Pulse
Where Art Meets Science
A University of Minnesota initiative promotes the arts as a means to explore the human side of medicine.
Wearing a houndstooth jacket that’s too heavy for the warm Friday afternoon and with his long silver hair slicked back from his forehead, actor Charles Keating steps up to the pulpit of historic Grace University Lutheran Church on the University of Minnesota campus in Minneapolis. He has come to talk about aging.
Addressing about 75 people, some of whom are 20-something students and others who are old and facing challenges time has handed them, Keating describes his qualifications: more than 50 years’ experience on the stage and being “65 years of age, plus 9 months in the womb.” “I realized I couldn’t remove myself from the crosshairs,” he says slowly, his accent giving away the fact that the wiry actor was born to an Irish mother in London during World War II.
The audience chuckles, and Keating delivers an abbreviated version of a performance he gave to family medicine physicians earlier in the week, sharing his own observations and quoting the works of Simone de Beauvoir, W.H. Auden, M.F.K. Fischer, even Betty Friedan about growing old. His goal is to get his audience thinking about the way people in this society see and treat older people.
Keating’s appearance, sponsored in part by the University of Minnesota Medical School’s new Center for Arts and Medicine, grew out of a 2004 meeting with Jon Hallberg, M.D., assistant professor of family medicine and community health and the center’s creative director. Keating was performing at the Guthrie Theater in Minneapolis, where Hallberg serves as company physician. Hallberg discovered that Keating was interested in creating a narrative on aging. Hallberg later asked the Emmy Award-winning actor if he would present the act at an annual family medicine continuing medical education program at the university, which devoted a day to geriatric medicine, in order to get participants thinking about the less clinical side of growing old.
“It’s another dimension of learning,” says Kathleen Brooks, M.D., assistant dean for continuing medical education, who coordinated the event. “It provides another way to look at our work, and I believe that sometimes looking through a different lens at the work we do every day helps us better understand the humanity of our patients and ourselves.”
Creativity in the Curriculum
Getting physicians—and future physicians—to view their work from another plane is what drove Hallberg to create the center, which was formally launched this year. As an instructor in the Physician and Society course, a two-year-long requirement for first- and second-year medical students, he became concerned that the demands of medical school were crushing their sense of curiosity and creativity.
“During the first two years, you hear all the time how you lose your sense of why you went into this in the first place,” he explains. “I wanted to keep encouraging them and give them some context and a little dose of humanity.”
In order to restore students’ enthusiasm, Hallberg is trying to “infuse” the medical school curriculum with the arts and humanities. He began experimenting with the idea six years ago, when, rather than deliver a lecture on ethics to first-year students, he used a performance of Miss Evers’ Boys, a play about the Tuskegee experiment in which poor African-American men were used in a study on the effects of untreated syphilis, to generate discussion and drive home the lesson.
Hallberg has since taken students to the Minneapolis Art Institute to hone their power of observation by looking at paintings. He also showed films—Dirty Pretty Things and Born into Brothels—during the first week of medical school in order to expose new students to some of the social issues they’ll be confronting as physicians.
Hallberg went about this quietly until 2005, the year Mary Faith Marshall, Ph.D., who had worked with the medical school’s dean, Deborah Powell, M.D., at University of Kansas School of Medicine, was hired as associate dean for social medicine and medical humanities. Powell connected Marshall and Hallberg and asked them to come up with a more formalized approach to bringing the arts and humanities to medical education.
Their first act toward creating the center was being a sponsor of the Harvard Street Forum, a series of programs on topics such as the response to Hurricane Katrina, military medicine and torture, and AIDS and social justice. Their second was working with the college of liberal arts to bring Tracy Kidder, author of Mountains Beyond Mountains, the story of humanitarian physician Paul Farmer, to the university last fall for a talk. “We’ve been testing the waters to see what we can do and what works,” Hallberg explains.
What Lectures Can’t Teach
The idea of exposing physicians and medical students to the arts and humanities is hardly new. According to the Association of American Medical Colleges, 94 of the 125 U.S. medical schools offered courses in bioethics and medical humanities in 2006, up from 71 schools in 1991.
Hallberg admits the University of Minnesota has come late to the table in terms of bringing the arts and humanities to the curriculum. But he believes the university can learn from and improve on what other schools have done.
For one thing, Hallberg is going beyond just educating medical students and opening up some of the programs to residents and practicing physicians as well as nonphysicians. One of his next projects is to create a film series with a medical theme that would include discussions with physicians and other health care professionals after the screenings. Physicians would earn CME credit for participating.
Hallberg and Marshall are also planning to work with arts organizations in ways that haven’t been done at other medical schools. “People are knocking on the door wanting to help out and work with students,” Hallberg says. So far, they have had interest from a photographer, several writers, and the Illusion Theater in Minneapolis. In addition, they have been working with the American Composers Forum in St. Paul to establish a composer-in-residence program at the medical school. The selected composer would use music to capture the essence of the medical school experience. Hallberg and Marshall are looking for sponsors for such a program. This spring, Hallberg, who provides commentary on Minnesota Public Radio, had his students do audio documentaries, rather than written summaries, of their experience at the Southside Community Health Center in Minneapolis. “Being an interviewer, creating this artistic piece was quite remarkable for the students,” he says. “It’s having them use their right brain a bit more.” He would like for some of the segments to air on the radio.
Several medical school faculty members are incorporating Hallberg’s ideas into their own courses. Brooks says at the end of a morning discussion on geriatric medicine during the family medicine conference, Keating recited “Crabbit Old Woman,” a poem written by an elderly woman in a London nursing home that asks the nurses to take a closer look at the person inside the aging body. “It was quite moving, and the room really got silent,” she recalls.
Greg Filice, M.D., who teaches infectious disease to second-year medical students, showed three films as a supplement to his class: State of Denial, about the South African government’s denying that AIDS was caused by an infectious agent; Leper, about people living with leprosy in Nepal; and A Closer Walk, about people living with HIV/AIDS. “Infectious diseases have had a huge impact on human history. … In order to be good physicians—and especially good infectious disease physicians—we have to understand the impact not only on patients but on societies, on populations, and the impact not only on our bodies but on our emotions.” Film does that in ways lectures cannot.
But will exposing Minnesota medical students—and practicing physicians—to the arts and humanities make them better doctors? Hallberg says it’s too early to tell. “The comments I’ve received from students and colleagues suggest people love this stuff,” he says. “And if they love this kind of thing … and if it creates an atmosphere of curiosity, compassion, and understanding, it’s important.”—Kim Kiser