‘The humanities humanize us’: Students explore patient care through art

A fine arts museum may not be a typical setting for a class of medical students. But for students in the Medicine, Arts and Humanities elective, it’s the ideal spot to think outside of the box and beyond what they learn in the classroom.

During a January visit to the Virginia Museum of Fine Arts in Richmond, Va., about a dozen students from the School of Medicine’s Class of 2028 wandered the gallery, sharing their initial thoughts of each art piece they were presented and discussing their takeaways. The students weren’t given the name, date or artist of the pieces, and their observations were dramatically varied, with the subject of one painting, “Ericksons” by Andrew Wyeth, being described as everything from "content" to “distraught."

"You can never know the full story behind a piece of art, but you can try to comprehend what you’re seeing presented to you,” Akhila Kunuthuru, an M1 enrolled in the course, said. “It’s similar to seeing patients for the first time. There’s no way to know their whole story, but we need to try getting to know them better as a person.”

Gaining new perspective

Since 2019, the Medicine, Arts and Humanities elective has offered first-year students the chance to explore dimensions of medicine outside of the traditional classroom setting. Each session takes place in a different Richmond institution — like the VMFA and the Black History Museum and Cultural Center of Virginia — and asks students to investigate the intersections of culture, the human experience and medical care.

Megan Lemay, M.D., an associate professor in the Department of Internal Medicine and one of the co-directors of the course, said she wants students to challenge themselves to think beyond finding the right answer for a test.

“A lot of medical students learn in a sort of funneling manner, where they are given all this information and it is funneled toward a correct answer,” Lemay said. “Our elective hopes to do the opposite –– taking that information and expanding it by considering more elements and perspectives.”

Lemay co-leads the course with Sara Wilson McKay, Ph.D., an associate professor of art education at VCU School of the Arts. The two faculty were introduced by John Nestler, M.D., professor emeritus in the Department of Internal Medicine and first “physician-scientist-in-residence” at the arts school. Drawing inspiration from a VCU School of Nursing elective called the Art of Nursing, the three of them collaborated on a new curriculum tailored specifically for medical students.

“In my experience, students relate what they are seeing and experiencing during this class to what they experience in the hospital,” McKay said. “It helps them reflect on their assumptions that may have been rooted in preconceived notions or biases.”

The elective is rooted in the concept of narrative medicine, an approach to medicine that emphasizes "empathy, listening, understanding and acknowledgement” of the patient’s experiences. Narrative medicine also includes the analysis of art, literature and other forms of expression to better connect doctor and patient, as well as examine their roles in relation to each other.

For one exercise at the VMFA, McKay handed each student one of four descriptions of a statue in the South Asian art collection, each significantly different from the other but all describing the same piece. After discussing their expectations for the piece based on the write-ups, they were led to a statue of the Tibetan Buddhist deity Vajrabhairava, and asked to reflect on their initial conclusions. The exercise was designed to mirror the experience of reading patient notes written by another clinician, which physicians typically do before meeting a patient.

“It's a way to shift their perspective, not just of patients and medicine, but of themselves,” McKay said. “They can practice observation in a way that isn’t graded and allows for ambiguity. It’s also building tolerance for discomfort in not necessarily having the answer.”

After exploring the world of visual art, the students next session focused on movement arts and improvisation at the VCU Health Hub, a community center in Richmond’s East End. Students were instructed to use touch and walk in a way they felt signaled trust and confidence. While some were uncomfortable and giggly at first, the instructors encouraged students to embrace the awkwardness that can come with prolonged eye contact and unnatural movements.

They quickly warmed up and paired off for an exercise similar to a traditional trust fall, gently leaning into and physically supporting one another, to practice nonverbal communication and reaction. The session also covered improvisational skills, utilizing the “yes and” technique, in which performers accept what another has said and expand upon it.

“I use a lot of the skills I learned in theater during undergrad in my medical practice,” Lemay said. “Thinking on your feet is crucial in medicine, just like it is in improv. It requires similar listening and communication skills. The humanities can make us better doctors.”

An opportunity for exploration

The rigorous, time-consuming nature of medical school can make it difficult for students to maintain hobbies, something Lemay said she experienced when she was an M.D. student at VCU in the late-2000s. After feeling disconnected from the arts while training to become a physician, Lemay, a “theater-kid-turned-doctor," said the experience of teaching medical students through the arts inspired her to revisit her old passions. Now, she performs in improv comedy shows with a local group at Richmond’s Coalition Theater.

“I felt I needed to practice what I preach,” Lemay said. “It's been really nice to reconnect with that side of myself.”

McKay and Lemay said many of their students over the years have signed up for the elective to reconnect with their past artistic practices. One of those students, Antara Sarkar, said she was attracted to the course as a way to reignite her creative spirit.

 “As a kid, I had such a creative brain. I was always doodling and drawing, but that all kind of fell to the side once I got to high school,” Sarkar said. “When I saw the elective, I thought ‘Oh my gosh, this is the perfect way to get back into that.’”

Sarkar said that from the very first class, it has been “eye-opening” to hear her peers' perspectives throughout the sessions, points of view that she said students don’t often get to hear in more science-heavy fields.

“The humanities humanize us and it's a great way to connect with other people,” Sarkar said. “As doctors, we can know all these diseases, medications and treatments, but it’s a different skill to actually be able to be human with your patients.”

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