Narrative medicine and the arts: Four perspectives on a student workshop (Essay 1)

This mini-series of short essays by Jane Hibberd, Andy Hibberd, Winifred Lee and Emily Player offers four perspectives on an innovative example of embedding health humanities within the undergraduate curriculum for medical students at the University of East Anglia. The series is published over four days (5th-8th October 2020), and each day we feature the reflections of one of the collaborators. In this contribution, the convenor of the undergraduate module ‘Narrative Medicine and the Arts’, Emily Player, who is also a Norwich-based GP, examines what student medics can gain from an engagement with the arts.
Drawing by AJ Hibberd: ‘Health Humanities Rocks’.
Introduction (by all contributors)

The workshop we discuss in this series enables students to explore what it is like to be Deaf via engagement with a lecturer’s narrative of her lived experience; this is followed by a practical introduction to print-making offering opportunities to develop artistic expressions of hearing. Over the course of this essay series, we hear from the module convenor for ’Narrative Medicine and the Arts’ (a GP and medical educator), the two individuals who deliver the workshop itself (a Lecturer in Occupational Therapy who tells her story of deafness, and a professional artist) and a medical student who attended the session.

Lino production and completed print by AJ Hibberd: part of the ‘Chaos’ series.
Lino production and completed print by AJ Hibberd: part of the ‘Chaos’ series.

At the UEA, medical students are exposed to patient stories and perspectives throughout their training. This supports their evolving understanding of the role of complex human interactions in health. There is also the option to explore medical humanities further in the second year of study, including an optional module on arts and narrative medicine. Parts of this module are delivered by people with long term conditions and disabilities – experts-by-experience – who share their healthcare stories with the students. Alongside this, we examine the relationship between medicine and the arts, exploring both liturgical and artistic expressions of illness.

As educationalists, we wanted to explore a dynamic means of delivery by combining a narrative of deafness with opportunities for students to reflect on the lived experience of hearing through the medium of art. In writing up our reflections, we have come to recognise that, as individuals, we often spend large amounts of time working alone or in silos, and sometimes feel defined by our professional identities. However, interacting with other creative people from across the disciplines generally enables inspiring projects, such as this one, to emerge. For this project, we chose lino-cutting and print-making for the practical element of the session, because they afford rich opportunities for drawing upon, and developing, the coordination skills of the trainee doctor via processes of observation and hand dexterity. Furthermore, they introduce the patient-narrative in a form outside of language, offering a way of knowing and communicating through art.

The session content was delivered as follows:

  • a narrative of deafness was presented by an expert with lived experience;
  • a brief introduction to printing was offered, followed by a practical session of print-making;
  • the session ended with the production of the students’ prints and time for reflection and debrief.
The Marliyn Print Press is a Furnival Stop Cylinder Printing Press C1884. It is privilege to use it, given its history; it has not been used in decades. The image features AJ Hibberd.

Reflections from the module convenor – Emily Player

Facilitating and teaching on this module is a pleasure. It is something I am increasingly passionate about particularly when reflecting on my own medical education and journey to working as a general practitioner (GP). Throughout medical school and through the transition to my junior doctor years, I was content following protocols, guidelines and science as an approach to medicine. During my first job as a trainee GP, I realised that something was missing. I struggled with simultaneously listening to patient narratives, and attempting to regurgitate what I digested into a guideline or medical model. I was juggling too much: I was trying to remain empathetic whilst inside I felt that I was managing vast uncertainty; I was trying to work in partnership with patients but often taking on too much myself and in the process I felt I was failing us both. I would find that there was nothing in my doctor’s bag, prescription pad or computer to help me help many of the patients I was seeing, which left me feeling frustrated and unsatisfied, like I was not doing the job I trained for, or being the doctor I hoped to be. I was fortunate to have a supervisor who introduced me to medical humanities. Over time, I have used literature and the humanities to develop a better awareness of myself and appreciate the human skills which can help me both to help patients and understand the art of medicine. I recognised my scientific and analytical brain trying, failing and disliking myself for attempting to problem-solve ‘the human’. I started to embrace other ways of knowing such as art and literature, using life drawing to see differently and narratives to truly hear a different perspective.

An image of a doctors bag. I am ever hopeful for the Mary Poppins experience when I open it, and am often left disappointed. Image by AJ Hibberd.

Providing this module feels like passing on a gift which was given to me. In truth, I do very little as a teacher on this course, the art and the narratives speak for themselves. In this session I observe the students exhibit two skills: firstly, listening to a story, a skill which is essential for all doctors. Secondly, they create something, a piece of art, which, from my observation, provides a meditation for their busy minds and an opportunity not to fix, read or cure but to create and express. Having worked with experts-by-experience (patients who are expert in their illness or narrative through lived experience, who work with healthcare professionals to co-produce research and education) in the field of medical education for 4 years now, I can see the therapeutic benefits of involving experts-by-experience in the medical curriculum, both for trainee doctors and for the patients who do this work. It increases students’ understanding of the varied and unequal experiences people have of accessing healthcare, and goes some way towards addressing the power imbalance between the doctor and patient which exists historically within paternalistic medical models. Something happens to create unity in the room when we all work to create an art object whilst sharing skills and stories to ultimately learn from each other. William Osler, a famous medical educationalist, has many quotations which express this:

‘He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all’

The doctor patient relationship is a complex one, with power dynamics running through it. Reminding student doctors of Osler’s words early on in their training can enable us to address this issue. Image by AJ Hibberd.

References

Sturdy S. William Osler: A Life in Medicine. BMJ. 2000;321(7268):1087.

Dr Emily Player is a GP based in Norwich in the UK. She completed an academic training in general practice and now works as a GP in a city practice and carries out some sessional work at the vulnerable adult service in Norwich. Academic interests include health inclusion, health humanities and medical education.

2 thoughts on “Narrative medicine and the arts: Four perspectives on a student workshop (Essay 1)”

  1. Great workshop! I wondered whether you were going to attempt to adapt it for online delivery? Asking as someone mourning the loss of tactile engagement with arts practices in my health humanities classes that are having to be delivered remotely.

  2. Hello, thank you for your comments on our collection of essays, we are glad you enjoyed reading them. Yes, we may well indeed need to consider adapting for online delivery and we are happy to liaise with you re the outcome of that if helpful? Absolutely agree with you re the loss of tactile engagement – this is where we all need to be even more creative in order to achieve this online!
    Kind regards
    Jane, Emily, Andy & Win

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: