Creating Space

Categories: Care.

None of these are phrases or statements that would be commonly heard in the corridors of many academic medical institutions, but they were proposed and discussed at the Creating Space IV Symposium at the Chateau Laurier in Ottawa, Ontario this past weekend. The symposium was the antecedent to the 2014 Canadian Conference on Medical Education (CCME), taking place April 26-29, which hosts the largest gathering of medical educators in the country. The symposium focuses on the health humanities; arts based teaching and social sciences scholarship across Canada. What made the symposium unique this year is that it was coordinated and presented by a palliative care physician, Dr. Pippa Hall, who was also one of my teachers and mentors in the field.

Within the first 2 sessions, presenters questioned the importance of the symposium’s own existence, asking “why do we care about humanities in health?” and “does it even matter that we’re here?”, and proceeded to take the next 36 hours to answer that question with a series of presentations and workshops designed to highlight the role that humanities have had in the development of well-rounded health care providers, especially those that participate in the care of patients at the end-of-life. An example of this was a special workshop held at the National Art Gallery called “The Art of Being Human,” a one hour presentation of several of the gallery’s most famous works, depicting scenes from biblical times (the ascension of Mary), historical events (the fall of General Wolfe on the Plains of Abraham), and some contemporary pieces as well (the statue Jim Revisited).

So was there a purpose to this besides cultivating an appreciation of art and art history? In fact there was, and perhaps beyond what many might expect. With didactic techniques, the instructor used the featured pieces to get the participants to employ their skills of perception and intuition to interpret meaning and context. Similar to patients that we may see in clinical practice that are, for various reasons, unable to communicate their specific symptoms to us, we must often use these skills of discernment to appropriately assess and treat patients in many instances. There are many things that we can tell from looking at faces, postures, colours, and background. The exercise also underscored the importance of taking the time to observe the layering, textures and subtleties that run through many of the complex patient and family dynamics that health care providers must navigate on a regular basis. This certainly applies to all fields of health, but is perhaps particularly palpable in palliative care.

It was obvious that all of us had certain gut feelings or instincts when we first saw a work of art. Similarly, health care providers will notice or relate to certain aspects of patients, their families and their presentation, which may lead us to respond or react in a certain way. This is especially important in light of the findings that, for many medical learners, much of their empathy is lost by the end of their training. Is it possible that a trip to the museum can help to regain it?

Well maybe, but certainly the answer is more complex. In a larger context, however, such activities may help to enhance our ability to interpret stories, and to see patients in the context of their own story, which is what makes the care of patients a human and humane endeavour.

And at the very least, it was not a bad way to spend a rainy Saturday afternoon.

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