Archives for posts with tag: Medicine

…which is a quote from Anna Quindlen, the Pulitzer Prize winning journalist, novelist and essayist.

But her question does not in any way relate to her hugely impressive CV and achievements. Rather, it stems from her encounters with healthcare professionals, which has prompted her reflections on the extent to which she was seen as an individual in that context, as a person rather than as ‘just another patient’.

The writer was recently invited to deliver the Humanism in Medicine lecture at the Association of American Medical Colleges (AAMC) annual meeting (http://humanizingmedicine.org/anna-quindlen-advises-physicians/).

Quindlen’s question – “Do you know who I am?” – arose from her experience of two separate medical encounters, both involving anaesthesiologists. The first was patronising (my judgement call), and left her doubtful as to whether he knew anything about her or about her previous history.

The second encounter was a positive one:

“Only a short interchange, yet in some fashion she knew who I was.”

Quindlen continues:

“And I assume she was at least as busy as her male colleagues.”

But gender distinctions are not the point. Instead, what Quindlen wants to get across is that she felt ‘seen’ by one professional, and not by the other.

“She was professional, and she was kind. Oh, what a combination that is in what often seems like a cold and inhuman world.”

Quindlen sees the problems in health care – patients feeling ignored, isolated, patronised – as part of a larger societal problem. Power relationships wherever they occur, and which too often underlie the doctor-patient encounter, ‘foment fear and mistrust and alienation’. She speaks of the ‘MDeity’, doctors as little gods, and is surprised how pervasive this remains, despite huge technological and other advances.

Quindlen’s conclusion is that in the end, the person – the patient, the sufferer – seeks and needs ‘the human touch’, to be seen as an individual, and to be considered as such.

She ends with advice for the doctors she addresses:

  • Try to be present in the moment
  • Acknowledge uncertainty
  • Practice empathy
  • Try to be kind

CQ

IMG_0137

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

I have come across two events over the past week where links between poetry and science or medicine have been initiated.
Firstly, appropriately at Keats House, I attended the launch of a collaborative project between poets and scientists (http://www.poetry.gb.com/BiomedicalScience). Eleven poets teamed with 11 scientists to create poetry that reflected on the life/work of the latter. At the event, both the poet and the scientist of each ‘team’ spoke about their respective experiences throughout the collaboration. The resulting poetry is wonderfully rich and evocative. It was also very moving to hear the scientists speak, and so poetically, of what the experience meant to them.

Secondly, today I came across a piece in a recent New Yorker (http://www.newyorker.com/talk/2013/10/14/131014ta_talk_singer) on poetry and medicine. John F. Martin is a ‘cardiologist, transatlantic academic, specialist in gene therapies for treating heart attacks, clinician, and published poet.’ I guess the ‘poet’ element is last mentioned in order to heighten the impact of this apparent incongruity. There have indeed been clinicians, such as William Carlos Williams and Dannie Abse, who were also published poets. But they are in the minority. I have not yet come across Martin’s poetry, but I will now seek it out.
Apart from his own poetry, Martin has also initiated an annual poetry competition for medical students both at UCL and at Yale School of Medicine. This project arose out of his concerns that ‘medical students are at risk of becoming “intellectually brutalized”…conditioned to focus upon the microscopic at the expense of the holistic.’
The competition is now in its third year, and I have been reading the work of past winners. Impressive. My favourite is Encounters with Death, by Kevin Woo (Yale University, 2012):

‘In the First Year
I gazed upon a body overtaken by Death
The fingers, withered and cold
Eyes as gray as the stainless steel casket
Call her Cadaver, they explained, and learn
Her lines, her edges…
…And in the First Year, I dissected Death.’

There is a separate stanza for each year, of four.

‘In the Second Year
I memorized the signs of Death
A lung, scarred and emptied
The nodes of Osler revealing infection within…
…And in the Second Year, I pathologized Death.’

‘In the Third Year
I saved a man from Death
His heart, so worn and weary
That it had surrendered its rhythm…
…And in the Third Year, I conquered Death.’

‘In the Fourth Year
I had a conversation with Death
Of what do you remain afraid, Death asked
That you might know Death only by dissection, as pathology, to be conquered?
And I learned that Death
Was a companion along the journey of humanity
Along which we travel
I smiled, because I understood
At last
And in Fourth Year, I accepted Death.’

A most impressive journey in just 4 years. For most of us it takes a lifetime, if we do even manage to arrive.

CQ

I have just spent the weekend at my Alma Mater, UCC, Cork (http://www.ucc.ie/research/apc/content/experienceofillness/).

The event was a thought provoking and enthralling symposium, which covered many diverse aspects of potential interactions between Illness and the Arts.

Music and poetry, including live performances and readings, visual art, fiction, social media and film, in the context of the experience of illness, were all explored in innovative and refreshing ways. Personal stories of the experience of illness were shared, and were both moving and enriching. We also heard about new models for exposing medical undergraduates to the humanities.

A very imaginatively curated art exhibition Living/Loss: The Experience of Illness in Art is currently on at The Glucksman Gallery, UCC (until March 2013). It is so worth seeing.

Much to consider, and hopefully to follow on from the symposium, including a book in 2013.

I was particularly proud that, firstly, I was able to contribute to this landmark event, and secondly, that it took place where many years ago I first set off on the road that has led me here.

CQ