Monday, December 13, 2010

Comics & Medicine: The Sequential Art of Illness

Comics & Medicine: The Sequential Art of Illness conference

9-11 June 2011
Northwestern University Feinberg School of Medicine
Chicago, Illinois

This second international interdisciplinary conference* aims to explore the past, present, and possible future of comics in the context of the healthcare experience. Programs in medical humanities have long touted the benefits of reading literature and studying visual art in the medical setting, but the use of comics in healthcare practice and education is relatively new. The melding of text and image has much to offer all members of the healthcare team, including patients and families. As such, a subgenre of graphic narrative known as graphic medicine is emerging as a field of interest to both scholars and creators of comics.

We are pleased to confirm two important keynote speakers: David Small, author of 'Stitches' and Phoebe Gloeckner, author of 'A Child's Life'.

We invite proposals for scholarly papers (15 minutes), poster presentations, and panel discussions (60 minutes), focused on medicine and comics in any form (e.g., graphic novels, comic strips, graphic pathographies, manga, and/or web comics) on the following—and
related—topics:
  • graphic pathographies of illness and disability
  • the use of comics in medical education
  • the use of comics in patient care
  • the interface of graphic medicine and other visual arts in popular culture
  • ethical implications for using comics to educate the public
  • ethical implications of patient representation in comics by
  • healthcare providers
  • trends in international use of comics in healthcare settings
  • the role of comics in provider/patient communication
  • comics as a virtual support group for patients and caregivers
  • the use of comics in bioethics discussions and education
We also welcome workshops (120 minutes) by creators of comics on the process, rationale, methods, and general theories behind the use of comics to explore medical themes. These are intended to be “hands-on” interactive workshops for participants who wish to obtain particular
skills with regard to the creation or teaching about comics in the medical context.

We envision this gathering as a collaboration among humanities scholars, comics scholars, comics creators, healthcare professionals, and comics enthusiasts.

300 word proposals should be submitted by Friday, 28 February 2011 to submissions@graphicmedicine.org. Proposals may be in Word, WordPerfect, or RTF formats with the following information and in this order: author(s), affiliation, email address, title of abstract, body of abstract. Please identify your presentation preference: 1) oral presentation; 2) poster presentation; 3) panel discussion; or 4) workshop. While we cannot guarantee that presenters will receive their first choice, we will attempt to honor people’s preferences,
and we will acknowledge the receipt of all proposals submitted. Abstracts will be peer-reviewed by an interdisciplinary selection committee. Notification of acceptance or rejection will be completed by 14 March 2011.

This event is co-sponsored by the Medical Humanities and Bioethics Program at Northwestern University Feinberg School of Medicine, the Department of Humanities at Penn State College of Medicine, and the Science, Technology and Society Program of Penn State University, and
is supported by a grant from the Charles Schulz Foundation.

*Information about the 2010 conference, “Comics and Medicine: Medical Narrative in Graphic Novels,” in London, England can be found at www.graphicmedicine.org.

Tuesday, November 23, 2010

Poetry in spam

As spam detection for blogs gets more sophisticated, some companies have taken to employing individuals to write realistic looking comments on blog postings, with a link to their business, embedded in it somewhere. I spend more time deleting spam than writing postings. But a spam comment cropped up this week which I feel qualifies as 'found poetry'. The formatting is mine, but the words are attributable to one Rizwan Ali, whom I hope is earning a living wage (or should that be 'learning a waving age') from the essay mill that employs him. I particularly like the 'endearing play' (which Wit undoubtedly is).

Medical conference mash-up

The conference will be supported by a rumor
at the British Museum in the fields
of the humanities and medicine, which explore
representations of, and the American TV
drama based on the Pulitzer Prize-endearing play
by Margaret Edson,
directed by Nike Nichols and
the Kent, Surrey and Sussex Medical Deanery.

It takes part over two living –
Saturday and Sunday 2nd-3rd July 2011.
Refreshmeents and lunches are welcome.

The conference is the answer
of three speakers are provided,
and there will be followed
in the daylight
by an exhibition, which will contain
books, tune, and visual art,
which explore any feature of
communication,
style,
narrative, and
representation
in relative to

illness and sorrow.

Wednesday, November 03, 2010

Sew intriguing

The artist Andrea Dezsö's artworks are just gorgeous. You can see more of her work here. The series of embroided 'homilies' from the series 'Lessons from my mother' are hard hitting.

Doctors in literature


Thanks to my friend Anna Nyberg for pointing out this wonderful page of 'The Doctor is in... Literature' titles on AbeBooks. I've only read one of the 'Evil doctors' books (Jekyll and Hyde), but I have read all but two of the 'Good doctors' books. I guess that makes me an optimist.

It takes an embryologist...

Fascinating article on CultureLab about how an embryologist has identified the symbols on Danaë's cloak in Klimt's iconic painting as blastocysts -- early embryo forms. The symbolism is apt as the legend of Danaë has it that she was locked away from men by her father, but Zeus disguised himself as a river of golden coins, thus managing to impregnate her. Scott Gilbert, who proferred the new interpretation, found that Klimt often attended gatherings in Vienna, to which an eclectic mix of artists and scientists was invited. More details here.

Tuesday, October 26, 2010

Hippocrates Prize and 2nd International Symposium in Poetry and Medicine

The Hippocrates Prize for Poetry and Medicine, is now accepting applications for the 2011 entry and invites both national and international submissions. I attended the one-day symposium and prizegiving last year and it was a real treat. The talks were very varied and it was a delight to hear the prizewinners read their poems. Next year's symposium is scheduled for 7 May 2011. More details here.

New blog, and help save the workhouse!

The Centre for Humanities and Health at King's College London has a new blog which has a number of posts on Medical Humanities related topics, contributed by staff and students at the Centre. Of particular note is the campaign by historian Ruth Richardson to save the Strand Union Workhouse. There is more information about the workhouse, and a chance to sign a petition to save it from redevelopment as office space, at the website http://www.workhouses.org/. Do get involved -- this is an important part of London's medical and architectural history. There is also a Facebook campaign underway here.

Sunday, October 17, 2010

The Language of Illness and Pain conference

The Language of Illness and Pain
Identity, Communication and the Clinical Encounter

Date: Saturday 2nd and Sunday 3rd July 2011
Venue: Birkbeck College, University of London

Following the establishment of the British medical profession in the nineteenth century, which endorsed the concept of medicine as a science, the clinical encounter between doctor and patient came to occupy a contested territory with equally contested boundaries. The period saw a theoretical and practical shift away from the classical perception of medicine as an art, based on the patient’s story of his or her illness, to medicine as a science, based on the doctor’s clinical observations and supported by the rapid increase in technical training and new scientific procedures.

Arguably the effect of this development was to suppress the patient’s identity and voice. It also sidelined psychologically-driven theories, which were thought to lack evidence-based scientific rigour and were regarded as inferior to biomedical practice. As a result, conditions and identities associated with the troubled mind and with anti-social behaviours, for example, were pathologised to bring them into the province of orthodox treatments. The cure rate for the new taxonomies of stigmatised identities and psychosomatic conditions was disappointing. Moreover there was considerable confusion at the interface between the disciplines of law, medicine, psychology, and social science in relation to distinctions between normal behaviour and deviancy, between the criminal and the patient, and between the mad and the bad.

This interdisciplinary conference seeks to examine the legacy of these trends through the analysis of communication and language in the clinical encounter, as it is represented today in medicine and in the humanities. The objective is to break down the artificial boundaries between the arts and biomedical science to identify mutually beneficial fields of enquiry. In particular the conference aims to establish a forum in which academics, practitioners and students in the medical profession and in humanities can interrogate and evaluate the clinical encounter, the relationship between doctor and patient, and the language of illness and pain. The intention is to publish a collection of the best conference papers in a medical humanities book that will be of interest to the general reader but which can also be used by students and academics in teaching and research.

The conference is the result of the collaboration between Medical Humanities at Birkbeck College, University of London and the Kent, Surrey and Sussex Medical Deanery. It takes part over two days – Saturday and Sunday 2nd-3rd July 2011. Refreshments and lunches are provided and there will be a wine reception on Saturday, followed by a screening of Wit, the American TV drama based on the Pulitzer Prize-winning play by Margaret Edson, directed by Nike Nichols and starring Emma Thompson. Formal presentations end at lunchtime on Sunday and will be followed in the afternoon by a talk at the British Museum in the Wellcome Trust-sponsored Living and Dying Room.

The conference will be supported by an exhibition, which will include books, music, and visual art, which explore representations of, and the creative interaction between medicine and the humanities throughout the ages.

CFP: We invite proposals (300 words max) for 20-minute papers from academics and practitioners in the fields of the humanities and medicine, which explore any aspect of communication, language, narrative, and representation in relation to illness and pain. Proposals for panels of three speakers are welcome.

The following list of ideas is intended as a guideline only:

Altered mental states
Collective illness, collective healing
Cultural perceptions of illness: gender, class, and ethnicity
Cure or healing?
Difference, otherness and pathologised identity
Identity and the 12-step programme
Illness, language and writing
Illness as metaphor
Illness and creativity / genius and madness
It’s all in the mind
Medicine and anthropology
Medicine and music
Medicine and place: exteriors and interiors
Medicine and ritual
Medicine and visual culture
Narrative medicine and the clinical encounter
Narrative, identity and psychoanalysis
Narrative and the case history
The art of dying
The fictional doctor and patient
The medical autobiography / memoir
The Illness memoir
The language of pain
The language and lure of ‘Bad Science’
The poetry of pain
Symbolic medicine: the staff of Asklepios and the caduceus of Hermes
Trauma and language
Western biomedicine and trans-cultural practices
Who owns the illness?

Format: Given the interdisciplinary nature of the conference, we would like papers to be accessible to all participants. If your proposal is accepted we will ask you to provide a short handout in advance of the conference, which includes an abstract that sets out your key arguments followed by brief definitions of terminology.

CPD points for clinicians: Given the contribution the conference will make to clinical practice, CPD credits may be claimed under your individual College guidelines.

The deadline for proposals is Friday 17th December. Please contact Debbie Harrison (d.harrison@bbk.ac.uk) and Jo Winning (j.winning@bbk.ac.uk). We would be delighted to discuss your ideas informally in advance. The website (http://www.bbk.ac.uk/eh/research/research_conferences/language_illness_pain) will be updated regularly to provide further information about plenary speakers, accommodation options, parking arrangements etc. Birkbeck's facilities include wheelchair access.

Monday, October 04, 2010

Birkbeck MA in Medical Humanities open evening

The MA Medical Humanities at Birkbeck is having an Open Evening on Tuesday 19th October 2010, 6-7pm.

The course explores ‘the art of medicine’ and how it can improve patient care. This new, two-year, part-time Master’s degree allows reflection on and development ofdaily clinical practice, through a deeper understanding of the Humanities – art, literature, music, myth and culture.

Taught by Birkbeck Faculty and KSS Deanery’s senior educational and clinical staff, the MA draws together the emergent fields of Medical Humanities and Intercultural Medicine, to explore and develop the lived experience of clinicians, in the everyday complexities of real-life clinical settings, as they interact with patients and cultures.

The course offers rich insights of the Humanities about culture, the body and what it means to be human, and find ways to integrate these with medical science, to develop a richer understanding of clinical practice. As part of this engagement, students will have the opportunity to explore non-Western models of medical practice, and to consider how far they complement biomedicine, from the points of view of cultures, patients, and practitioners. Students will acquire and refine skills in verbal and written communication, as well as research and critical analysis.

The unique link between Birkbeck and KSS Deanery means that this programme combines world-class research-led Humanities teaching with an established understanding of the real-life experience of clinical practice and patient care. Our location in Bloomsbury offers excellent access to all the major research libraries in London, including Senate House Library, the British Library and the Wellcome Collection.

People can learn more about this exciting new development in medical education, meeting teaching staff who will talk about the programme and explain the application process, by coming to the Open Evening to be held at Birkbeck College, room 541 (Birkbeck Main Building), Malet Street, London, WC1E 7HX.

For more information about the course, and about Birkbeck, visit: www.bbk.ac.uk. Alternatively you are welcome to contact the Admissions tutor, Dr Jo Winning.

After Shock conference


The Maine Humanities Council in the States are hosting a conference on 12-13 November 2010. It's aimed at health care professionals and focuses on ways that the humanities can help them better understand the long term effects of trauma of all kinds on their patients, and on themselves. There will be storytelling, theatre performances, reading & discussing literature, discussion of film, graphic novels, and writing represented in the workshops and plenary sessions.

Sounds fabulous, wish I could go. More details here.

Hospital linen reimagined


Sara Hendren is thinking innovately and alliteratively about hospital linen.

Wednesday, June 30, 2010

Necromance

The degree show at the Royal College of Art is always a fascinating insight into imagination-made-tangible. I was intrigued by Lauren Dutton's architectural project envisaging supplying body parts for donation whist providing a substitute mourning site, using memento mori grown from cell cultures. The out-of-body aspect, emphasis on ritual, and the stunning graphics all combine to suggest 'gothic Avatar'.

Also at the show was a project by Alison Thomson called 'The Chronic Facility' which uses food as metaphors for diseases and symptoms. A lot of Alison's work is medically related and deals with ameliorating unpleasant experiences. Her website has details of these projects.

Picturing the dead


As part of a new specialist course called 'Death, autopsy and the law' for fourth-year medical students at Imperial College London, I'm thinking about a session on the representation of death in Western culture.

Daphne Todd's 'Last Portrait of Mother' has just controversially won the BP Portrait Award. The artist spent three days painting her mother after her death. In a very candid interview with the Evening Standard she revealed that members of her family were upset by the painting. For me, the portrait's fascination lies in the tension between the shock of the 'ruined body' and the intimacy of the portrait. There is a very good piece on deathbed portraits by Jonathan Jones here.

Sally Mann's new exhibition at the Photographers' Gallery is also pertinent to this theme. Photography is often characterised as being 'click and go', but Mann uses an antique camera that requires a long exposure time. Her large-scale prints are using gelatin silver, give them a highly atmospheric, 'memento mori' feel.

The exhibition, called 'The Family and the Land', includes photographs from the series 'What Remains'. These are photographs of bodies decomposing in the open air at a research facility in Tennessee where the process of decay is studied. (The 'Body Farm' is well known through Patricia Cornwell's novel of the same name, and there is also a series of Body Farm thrillers by Jefferson Bass.) I was lucky enough to see the exhibition in the company of ethicist Wing May Kong, and our reactions to the 'disturbingness' of individual photographs were very different -- tempered, no doubt, by our different experiences with corpses. Wing May has direct experience of dissection, whereas my frame of reference is mainly cultural.

Both Todd and Mann are artists who feel that we ought to be more upfront about the reality of the dead body. Although there are so many representations of death on our TV screens and in films, it is telling that these artworks still have the power to shock.

Monday, June 21, 2010

Good/bad literary doctors

John Mullan of the Guardian has put up a list of the Ten of the Best Good Doctors in literature and Ten of the Best Bad Doctors. Decent lists, both, although one inevitably can think of additional deserving characters. I found it easier to think of 'bad doctors' than good, although maybe because central characters tend to be more interesting if they have a 'moral flaw' which gets in the way of good patient care. It might be a good intellectual work-out to think of equivalent lists for film and TV. But tricky... Is 'House' a good or bad doctor? William Hurt's character in 'The Doctor'? Bad at the beginning, good by the end.

Comics and Medicine conference

The Comics and Medicine conference last Thursday was wonderful! It was an example of a truly interdisciplinary conference, with authors, educators, researchers and commentators all represented and contributing to a very inspiring day. Delegates came from all over the world to share their expertise. It really did feel like the inception of an important new movement in medical narrative. The conference programme is here. All the talks were very worthwhile. It was particularly thrilling to meet the lovely Brian Fies, author of Mom's Cancer which has become a classic in the genre of autobiographical comics.

For the interested but ignorant, like me, Paul Gravett provided a very useful survey of the field, putting key titles in context. His comprehensive, cross-genre website is well worth visiting. For specifically medical comics, Ian Williams's website Graphic Medicine is a treasure trove of titles.

Whilst there are many patient-authored comics, ones by doctors and other health professionals are still relatively rare. GP Thom Ferris has a witty webcomic called Fear of Failure featuring Dr Lois Pritchard. I particularly like the narrative style of Thom's work: multiple smaller panels show the throughput of patients, body parts and symptoms, replete with the constant interuptions of a ringing phone.

Phillipa Perry has just published Couch Fiction, illustrated by her talented, one-time housekeeper. Along with a strong storyline, there are annotations explaining the psychotherapy underpinning the action. I have a signed copy and I'm finding it a fascinating read. It was also interesting to meet Daryl Cunningham, former psychiatric nurse who has drawn on his experience to write Psychiatric Tales.

I must congratulate Fatimah Mohamied, a former student on my Medical Humanities course at Imperial College, who developed her work on medical manga and gave a cracking presentation!
I came away from the conference feeling more confident about using graphic novels in my teaching, inspired by Michael Green and Susan Squire from Penn State University who have a great humanities programme within the medical school; Stella Williams from the West Indies who uses comics to teach communication skills; and Linda Raphael from Washington who spoke about using autobiographical comics.

Well done to Ian Williams for being the driving force behind such a great conference, and to the Wellcome Trust who sponsored the event.

Friday, April 23, 2010

Bellevue Makes Literary History


The Bellevue Literary Press is honored with the Pulitzer Prize. Paul Harding’s debut novel–Tinkers–won the 2010 Pulitzer Prize in fiction.

The Bellevue Literary Press was founded in 2005 as a sister organization to the Bellevue Literary Review. The BLPress publishes literary and authoritative fiction and nonfiction at the nexus of the arts and the sciences, with a special focus on medicine.

This is the first small publisher to win a Pulitzer since “Confederacy of Dunces” in 1981. And it’s certainly a first for a public hospital!

Tinkers is a poetic novel in which a dying man explores his own life and the generations before him. It is an elegiac meditation on love, loss, and the fierce beauty of nature.

Big congratulations to author Paul Harding, editor Erika Goldman, publisher Jerome Lowenstein. And congrats to Bellevue Hospital and NYU Dept of Medicine for supporting the Bellevue Literary Press.

Become a Fan of the Bellevue Literary Press on Facebook.

Read how the New York Times missed this one….

Check out all the books at the Bellevue Literary Press.

-------------

Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients.

View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Thursday, April 22, 2010

Artopsy


It's nearly time for the annual art exhibition from Imperial's Medical Humanities Students. This is a real celebration of creativity. The official opening is on 11 May at 7.30 pm -- open to all, and no need to RSVP.

Thursday, April 01, 2010

Birkbeck MA in Medical Humanities

There is a brand new MA in Medical Humanities being offered at Birkbeck. Here are the details:

This two-year, part-time programme for clinicians, and other healthcare professionals, focuses on improving patient care through a deeper understanding of the Humanities disciplines (Literary Studies, Cultural & Critical Studies, History, Law, Philosophy, Art, Film and Visual Studies).

Taught by Birkbeck College and KSS Deanery, the MA draws together the emergent fields of Medical Humanities and Integrated Medicine to explore, critique and develop the daily practice of individual doctors in their interactions with patients and cultures.

This programme offers students a unique opportunity to encounter the rich insights of the Humanities about culture, the body and what it means to be human, as these have direct relevance upon clinical practice.

Students will acquire and refine skills in verbal and written communication, as well as research and critical analysis. They will engage with non-Western models of medical practice and undertake a research placement in a non-Western medical setting in London, or abroad.

Our location in Bloomsbury offers excellent access to all the major research libraries in London, including Senate House Library, the British Library and the Wellcome Collection.

The unique link between Birkbeck College and KSS Deanery means that this programme combines world-class research-led Humanities teaching with an established understanding of the real-life experience of clinical practice and patient care.

For more information about the course, and about Birkbeck, visit: www.bbk.ac.uk/eh/. Alternatively you are welcome to contact the Admissions tutor, Dr Jo Winning (j.winning@bbk.ac.uk).

To apply online, visit:
www.bbk.ac.uk/study/pg/newcoursesfor2010/medhum.html

Photographing Alzheimer's

There is a beautiful and moving (in both sense of the word) gallery of photographs of the surgeon Ed Akell, taken by his wife Judith Fox, since his diagnosis with Alzheimer's twelve years ago. These are emotive portraits and really tell a story -- testimony to the power that still photography retains. The photographs are on display at the Cork Street Gallery in London this weekend. But the slideshow on the BBC with a commentary by Judith Fox is a good substitute if you can't make it.

Tuesday, March 16, 2010

Dance and Medicine

The mid-point of medical residency is probably the bleakest point in medical training. The daily grind of death and disease wears young doctors down, and the end of residency seems impossibly far off. In the second year of my residency at Bellevue Hospital, I began taking dance class at the Martha Graham studio in Manhattan. It turned out to be an unexpectedly visceral lifesaver for me.

Here is an excerpt from the essay, “Pas de Deux,” which appears in the new anthology from “Becoming a Doctor,” edited by Lee Gutkind. (Norton, 2010.)

“One day, after a long night in the ICU, I rushed straight to dance class, leotards under my scrubs. I had spent the bulk of my last thirty hours with Nilsa, a young woman dying of HIV. Nilsa’s body was ravaged by bacterial, viral and fungal infections. The body cavities that weren’t drowning in their own fluids were hemorrhaging blood. Her temperature never dipped below 103°. The breathing machine provided oxygen in exchange for her tuberculosis-laden breaths. I injected sedatives when she convulsed, her water-logged lungs laboring to absorb more oxygen. The nurse and I arranged icepacks around her burning skin, but they melted rapidly. Her death was slow and brutal. Her mother, two brothers, and aunt sat with her, weeping into their protective respiratory masks.

I limped out of the hospital after signing Nilsa’s death certificate. There were so many infections that I couldn’t decide which one to write for “immediate cause of death.” My sleep-starved body longed for bed, but my aching soul dragged my protesting limbs to East 63rd Street.

We were doing the plié-relevé series, a set of exercises that I have always found particularly beautiful. There is one point, in fifth position, in which the drama builds until the climax occurs with just one simple motion: a 90° twist of the body while lifting into a relevé, one arm scooping an arc into the sky. In one brief, but compelling, moment, the whole class rises into the air as a single being, sweeping its focus from the one corner of the room to the other. Physically subtle, yet emotionally dramatic, almost more so for the understatement of the movement.

…I look back now and realize that it was the continual infusion of the aesthetics of dance that helped keep me alive throughout those draining years. After each daily dose of agony and suffering, I needed not only to witness beauty, but to participate in beauty. I was well aware that I couldn’t possibly approach the feats of the advanced dancers, but that turned out not to matter at all. It was enough just to be a bit player in that world, to be a miniscule stitch in that weave of beauty.”

Reprinted from “Pas de Deux” by Danielle Ofri, from “Becoming a Doctor,” Gutkind, L., ed. ©Norton, 2010.


*********



Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients.

View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.


Monday, March 15, 2010

Concepts of health and illness conference

Conference announcement and call for papers: Concepts of health and illness
1-3 September 2010, UWE, Bristol, UWE, Bristol and Lancaster University
Conference funded by the AHRC

Keynote Speakers:

Dr Jonathan Andrews (Newcastle, UK), The 'deja la' of madness? Continuities and shifts in the relationship between madness and death

Prof Baroness Ilora Finlay (Cardiff & House of Lords, UK), Fear as a key driver in the assisted suicide debate

Prof KWM Fulford (Oxford & Warwick, UK), Delusion and Spiritual Experience: Facts, Values and Concepts of Disorder in Mental Health

Prof Lennart Nordenfelt (Linköping, Sweden), The Controversy between Naturalistic and Holistic Theories of Health and Illness

Prof Fredrik Svenaeus (Södertörns högskola, Sweden), What is phenomenology of medicine? Embodiment, illness and being-in-the-world

Dr Alex Wood (Manchester, UK), Conceptions of Psychological Well-Being and Illness: Sickness, Optimal Functioning, and Authenticity

Over the past three decades, various accounts of health, illness and disease have been proposed by researchers from history, sociology, law, philosophy, public health and economics. Often, however, proponents of various accounts have been isolated within their own discipline with an apparent unawareness of competing accounts. As a result, while there are now a number of different accounts of health, illness and disease available, there is no consensus about which, if any, of these accounts is ultimately acceptable and what implications each account may have.
This three-day international conference will explore differences and overlaps between these different accounts. The conference aims to bring together researchers from multiple disciplines to create dialogue between them, as well as between researchers and healthcare practitioners, on the concepts of health, illness and disease.

We welcome contributions from any relevant discipline on any topic that falls within the broad remit of the conference title. Each paper will be allotted 20 minutes for presentation, followed by a ten-minute discussion. We aim for the conference to be inclusive and to represent a broad range of views and approaches. We particularly welcome contributions from healthcare practitioners. There will be a number of slots reserved for graduate papers and graduate bursaries will be available.

Contributions are invited for:
· Panel topics
· Individual papers
· Healthcare practitioners contributions
· Graduate papers

NB: please send us your abstract before the deadline if you require an early response. We strongly recommend this option for overseas participants who may need to book flights.
Please send proposals (500 word abstract) via email by Monday 12 April, 2010 to both organisers:Dr Havi Carel havi.carel@uwe.ac.ukDr Rachel Cooper r.v.cooper@lancaster.ac.uk

Registration

There is no registration fee and meals and refreshments will be provided during the conference. Participants who may wish to attend the conference without presenting in it are welcome to do so.

Rooms have been block-booked from the UWE Conference Centre and information on how to book accommodation for the duration of the conference will be circulated shortly.
The conference will be held at the UWE Frenchay Campus, in Bristol, UK. For maps and directions: http://www.uwe.ac.uk/aboutUWE/campus/Frenchay.shtml

This conference is part of the AHRC-funded project on the concepts of health, illness and disease.

For the project home page: http://www.uwe.ac.uk/hlss/courses/philosophy/ahrc_chid_network.shtml

Conference organisers:
Dr Havi Carel (UWE, Bristol)
http://www.uwe.ac.uk/hlss/politics/staff_hcarel.shtml

Dr Rachel Cooper (Lancaster)
http://www.lancs.ac.uk/fass/philosophy/profiles/183/

Tuesday, March 09, 2010

Poetry in Medicine


When I make rounds with my students and interns, I always try to sneak in a poem at the end. I think poetry is important because it helps convey the parts of the medical experience that don’t make it into textbooks. It’s important because it teaches creative thinking—something of immense value to doctors.


It’s important because interpreting metaphors is a critical clinical skill in diagnosis; patients’ symptoms often present in metaphorical manners and we doctors need to know how to interpret our patients’ metaphors. Last but not least, there is a therapeutic value to introducing beauty into a situation that is not commonly associated with aesthetics.


I’ve been giving poetry to my medical team for a few years now, but I’ve always wanted to give poetry to my patients. Unfortunately, English is not the first language for most of the patients in my hospital, so this has been challenging.


But there is one set of patients that seems to consistently speak English—the alcoholics. The Bowery-type alcoholics aren’t necessarily the favorite patients of the interns. These patients are frequent fliers, they are clinically “uninteresting,” they are often malodorous, and their illness is perceived as self-inflicted. But they do speak English.


So one morning on rounds, our team went to examine a new alcohol-withdrawal admission. His condition was standard: alcohol-on-breath, speech slurred, fingers trembling, hair and beard disheveled, body odor a mix of unwashed socks and cheap beer. He was cranky, and impatient with the detailed questions we asked.


As the team was finishing up, I whipped out some papers from my pocket—Jack Coulehan’s poem “I’m Gonna Slap Those Doctors. I gave a copy to the patient and distributed the rest to the resident, interns, and medical students. Asking their forbearance for this slight divergence from medical protocol, I plowed onward and read the poem aloud.


I’m Gonna Slap Those Doctors

Because the rosy condition

makes my nose bumpy and big,

and I give them the crap they deserve,

they write me off as a boozer

and snow me with drugs. Like I’m gonna

go wild and green bugs are gonna

crawl on me and I’m gonna tear out

their goddamn precious IV.

I haven’t had a drink in a year

but those slick bastards cross their arms

and talk about sodium. They come

with their noses crunched up like my room

is purgatory and they’re the

goddamn angels doing a bit

of social work. Listen, I might not

have much of a body left,

but I’ve got good arms -- the polio

left me that -- and the skin on my hands

is about an inch thick. And when I used

to drink I could hit with the best

in Braddock. Listen, one more shot

of the crap that makes my tongue stop

and they’ll have something on their hands

they didn’t know existed. They’ll have time

on their hands. They’ll be spinning around

drunk as skunks, heads screwed on backwards,

and then Doctor Big Nose is gonna smell

their breaths, wrinkle his forehead, and spin

down the hall in his wheelchair

on the way to the goddamn heavenly choir.


(from Medicine Stone, 2002. © Jack Coulehan, reprinted with permission)


As I read the poem, I could feel the atmosphere in the room changing, ever so slightly. The focus shifted from the patient to the poem, and everyone was an equal neophyte with this particular poem.


When I finished reading, some of the medical team looked uncomfortable, but the patient was smiling broadly. “This is great,” he said. “I love it!” With his pronouncements, everyone relaxed a bit.


“You know,” the patient continued, seemingly happy to have an audience, “ I used to read some books, back in the day.” He sat up in bed, more animated now. “I like history stuff—ancient Greeks, ancient Romans. Real characters, those guys.”


We ended up having a conversation about his childhood in small-town New Jersey, how he cut classes in high school to putter around on the beach.


We left the room feeling awkward but also somehow lighter. Suddenly our patient wasn’t just another alcoholic drying out on the ward. He was a real person, someone who stood out in our minds.


The poem certainly didn’t change the course of his devastating disease of alcoholism. It didn’t offer him the epiphany to suddenly quit drinking or to reconnect with his estranged family. His liver enzymes didn’t miraculously normalize. His platelets didn’t bound back to health. But it gave all of us a sense of human connection.


Throughout his four-day stay in the hospital, the patient was much more pleasant to the team. I noticed that the students and interns wandered in more frequently to say hello. We all felt just a bit more connected.


Rx: Take two sonnets and call me in the morning.


If you are interested in poetry and medicine, check out this unique conference at Duke University on May 21-23. Life Lines: Poetry for Our Patients, Our Communities, Ourselves. (I will be giving a presentation there.)


Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.


You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.

Sunday, February 28, 2010

Burnout


Taking care of ill patients exerts an enormous physical and emotional toll. Caregivers of all types—doctors, nurses, therapists, family members—are susceptible to these strains. But reactions to these stresses are different. Some caregivers possess large emotional reserve and strong support systems. Others become cynical or callous. Still others find that these stresses exacerbate underlying depression or drug and alcohol issues. For most caregivers, it is a complex combination of individual coping mechanisms and an evolution of our personalities—for better or worse.

In this video “Intensive Care,” I tell the story of a remarkable and brilliant physician who had a profound effect on me during my medical training. It is a true story, but the names have been changed.

The essay is from the book “Singular Intimacies: Becoming a Doctor at Bellevue” (Beacon Press). The reading was filmed at Baruch College.

Watch video here.

Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.

Thursday, February 25, 2010

Screening the Nurse: Call to Service

An exploration of nursing in the film collection of the Imperial War Museum

Saturday 27th and Sunday 28th February 2010, 10am-5.45pm

On the 27th-28th February the Florence Nightingale School of Nursing & Midwifery and curators from the Imperial War Museum will use film to celebrate and analyse nurses' contributions to war - from Florence Nightingale and Mary Seacole in the Crimean War to 21st century nursing in Iraq, via 20th century wars.

Modern professional nursing was born in the crucible of war. 2010 marks the 150th anniversary of the Nightingale Training School from which the Florence Nightingale School of Nursing and Midwifery at King's College London is descended. The School was funded by an outpouring of national thanksgiving for Florence Nightingale in the form of charitable donations, following her expedition to Turkey during the Crimean War.

Experts from the School and colleagues from Film Studies, War Studies and the Institute of Psychiatry at King's College London, together with the Museum's curators and guests from other universities, will introduce documentary, recruitment and feature films followed by question and answer sessions featuring panels of experts. A live musical accompaniment will provide a soundtrack to the silent films. Some of the films have never been screened to the public before.

Screening the Nurse: Call to Service is open to the public and entry is free. Admission is first come, first entry, and visitors may enter and exit between, but not during, sessions.

For the programme and more information see

http://london.iwm.org.uk/server/show/conEvent.3224

http://www.kcl.ac.uk/schools/nursing/events/other.html

Friday, February 19, 2010

Music in Medicine?



The holiday season is finally over. Not to be a complete Grinch, but I am more than happy to see all the tinsel and reindeer and artificial snow come down from the halls of our hospital. Whether all that holiday ornamentation actually belongs in a hospital is fodder for a difference essay, but the part that I’m most glad about is that the piped-in music has stopped.

Every morning, for two long months, when I slogged into the hospital to make rounds on my ill patients, I had to suffer the repeating loop of Christmas music on my way to the elevators. It’s not necessarily that I dislike holiday music—though these renditions were definitely not Grammy finalists—but that I didn’t want someone else’s music forced into my head.

Music is intensely personal. Unlike the art that adorns the hospital walls, which I am free to turn away from if I don’t like, the music was inescapable for the length of the hallway, which could feel interminable on the 57th loop of “Jingle Bell Rock.”

Music has strong therapeutic qualities, as evinced by the growing number of music therapy programs in hospital settings. There’s even a scientific journal “Music and Medicine” devoted to scientific developments in musicology that affect patients.

But I wonder about the effects on the staff who are forced to listen to music that is not of their choice? I’m not sure about the rest of my colleagues, but I am horrifically susceptible to musical worms—the melodies that get stuck in your head and replay in perpetuity.

So, for the majority of the extended holiday season, I would round on my patients and review their medical conditions with “Deck the Halls with Boughs of Holly” as an underlying basso continuo. Some would say that this could be a good thing, but personally I felt hostage to these saccharine tunes.

When finally I turned in despair to my (Jewish) supervisor, he said confessed to me in a low voice: “Oh, this is my favorite time of year. The music in hall just makes me feel so happy.”

Maybe it is just personal taste, but to me music is too potent to squander with tinny Muzak forced on the unbidden masses. Here’s an essay I wrote on music and medicine that appeared in The Lancet, trying to reconcile my day-job as a physician and my after-hours gig as a struggling cello student. I’d appreciate your thoughts.

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Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.

Friday, February 12, 2010

Bryan Charnley

Bryan Charnley was an artist and schizophrenic patient, he started the 'Self Portraits Series' in 1991 and was encouraged by a friend to keep a diary that explained the imagery of the portraits. You could call it an experiment of sorts as the series openly describes the graded sufferings he was oppressed by, as he struggled with his medication (see the enclosed linked for more information). The portraits describe his paranoia, depression, and psychosis accurately.

Brian Charnley in March 1991 at the beginning of the series.


3 Months later


18th of May 1991


13th of June 1991


There was no commentary for the penultimate and final portraits which do not even have faces on them, but this 'map' shows very well the paranoia Charnley was facing as he feels surrounded by enemies, despite 'Hope' being at the centre.

This final portrait was left on the easel in his studio where he committed suicide shortly after painting it.

Writing About Patients: Is it Ethical?


There is a veritable epidemic of doctor-writers out there. What is going on?

Are doctors suddenly in the kiss-and-tell mode? What about confidentiality? Professionalism? HIPAA?

As one of the aforementioned doctor-writers, I look upon this trend with both awe and trepidation. I suspect that that this flourishing literary phenomenon relates to the public’s fascination and fear about all things medical. It also relates to the falling away of previous, pedestal-like images of doctors and doctoring. Lastly, it may have occurred to the medical profession—and this has taken a few centuries, it seems—that doctors have profound emotional reactions to the work we do, and that exploring these reactions may offer benefit to both patient and doctor.

Whatever the reason, this literary genre appears to be here to stay, and it is worth considering the ethical implications. Legally, there doesn’t appear to be much beyond protecting identity and avoiding libel.

But physicians clearly need to work with a higher bar. For starters, patients speak to doctors with an expectation of confidentiality. This is vastly different from an ordinary citizen speaking to a journalist. This confidentiality needs to be preserved. Unless a patient indicates otherwise, a doctor-writer must change the name and identifying characteristics. My rule of thumb is that the description must be different enough that it would be tough for anyone other than that person or a close associate to recognize them.

This, of course, brings up an issue of reliability. We’re trafficking in nonfiction, not fiction. When I write, I try to ensure that the aspects I change are not the crucial ones in the story. When talking about the intricacies of an illness, it probably doesn’t matter whether the hair is blond or brown, or the country of origin is Trinidad rather than Jamaica. If these minor things mask the patient’s identity without altering the key aspects of the story, then I think it is a reasonable trade-off.

But most importantly, there is the consideration that patients come to us for our help. They are in a particularly vulnerable situation and doctors have an ethical obligation to put that first. If, at some later time, this seems like a story that might edify the current discourse, the doctor might think about writing it up. It is helpful to let some time pass, so that the situation is no longer “active.” If it’s possible to obtain consent, we should do so.

If I can’t obtain consent, then I need to ask myself whether I feel the patient might be hurt by the publication of the story. If there’s any thought that this person would be uncomfortable or embarrassed or pained, then the story stays in the drawer, no matter how amazing it is. (I have one powerful story—about a patient lied to me, and the implications of that lie—but I suspect that my patient would be unhappy if he ever saw the story, so I’ve never pursued publication.)

Ultimately, I want to give a respectful rendering of my patient’s story, one that I hope would honor them and what they’ve endured. Of course this is necessarily a subjective decision, but it is the only internal ethic that I can live with. My patients have entrusted me with their stories, and I need to respect that. If a particular story can edify future doctors, or educate the public, there might be value in publishing it.

I choose these stories very carefully. I obtain consent when possible—patients almost always have a positive reaction. I let time pass. I try my best to write a story that honors them, and show a draft to them if circumstances permit.

Ultimately, doctor-writers have to treat patients’ stories as we treat our patients, realizing that we are in a privilege position, and taking care not to abuse that.

(Read more about the ethics of doctors writing in Danielle Ofri’s essay in The Lancet.)


Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients. View the YouTube book trailer.

You can follow Danielle on Twitter and Facebook, or visit her homepage.

Her blog, Medicine in Translation, appears on Psychology Today’s website.


Wednesday, February 10, 2010

Portraits, Patients and Psychiatrists

Last week I attended a very interesting seminar at King's College London's new Centre for the Humanities and Health. Artist Gemma Anderson and psychiatrist Tim McInerny have collaborated on a project called 'Portraits: Patients and Psychiatrists'. Dr McInerny, a forensic psychiatrist working at Broadmoor, was inspired by seeing Gemma's etchings at the RCA's graduate show. He felt that they had parallels with psychiatry in that they gave an insight into the personalities of her sitters. They decided to collaborate on a series of portraits of psychiatrists and their patients, supported by a Wellcome Trust Arts Award.

The portraits are deliberately ambiguous -- doctor and patient are not immediately discernable. One of the strengths of the project is that it honours both sitters as individuals, rather than highlighting the differences in status between them.

Gemma works from life on a large wax tablet. She gets to know her sitters, finding out what interests them. She then incorporates imagery from their narraties into the portrait, often drawing from natural history museum collections. The portraits reminded me of frontispieces to 18th century books -- full of symbolism and 'emblems'.

Because anonymity needs to be respected, the line-drawing nature of the etchings is ideal. There is not too much facial detail, but each is still recognisable as a portrait. Gemma stressed that she was not trying to capture the entire life story of her subjects, although this informs her work. The portraits are her interpretations, rather than a transcription of her sitters' stories. She did not seek 'approval' from the sitters about what to include.

Dr McInerny explained that the patients and the doctors enjoyed having their portraits made. The natural imagery and the sense of calm that pervades the portraits serves as a counterbalance to the often very negative imagery that abounds about psychiatric patients in the press. Of course, it is tempting to focus on the patients' portraits because their life stories have had such a profound influence on their circumstances, but this is also true of the doctors who treat them. The portraits remind us that there is more to the personality than the sum of our personal or profession actions.

You can read more about the project and find out about the fascinating working methods employed in making the etchings on Gemma's blog.

Tuesday, February 02, 2010

Hippocrates poetry prize -- deadline extended

The deadline for the Hippocrates Prize for Poetry and Medicine has been extended to 15 February. The prize will be announced at the splendid sounding 2010 International Symposium on Poetry and Medicine being held in Warwick on 10 April.

8.45am Registration
9.25am Symposium start
5pm Close of Symposium followed by a reception for speakers, delegates and Hippocrates Prize winners.

Symposium speakers will include: Peter Goldsworthy Poet and medical practitioner, Australia Michael Hulse Editor, The Warwick Review

Symposium topics will include: poetry in medical settings (oncology, cardiovascular disorders, childhood illness ...); doctor poets (Gottfried Benn, William Carlos Williams); poetry in the consultation; creative health professionals; medical inspirations for poetry (anatomy; poisoning in Shakespeare's writings ...).

Call for papers
Submissions are welcome for the Symposium as posters for discussion or short oral communications. Email the Symposium Office to express interest in submitting a Symposium Abstract. Closing date for Symposium Abstract submission has been brought forward to 6pm Friday 19th February 2010.

Key themes will include:history of interactions between medicine, health and poetry; impact of health and disease on the writings of the professional poet; poetry as therapy; the nature of the body, and anatomy; the history, evolution, current and future state of medical science; the nature and experience of tests; the experience of doctors, nurses and other staff in hospitals and in the community; the experience of patients, families, friends and carers in these situations; the experiences of acute and long-term illness and dying, of birth, of cure and convalescence; the patient journey; the nature and experience of treatment with herbs, chemicals and devices used in medicine.

The Symposium is being held on the awards day for the 2010 International Hippocrates Prize for poetry and medicine.

2010 Hippocrates Prize - Closing deadline 12 midnight GMT Monday 15th February. The 2010 Hippocrates Prize awards will be announced at the Symposium. There is a £15,000 award fund for the prizes, which will be given in an ‘open’ category which anyone can enter and in an ‘NHS’ category open to National Health Service employees and health students. The first prize for the winning poem in each category is £5,000.

Broadcaster, journalist and writer James Naughtie are joining NHS Medical Director Professor Sir Bruce Keogh and poet and Doctor Dannie Abse as judges of this new pair of national and international medical poetry awards.

The 2010 Hippocrates Prize is being organised by a joint team from the University of Warwick’s Department of English and Comparative Literary Studies and the University’s Medical School.

The International Poetry and Medicine Symposium and the 2010 Hippocrates Prize are supported by the Institute of Advanced Study at the University of Warwick and by the national Fellowship of Postgraduate Medicine.

Friday, January 15, 2010

Nurse Jackie


What to make of the new hospital series Nurse Jackie? Having watched the first week of episodes (thank you iPlayer! It's screening on BBC2 at 10 pm every night), it's hard not to feel rather horrified. Nurse Jackie is, in so many ways, inspirational. She acts in the patient's best interests. She subverts hospital bureaucracy whenever necessary, stealing from the bad to give to the more deserving. Unless, of course, the patient is a misogynist with diplomatic immunity, in which case she has no compunction is flushing his ear (sliced off by a prostitute he attacked) down the toilet. So far, so entertaining. But Jackie has a serious drug problem. She scores pills from her pharmacist lover, and takes them in a variety of ways -- from sprinkling them in her coffee to snorting up the contents of capsules.

The idea of a 'conflicted' health professional is not new. House has a drug problem too, along with brilliant clinical judgement. Why then, in Nurse Jackie so much more disturbing? Jackie is smart and sassy, and it is so refreshing to see a nurse in the prime role rather than another stereotyped doctor. But the message that Jackie gives is that it is not possible to cope with the job unless you have a pharmaceutical crutch. What sort of a role model is she?

There are plenty of cop shows on TV that show corruption, and we don't worry that these are serving as poor role models for aspiring policemen and women. Also, there is no shortage of doctor dramas that highlight character flaws in health professionals. So why do I feel so anxious watching Nurse Jackie? I think it is because we are seeing something new by way of character development, hinted at in House but fully developed in Nurse Jackie. Usually in TV dramas, you have clearly identifiable 'goodies' and 'baddies'. Over the course of a series, one type might turn out to be another, but almost invariably, character flaws are explicable in terms of someone's circumstances. The evidence of the first week of Nurse Jackie, however, plays havoc with the usual conventions of TV drama. Jackie has a lovely family: gorgeous husband and two adorable daughters. She is good at her job. And she seems entirely unconflicted by her frequent unethical personal behaviour. This may, of course, all come unstuck over the course of the series, but it's too late. We already love Nurse Jackie for her sheer chutzpah and her apparent ability to be in total control of her complicated life. Most tellingly, one would really want her on your side if you were a patient.

Medical students often tell me that they are inspired by House. But they do realise that House is utterly unrealistic, and most admit that they would not like to be his patient. For all its good writing and well researched medical interventions, House still comes across as a bit of a soap opera. Personal relationships unfold within a clinic that looks like a hotel, with little evidence of the demands of 'real' medicine. Nurse Jackie sets up greater intimacy with the viewer, using the Gray's Anatomy voice-over technique to impart wisdom. The bureaucracy in the hospital makes it feel more realistic, albeit in a rather superficial way. She is a far more sympathetic character than the gruff and misanthropic House ever could be.

Nurse Jackie will undoubtedly inspire more people to enter the nursing profession -- and that's good. We need more nurses. But we have to trust that people can distinguish right from wrong. Drug taking has no place in the profession, but this doesn't mean we should condemn a well-written, well-acted TV drama.