- So we are expecting 12 students today
and we've got one, two, three, six?
Come on, fill the sides
and there's a seat waiting here for someone.
It's special, I'm assuming that somebody here will be...
And I think we're almost ready to go.
One, two, three, four, five, six, seven.
So why don't we start, if you'll just pass that up.
My name is Ellen Malomed
and my work is with something called narrative medicine.
It's storytelling about people's disease and people's lives.
So that we don't separate the two.
We've expanded it beyond the narrative
in terms of storytelling, we include all the arts.
The daily practice of medicine
is connecting to other people.
If we have that capacity, even as a person who admires art,
then can we develop those skills of empathy?
A week in a bed as a patient, what happens?
Everything from janitors coming in and turning lights on
when you're trying to sleep.
Getting food that is absolutely inedible.
Having visitors that you can't send away
because otherwise you're the creepy bad patient in room 230.
So, being a patient is really important
for a doctor to understand.
Empathy is the feeling that one might have for a patient
and compassion is the action that one uses
in order to work with that patient.
So one is more the feeling and one is more the action
which is where we get the statement, compassionate care.
So I guess my next question to you is,
if you grow up in a house where there's no expression of it,
can you learn how you can translate feelings
of empathy into compassionate care?
We look at medicine kind of like theater.
There is no script, you're improvising
with each patient at each session.
- I'm glad that you came in
and let's see what we can do to get to the bottom of that.
- It means being present, it means understanding
that empathy can mean many things.
Holding the space for someone, learning to listen.
- No, I think that might be it.
- Okay so it's just --
- That's when I noticed it.
- Okay and it hasn't been...
- Being a patient really is the best way
to understand the problems within our healthcare system.
(soft music)
I was very healthy, I was a vegetarian,
I was teaching exercise class,
I was a certified Alexandra technic teacher.
So I was teaching people how to deal with pain
and then when I was 52 years old,
a lump was in my breast through a mammogram
and I was pretty shocked.
At first I like made a joke of it
because it was not easy to accept.
I stopped making a joke after the first day.
It wasn't funny.
I was aware that medical ease,
even though I'm very smart,
did not make sense when I was panicked.
I felt like doctors would come into my room
and walk out without making any kind of connection.
My nurses during chemotherapy and radiation
and surgery were amazing
because people go into nursing
if they have a sense of empathy or compassion.
But doctors need to be trained in that too.
Being ill is hard enough.
If there are ways that we can make being ill easier
for people, it makes a real difference.
It's not expressed in every culture,
it's not expressed in every family unit.
Can you learn it by absorbing art?
And you might think well, you know, I'm not an art person.
I'm a science person,
as though the brain is split in two so clearly
that we can't absorb both of those concepts.
Even if you are a listener, a watcher,
what are your art forms?
What do you like?
- I like to read.
- Aah now to me, reading,
I mean talk about absorbing other cultures, empathy,
understanding by looking at what we call close reading
in our work here, how do you read between the lines?
Which is what you gonna be doing with patients all the time.
What do you like?
- Country Western Dancing.
- Oh great, did you know that about him?
You do now.
(laughing)
- So when you first presented this question,
I thought of the food program I run.
We take produce that's been rejected
and we save approximately 30 million pounds
of fresh produce and I just...
- This is going beyond traditional training
and a lot of seasoned doctors and faculty members
say why reinvent the wheel,
we've been doing it like this for years.
And my argument there is we've been doing it,
but a lot of people have gotten hurt through this process.
Have had illnesses perhaps that were overlooked
or that were caused by inadequate communication.
So, I think this is absolutely necessary,
especially as technology becomes so much more a part
of healthcare, that we cannot lose the humanity,
the humanness in the medicine.
- Okay, what if it's like a person stroking down into water
and it's just somebody swimming
and you can't even see their body over here.
- Oh.
- Yeah.
(laughing)
- Yes, considering all images we've seen.
- This is like a clock or something.
This is the hour hand, it's almost back up to 12.
It's the cycle of the day.
- I honestly think it's just, whatever medium...
- Something we look at at the beginning of session one
where we're focusing on visual arts.
We look at the traits, characteristics that are similar,
the skills that a physician needs to know.
(crowd chatting)
And an actor needs to know, but also a dancer,
or a musician.
Can you hear more than one sound at a time
when you're listening with a stethoscope?
- We were wondering
if either it was age causing the wrinkles
or if they had been in the water for a long time...
- Those skills that you know as appreciators of art
are similar to the skills
that you will have to learn as medical practitioners.
So, I can throw out one example.
A person who sculpts,
the shared skill with you learning to be a physician
is that you both need to know anatomy.
It's made out of glass and ceramic.
It was made by a patient whose name is John Woos.
It's called "Imperfect Bone Origin".
- When you really start looking at the position
we notice he's kinda like relaxing.
He or she, the skeleton is like --
- Could you tell the gender?
- I'm sure I'm supposed to but no.
(laughing)
- You've got three more years to know this,
don't you worry about it.
- He was kinda like reclining.
- Okay, so this is his quote,
"It is marked with gold
and there is deformity in every location
of every fracture I have ever had.
And contains the actual plate
that was in my femur when I was a child.
This piece is a tribute to human abilities,
specifically the human ability to create and overcome..."
- You know, the hand looks sort of like the knuckles
are a little thicker and that makes me think...
- So what we're trying to teach is how to look quickly
and see a lot.
- Grasping, grasping for an object
or for something greater, you know.
(laughing)
- I want students who have been told for a very long time
that they are perfect, to get rid of that
and to have a little humility and look at themselves.
- Kind of a physician unveiling that art form
and at least for us we're thinking
about how much training we're getting...
- This is the time to know yourself.
This is a time for reflection
because in medical school you won't have that leisure.
It's a hard job
and that's in addition of course
to the science that they need to learn.
There have been studies, over years,
looking at how doctors respond to their experience
with medical humanities courses.
And most doctors will say,
their work is bigger than just medicine for them,
it's fulfilling in a different way.
They're happier.
Part of learning how to be a physician
that goes home at the end of a work week
and still has something left is what your boundaries are.
There needs to be a knowledge before you begin this work
of what you can give
and I think knowing what you can give
and still stay whole is really important.
So, thank you and I'll see you again
at the end of the semester
for a different kind of workshop.
Take advantage of being here, you know,
not just sitting in those very dark classrooms
that you have.
(crowd chatting)