training. One hope is that it might help medical students emerge as better, more humanistic doctors, not just crammed with facts like names of nerves, 10 crucial functions of the liver and the difference between Accupril and Accutane. Sensitized doctors might be more apt to see things from the patient’s point of view.
That’s one reason, anyway, why Dr. Robert Collins (chairman of the UCLA neurology department) started a literature and medicine course for third-and fourth-year med students. But he also did it for himself. Collins loves the arts--does sculpture himself, has had exhibitions. Among the artwork in his office is a sculpture given to him years ago by a hard-up artist-patient. (We don’t recommend you try offering art in lieu of co-pay at your HMO, however delightful your dried-macaroni collages may be.) “I love the class, I love to go there,” Collins says.
Students in Collins’ class discuss all kinds of medical literature: “The Plague,” by Albert Camus; a short story by Ernest Hemingway about a doctor delivering a baby; poems; movies such as “The Elephant Man” and “My Left Foot”; even medical cartoons, tasteless or otherwise.
Then they write things relating to what they’ve read--from not just a doctor’s viewpoint but also from the perspective of a patient, the patient’s family, a good doctor or nurse or a bad one, etc.
Makes me wonder how this column would read if it were written from the point of view of doctors I interview: (“Why is she asking me that question about the spleen again? I’ve explained it perfectly clearly!”) Or a reader: “When is she going to get around to answering that question about sweaty palms?”
Fine arts may be good for instilling sensitivity and helping students cope with sad things they encounter, but that’s not all. Dr. Irwin Braverman, professor of dermatology at Yale University, thinks the arts--notably, paintings--can help new students hone observational skills.
It’s a strange thing about those skills, he says: Med students, in his experience, learn a lot of stuff by rote but aren’t good at really looking--at noticing fine details that may not fit with a set of symptoms they’ve memorized. “They become walking atlases,” he says.
What’s more, Braverman and others have noticed that--in these high-tech days of body scans and 1,001 lab tests--students are getting worse at observing, not better. “A physician doesn’t have to use his head as much as they did when I started out 30, 40 years ago,” he says.
Case in point: A resident doctor couldn’t diagnose the swelling in a patient’s leg because he’d failed to notice the man’s bulging eyes (he was there to look at a leg, after all). Yet the eyes were a clue to a thyroid complaint.
Eventually, after maybe five to 10 years of practicing in medicine, something clicks and doctors do learn to truly observe, Braverman says. “And so I wondered: Is there some way to jump-start the process? What if I showed them something totally foreign to them, something about which they had no biases?”
Fine-art paintings might be just the ticket, he reasoned. That’s why, for the last few years, sundry Yale students have found themselves at the Yale Center of British Art, poring over paintings with curator Linda Friedlaender, then getting drilled in the art of really noticing details.
It makes a difference. In tests, including a controlled study by Braverman’s student, Dr. Jacqueline Dolev, those taking the painting class were better, later, at noticing details of medical conditions than students who never took the class--even though it’s hard to imagine less of a link between “George, 3rd Earl of Cowper” (1775) and a bright, red herpes zoster rash (or let’s hope so, for the Earl of Cowper’s sake).
The art class is now required of all Yale medical students--the first-year medical students. Get ‘em young, says Braverman. Before they learn bad habits.
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If you have an idea for a Booster Shots topic, write or e-mail Rosie Mestel at the Los Angeles Times, 202 W. 1st. St., Los Angeles, CA 90012, rosie.mestel@latimes.com.
