By Gina Shaw
February 18, 2021
Article In Brief
Nita Chen, MD, a senior resident in neurology, discusses her passion for art, the cartoons and doodles on her Instagram account, and the things that drew her to neurology.
Nita Chen, MD, a senior resident in neurology at the University of California, Irvine Medical Center, plans to pursue a movement disorders fellowship at the University of Florida in 2021. Dr. Chen said that her choice was sealed by her encounter with a patient who had had deep brain stimulation and shared how it had transformed his life. Also transforming, she said, has been the role that art has played in her life. She has since childhood always pursued things artistic—whether learning new crafts or creating anime comics or cartoons depicting family members. In medical school, she used illustration and diagrams to help learn anatomy.
“I would draw things out to help me memorize and understand them,” Dr. Chen said.
Over time, Dr. Chen has built up a collection of medicine-related comics and doodles, which can be found on her Instagram account at @neurologicalpanda and at in-House, the UCI peer-reviewed publication for residents and fellows (https://in-housestaff.org/author/nita-chen).
She spoke to Neurology Today about her passion for art and the things that drew her to neurology. Her comments are excerpted below.
Does an interest in art run in your family?
I started with mostly arts and crafts when I was little, and took basic art classes like sketching and still lifes. My dad is an engineer and my mom is an English teacher, and they are both creative in different ways and were very open to me pursuing all my interests, so I took lots of both art and science classes as I was growing up. My brother is also very creative and we used to do a lot of art projects together. We'd come home with things we had collected from nature, like leaves and branches, and make scrapbooks from the things we'd collected and make drawings of them. We were also very into amphibians when we were kids, and we would do a lot of sketches of tadpoles and drew the process of development.
How did your doodling style evolve?
My brother and I were both into manga and anime growing up, and we were also really big doodlers. He and I would often exchange doodles in school when we were in different classes: “This is what my boring teacher looks like.” There was a lot of that. And he and I would draw pictures of our parents when they were angry and yelling at us, and then show them later when they weren't mad, and they'd make fun of each other. They'd both keep stacks of our doodles. I'd show my dad pictures of my mom when she was lecturing us, and he'd say, “See, this is what you look lie when you're mad. Very unattractive!” So then my brother once drew a picture of me crying when my dad was trying to teach me math, a very grumpy looking man and a teary little girl, and my mom told him, “See! You're a tyrant too!”
“You shouldn't have to be miserable and go through such terrible things to be successful. When we become more senior, we forget how hard it was. Documenting that process, and then going back through my art, is a good reminder to have compassion not just for our patients but also for ourselves and our colleagues.”
—DR. NITA CHEN
As I got older, I started reading a lot more different types of web comics, graphic novels and things like that, and it helped influence my art. A lot of it was very observational and continued to be. I would enjoy sharing it with my friends.
How did you decide to become a doctor, and specifically a neurologist?
I had enrolled in a lot of science camps when I was younger. In sixth grade, we dissected and labeled a fish and I came home and told my parents I wanted to be a doctor. They were like, “Yeah, okay, sure.” They didn't really believe me but they saved money just in case I was serious. In ninth grade, we dissected a fetal pig and again I came back and told my parents I wanted to be a doctor, maybe a surgeon. They still didn't really believe me. Because I was also so artistic they thought maybe I'd be a science teacher. I also thought that the brain was the most interesting part of that dissection, so my mom sent me an article about the mind and multitasking and how different parts of the brain work, and my ‘mind was blown,’ for lack of a better way to say it. I decided that the brain was the coolest organ so I wanted to learn more about it. To this day, my mom still says it was her influence that led me to become a neurologist.
What shaped your interest in movement disorders?
Early on in medical school I thought I wanted to be a neurosurgeon. I love doing things with my hands, and neuroscience plus hands is neurosurgery, right? That's not how it worked out! I started shadowing neurosurgeons and decided it was too scary. And I like it when my patients are awake and can talk to me, so I gradually shifted from neurosurgery to neurology. But one neurosurgeon whom I shadowed, Dr. Julie Pilitsis, helped shape my subspecialty interest in movement disorders. She is a functional neurosurgeon specializing in deep brain stimulation [DBS] for Parkinson's and other movement disorders, and she gave me the opportunity to work on research projects and observe her surgeries. Dr. Adolpho Ramirez-Zamora was the neurologist who performed intraoperative monitoring during those operations. He coerced me to the dark side—or the cool side, as we neurologists like to call it. He also served as my mentor for the rest of my medical school. Coincidentally, he has moved to University of Florida in recent years, where I am going to start my movement disorders fellowship in 2021! It will be exciting for us to be reunited.
Did you draw a lot during medical school and residency?
Oh yes! During the first year of medical school, of course we had to do a lot of anatomy and dissections, and the way I learned was drawing these diagrams over and over again. And the habit of drawing boring teachers or funny scenarios never went away either. We would share our class notes a lot on the medical student Facebook group, and some of my notes had doodles on them, which my classmates enjoyed and would share around. One of the senior medical students was really into writing and created an online newsletter, In Training, that welcomed a lot of artwork and reflections that med students wrote. I got very involved with that.
During my third and fourth years of medical school, while doing rounds, I always had a notebook in my pocket and would draw things I felt, interesting things I experienced, funny stories that I heard. It was mostly for myself, but other people would see them and pass them around and commiserate.
Drawing and sharing my art became even more therapeutic for me during residency. It's like, “Oh, you feel like this too?” We all go through these difficult times, feel stupid during rounds, have embarrassing moments, struggle with specific patients, and have amazing and horrible experiences. Residency is a unique experience. You have the privilege of working with patients at their most vulnerable, but it's also incredibly difficult, a lot of responsibility, and stressful. A lot of things are expected of you that you didn't know that you could give. Sharing my art has allowed me to understand myself and others as we go through these rites of passage.
When did you decide to start sharing your art on Instagram?
What turned it into a more formal thing for me happened during my intern year. I had a block of night shifts on the ICU, which is a very stressful place. It's very busy sometimes, and other times dead quiet. One night we had a very complex patient with a big stroke at the base of his brain, and he needed to see a surgeon right away, but the hospital I was working in that night didn't have a stroke surgery service, so we were trying to get this patient transferred. It was Martin Luther King weekend and hospitals were full. We were calling places and begging them to take this patient as I watched him deteriorate in front of my eyes. At midnight, we finally got a hospital to take him, and worked on keeping him stable to get him there—only to find out when we called back at 2 am that they had given his spot away. It was so devastating. We were helpless. He was a younger man with a girlfriend and kids asking me, “Is he going to be okay?”
And I knew he wouldn't be. He experienced devastating brain damage and later passed away.
I drew a diary with diagrams about this, because there was no other way for me to express how devastated I felt. There's a lot you can do to help your patients, but a lot you cannot do. It's so frustrating when you know there is treatment but logistical and administrative barriers are in the way. That's why aspects of my doodles and comics have resonated with people, I think.
So then my third or fourth year of residency, I started posting this and other drawings on Instagram, after a colleague suggested it. It's been a nice way to keep in touch with former colleagues, but I've also had a few people that I don't know from medical schools and nursing like the drawings.
Why do you think they resonate with other medical professionals, and why are they so therapeutic for you?
Not just doctors but people at all levels of health care can relate to these struggles. As I progressed through residency, I found that it's difficult to maintain that humanism. It's easy to become jaded, bitter and upset. I've heard attendings say things like, “If you haven't cried and shut down after a long day of work, you're not a doctor yet. If you're sleeping more than six hours at night, you're not working hard enough.” Why though? That's not what marks a good physician. You shouldn't have to be miserable and go through such terrible things to be successful. When we become more senior, we forget how hard it was. It's important to remember how you feel about something in these circumstances. I'll go back and look at my previous art and cringe at how it looks, but I'll remember those feelings of vulnerability.
Documenting that process, and then going back through my art, is a good reminder to have compassion not just for our patients but also for ourselves and our colleagues.