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Bouncing Back

Bouncing Back

The Intensity of EM, the Healing Power of Art

Schiller, Joshua MD; Brown, Mary Jane MD

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doi: 10.1097/01.EEM.0000532181.01230.4b
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    As members of the American Academy of Emergency Medicine Wellness Committee, Drs. Schiller and Brown share an affinity for fine art and discovered it helps them deal with stress. They recently discussed with EMN the healing powers of art for them and patients.

    Many people may think “art” and “medicine” are on opposite sides of how we think. How does art play a role in the practice of medicine? Can art exist in the ED?

    JS: There is much drama in the ED; it is a place where society's ills are played out in full—poverty, illness, trauma, addiction, incarceration...we all know this. This world makes most of our society uneasy, but it gives us a unique perspective into life's extreme offerings. In the tragedy and triumphs we witness, there lies something truly beautiful—how the human condition encounters and endures burden.

    This beauty is not necessarily comfortable; the difficulties our patients confront are not morally grounded, and they are often based on circumstances beyond their control (i.e., genetics) and by extension, ours.

    Art and literature can thrive in this space. It explores life's uncertainties that can plague us over our careers, like why bad things happen to good people or why one patient lives and another dies. When asking such questions, there are no clear answers, only perhaps more questions. What do you think, MJ?

    MJB: Art plays an invaluable role in medicine, medical care and caring, health care delivery and practice. The AMA recognizes this connection through its slogan...promote the art and science of medicine and the betterment of public health. A recent CME module from the AMA focuses on the organizational foundation for joy in medicine, and it emphasizes a national program to foster the medical humanities through discussion of literary works. The recent National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience is inviting artists of all kinds to submit artistic expressions of clinician burnout and wellness.

    I feel that art has a place in the emergency department. It can promote health and healing as an adjunct to medical therapies. It can engage family members, caregivers, and medical providers to connect and stay in the moment with each other. This could be something participatory, experienced, or enjoyed as respite.

    How can practicing physicians be prepared to capture inevitable moments of meaning?

    JS: Like MJ said, medicine is honed with active participation, and I think, similar to putting in a central line or intubation, art takes practice. Creating a narrative can be a good start to describing the importance of meaningful events in the ED. By retelling the event in the form of a story, you construct an arc of progression, with tension and possible resolution that lends itself to securing it into your memory and with emotional import.

    MJB: Physicians experience intense moments with patients during their practice. These moments can be captured or articulated into understandable meaning through artistic expressions that move, uplift, challenge, lament, restore, reset, and foster reflection. Some of my favorite paintings are Munch's “The Scream” and Van Gogh's “The Starry Night.” Like pieces of music, these famous paintings often capture the essence of what I am experiencing in the moment.

    What advice would you give to medical students considering how art fits into a career in medicine?

    JS: I remember medical school seeming like a universe unto itself—endless study, strange work hours, and always the pressure of performance. I would often feel like a ghost when I left the hospital to go home, knowing I would be back before I knew it.

    Don't forget about the world you are leaving behind. Stay connected. Even if it doesn't seem intuitive to go to a museum or read non-medical, make yourself! You could be surprised by how it can change the way you look at your work.

    MJB: I encourage pre-med students to take fine arts classes if possible and for medical students to seek out medical humanities courses. These courses can augment medical study and create enrichment through art.

    How would you inspire art to be a part of medical practice and education in your ED?

    MJB: Patient rooms could be personalized through artwork and enclosed display cases with rotating exhibits of poetry, painting, photos, and sculptures in public hallways, in EMS and staff breakrooms, and public cafeteria spaces. Submission of artwork through friendly competitions could encourage the medical staff and the surrounding hospital community to nurture and restore coherence as we encounter pain and hurt that tears at the fabric of the lives we have and the lives we treat.

    JS: I try to use references that may illustrate any number of events that occur clinically, whether it is the ambiguity of the Mona Lisa's smile or a Catch-22. Art and literature's place in the world is to reflect upon it, provoking us to ask, describe, enjoy, doubt, and discover.

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