Art | Medical Futures Lab

Feb 28 2015

Art Gallery

Art and Medicine

Guest posting by Rachel Marren

A classic debate in the medical community, and one particularly relevant with today’s push towards patient-centered care, is whether medicine is an art or a science. Does being a good physician result from using personal judgment in evaluating each patient as an individual or systematically following clinical guidelines? A number of studies indicate that, although it is important to generate positive interpersonal patient-physician relationships, strict adherence to protocol leads to the best patient outcomes.^[1]

But what about the role of creative art and aesthetics in medicine? Research strongly supports creative outlets such as music, visual art, and writing as expository tools through which patients can ultimately improve their health and well-being.^[2] I was introduced to the power of art in healthcare by Dr. Marcia Brennan, Professor of Art History and Religion at Rice and the Artist in Residence at M.D. Anderson’s Palliative Care Center. She works with terminal patients to help them express their thoughts at the end of their lives through words and visual art. Although the value of this work is difficult to quantitate given that these patients ultimately pass away, Dr. Brennan’s anecdotes about the serenity she helps her patients find are tremendously compelling.

Viewing and reading these pieces, there is an unbelievable beauty, one that, for me, calls attention to the lack of recognition of aesthetics in modern medicine. In a formalist sense, we can see this beauty in the following images of a bone cancer cell,^[3] a kidney stone,^[4] and a bacterium.^[5]

The haunting beauty in these images is quite apparent—they are aesthetically enchanting, and, yet, represent the pain of disease that we are all familiar with. Given that illness can be considered a central aspect of our shared human experience, I would urge healthcare providers to call upon shared experiences to build deeper—and more beautiful—connections with their patients.

[1] Pearl, Robert, MD. “Medicine Is An Art, Not A Science: Medical Myth Or Reality?” Forbes. Forbes Magazine, 12 June 2014. Web. 26 Feb. 2015.
[2] Stuckey, Heather L., and Jeremy Nobel. “The connection between art, healing, and public health: A review of current literature.” American journal of public health 100.2 (2010): 254.
[3] Burnette, Dylan T. A Crawling Bone Cancer Cell at 8000x Magnification. Vanderbilt University School of Medicine, Nashville. Nikon Small World. Web. 26 Feb. 2015.
[4] Mackenzie, Kevin. Kidney Stone. 2014. Wellcome Image Awards 2014. Web. 26 Feb. 2015.
[5] Ben-Jacob, Eshel. Paenibacillus Dendritiformis. Smithsonian. Web. 27 Feb. 2015.

Feb 28 2014

Art, Communication, Design, e-patient

Conveying information (Feat. The best infographic ever)

First things first—doesn’t anyone else find it funny that there are 10 13 new posts here in the past couple days? No, just me? Ok…

How is everyone today? I’m a bit miffed writing this, because I’m not scoring as well as I would like in this class, according to my critique and dossier grade (pre-med problems, am I right?). No biggie, I can do better next time, but I’ve got to solve a very important problem first. In our presentation, we gave a lot of information—probably too much as we went a good 2 or 3 minutes over time. Having this information is great, but the problem seems to be that we couldn’t convey it effectively. My introductory linguistics professor described it well: language is used to take an idea in one’s head and vibrate some air with some flaps in our body in such a way that another person in the vicinity can have the same idea. We could not accomplish this pseudo-telekinesis, so we didn’t do as well as we wanted.

I can guess what you’re thinking though: “Wah-wah. That’s not a real problem. How does this apply to me?” Well, I figure that if we cannot get an idea across accurately to doctors, professors, and others sufficiently, what chance do we have of getting the same (or other) ideas across to the patients that we aim to empower?

There are a couple of things we could do, actually. For one, we can work on basic presentation style, so that the information we give is more engaging for an audience. We can also make analogies. When you simplify an idea by comparing it to other things (e.g. the heart to a pump) people can get a better sense of what something truly means and can figure out implied effects or solutions of that thing.

However, one new trend that is becoming more and more used is called an inforgraphic. For those of you who don’t know what that is, it’s basically some type of image that conveys information, usually in a fun and easily digestible manner. If you want a few examples, here’s like 80 of them. Info graphics are useful because people only really read a portion of the information they encounter, according to Dr. Paul Lester in his paper “Syntactic Theory of Visual Communication” . People following instructions with infographics are much better at following them than without and adding pictograms to medicine labels increased patient compliance significantly (around 25%). And honestly, infographics are just fun. People like them—a lot. If you want to know more about why we like infographics, check out this one. I know I put up a lot of links, but you seriously should check it out.

No, seriously. Look at it. It’s pretty great. I’ll wait.

Anyway, I feel that both in our next presentation and in our solution, it would be a great idea to create some visual representation of our information. I’ve been looking up infographics and how they work so we can harness their powers for good, but honestly, this information is pretty useful for us all.

Feb 28 2014

Art, Culture, Design, Humanities, Medicine

The Art of Medicine

Is medicine a science or an art?

Physicians and artists alike have tried to answer this question for over two thousand years. The former tend to claim that medicine is predominantly a science, and that it is an art only because it involves skills acquired by experience or observation. The latter commonly say that medicine is predominantly an art, for it evolves on the basis of human values and seeks to heal above all else.

So which is it?

It’s not a science. It’s not an art. It’s both.

Effective medicine employs science to accurately diagnose and treat, but it also utilizes art to arrange our awareness of health and healing into a storied structure. This “narrative medicine,” as it’s often called, takes a medical story and unfolds it in a way that gives meaning and purpose to both illness and the experience of recovery.

Narrative medicine, however, is not the only art form to have influenced medical storytelling. Throughout history, each introduction of digitalized technology into medicine—take the X-ray, the CT scan, and the ultrasound, for example—has utilized illustrative visualization to enhance medical accuracy.

Analogous to illustrative visualization, recent development in graphics hardware has enabled the rendering of innovative medical imaging methods that are completely changing the way that we see and study the human body. These new techniques enable both photo-realism and a technical form of hyperrealism in art in which it’s possible to enhance medical visualizations to better convey information.

But medical illustration and anatomical imaging are beginning to break out of the confines of the hospital. They are beginning to crawl into the dirty gutters and cracked sidewalks of the real world in the form of something known as street anatomy.

damien_hirst_virgin_mother

(photos courtesy of http://streetanatomy.com/2007/02/15/damien-hirst-anatomical-representation/ and http://vi.sualize.us/praying_street_skeleton_graffiti_street_anatomy_picture_5Qqm.html)

Street anatomists are experimenting with new mediums, such as papier mâché, graffiti, and sculpture, to portray the human body in creative new ways. Thanks to this new form of biomedical visualization, human anatomy is no longer contained within the human body. Science no longer lives in a hospital. Take a look around and you’re bound to notice your skeletal system plastered to a telephone pole or your back muscles adhered to the side of a Metro bus. You may even discover that your heart has been spray-painted on the side of your apartment complex.

I went ahead and gave street anatomy a whirl, too. Here’s what I ended up painting:

While painting these on the concrete floor of my dorm room, I was silenced by the realization of how truly incredible the human body is.

It is a wonder of science. It is a work of art.

Jul 12 2013

Art, Communication, Design, Education, Electronic Medical Record, Prototyping, Story

Transmedia Hackathon @ OEDK!

Earlier this week the Medical Futures Lab parachuted into Matthew Wettergreen’s class in the Oshman Engineering Design Kitchen at Rice University to run a two-day transmedia hackathon inside a summer engineering design course. Our goal: explore how the visual and narrative representation of problems shapes our ability to find solutions to those problems. Students engaged in a series of experiments using different communication and representational tools to develop their understanding of how the form of representation for a problem shapes the way we analyze and solve that problem. By exploring with different tools, students saw different dimensions of their problems, which included doctor-patient communication about a variety of complex subjects, including risks & benefits of genome sequencing, end-of-life conversations, and talking about socially uncomfortable topics.

Peter Killoran started things off with a narrative medicine + EMR re-design warm-up exercise, routed through two classics: IOM’s To Err is Human (1999) and Edward Tufte’s Visual Display of Quantitative Information (1992). We spent a lot of time talking about the role of storytelling in design, and then these incredible students went about prototyping (in about 90 minutes) consumer-facing EHRs that could also be useful to clinicians. The beauty of the non-expert approach was definitely on display, as these young creatives weren’t hampered by all the restrictive protocol (HIPPA, can you hear me?) and instead could concentrate on the core message: get the patient’s story into the EMR.

Later in the day, Allison Hunter ran the group through some eye-opening visual arts exercises in flow-charts and mood-boards. The next morning, I launched the group into a session on doing things with words. We did exercises on metaphor, simile, and analogy, both textual and visual. We also worked on point-of-view as a critical dimension of design. After a final session on storyboarding with Allison, students were tasked with a problem to solve using a set of tools (written, visual, moving image, audio), and at the end of the hackathon they presented their experience of experimenting and identifying which tool best helped them develop a solution to the problem.

This was a laboratory designed to generate ideas and strategy for the Medical Media Arts Hub, and my big take-homes included affirmation (again) that collaboration across difference is truly critical to engineering design, to medical problem-solving, and to tackling the wicked problems of the world; that art+engineering+storytelling is the answer to many problems; and that listening to future users’ needs is everything. Mind-expanding experience, and fun to boot. Next time, we’re taking it public, so stay tuned – we’ll be seeking local “wicked problems” to tackle soon!

May 24 2013

Art, Design, Education, Health, Humanities, Story

Angelina Jolie: Teaching Medicine through Literature

Guest post by Olivia Banner

I’ve been thinking a lot about Angelina Jolie’s New York Times op-ed (“My Medical Choice”) because I include a section on breast cancer when I teach Literature and Medicine for pre-med students. In her piece, Jolie reveals that she underwent a double mastectomy after testing for the BRCA1 gene; she had reconstruction and implants too.

In my class, we read poet Audre Lorde’s Cancer Journals: she too underwent a double mastectomy but had no follow-up surgeries, and she criticizes the assumption that every woman will immediately want reconstructive work and implants. Lorde recounts a visit by a health care worker, who assumed Lorde would want implants and who encouraged Lorde – for the sake of her emotional heatlh – to get them. Lorde refuses the treatment, and she is very clear that within that encouragement lurks a culture that values women according to their desirability, and that assumes a woman’s emotional health will be influenced by how well she fits into cultural norms for appearance. Lorde’s story often surprises my students: many of them too assume all post-mastectomy women must want implants.

It is especially interesting to hear students respond to the health care worker’s visit, as they come to terms with what this scene reveals: many medical professionals have internalized this way of valuing women, and such encouragement reinforces cultural expectations for bodies, without actually addressing real health concerns (such as the high rate of complications after reconstruction and implant surgeries).

Many people called Jolie’s revelation brave: for some people there was bravery in undergoing the arduous surgeries themselves; for other people, it was brave of a woman whose career depends partly on her breasts to reveal that she’d had them removed. Yet perhaps the even braver choice would have been, like Lorde, to refuse reconstructive surgery and implants. To what extent, I wonder, did Jolie’s physicians encourage her this decision? This may seem a silly question — again, after all, her career has been built on her physical attributes. But it’s an important question for women generally. (A follow-up article in the New York Times stated that in fact many women feel pressured by physicians to get larger implants.

One of the issues I ask students to examine throughout our Literature and Medicine course is whether certain assumptions that we’re socialized into — assumptions regarding norms of appearance and behavior — might make it hard for them, once they’re physicians, to see the alternatives to standard treatments that patients might wish to pursue.

We examine how people make art out of their post-mastectomy bodies, through chest tattooing and other visual works, so that students can consider other ways to conceive what makes a body beautiful. What else should we be looking at?

Medical Futures Lab

Category Archives: Art