New arts and humanities center aims to feed the soul of those who care for the body
The news from poems—This fragment of a poem by William Carlos Williams would be a perfect medical school course title, says Mary Faith Marshall, Ph.D., director of the new Center for Medical Humanities and the Arts at the University of Minnesota Medical School.
It is difficult, Williams wrote, to get the news from poems/Yet men die miserably every day/for lack/of what is found there.
That is to say, poetry may be less practical than the news, yet our spirits are diminished for want of it. Williams, who was a doctor by day and poet by night, understood the importance of ministering to both body and soul.
Feeding the soul of those who care for the body is the new center’s mission. To that end, Marshall and Jon Hallberg, M.D., the center’s medical director, will forge links between the Medical School and the College of Liberal Arts, and draw on the resources of the Twin Cities’ vibrant arts community. Their task is to make room for the right brain in the left brain-dominated world of medicine.
“Medicine is not just about science,” says Deborah Powell, M.D., dean of the Medical School, which provides funding for the center. “Medicine is about human beings caring for the health and wellness of other human beings.” The arts and humanities are key to nurturing, what Powell calls “the humanness of medicine.”
Both Marshall and Hallberg credit Powell for supporting the center, which is currently housed in the Center for Bioethics, where Marshall has a part-time appointment as a professor. “I loved the idea of this center,” Powell comments. “Deans can supply resources, but it takes dedicated faculty champions to make something happen.”
A new focus
Nationally, the idea of injecting a dose of humanities into the medical curriculum coincided, some 50 years ago, with a movement toward primary and patient-centered care. Over the next 30 years, more than 90 U.S. medical schools introduced the humanities into their medical curricula, according to the Association of American Medical Colleges.
Many of the early programs had a literary bent. One of the best known, the Program in Narrative Medicine at Columbia University in New York, required all second-year medical students to study literary texts as a way of learning to “read” their patients’ stories. Proponents contend that honing a literary sensibility enhances one’s clinical skills. In theory, a doctor who can read fiction is better prepared to listen and follow the narrative thread of a patient’s story. Similarly, it has been argued that learning to view a painting can sharpen a physician’s observational skills.
Minnesota’s program will expand on those early ideas, says Hallberg. “Mary Faith and I are trying to break the mold. We don’t want our program to be like any other.”
“We want to effect a culture change—to expand our notion of health and social justice,” adds Marshall, who is also a professor in the Department of Family Medicine and Community Health and associate dean for social medicine and medical humanities in the Medical School.
For starters, they plan to embrace all of the arts—music and film, as well as literature—and history and social science. Hallberg and Marshall envision a large-scale collaboration with area arts organizations, including the Weisman Art Museum, Walker Art Center, Minnesota Opera Company, Guthrie Theater (Hallberg is company physician), and perhaps even local bookstores and Minnesota Public Radio (where Hallberg regularly reports).
At the same time, the center will play muse to the artists. Currently, Hallberg is working with the American Composers Forum in St. Paul to establish a composer in residence at the Medical School, perhaps the first program of its kind in the nation. The plan is to invite a composer to take part in all aspects of the medical school experience, from patient care to end-of-life decision-making—the idea being that immersion in the medical culture will inspire a musical composition.
A strong foundation
Much of the groundwork for the center has been laid by Hallberg, who left private practice in 2001 to find a place where he could match his passion for medical humanities with his interest in education.
As assistant professor in the Department of Family Medicine and Community Health, Hallberg quickly put his arts and medicine plans into action by inviting Guthrie actors to perform Miss Evers’ Boys for the Medical School’s Physician and Society course, which deals with everything from bioethics to spirituality in health care. Hallberg acknowledges that bioethics can be taught more conventionally. But he says Miss Evers’ Boys, a play by Medical School alumnus David Feldshuh, M.D. ‘79, about the notorious Tuskegee syphilis experiment, delivers a message about research ethics in a way that a standard lecture can’t.
At its simplest level, the Center for Medical Humanities and the Arts will serve as a clearinghouse, informing the medical community—via a website—about local arts happenings.
Besides publicizing events, the center will also create them, as it did last fall, when it cosponsored programs featuring Medical School alumna Joia Mukherjee, M.D., M.P.H., and Pulitzer Prize-winning author Tracy Kidder. Mukherjee is an advocate for health-care rights and medical director of Partners in Health (PIH), an international medical organization that leads community-based health programs around the world. Kidder’s book Mountains Beyond Mountains is about PIH founder Paul Farmer, M.D., Ph.D.
Many of the center’s aspirations were embodied in those events, which Marshall regards as its official launch. Aside from bringing together writer and physician, these human rights-focused events featured a performance by local jazz musicians and a photo exhibit by Need, a local magazine devoted to humanitarian efforts. It also crossed disciplines, with sponsorship by the Center for Creative Writing and the Harvard Street Forum, a joint venture of Grace University Lutheran Church, the Department of Family Medicine and Community Health, the Academic Health Center, and the Center for Medical Humanities and the Arts.
Future collaboration, especially between the College of Liberal Arts and the Medical School, is high on Marshall’s agenda. At the center’s prompting, a multidisciplinary faculty group has begun exploring joint research and scholarly projects. The trend among grant-givers, including the National Institutes of Health, is to encourage such cross-fertilization. “The more multidisciplinary a proposal, the stronger it is,” Marshall says.
The center’s long-range plans include the creation of instructional courses, some of which might be jointly taught. Marshall, for example, would like to teach a course on the blues—music, that is—which she says evince many ailments physicians will encounter in clinical practice: depression, addiction, abuse, violence, dying, and grief. “It’s all there in the music,” she says. “It’s a different way for students to understand.”
At the same time, the center might offer a writing class or a course on producing audio documentaries like those aired on National Public Radio, says Hallberg, who favors an elective approach. “As passionate as I am about the humanities, I find it hard to force too much on anyone,” he says, adding, “You can’t create an empathetic student. But the center can create an atmosphere to nurture and foster humanistic impulses.”
Students need that reinforcement, says Cuong Pham, a fourth-year medical student and cofounder of Harambee, a cultural arts celebration for medical students. “A lot of students love humanities and arts. They were in liberal arts before medical school and lost that along the way. It’s important to keep them in touch with their own humanity.”
But does it work?
Does a grounding in the arts make better doctors? Nobody knows. Marshall intends to conduct research to determine whether an interest in the arts and humanities has any effect on clinician performance. Whatever the findings, the center fills a big hole. “The center,” says Pham, “is very important for medical students and an opportunity for our university to show that medicine is much more than drugs and procedures. It’s also about compassion and empathy.”
As Hallberg puts it: “No matter how technologically based and oriented we become, no matter how focused on the molecular basis of disease, medicine will continue to be as much an art as a science. Our center will remind us of that. Thinking broadly, reading widely, being curious about the world and people who inhabit it, those are all essential to creating compassionate and caring physicians.”
Surely, Williams, the physician-poet, would agree.
By Miriam Karmel