Narrative medicine and the arts: Four perspectives on a student workshop (Essay 3)

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 post, the third in the series, Andy Hibberd discusses the embodied skills involved in creating visual art and their relevance to medics, as well as reflecting on the potential health benefits of making art.

Reflections from the Artist – Andy Hibberd

My part of the group session was to run a lino block production and print-making workshop. This involved overseeing the medical students who were instructed in the technical side of lino-cutting – tool-handling and health and safety as well as a demonstration of print production. I also brought along some hand-finished lino blocks of my own design, plus the associated artwork leading to finished prints. I begin this piece with some reflections on my own experience of the creative process before describing my sense of what the session contributes to medics’ learning.

Thinking through dynamic means of embedding the medical humanities within the curriculum. The image features AJ Hibberd.

Drawing – a skill I rely upon heavily – usually starts my creative process and changes my perception of everyday objects and ideas. Translating these ideas into physical media such as block-printing takes me further down a pathway which often results in a change to my mental state: maybe a calming one or alternatively an excited, energised one. There is no hard and fast rule, it probably depends upon the subject matter and the ideas emerging as I become drawn in.

Completed print by AJ Hibberd, depicting an example of negative space.

Generally, I experience a heightened sense of awareness particularly of form, and its relationship to an object and its surrounding negative space. This is not just observed but can be sensed in an almost physical way. I can only describe it as an ethereal feeling of being sucked into the objects that you are observing. Reflective surfaces carry imagery which can often be overlooked. By relaxing and looking deeper suddenly you can be drawn into a different state of awareness – ’seeing’.  This is an observational technique passed onto me by a valued mentor, which I now use in my teaching. I have experienced what is termed as ‘flow’, a pleasant meditative state of being (Csikszentmihalyi, 2000).  Two hours of concentrated work has made time appear to flash by without me noticing. (The last time I looked it was 10.00am and now it is midday!).

Flow Drawing by AJ Hibberd – an original design.

Our innovative session, combining a narrative of lived experience of disability and an introduction to print-making, was designed to enable students to develop some of the skills and attributes that are essential to being a doctor, but which may not be so easy to develop through the academic elements of their course:

RECEPTIVITY AND MOOD: I believe that the engagement, initially, with Jane’s lived experience of deafness, and then later with the prospect of producing a reflective piece of art, creates the potential for receptivity and responsiveness in students taking this session, perhaps mirroring my own experience of creativity. The concentration involved in using unfamiliar artistic techniques, including the development of hand-eye coordination, can have a calming effect. The process of producing a design, making a physical printing block, applying ink and taking a print is exciting, and often the result unexpected. This meditative state of concentration and being in the present moment, in the now, or mindfulness, is something often recommended to healthcare professionals for maintaining wellbeing and resilience – although in practice, it can be very difficult for busy healthcare professionals to find time to cultivate these states.

AUTONOMY: Students were encouraged to reflect on the narrative of deafness during the artistic phase of the session. Some chose to create visual representations of deafness, others created their own themes. Crucial, perhaps, was the sense that students had free rein to create what they wanted, reflecting the trajectory towards autonomous practice as a healthcare professional.

EMPATHY: Doctors’ awareness and empathy is crucial to their ability to understand patients and treat their needs. Therapeutic engagement with the arts and crafts can help develop such skills, affording time and space for thoughtful reflection, and stimulating personal and professional growth as a healthcare profession student. Perhaps, when they become doctors, the development of these skills will help this generation of students relate to patients with hidden disabilities. As children we learn to look; my experience has allowed me to reengage with looking and seeing. Sometimes, looking and seeing are not the same.

PROFESSIONAL SKILLS: Engagement with the process of lino-cutting and print-making can help to engender a range of invaluable skills including observation, hand dexterity and communication. Doctors have to learn to deploy a range of highly developed skills to aid their diagnostic and therapeutic interventions with patients.

SENSORY ENGAGEMENT: Almost all of the senses are engaged by this practical, creative work: an artist’s touch (muscle memory in regard to tool-handling), smell (ink and paint), hearing (concentrating or working outside allows natural sounds to influence mood and ultimately the creative processes). Of course, eyes are deployed as well, but differently – focusing on multifaceted images, the effects of light and shade.  Observations are made by doctors and artists alike; we all see differently. Perhaps with a disability, different senses are used in different ways? I suspect awakenings can still occur to enhance the creative experience. Commenting on the importance, for health care professionals, of drawing upon and trusting the senses to inform clinical reasoning, Bleakley et al (2003: 547-548) acknowledge that ‘novices typically follow rules and protocols to reduce perceived risks’, and a ‘lack of clinical experience’ can mean novices

fail to trust the evidence of the senses (‘seeing is believing’). Rather, the textbook example intervenes. In other words, what is ‘seen’ is firstly in the mind (the received illustration or description) and secondly in the perceived patient, specimen, or image. (Bleakley et al, 2003: 547-548)

Cultivating the art of using one’s senses, through the medium of an art-based activity such as our session, can help students to generate a heightened awareness of tuning into their innate untapped resources. Knowing themselves and trusting themselves, relaxing and ‘seeing’ will come with experience.

 

References

Bleakley A, Farrow R, Gould D and Marshall R (2003) Making sense of clinical reasoning: Judgement and the evidence of the senses. Medical Education,  37: 544-552.

Csikszentmihalyi, M. (2000). The contribution of flow to positive psychology. In J. E. Gillham (Ed.), Laws of life symposia series. The science of optimism and hope: Research essays in honor of Martin E. P. Seligman, Templeton Foundation Press (p. 387–395).

Andrew Hibberd is a fine artist, printmaker, carver and author. As an associate tutor, he has taught on several programmes at the University of East Anglia, using his expertise as an artist in health education contexts. Educated at the prestigious City and Guilds of London Art School, he combines the disciplines of painting, printmaking, carving and sculpture, creating unique, multi-media three dimensional pieces and editioned prints. His book Letter Carving is sold internationally.

www.andyhibberd.co.uk

Instagram @andyhdesign

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