Always a Nurse
Cheryl L. McLeanDelivered as part of the keynote address to the Alberta Psychiatric Conference
Banff Alberta 2014
The creative arts can relate to many forms of the arts embodied in action and practice among them (but not restricted to) drama, dance and musical performance, visual arts, writing, publishing, graphic arts, cartooning, film, multi media and design.
To be humane is to have or show compassion or benevolence.
Being concerned with the alleviation of suffering.
To interact with care, consideration and respect.
the word medicine is from the Latin ars medicina, meaning the art of healing.
Broadly speaking the practice of medicine is to be
active in the prevention and treatment of illness.
"Creative Arts in Humane Medicine takes us on a fascinating journey to meet the educators, clinicians, support workers and artists who apply arts-based methods in innovative ways to enhance patient care, reflexivity in learners and a sense of community, and well-being in practitioners. The book stands out with an emphasis on multiple media (theater, music, visual and digital imagery, literature and reflective writing), as well as the inclusion of international and interprofessional perspectives."
Allan D. Peterkin, MD, FRCPC, FCFP -- Head, Health, Arts and Humanities Program and Humanities Lead, Undergraduate Medical Education, University of Toronto
"Some have said that medicine, rather than being a science, is really an interactive process. It is informed by science but also dependent on psychology, sociology, philosophy, law and human creativity. McLean’s book should be a must read for those responsible for medical education...so that in the end the human connection between healers and those they heal is enhanced."
Michael Gordon MD, MSc, FRCPC -- Medical Program Director, Palliative Care, Baycrest Geriatric Health Care System; Professor of Medicine, University of Toronto
"Cheryl McLean's Creative Arts in Humane Medicine is a fascinating collection of essays that evocatively illustrates the importance of literature, music, photography, and art in facilitating self-care and awareness among health care providers, training empathetic physicians, and improving patient care."
"Creative Arts in Humane Medicine is a graceful and important book that offers a groundbreaking, inspiriting engagement with issues such as empathy, empowerment, ethics and evidence, explored by a rich cast of inter-professional authors such as artists, educators, clinicians, and researchers. Through a collage of creative arts methods and messages, these authors illuminate the essence of the “human story of health care” as loving, healing and humanly embodied—an essential message in an era of highly institutionalized technical health care. A must read for academics, researchers, clinicians, and students interested in creative healing arts, narrative health and humane medicine, or for anyone interested in the application of reflection and curiosity, creative expression and arts-based methods to the field of healthcare."
Sue MacRae -- Registered Nurse, Clinical Ethicist, Psychotherapist, Former Deputy Director University of Toronto Joint Centre for Bioethics
Distributed by University of Toronto Press
This publishing project has been a year in the making and it has been a busy month working with the team at Brush Education on last minute editing details for our upcoming book Creative Arts in Humane Medicine which is expected to be released in October. As Editor of the book, Creative Arts in Humane Medicine, I have been fortunate to work with some of the best editors in the Canadian publishing industry among them, Brush managing editor, Lauri Seidlitz and copy editor par excellence, Leslie Vermeer. I want to extend heartfelt thanks as well to our talented cover designer Carol Dragich of Dragich Design (an important feature of our unique cover is the photography /artwork "Peace of Heart" by medical student and photographer Cyrus McEachern, which was featured in the Heartfelt Images exhibit at the University of British Columbia, Cardiology.) Our creative cover is, in itself, another fine example of the arts and medicine in action. CM
|Distributed by University of Toronto Press|
Creative Arts in Humane Medicine, Editor, Cheryl L. McLean, Published by Brush Education, is a resource book for medical educators, practitioners and students as well as those in the allied health professions who wish to learn how the arts can contribute toward a more caring and empathic approach to medicine.
In this collection, which features the latest research and real life examples, physicians, medical educators, researchers and allied health professionals, as well as medical students, residents, artists and others across Canada, the United States, United Kingdom and Australia show how the arts in action can contribute toward humane medicine.
To be humane is to show empathy or understanding and to care about the condition and suffering of others, to treat others as we ourselves might wish to be treated. The word medicine itself is from the Latin “ars medicina” refers to the art of healing, the practice invested in the treatment and prevention of illness. Humanistic Medicine is a growing trend today as more medical professionals integrate the arts into their practice to improve communication with their patients and build better relationships. A recent study found that close to half of all medical schools in The United States involved the arts in some form in learning activities(Rodenhauser, Strickland, & Gambala).This survey showed that the arts are used to foster student well-being, enhance teaching and learning, and improve clinical and relational skills,for example, observation and diagnostic skills, reflection and insight.
There are other encouraging signs that the arts are alive and thriving in medical education today with programs integrating the arts and humanities into medical education and leading medical schools and universities offering more programming to promote creative and scholarly work at the intersections of the arts, humanities and medicine. One Canadian effort, the Medical Humanities HEALS Program at The Faculty of Medicine, Dalhousie University, offers programming in visual parts, performing arts, the history of medicine and creative writing. Another, The Arts and Humanities in Health and Medicine Program at The Faculty of Medicine and Dentistry at The University of Alberta, launched in May 2006, has a mandate to balance scientific knowledge and compassionate care. Its mission statement formally acknowledges “the explicit recognition within the Faculty that clinical practice is both an art and a science”. At The University of Toronto, the Undergraduate Medical Education (UME) program, has begun to integrate different types of narrative systematically into the curriculum with a new companion curriculum.
At Yale School of Medicine, The Yale Medical Humanities and the Arts Council reports it is committed to fostering the use of the humanities, social sciences, and the arts as a lens for examining issues in health, medicine, and healing. Arts and Humanities at Harvard Medical School aim to promote the role of the humanities in medical education, clinical care and research. Stanford School of Medicine, Arts, Humanities and Medicine, has been established to promote creative and scholarly work at the intersections between the arts, humanities and medicine.
And there is growing support for the creative arts in humane medicine today coming from the medical students themselves. The AMSA (American Medical Students' Association) has over 150 chapters in medical schools across the United States and an estimated 350 pre-med chapters. Aliye Runyan M.D., Education and Research Fellow, American Medical Student Association, reports , The AMSA Medical Humanities Scholars' Program exposes students to lead faculty in narrative medicine, humanities and the arts as they explore reflective capacity, communication, self care and the art of listening to their patients' stories. "AMSA," Runyan writes, “believes it is paramount that the physician not only be a scientist but a humanist, a communicator and an advocate.”
I was recently a guest presenter for a webinar for The American Medical Student Association’s Medical Humanities Scholars’ Program. During the session a student asked, “If this work (about the creative arts in medicine) is frequently about empathy and feeling the human story, how much empathy is too much empathy? What if I can no longer bear it?” The student asked me a very difficult question, one not easy to answer. Our creative work is powerful and profound in the way it frequently uses all the senses to foster empathy and draw us closer to human understanding, but what are our human limits? If I were in bed, ill and fighting for life, I asked myself, how much empathy would I hope my caregivers would extend to me? When would enough be enough? This collection raises provocative questions and proposes alternative approaches in the hopes of inspiring new areas of investigation while opening up a larger conversation about the creative arts in medicine among students and medical practitioners.
The book, Creative Arts in Humane Medicine has been divided into four distinct and related sections. Section 1, “Educating for Empathy through the Arts”; Section 2, "The Arts in Medicine and Practitioner Self Care" ; Section 3, "Navigating with Narrative Through Life Experience" ; and Section 4," The Creative Arts in Action for Change in Health".
“It is not easy to go to work every day and care for people who hurt themselves, are going to die, cry on your shoulder, feel terrified or distrust the health care system…The arts and humanities, with respect to medicine, are about understanding how humans experience illness and disease and placing that within a context of diagnosis, treatment and care”.
Contributors present personal stories and engage with narrative in Section 3, Navigating with Narrative Through Life Experience, as well as demonstrating the applications of literature in medical practice. Dr. Rita Charon, a leader in the field of narrative medicine, has long advocated for the use of the narrative in medical education. Each of our contributors navigate with narrative or use story in uniquely different ways, however, all writers in this section share in common an underlying belief about the humanity and dignity that can be found through fostering the practitioner patient relationship. Jasna Schwind, a nurse educator, writes about her work, informed by narrative inquiry while sharing aspects of her own illness story to demonstrate how intentional and thoughtful reflection allowed her, as both patient and caregiver, to make sense of the experience. Narrative and poetic inquirier, John J. Guiney Yallop, writes in the article that follows, about his lived experiences over time with medical practitioners and, in so doing, poignantly illustrates the importance of the relationship between practitioner and patient. Catherine L. Mah, MD, FRCPC, PhD a scientist, practitioner, researcher, and teacher discusses in her article the uses of literature and the childhood novel in pediatrics practice suggesting the approach may help establish a foundation for narrative examination in the one on one interview.
In Section 4, The Creative Arts in Action for Change in Health we embrace change and the future opening with an exploration by Louise Younie, a Clinical Senior Lecturer, Barts and The London School of Medicine and Dentistry, who writes about her journey of discovery through arts based inquiry and considers the transformative influences of the arts in medical education as well as within her own work. In the next chapter Canadian activist artists Carole Conde and Karl Beveridge are featured demonstrating the arts in action for change and the power of story and photography to touch people and advocate for humanity for those who work in healthcare settings. Bandy X. Lee MD at Yale University believes that today there is a great need for collective and emotional healing. She reports The World Health Organization has noted that health is not just the absence of disease and, in terms of change, effective violence prevention may be the key to health and human flourishing and creativity. Louise Terry PhD PGCHE LLB illustrates how digital stories and technology can help teach ethics and law to health and social service professionals while contributing to humane medicine. Visual and audio technologies, she suggests, help realize and bring to life our human stories complete with actions, omissions, aspirations and values.
Our chapter closes with an exhibit from the heart as medical and fine arts students from The University of British Columbia, Canada, reach out and build bridges to understanding health and the heart while connecting to communities through the visual arts.