Most days, first-year medical students spend their time in classrooms and laboratories studying subjects like anatomy and pathology or learning clinical skills by examining patients.
But at the University of Arizona, each of the 120 medical students in the class of 2022 is taking a course in medical humanities at the UA Poetry Center, a setting that highlights the course’s emphasis on empathy and compassion.
The course was designed by Ellen Melamed, an instructor in both the College of Medicine – Tucson and the UA Honors College. The goal is to produce doctors who have a more holistic understanding of their patients and view each patient as a whole person instead of merely an isolated medical problem.
Melamed has taught the course for a few years, but this is the first semester the Poetry Center has opened its doors to host the medical students.
"There's something very literal to medical school training," Melamed says. "Isn't it amazing to open students up to the concept of metaphor, to the concept of allusion, to the concept of abstraction? Those are the things that poetry celebrates. By bringing them to this space, with its sense of openness and lightness, we’re opening the minds of these physicians-in-training to look for solutions that take into account the patient as a whole."
The point of using arts in medicine is to give a sense of empathy and compassion. Providing first-year medical students with a course in medical humanities helps teach them how to channel that empathy and compassion into scenarios with patients.
"Art and health should not be separate," Melamed says. "They aren’t separate, any more than the mind and the body are separate."
The program in medical humanities adds to the rich education on patient-centered medical care and professional-identify formation that UA medical students receive. The course revolves around the concept of narrative medicine, an approach created at Columbia University that utilizes people's narratives in clinical practice, research and education as a way to promote healing. Melamed’s course is now a requirement for all first-year medical students at the UA.
"We need to train all physicians on why the humanity of medicine is as important as the science of medicine," she says. "We talk about empathy and compassion, what it is, how they can use it. These are skills doctors need, but they don't always get to practice them in medical school. Doctors have to observe and respond to the complicated stories of patients. When we look at patients' stories, we're treating the whole person, we're not treating the kidney in room 206."
In the class, Melamed has students examine works of art, each created by a patient, a physician or a caregiver. In pairs or small groups, the students draw on their observations to describe what the artwork is conveying, who created it and how illness is being expressed. It's an exercise that unites the scientific skills a doctor practices – observation and diagnosis – with a narrative medicine approach.
"How do we look at art, whether it's visual, performance, photography? And how are the skills an artist has similar to the skills a doctor has? A sculptor has to learn anatomy, and a physician has to learn anatomy. A dancer has to learn physiology, and a physician has to learn physiology," Melamed says.
First-year medical student Nicolas Iadarola says he was struck by all of the different interpretations of narrative and art that he and his fellow students considered.
"I hope that experiences like the medical humanities course will help me to be as open-minded as possible when it comes to how I approach my future patients, and that I won't be limited to a simple diagnostic/treatment algorithm when dealing with their ailments," Iadarola says. "I wanted to enter into medicine because I wanted to forge strong, healing bonds with patients, and I believe that medical humanities will help me in that effort."
By welcoming the medical students, the Poetry Center is expanding its outreach mission as part of an exciting partnership, says Tyler Meier, executive director of the Poetry Center.
"I describe the Poetry Center as a kind of a national park for the imagination," Meier says. "This partnership celebrates a belief by the institution that we best create future doctors by pairing their medical training with elements that emphasize what the imagination makes possible: creativity and creative problem-solving, articulate expression, empathy, and a sense of wonder for our lives, in all their complexities.
"This collaboration has created a signature experience: the University of Arizona is the only medical school in the country that has regular course meetings for all its students at a leading literary arts center. It is an exciting expression of our institutional values," Meier added.
Karen Spear Ellinwood, director of instructional development for the UA College of Medicine – Tucson, says the learning environment for medical students changes significantly as they enter clinical settings, where they will inevitably communicate with people from diverse cultural, racial, social and linguistic backgrounds.
"We know they will encounter a broad range of emotion as they engage with and learn from patients, physicians, nurses and other health care providers," says Spear Ellinwood, who is also an assistant professor in the UA Department of Obstetrics and Gynecology. "Looking at health care through the arts – learning to speak the language of medical humanities – offers students insight into how to reflect on and make sense of these experiences. The Poetry Center offers a unique muse to reflect on who they are and who they want to become as future physicians."
College of Humanities Dean Alain-Philippe Durand says the partnership emphasizes the expansive applications that instruction in the humanities can have.
"This is a wonderful initiative from one of our units in the College of Humanities in partnership with the College of Medicine – Tucson," Durand says. "We have every confidence these students will become doctors who have a greater understanding of their patients' humanity."
Melamed credited both colleges with seeing the unique value of hosting a medical school class in the Poetry Center.
"If we think about poetry, there are no wasted words," she says. "Every word has an image, has a sensation, evokes an emotion. We respond to poetry. Doctors have to have that succinct way of communicating. The way poetry speaks to listeners is the way I'd like doctors to speak to patients."