Mr. Donaghy is a third-year medical student, University of Michigan Medical School, Ann Arbor, Michigan.
Ms. Neill is a second-year medical student, University of Michigan Medical School, Ann Arbor, Michigan.
Dr. Clay is assistant professor of internal medicine, University of Michigan Medical School, and attending physician, VA Ann Arbor Health Care System, Ann Arbor, Michigan.
Dr. Skye is associate professor of family medicine and assistant director, Family Centered Experience, University of Michigan Medical School, Ann Arbor, Michigan.
Two Worlds Apart is a mixed-media painting created as part of a required course, the Family Centered Experience (FCE), at the University of Michigan Medical School. The FCE pairs two first-year medical students with volunteer patients and their families who are managing chronic illnesses. Students explore a humanistic and patient-centered curriculum through a series of home visits. As part of the program, students are asked to reflect on the stories of their volunteers and represent their understanding of their volunteers’ messages through a medium of their choice. Student projects have included the creation of musical pieces, interpretive dance, creative writing pieces, video productions, and visual art work, such as the painting Two Worlds Apart.
Patients and physicians experience illness in vastly different ways. As physicians, we are trained to see illness as a problem to solve, and the tools to do so are largely at our disposal. Although physicians connect emotionally with patients, their expertise requires a controlled and calculating approach that is inherently academic, rational, and detached. Conversely, our patients’ narratives illuminate the highly emotive, capricious reality of living with chronic illness.
Our project aimed to capture both viewpoints. On the right, we have depicted a physician in a tight, realistic style representing the logical, calculating diagnostician. Faintly underlying the paint is a collage of anatomical diagrams, biochemical structures, and journal articles, embodying the doctor’s “tool kit.” We drew inspiration from a specific experience in the FCE program in which our patient’s family expressed finding a reassuring confidence in interacting with a new doctor whom they considered both an astute teacher and a caretaker.
On the left, we have portrayed the patient in an expressionistic style. The strong use of color illustrates the conflicting emotions illness can evoke for patient and family. Underlying these emotions, the delicate silhouette shows vulnerability to the burdens of chronic illness. We drew inspiration from our patients’ descriptions of how illness had inundated the most prosaic aspects of their lives, challenging their sense of self and elevating the impact of their medical condition beyond the physical.
Bound down the center with sutures, the composition displays the way in which compassionate medical intervention can juxtapose these two differing worlds. With this project, we hope to shed light on the contrasting and complex relationship between illness and treatment, doctor and patient.
Acknowledgments: The authors would like to thank Sandy Presley-Dorda for photography of the original work.