Just attended the ‘Narratives of Health and Illness across the Lifespan‘ conference (- a rather unwieldy title, perhaps  reflecting (unintentionally, I’m sure) the slight nervousness we all seem to feel about looking for a CONNECTION between the “fuzzy and creative” arts & “practical and factual” healthcare).

Because of my personal interest in representations of medicine in literature, I was really disappointed to have missed the first day, which seems to have dealt more specifically with how health issues are treated in narratives and what we can learn from the arts that might help us in healthcare settings:

‘Narrative Medicine and the Medical Humanities’ by Professor Maura Spiegel, Columbia University, New York, USA; ‘Pregnancy and birth in film and literature’ by Prof Patricia Crowley, Dept. of Obstetrics and Gynaecology, TCD; ‘Ageing in Childrens’ Literature’ by Dr Amanda Piesse, Dept of English, TCD; ‘The message of ageing for children’ by Prof Suresh Rattan, University of Aarhus, Denmark.

The second day, which I was lucky enough to be there for, was still very interesting, and perhaps more diverse in terms of the angles from which it came at the relationship between the arts & healthcare. In the broadest terms:

  • We had artists / art therapists presenting the case for how the arts should be and can be made part of our healthcare services. (‘An exploration of Art Therapy interventions in Psychiatry’ by Catherina Brady, Arts Therapist, Dr Ian Daly St. Loman’s /AMNCH; ‘Music Therapy Choir in the Nursing Home’ by Bill Ahessy, Music Therapist, Meath Community Unit)
  • We also had two talks that dealt with, among other things, the issue of the design of healthcare SETTINGS, arguing that they need to be treated like any other public spaces in terms of aesthetics. (‘Aesthetic Deprivation: The role of the arts in an acute hospital’ by Hilary Moss, AMNCH; ‘The ARThritis Programme’ by Dr Ronan Mullen AMNCH and Brina Casey, Education Officer, The National Gallery of Ireland)
  • We had a doctor showing how the arts, as a reflection of societal views (always a problematic equation to solve), reveal misunderstandings about health issues, which in turn can entirely skew our healthcare assumptions and practices. (‘Myths of Ageing’ by Prof Graham Mulley, Leeds, UK)
  • We had another doctor using the arts to undermine such misconceptions and present a more sophisticated picture of there being loss AND growth throughout life (rather than the traditional beginning, middle, end structure of stories, perhaps?). (‘The Art of the Demographic Dividend‘ by Prof Desmond O’Neill, AMNCH)
  • We had a ‘patient’ perspective, powerfully displaying and telling us about the reality of that loss-growth change. (‘Stroke: An insider’s story’ by Prof Terry Dolan, Dept of English, UCD)
  • We had an academic using aesthetics to tease out the unspoken messages in the interactions between healthcare workers and patients. (‘Photography in palliative care’ by Dr Chiara Garattini, TRIL, UCD.)
  • We had a doctor using the quality of artistic output as a measurement of health, a diagnostic tool almost. (‘PG Wodehouse, ageing and lexical richness’ by Dr Shaun O’Keeffe, Merlin Park Hospital)
  • And we had a publishing perspective, in terms of a forum where SOME of these topics can be presented for wider consideration. (‘Medical Humanities – the editor’s viewpoint’ by Richard Hurley, British Medical Journal)

What a range! And playground!

(NB: all the notes here following are my own rough attempts to relay something of what the speakers said; accuracy cannot be guaranteed.)

Medicine as a theme in literature and film was the main concern of Richard Hurley in his talk on BMJ’s editorial approach: how reflections on medicine in a humanities context might “help doctors to make better decisions” (as in, improving their understanding of certain situations, for instance, or making them more alert to other factors in patient-doctor-society relations). Richard finished with the Einstein attributed quote: “Not everything that can be counted counts, and not everything that counts can be counted”.

Thoughts: Can reading & appreciating the arts provide doctors with clinically relevant insights? Are doctors who have an appreciation for and understanding of the arts better at their jobs? (And, in the context of my involvement with medical students: does medical school damage the ‘humanity’ of doctors?)

Hilary Moss’s presentation covered a lot of ground reflecting the range of issues she deals with as an arts officer in a big hospital. What I took most from it was the sense that, at the very least, as significant sites of human society hospitals have to be treated as holistically as any other planned environment, and perhaps we should try even a little harder in their case considering the vulnerability of the people in that environment; and perhaps diversion, entertainment, creative efforts could actually do them some good.

Thoughts: Given limited resources, how much emphasis should be placed on design, aesthetics, cultural activities and arts-based therepeutics in healthcare?

Geriatrician, Des O’Neill was quick to declare his unease with phrases like ‘the healing arts’. Being a physician, he has a soft spot for information derived from hard evidence, statistically significant evidence; and yet, being an aesthete, he is clearly convinced of the need for metaphor and the power of metaphor. He argued that the creativity of older artists demonstrates that our assumptions about ageing, based on false understandings and historic limitations, lead us to overlook the positive aspects of the changes that come about in old age, and to underestimate the massive cost to the economy of treating the illnesses in older people as “just part of getting old”. A paradigm of gradual failing in old age should be replaced by one that acknowledges failing as part of all stages of life, and how loss can be followed by new-found strength.

Thoughts: Could this argument be taken too far and cause us to overspend on extension of life at the expense of improving basic health evenly across all ages?

Graham Mulley, geriatrician, showed how some art could be seen to contribute to a negative stereotype of old age, “not in the best interests of older people.” Bleakness, sadness, decrepitude, burdensome were some of the messages he picked up from the creative works he selected. He highlighted the misapprehension that some diseases are practically CAUSED by old age (rhinopyhma, acromegaly, hyperkyphosis [mostly called ‘dowager’s hump’], for example), when, in fact, they are treatable diseases: ageing is not a “social problem” like homelesses or poverty; its ailments need diagnosis and medical intervention.

Thoughts: Isn’t it possible to argue that if we allow ourselves to see negative stereotyping in the art depicting old people we are misunderstanding artists and their work? Is the creative impulse not more sophisticated than simply positive-negative? Can’t what one person sees as mocking be seen by another as celebrating?

Shaun O’Keeffe employed an analysis of the use of language (syntactic complexity, mean number of clauses per sentence, rate of new word introduction etc.) as a reflection of cognitive health to prove that not everyone’s faculties are impaired by ageing. Common but not inevitable, with the ring of down but not out, was the gist of it.

Terry Dolan decided against calling himself a victim because it was “too dramatic” for something as “banal and ignoble” as the effects of a stroke, in his view. He didn’t use survivor, either, and didn’t have to explain why. ‘Insider’ was, typical of him, le mot juste. He relished the irony of Joyce giving up medicine because he didn’t understand the terminology. By the law of unintended consequences, he lives, with his gammy arm, travelling more in memory now than in space (and insisting that Skellig Michael is more thrilling than anywhere else he’s been on his travels). He touched on his new perspective on older people in recounting how he alone picked up A Short History of Tractors in Ukranian’s negative portrayal of an older character as a “shrivelled wreck”. With great wit he finished by making Hugh Heffner’s ‘Age is just a number’ stand for Obama’s ‘Is feidir linn’.

Brina Casey summarised what the National Gallery can offer in terms of bringing visual arts to a wider audience, and the images that Ronan Mullen showed us from the ARThritis Art Programme made me want to ask if the participants were in fact artists who happened to have rheumatoid arthritis. They were truly stunning images that called out from depths that one would prefer not to have to experience.

At that stage, I had to put down my pen, so overflowing was my cup, but the remaining papers were all similarly engaging.