The poster for this conference epitomises the creativity and richly imaginative content that defined the event itself.
I have attended many ‘Medical Humanities’, ‘Health and Humanities’, ‘Medical Narrative’ and such like conferences in the past. Medicine Unboxed 2013 – with this year’s theme of Voice – stands alone as something uniquely innovative and stimulating, as well as both emotionally and intellectually challenging.
The twitter (#MU13VOICE) and facebook feeds are excellent and will give you a real sense of the diversity and substance of the content. Although I could only attend the first day, I was so very pleased to have been physically present for even 50% of the entire programme.
‘Voice’ (full programme – http://www.medicineunboxed.com/2013-voice/) was presented and discussed as the poetic voice (Jo Shapcott and Andrew Motion), the patient (Rhys Morgan), the captured voice (Fi Glover, The Listening Project), the singing voice (Birmingham Medical School Choir, Melanie and Rebecca Askew), the performed voice (Bobby Baker), and the sung voice (in terms of composition and phonetics, and music as therapy, and as an end in itself).
It is difficult to pinpoint exact reasons why I found the conference so refreshing and stimulating. The absence of medical-type presentations contributed, and Sam Guglani et al.’s creative approach to all possible aspects of ‘Voice’ in terms of health and medicine was hugely impressive.
I wonder whether the audience consisted of many non-medical/non-health-care professionals. One thing that irked me was the repeated use of the word ‘patient’. It grated. Perhaps this is because I no longer work in clinical medicine. As an ‘outsider’, ‘patient’ feels like a label that attaches an otherness to those who are ill, whereas in fact, as identified by Susan Sontag, the gap between ‘them’ and ‘us’ is very narrow…
My experience of sitting outside clinical medicine left me much to consider also following the session on the ‘Medical Voice’, in which Iona Heath, Deborah Bowman, Julian Baggini and Charlotte Blease participated. A ‘crisis in empathy’ amongst doctors was highlighted here, and there was much discussion on how medical training could be improved to address this.
I have often been critical of the lack of empathy and compassion that those who are ill have experienced during the medical consultation. I left clinical medicine a few years ago, to explore medical humanities/health and humanities (not quite sure what to call it anymore), and now work as an editor for an organisation that creates books on health and illness for children. We recently advertised for a junior doctor for the role of a medical writer. I was overwhelmed by the quantity (and quality) of the applicants – over 20 junior doctors, all disillusioned by their first years in clinical medicine. Most had no intention of ever returning to the field.
I found this sad, that the system (‘medicine’, the NHS…) had somehow failed them to the extent that just a few years working as clinical doctors made them want to walk away. We are quick to criticise doctors and how they behave, which is sometimes, but not always, justifiable. Yesterday, I found myself in the unusual position of wanting to make a plea for the ‘Medical Voice’, that it might be heard and witnessed too…
My view has inevitably been tempered by my distancing. For a perspective from a doctor within clinical medicine, do check out Jonathon Tomlinson’s response to Medicine Unboxed 2013, which truly reflects a ‘Medical Voice’ that needs to be heard: http://abetternhs.wordpress.com/2013/11/23/burden/
CQ
Living through the Arts 
I think the thing that really irked me about the “crisis in empathy” comments–especially from Charlotte Blease was the idea that medical training is deficient, or that students come in as vessels to be filled not only with clinical knowledge but with empathy. The students are hugely capable of humaneness and empathy already but the system in which we work as doctors is wringing it out. I am a GP partner, I have just resigned. I am not sure I will return to clinical medicine right now. I have huge amounts of empathy and even love and compassion for my patients but I can’t do it anymore. I am cracking under the demands of 40 to 50 direct patient contacts a day, let alone the 100’s of “non direct” contact through results and paperwork and the work that is now coming out of hospitals. I intended to be an advocate, a part of a community, a doctor who would learn the art of when to do nothing. I am now doing work I don’t believe in: I am referring when I think it is detrimental, treating when I think it is unnecessary because I am afraid of the complaints and potential litigation –and because I am too tired to fight. I found this weekend utterly healing and inspirational–so thank you all speakers. But I applaud you in asking for the doctor voice. This is mine. The voice of the foot soldier.
Jess
Thank you so much for this.
I agree that the weekend was inspirational, and it is so reassuring – and sustaining – that such events happen and can touch our lives.
I left clinical medicine after more than 20 years, for many reasons, including the challenges of Palliative Medicine specifically, but not only. It is a tricky one, leaving the clinical arena I mean, and I have much to say about it! You might be interested in a piece I wrote for doc2doc recently on this:
http://doc2doc.bmj.com/forums/open-clinical_general-clinical_week-leaving-medicine-dr-ms
It seems really sensible for you to stand back and to re-evaluate. Space and time can be amazingly positive and inspiring, both of which you probably have not had much of in your working life, which is so sad and so short-sighted of the whole system…
C
Thank you for sharing your thoughtful article. I am worried about making disclosing my departure not because I fear others opinions but because my general point will be lost in the personal. We can not have doctors as carer, advocate or gatekeeper if they are exhausted. And I am seeing a pile of exhausted doctor friends and colleagues retiring early or heading abroad. I think an important question to ask ourselves individually and collectively as medical (and allied health care) professionals is what WE need to do the best job we can do? What do you think is needed for retention and empowerment?
Hi Jess
Yes, I agree that there is always the risk of losing the general in the personal, which is mostly out of your control…
I was interested to hear the medical student’s comment (I think Ben was his name) during the Medical Voice round table discussion on Saturday. It will be interesting to see whether students such as Ben who do a Med Hums BSc during their undergrad training end up in a ‘better’ position years down the line.
While the emphasis is usually placed on developing empathic and compassionate doctors as a result of exposure to Med Hums, I think it may well work the other way also, and facilitate a framework for doctors that may ‘give’ them something for themselves, rather than always ‘giving’ to others.
But of course, we know so little about all of this. There is actually so little evidence that exposure to literature/the arts/medical humanities, even the wonderful event at Cheltenham makes a difference outside of out intuitive sense that it does/should/must…
Thanks for you write up and link to my blog. I’ve written an essay on the use of the word ‘patient’ which takes into account historical and philosophical perspectives, including Sontag: http://abetternhs.wordpress.com/2012/04/09/whats-in-a-name/
I have many other thoughts about the weekend, but my patients are waiting!
Jonathon
Hi Jonathon
Thanks for this, and especially for the link to your essay. What a thoughtful and considered piece…
C