Reclaiming the Art of Medicine

Thank you so much for having me. Thank you to everyone who made time in your busy Monday. Um, and I'm really glad to 0:31 31 seconds be able to talk to something um, that I'm super passionate about um, but that maybe you haven't been thinking about 0:37 37 seconds lately. Um my question to begin our talk today is um how would you paint yourself? Uh you may not think of 0:46 46 seconds yourself as a painter. Um but uh if you were painting your portrait uh what colors would you use? Uh what medium 0:54 54 seconds would you use? Would you use words? Um watercolors, crayons. Um many of us are 1:01 1 minute, 1 second um uh branded as healers, helpers. Um but sometimes we also feel like a cog in the wheel. And so our goal today is to 1:09 1 minute, 9 seconds try and um not feel that way. Uh professionally I am a pediatrician um amateur uh writer, singer, artist. Uh I 1:19 1 minute, 19 seconds am a teacher um as Mariah said, but I'm also a student. I'm taking a certificate program at Columbia University in narrative medicine, which we're going to 1:27 1 minute, 27 seconds be talking about today. Um so it's okay if you don't know what that means. Um, 1:31 1 minute, 31 seconds over the past 10 years, I have been really lucky to get grant funding to help publish two books on children's health. And then I have a third book 1:39 1 minute, 39 seconds that I'm looking for funding and I would be so happy if the next time I give a speech, I have to give an actual disclosure about money. So, help me out. 1:46 1 minute, 46 seconds Uh, I have consulted on a kid's play about health. Uh, and I have um two poems um being uh published um coming 1:55 1 minute, 55 seconds out uh in the articulation u magazine this past month including. So what are our objectives today? Um my goal for you 2:03 2 minutes, 3 seconds guys is that at the end of this talk you will be able to describe um if not what narrative medicine is because that's a little um obtuse uh but the importance 2:12 2 minutes, 12 seconds of narrative medicine in medical education. Um to be able to identify one creative resource to use after a bad day 2:20 2 minutes, 20 seconds and to recognize one creative resource to prepare for a good day. Uh my goal is that this is a functional talk for you 2:27 2 minutes, 27 seconds as well as for your students. Uh we're certainly going to talk about what is narrative medicine. We're going to explore images, words, and sounds. And 2:36 2 minutes, 36 seconds we are even going to try um doing this together. Um so when I think about my 2:44 2 minutes, 44 seconds normal week as a pediatrician, um it is a lot. If I was to pick a percentage, I 2:51 2 minutes, 51 seconds would say maybe even 75% of the time I am telling my patients that their problem is going to go away in two weeks to 18 years uh depending on the problem. 3:03 3 minutes, 3 seconds And so having a finite task is something that really helps me find balance. Uh so Kurt Vonagget um a great author wrote go 3:12 3 minutes, 12 seconds into the arts. I'm not kidding. The arts are not a way to make a living. They are a very human way of making life more 3:19 3 minutes, 19 seconds bearable. Practicing an art, no matter how well or badly, is a way to make your soul grow for heaven's sake. Sing in the 3:28 3 minutes, 28 seconds shower. Dance to the radio. Tell stories. Write a poem to a friend, even a lousy poem. Do it as well as you can. 3:37 3 minutes, 37 seconds You will get an enormous reward. You will have created something. 3:43 3 minutes, 43 seconds So when we talk about narrative medicine, I can't say what it is definitively because it keeps expanding. 3:49 3 minutes, 49 seconds Um, but it includes telling and listening to stories. And hopefully for those of you that are MDs, DOS's, RNs, 3:57 3 minutes, 57 seconds LPNs, CRNAs, all these different uh acronyms that we use, um we could also 4:04 4 minutes, 4 seconds say that we are storytellers and that it is so important that we are listeners to our patients, to their families, to our 4:11 4 minutes, 11 seconds colleagues. Um we pass stories around to each other and make sure that we're telling and listening well. Um, 4:18 4 minutes, 18 seconds narrative medicine includes reading and talking about both literary and visual texts. Now, this is one place where I 4:26 4 minutes, 26 seconds don't actually love that word text. I like to use the word source material um because sometimes we look at sculptures 4:32 4 minutes, 32 seconds or paintings uh or songs. Um, narrative medicine also includes an aspect of creative writing, which is different 4:40 4 minutes, 40 seconds from the writing that we do in our day-to-day jobs, whether it's grant applications or histories um or plans. 4:48 4 minutes, 48 seconds Um, we all write a lot, but it might not always feel creative. And then the sharing of creative writing with one another is a really important part of 4:55 4 minutes, 55 seconds narrative medicine. And that is because there are three words that I really want you to focus on in the next few minutes. 5:03 5 minutes, 3 seconds Um, narrative medicine is all about paying attention. And this is something that as a doctor I have to do. If I have 5:10 5 minutes, 10 seconds a teenager who is telling me that they are not worried but they're biting their nails, I need to pay attention to that. 5:18 5 minutes, 18 seconds Uh, we take even just, you know, short poems and we close readad them. In narrative medicine, um, we are trying to find out relationships and that is a lot 5:27 5 minutes, 27 seconds like what we do um, clinically as physicians and as um, healthcare providers. Um representation is the 5:34 5 minutes, 34 seconds second word. Um we want to um encourage you I want to encourage you to read 5:41 5 minutes, 41 seconds widely so that you can understand other people. Certainly in my clinic about 50% 5:46 5 minutes, 46 seconds of kids that come to Tangle Woods parents don't speak English. We use a lot of translators and trying to make sure I understand literally where 5:53 5 minutes, 53 seconds they're coming from and also how they are living in Ron Oak which is completely differently from me and my children. Um and then when we're writing 6:02 6 minutes, 2 seconds for oursel, we are writing for discovery um of where we come from and recognizing that we are not even the same as our 6:10 6 minutes, 10 seconds other providers um or office mates. Um and then the last word is affiliation. 6:16 6 minutes, 16 seconds Uh narrative medicine is all about affiliation, using those um uh those skills of attention and um representation to build partnerships. 6:26 6 minutes, 26 seconds Um, Rita Sharon is considered sort of the mother of narrative medicine. She practices at Columbia University, which is where I've been lucky enough um to be 6:35 6 minutes, 35 seconds taught by her. She wrote a um uh textbook compendium that has tons and tons of scientific research that's been 6:42 6 minutes, 42 seconds done to prove that all that what I'm about to tell you is true. I'd be happy to send you resources at the end of the talk, but I mostly did not want to focus 6:50 6 minutes, 50 seconds on um citations throughout this talk. Um so principles and practice of narrative medicine. It is a wonderful book. It is 6:56 6 minutes, 56 seconds huge. Um but I highly recommend it. Um so one of the things that we get challenged to do at Colombia and I am on 7:05 7 minutes, 5 seconds um to take my fifth class this summer out of a five um class uh certificate. 7:10 7 minutes, 10 seconds Uh so I'm almost done. And so four times in a row I've had to give essentially my elevator speech. Uh what is narrative medicine? Because plenty of people don't 7:18 7 minutes, 18 seconds know what it is. I didn't know what it was uh three years ago. Um, and the best and most concise way I've gotten to it, 7:25 7 minutes, 25 seconds uh, lately is that if medicine as a field, uh, is blood, um, then I think it's really easy for us to look at the 7:32 7 minutes, 32 seconds cells, the red blood cells, the white blood cells, um, the anatomy, the biology, the chemistry, the child development, dermatology, genetics, 7:40 7 minutes, 40 seconds pharmarmacology, psychiatry, radiology, 7:42 7 minutes, 42 seconds toxicology, the pieces that we all need to be able to practice medicine. But then there's also this little layer of patience and intelligence and 7:50 7 minutes, 50 seconds determination. Um, and we know we need that, but then there's something else. 7:55 7 minutes, 55 seconds There's something else. And to me, that something else is narrative medicine. 7:58 7 minutes, 58 seconds Uh, so to me it's it's like plasma. It's sort of hard to describe, but you know, it's really important. 8:05 8 minutes, 5 seconds Um, so I want to start by taking you guys way back in history. This is a painting um by Sir Luke Fields. Um, and 8:13 8 minutes, 13 seconds it's called The Doctor. Um it is uh pretty clear to see that there is a doctor making a home visit. He is 8:22 8 minutes, 22 seconds looking at a child and the two of them have literally the spotlight. Um looking at this painting, the child is not on a bed. She's on chairs. It makes you 8:30 8 minutes, 30 seconds wonder maybe she doesn't have a bed. Uh there's a cup of tea next to the light. 8:34 8 minutes, 34 seconds Was that served to the doctor? Um because he's a guest in the home. And then in the background you see the father standing and then you see the 8:42 8 minutes, 42 seconds mother sitting. And to me, you understand everything about the circumstances by her head in her hands. 8:50 8 minutes, 50 seconds Um, the lighting in the room is dim other than that lamp shining on a child who is obviously ill. Um, and and this 8:59 8 minutes, 59 seconds is a very traditional model that none of us practice anymore. And yet, I think this is how we think we're supposed to 9:06 9 minutes, 6 seconds think about oursel. And one of my goals in today's talk is to help you think, 9:10 9 minutes, 10 seconds how am I not like that? Even though there might be some roots in our culture of medicine, um that do help me connect with that feeling. 9:20 9 minutes, 20 seconds A modern interpretation, I couldn't find the actual artist who did this, is that this is how we spend our days, uh staring um with the same chagrin that we 9:29 9 minutes, 29 seconds might stare at a um sick child at the keyboard. Um that, you know, begging Epic to please let us just do our jobs. 9:37 9 minutes, 37 seconds Um, I found it fascinating that this piece of art had um the gold um background sort of shimmering. Um, that 9:45 9 minutes, 45 seconds is not the background we have here in Tanglewood certainly and I don't think most of our offices do. Um, but it speaks a little to that sort of doctor 9:52 9 minutes, 52 seconds all by themselves put on this pedestal asked to solve problems um asked to come up with answers. Um, and I think some of us can feel some affiliation with that. 10:03 10 minutes, 3 seconds We can feel some representation uh by that and uh we can pay attention to the fact that this is black and white. They 10:10 10 minutes, 10 seconds took all the color out of this doctor um to help him sort of meld into the computer. Um and that is maybe um not how you would paint yourself. 10:21 10 minutes, 21 seconds So narrative medicine courses certainly always have poetry. Um, but they also have comic books, short stories, 10:28 10 minutes, 28 seconds photography, movies, modern dance, paintings, sculptures, TV shows, um, 10:33 10 minutes, 33 seconds memes, and even reals. Um, and as they're continue to come up with, um, as our as our as our planet continues to come up with new ways to express ourselves, we will include those, too. 10:43 10 minutes, 43 seconds Um, this is a painting that I stumbled upon. Herbert uh, Plberger was not a doctor. Um, he was actually a 10:49 10 minutes, 49 seconds costumeumer in Germany um, in the early 1900s. Um, but he chose to make this picture of himself with an 10:58 10 minutes, 58 seconds opthalmological model. Um, and at the same time, you see he's pointing his very anatomically precise finger at his eyeball with another eyeball behind him. 11:08 11 minutes, 8 seconds Um, and I think this is a really interesting picture that breaks that um, 11:12 11 minutes, 12 seconds sort of image of the doctor as, you know, just presenting a good front. We, 11:16 11 minutes, 16 seconds you know, we doctors have our own medical problems. Uh, we get itches in our eyes when we're talking to people who have pink eye. Um, we need to go get 11:26 11 minutes, 26 seconds our glasses fixed so that we can continue to do all of our epic charts. 11:30 11 minutes, 30 seconds Um, and I think this is a really interesting um, portrayal uh, of a doctor in the white coat, right? Um, but 11:37 11 minutes, 37 seconds if you look at the sleeves, they're sort of costumey. They're a little bit over the top. Um, so something that you could talk about later when you um, come back to this. 11:47 11 minutes, 47 seconds Um, my favorite representation of doctors growing up was Norman Rockwell. 11:51 11 minutes, 51 seconds And yet, this is not what I look like in my office. I don't wear a white coat. Um, I don't give my own injections. Uh, 11:57 11 minutes, 57 seconds I don't even have my um, uh, my diploma on the wall. Um, but this is a very, 12:03 12 minutes, 3 seconds again, traditional um, view of what a doctor's office looks like. Um, but is this what our patients see? Certainly, 12:10 12 minutes, 10 seconds my patients don't usually look at Norman Rockwell. Uh, and I'd like to ask you guys, what do you think a doctor looks like? Um, Doc McStuffins is featured on 12:19 12 minutes, 19 seconds the right. She is the main character in a kids TV series. Um, and important to point out that she is a child dressing up like a doctor playing with her dolls. 12:27 12 minutes, 27 seconds U, but this TV series, her mother is a doctor and she's a black woman. Um, and when I was growing up, one of the first women that I met who was a pediatrician, 12:40 12 minutes, 40 seconds uh, was my friend Anne's mother. Um and uh she was so appealing to me. Uh my dad 12:48 12 minutes, 48 seconds was a surgeon. Um but I saw myself in Dr. Charity. Um and very much was drawn to the idea that I could be a pediatrician based on her. 12:57 12 minutes, 57 seconds Um so we're going to try the slidoh out. 12:59 12 minutes, 59 seconds This is a QR code that you can use with your phone to connect so that you guys can tell me uh where do you see yourself 13:06 13 minutes, 6 seconds represented in modern culture? Um, some of you may be familiar with the modern series The Pit with Noah Wy. Uh, some of 13:15 13 minutes, 15 seconds you absolutely um might know Nurse Jackie. Um, some of you might really uh feel more attached to uh Dr. Spock uh and uh the scientist on Star Trek. 13:27 13 minutes, 27 seconds Sometimes in our offices, we can feel like we are on a different planet dealing with different species. Um, if you've never watched Grey's Anatomy, it 13:35 13 minutes, 35 seconds is um, funny to me because it is so unlike our actual lives as doctors uh, 13:41 13 minutes, 41 seconds in the hospital. Um, each of those doctors wears way too many hats. Um, but Call the Midwife I have to give a shout out to. It's a BBC series about uh, 13:49 13 minutes, 49 seconds midwives uh, in England and it is absolutely wonderful. So, it looks like we are sort of evenly divided. A lot of you have been watching The Pit um, and 13:58 13 minutes, 58 seconds some of you are more old school with Star Trek. Um but these are options. Um 14:06 14 minutes, 6 seconds and certainly there are way more and to deal with those um context clues uh when 14:13 14 minutes, 13 seconds patients come into us, they sometimes are not sure what to expect um because there isn't a show that res represents 14:21 14 minutes, 21 seconds um uh endocrinology really well uh or necessarily radiology really well. Um, 14:28 14 minutes, 28 seconds so I'm going to give it another minute and see if there's any other answers and then we'll move on. Thank you guys so much for your participation. Uh, up until now I wasn't sure you were really there. 14:38 14 minutes, 38 seconds All right, I think that's going to be our final Star Trek wins. Dr. Unwin, I see you. Uh, so uh, what is this all 14:48 14 minutes, 48 seconds about? You know, I thought we were supposed to be talking about teaching. 14:50 14 minutes, 50 seconds So, one really important um uh research topic has been, you know, how should we best prepare our medical students to be 14:58 14 minutes, 58 seconds doctors? Uh, and it turns out there's a ton of um uh support uh that we should be giving them time to read fiction. Uh 15:06 15 minutes, 6 seconds medical students who read fiction have increased capacity for personal reflection, tolerance for ambiguity, 15:13 15 minutes, 13 seconds right? Um and then personal bias awareness. And we want our med students to be able to understand a situation from different points of view, to 15:22 15 minutes, 22 seconds empathize with their patient and their family's dilemma, and to acknowledge uh that especially when it comes to 15:28 15 minutes, 28 seconds differences of uh backgrounds that there are different ways of thinking and there's not always one right answer. Um 15:37 15 minutes, 37 seconds this is one of my favorite children's books. It's called Grace for President. 15:40 15 minutes, 40 seconds I highly recommend it to an all ages audience. The beginning of the book, 15:44 15 minutes, 44 seconds Grace is at school. I think she's in third grade and she's looking at a wall that has pictures of all these white men who were presidents and she says, "Where 15:51 15 minutes, 51 seconds are the girls?" And the teacher admits to her, "We've never had a girl president." And she decides to run for class president. Um so great book. Um 16:00 16 minutes and I think for all the um women of color who had not necessarily seen themselves in a book that would have the 16:07 16 minutes, 7 seconds word president on the cover, um this was a step forward. Um just like this u famous picture by Pete Duza who is the official photographer for the White 16:16 16 minutes, 16 seconds House um took in uh Obama's first term um I find this photograph to be a work of art. I find this to be a source 16:25 16 minutes, 25 seconds material and in narrative medicine class we could spend 10 minutes picking apart what does this represent. The fact that 16:32 16 minutes, 32 seconds he um the president has his hands in his pockets. uh the fact that the little boy is actually touching his hair uh to make 16:39 16 minutes, 39 seconds sure that it's just like his. Um so back to fiction, the more people uh the more fiction people read, the better they 16:46 16 minutes, 46 seconds were at perceiving emotion in the eyes and to a lesser extent correctly interpreting social cues. Um, and this 16:53 16 minutes, 53 seconds is essential if we are going to pay attention to our patients. If we are going to be good listeners to their stories, we need to look them in the eye 17:01 17 minutes, 1 second and understand when they're ready for us to ask more questions and when we need to let them just keep talking or even have a moment of peace. Um, Rita Sharon, 17:10 17 minutes, 10 seconds who I mentioned before, says in a very poetic way, even a brief bout of reading fiction can temporarily improve a 17:18 17 minutes, 18 seconds person's social skills. uh and she's got the data to prove it. These are some of my favorite fiction books from the last couple of years. I'd be fascinated to 17:27 17 minutes, 27 seconds see in the Q&A at the end of our talk um what some of your favorites are. Um uh State of Wonder is about a woman 17:35 17 minutes, 35 seconds scientist. I saw myself in that book. Uh All the Light We Cannot See is about World War II, but I still could see 17:41 17 minutes, 41 seconds myself in that main character. Um and uh would be fascinated to hear how you guys have um sort of backfilled your reading 17:51 17 minutes, 51 seconds of scientific literature. So the next question is what science books have you read? You might not have thought of these as textbooks. You might not have 17:59 17 minutes, 59 seconds thought of these as essential to your um training. Um, but who of you was a Michael Kiteon lover, the Andromeda 18:06 18 minutes, 6 seconds strain, um, precedes COVID, um, and had some really interesting, um, ideas about how our society would react, uh, if 18:14 18 minutes, 14 seconds things fell apart. Um, cutting for stone, um, Abraham Vergis is just a beautiful writer, um, and writing about an international experience of, um, 18:23 18 minutes, 23 seconds becoming a doctor. Um, House of God was rep uh recommended to me by my own dad who was a surgeon and was a very jaded 18:31 18 minutes, 31 seconds view of the hospital that I thought, "Oh my gosh, I hope this isn't the same anymore." Um, and yet, of course, it is. 18:39 18 minutes, 39 seconds Um, and I kept thinking about House of God when I used to watch Scrubs, 18:42 18 minutes, 42 seconds actually. Um, Mountains Beyond Mountains is worth um, pointing out. Tracy KDR uh is a physician um and um activist uh in South America and he just passed away. 18:54 18 minutes, 54 seconds Um so I highly recommend um that book as well. 19:00 19 minutes All right, getting lots of participation. Thank you guys so much. 19:03 19 minutes, 3 seconds This really helps me feel like I have a real live audience. Zoom is such a surreal experience, but seeing these number change um reassures me that 19:12 19 minutes, 12 seconds you're not all sleeping at your computer screens. Oh man, House of God is winning. I guess that's just because it's been around the longest maybe. Um, 19:20 19 minutes, 20 seconds I'm going to give it a couple more minutes for you guys to answer. If you're having any problems with the slidoh, please, um, let the experts in 19:27 19 minutes, 27 seconds the chat know. Um, it was used in a previous talk and I thought it was so lovely. Um, I'm glad that we are able to have some interaction since we know that 19:36 19 minutes, 36 seconds that is important um, for teaching. All right, I think we're done. House of God is the winner as the most known. All 19:44 19 minutes, 44 seconds right. So, when I started in narrative medicine, I only knew of one doctor who had been a poet. His name William Carlos Williams, but I wasn't really familiar 19:53 19 minutes, 53 seconds with the bulk of his work. Um, and I've read more of it now. Uh, this is one of my favorite lines. It is difficult to 20:02 20 minutes, 2 seconds get the news from poems, yet men die miserably every day for lack of what is found there. 20:10 20 minutes, 10 seconds So, in narrative medicine, we often read things twice. We circle back around to make sure we are paying attention to every single word that we are trying to 20:18 20 minutes, 18 seconds understand what is represented in this poem. We are trying to build relationship through affiliation. 20:24 20 minutes, 24 seconds Um so this is someone speaking from experience. It is difficult to get the news from poems. Well duh. We don't get 20:31 20 minutes, 31 seconds news from poems, right? None of us open the New York Times and expect to have poem on the front page. Yet men and 20:39 20 minutes, 39 seconds women die miserably every day for lack of what is found there. And so without 20:48 20 minutes, 48 seconds poetry, what is the life that we are living? Uh poetry is um was as essential to William Carlos Williams as his 20:56 20 minutes, 56 seconds practice of medicine. And um if we are all allowed to take this little bit of time to think about our our real true 21:04 21 minutes, 4 seconds selves, how we would paint ourselves, um what um poems that you grew up with or have come to know over the past couple years are important to you. 21:14 21 minutes, 14 seconds Uh I'm going to read you another poem. 21:15 21 minutes, 15 seconds This one is a little longer. It's called Hands. Uh it was published in JAMAMA in August of 2025. Um the doctor uh Jordan 21:24 21 minutes, 24 seconds Williams is an MDPH uh MPH and this is his poem. Lend me your hand. Calloused or calamined, 21:33 21 minutes, 33 seconds wrinkled or plump? Nails bitten, nails extended, splintered and pitted, nails 21:41 21 minutes, 41 seconds neatly or never cropped. Lend me your hand. Strong or weak, cold or warming, 21:49 21 minutes, 49 seconds swollen and swanned, gnarled in knots, 21:54 21 minutes, 54 seconds sanitized and soiled, scratching scabies, sensate and not. I'll feel it. 22:02 22 minutes, 2 seconds Tremulus, contracted skin thick, skin thinning, bones fractured, bones 22:10 22 minutes, 10 seconds frailing, tendons, fibrous or hyperflexible with spidery digits or athemmitus palms. 22:18 22 minutes, 18 seconds You can hold a lot in a hand. Tarot cards and prayers, peace signs or curses, 22:26 22 minutes, 26 seconds knives as well as forks, greetings or despair. Hands hold much, but nothing 22:34 22 minutes, 34 seconds compares with holding hands to know another person, their history, their hopes, their cares. Lend me your hand. 22:46 22 minutes, 46 seconds So, this is a poem that really affected me when I first read it. I think uh there's such an important part of the 22:53 22 minutes, 53 seconds physical exam that goes after usually um building trust through history taking um where we do get some really important 23:02 23 minutes, 2 seconds clues to who this person is. I can't tell you how many kids I take their shoes off and mulch falls out uh or a 23:09 23 minutes, 9 seconds kid that I would not expect has toenail polish on. Um I think the words in this poem are so interesting. Um, I don't know that calamind is really a verb. Uh, 23:21 23 minutes, 21 seconds I don't know that swand or um frailing are words that I've ever used before. 23:28 23 minutes, 28 seconds Uh, and yet in medicine we do sometimes speak a different language that our patients don't understand. And paying attention to our words um is just as 23:37 23 minutes, 37 seconds important as paying attention to tel injectas or clubbing. Um, and when we do shake hands to say hello or shake hands 23:46 23 minutes, 46 seconds to say goodbye or hold hands when we're giving bad news, I think we've all crossed this bridge of connection 23:54 23 minutes, 54 seconds through touch. Um, but representing touch in words, I think Dr. Williams does a wonderful job. I'd love to hear 24:01 24 minutes, 1 second at the end of the talk if you guys have any questions about this poem. Um, I do want to give a special shout out to 24:08 24 minutes, 8 seconds Articulation, which is the magazine uh that was started with help from uh Brian 24:15 24 minutes, 15 seconds and Cindy Unwin um based on the narrative medicine course that they um began. And the goal was to develop 24:23 24 minutes, 23 seconds students attentive listening skills. Um because we can't always ask them to read a whole novel, poetry is definitely some good bite-sized pieces um that we use. 24:33 24 minutes, 33 seconds um empathy, reflectiveness, and narrative competence. Right? We want our med students to be able to come out of a room and not just read verbatim what the 24:42 24 minutes, 42 seconds parent said, but put together a narrative that helps us get to that um end of the visit um assessment and then 24:50 24 minutes, 50 seconds a plan. Um extended patient interviews are a part of what's done in narrative medicine. Creative responses um have 24:58 24 minutes, 58 seconds varied. They just put out their sixth volume and at the exhibit that was at Riverside 2, uh there were paintings, 25:05 25 minutes, 5 seconds there was pottery, there was um poems, 25:08 25 minutes, 8 seconds there was a word cloud. Uh lots and lots of different ways to show creativity. Um and so this creative opportunity for all 25:16 25 minutes, 16 seconds VTC students, residents, faculty, and staff to explore humanism in medicine. The link is at the bottom of the slide, 25:23 25 minutes, 23 seconds and there will be volume seven in the spring, and I encourage all of you to participate. 25:30 25 minutes, 30 seconds Um, so this is a question you can keep the answer um private. Um, but I want to know when was the last time that you did something that you consider creative? 25:39 25 minutes, 39 seconds And it didn't have to be knitting or playing a guitar or painting. Um, but anything creative. Was it a day ago? Was 25:46 25 minutes, 46 seconds it a week ago? Was it a month ago? Or is it I can't remember. 25:53 25 minutes, 53 seconds This is a poem that really struck me um in thinking about how different some of my patients are from the very privileged 26:01 26 minutes, 1 second life that I grew up with. I went to a private school in Richmond, all girls. I almost never meet anybody who has that background. Um but this is called section 8, uh George T. Wilkerson. 26:12 26 minutes, 12 seconds I come from the broken playground littered with dented coke can crack pipes, bullet shells, and bottle shards 26:19 26 minutes, 19 seconds that scarred my arches. From my mother's squeaky yellow rubber gloves, and the burnt grease smell of my dad's mushy 26:28 26 minutes, 28 seconds fried chicken. I belong to my father's heavy leather belt, my girlfriend's 26:35 26 minutes, 35 seconds welloiled windows, and footlong bricks of blank label cheese that sweated orange. I come from crowding with other 26:43 26 minutes, 43 seconds families around a boxy aluminum community mailbox the first of every month. My mom's sweet cucumber scented 26:51 26 minutes, 51 seconds face cream that left lips oily. And I'm proud of you, son, though I am nothing to be proud of. 27:01 27 minutes, 1 second So, this poem is definitely pretty deep, 27:04 27 minutes, 4 seconds pretty dark. There's some um nods to u potentially child abuse. Uh definitely 27:11 27 minutes, 11 seconds um unhabeled cheese talks to um poverty and food insecurity, uh crackpipes, um bulletshells, violence and drug abuse. 27:23 27 minutes, 23 seconds Um many of us were lucky not to have grown up in this. Um and yet we can still connect to the very end having a 27:30 27 minutes, 30 seconds parent say, "I'm so proud of you." And feeling like you don't deserve it. I think all of us have had moments like that. uh imposttor syndrome I think 27:39 27 minutes, 39 seconds supersedes all uh socioeconomic uh guides or lines. So again uh a poem that 27:46 27 minutes, 46 seconds I think we can read and understand our patients um pay attention to the words uh feel some uh representation of 27:55 27 minutes, 55 seconds potentially um someone that we don't know well and then feel some affiliation with that father um child um or mother child relationship. 28:05 28 minutes, 5 seconds Uh, one more poem I'm going to read to you. I know you guys are getting tired of this, but this one is my favorite and I couldn't leave it off. This is the postpartum questionnaire, which is 28:13 28 minutes, 13 seconds actually um taken from the real postpartum questionnaire that we give to mothers here in my office and certainly in um midwife and OB clinics. Uh, this 28:23 28 minutes, 23 seconds was written by Kate Bear. In the past seven days, one, I have looked forward with enjoyment to things as much as 28:30 28 minutes, 30 seconds ever, though there have been times I have lost my grip on this world and can no longer see what used to sit in front 28:37 28 minutes, 37 seconds of me. And two, I have blamed myself unnecessarily when things went wrong. 28:43 28 minutes, 43 seconds Occasionally, I try not to imagine there is someone better suited to care for my infant who cries constantly is how 28:51 28 minutes, 51 seconds things have gotten on top of me. No, I have been coping as well as ever. Most of the time I have been coping well. 28:59 28 minutes, 59 seconds Yes, there are those times I cannot cope at all. 29:05 29 minutes, 5 seconds I used this poem in a short class that I did with some medical students that was actually a project for my Colombia 29:12 29 minutes, 12 seconds class. I had to teach a class. I had to practice teaching a class. Um, and I didn't expect that in this audience of 29:18 29 minutes, 18 seconds about 10 um, uh, MS-3s uh, that none of them had kids and they 29:25 29 minutes, 25 seconds still completely attached and identified with this poem and several of them were crying by the end of the class which was 29:32 29 minutes, 32 seconds certainly not my intention. uh but the idea that any of us at any time could take uh the questionnaires that we are giving to our patients whether it's 29:41 29 minutes, 41 seconds about memory loss or about postpartum issues and to really check in with ourselves um this is something that poetry can do for us this is something 29:49 29 minutes, 49 seconds our poetry um can do shared poetry can do with our students and I really really encourage you uh to show this poem to 29:56 29 minutes, 56 seconds everyone and anyone Kate Bear is is a is a treasure all right so now the moment you've all been waiting for uh Many doctors uh they 30:05 30 minutes, 5 seconds did a research study on this really hate the word creative writing. So we're just going to talk about writing and we write all the time. Uh doctors, nurses, 30:12 30 minutes, 12 seconds healthcare professionals. Um this is a cartoon that certainly um uh gives me a small giggle especially because my dad 30:20 30 minutes, 20 seconds has this handwriting. Uh when doctors get shipwrecked, uh the helicopter pilot says, "Yeah, I can't read it either. I guess let's keep going." Uh we're going 30:29 30 minutes, 29 seconds to do some writing and I'm not going to read it. uh no one is going to read it unless you choose to share it with uh your friends and loved ones. But in just 30:36 30 minutes, 36 seconds 5 minutes uh we are going to write a poem. And so if you can get your phone out and um I'm going to set a timer for 30:43 30 minutes, 43 seconds five minutes and um we're going to write some just really basic um answers. Uh this can be one word, this can be two 30:51 30 minutes, 51 seconds words, it does not need to be a whole lot. Um but I want you to answer these um five questions. Uh so number one uh what was your favorite cereal as a kid? 31:08 31 minutes, 8 seconds Number two, what was a book you read growing up? 31:18 31 minutes, 18 seconds Number three, what was something your parents said to you? 31:27 31 minutes, 27 seconds Number four, what do you remember from your first ever job? 31:36 31 minutes, 36 seconds And then number five, what is a happy reminder of your childhood? 31:47 31 minutes, 47 seconds Take a minute, think back, 31:50 31 minutes, 50 seconds put down the first thing that comes to your mind. But certainly if you feel like you must edit, edit. 32:03 32 minutes, 3 seconds And then I want you to write the phrase I come from 32:10 32 minutes, 10 seconds at the top so that you can read through with your answers. 32:17 32 minutes, 17 seconds And I'm going to share mine with you. 32:29 32 minutes, 29 seconds So, I am from Cheerios in a bowl with one extra spoonful of sugar. I am from Nancy Drew in her pumps and an A-line skirt sliding into her sedan. 32:40 32 minutes, 40 seconds I am from Girls Can't Be Doctors. 32:44 32 minutes, 44 seconds I am from Would You Like Paper or Plastic? 32:48 32 minutes, 48 seconds I am from a backyard swing that went so high, but I never got scared. 32:57 32 minutes, 57 seconds So, when you get to the end of your workday today and you go home and your um uh spouse or friend says, "How was 33:04 33 minutes, 4 seconds your day?" you can say, "I wrote a poem today." Um it's that easy. five questions starting with I am from uh to 33:12 33 minutes, 12 seconds center yourself to think about how you would paint yourself for yourself to look at and then if you knew you were going to share this poem with other 33:21 33 minutes, 21 seconds people how might you have answered differently um Paul Cologne is a beautiful poet um that I've read quite a 33:28 33 minutes, 28 seconds bit of and this quote really stood out to me only truthful hands write true poems I cannot see any basic difference between a handshake and a poem. 33:40 33 minutes, 40 seconds So that draws us back to um the poem about hands and thinking about the importance of touch. Uh I hope that this 33:49 33 minutes, 49 seconds brief experience of answering simple questions and then looping them together um to make a poem has made you feel uh 33:58 33 minutes, 58 seconds like this is something you could explore in your spare time. Uh it doesn't take long and um it can be a relief to put 34:06 34 minutes, 6 seconds down things um that you've had in your head. 34:10 34 minutes, 10 seconds Um this is a painting that I want us to look at for a minute. Um before I say anything, um I want you to look with 34:17 34 minutes, 17 seconds your eyes. Uh look with your heart. Um what do you see? Um what do you not see? 34:25 34 minutes, 25 seconds What is not represented in this painting? Um, what's going on in the foreground? What's going on in the background? 34:36 34 minutes, 36 seconds Can you see yourself in this person? 34:42 34 minutes, 42 seconds Can you understand even though most of this person is covered up how this person feels? 34:50 34 minutes, 50 seconds So, we're paying attention. 34:52 34 minutes, 52 seconds We're looking for representation and we're trying to make affiliation with what is portrayed in this painting. 35:09 35 minutes, 9 seconds So, one of the questions I would ask you is, you know, this uh person is gloved and ready for the O or are they? Um, 35:18 35 minutes, 18 seconds what is the armor that we wear to work? 35:21 35 minutes, 21 seconds what do you wear to work? Uh certainly ever since co I think a lot of us have been wearing more masks than we would 35:28 35 minutes, 28 seconds prefer. Um and yet we need to protect oursel and thinking about how the armor 35:35 35 minutes, 35 seconds of specifically the red boxing gloves uh what are the wounds underneath there uh that made this person choose to put 35:42 35 minutes, 42 seconds those on? Um, how does it feel to be practicing medicine at a time where people come in and say that their Google search is um more scientifically accurate than your entire training? Um, 35:54 35 minutes, 54 seconds it turns out that in the old days we used leeches to remove bad humors. Um, 35:59 35 minutes, 59 seconds did painting this poem remove a bad humor for the painter? Um, how could words help remove your bad humors uh 36:08 36 minutes, 8 seconds when you've had a bad day and have felt like you are arguing with, let's just say, the CDC or patients and families 36:15 36 minutes, 15 seconds who just don't see uh the risks and the benefits that you see. Um, asking the 36:22 36 minutes, 22 seconds question of where does it hurt? Um, how do you let it out? When was the last time you cried? 36:30 36 minutes, 30 seconds Where do you feel safe? Do you feel safe at work? How do you go back the next day? 36:42 36 minutes, 42 seconds So, writing for me um is on the left hand side of your screen, uh a way that I go from keeping it all in my head, 36:50 36 minutes, 50 seconds which looks like a very, very messy laundry pile, uh to writing it down, 36:54 36 minutes, 54 seconds which at the very least puts everything on a hanger. Makes it a little bit easier to see uh what's available. Uh it still doesn't always make sense. It 37:01 37 minutes, 1 second still might be too heavy. Um, but it does help. Um, and research from Rita Chiron and others in narrative medicine 37:08 37 minutes, 8 seconds shows proves uh it gives clinicians a safe place to question the way that they are taught. Uh, certainly a lot of things have changed in the past 20 years 37:16 37 minutes, 16 seconds that I've been practicing medicine um and the way that the medical system encourages them to practice. Um, so it 37:25 37 minutes, 25 seconds is um certainly something that uh we know more about RVUs and FTEES than maybe we ever went over in med school. 37:35 37 minutes, 35 seconds Um, and yet um what are the ways that we can push back um by painting ourselves the way we really are instead of our VU 37:43 37 minutes, 43 seconds machines? Um by moving what is internal to the external, particularly with experiences that trouble us. Um, and I 37:51 37 minutes, 51 seconds think this goes for any of us who deal with death and dying. Um, but even uh with fertility and with uh adoption and 37:58 37 minutes, 58 seconds foster care for me. Um, experiences that diminish the space inside of us when we maybe affiliate too much. Um, we can 38:08 38 minutes, 8 seconds create more room where new experiences can live. 38:12 38 minutes, 12 seconds By externalizing our experiences, we create literal objects, text on a page that can then be examined at different 38:19 38 minutes, 19 seconds angles. just as an X-ray can be held up to a light. Um, does this accurately represent my experience or what I wanted to say? Sometimes you write something 38:28 38 minutes, 28 seconds down and immediately say that's not actually true. That's just what I needed to say. Um, does this look like what I expected or do I even see things here 38:36 38 minutes, 36 seconds that I am surprised to see? Um, by externalizing, we allow others to share in our experiences and invite others to 38:44 38 minutes, 44 seconds bring their lenses uh to our experiences. Um, and I think it's so important when we're presenting cases to each other, we say, you know, this is 38:53 38 minutes, 53 seconds what I'm getting from the patient, what am I, you know, what bell is ringing for you that hasn't rung for me. Um, but also when we're talking about our own 39:00 39 minutes experiences and saying, I guess this is the way it has to be. Having a colleague say, "Oh, no, no, that's not how it has to be. Try doing it this way." Um, in 39:09 39 minutes, 9 seconds terms of the structure of our medical system, um, we're very grateful that we've made a lot of progress, right? 39:14 39 minutes, 14 seconds Thank goodness for technology. we wouldn't be able to have this teaching situation without it. Um, yeah. So, 39:20 39 minutes, 20 seconds we're going to pause talking about writing because for some people it's all about music. Music has tons of research behind it that it can help regulate 39:27 39 minutes, 27 seconds arousal and mood and achieve self-awareness, whether it's hip-hop, jazz, country, or Broadway tunes. Um, 39:35 39 minutes, 35 seconds put out a song many years ago that I think is just super helpful. This is my um song for the end of a bad day that 39:42 39 minutes, 42 seconds makes me really feel heard. Um, when your day is long and the night the night is yours alone, when you're sure you've had enough of this life, well, hang on. 39:53 39 minutes, 53 seconds Don't let yourself go cuz everybody cries. Everybody hurts sometimes. 39:59 39 minutes, 59 seconds Sometimes everything is wrong. Now, it's time to sing along. So, singing this song for me helps me. 40:06 40 minutes, 6 seconds And I wonder if any of you have a song that you use already, a song that you'd be willing to share with your office mates uh tomorrow and say, "Hey, what 40:14 40 minutes, 14 seconds song do you guys listen to at the end of a bad day?" And find if you have something in common or if they have something that you've never heard of. Um the other uh question, of course, is 40:23 40 minutes, 23 seconds what song would help you get ready for a workday? So, we're back to team participation. Uh these are some uh favorites. Um most of you, I'm betting, 40:32 40 minutes, 32 seconds have heard the song Lean on Me at least once. It was made popular in a movie. 40:37 40 minutes, 37 seconds Uh, the Rocky theme song comes into my head at unexpected moments when I'm trying to uh psych myself up to go take 40:43 40 minutes, 43 seconds a splinter out or um do something that might involve a little bit of screaming. 40:48 40 minutes, 48 seconds Uh I am a Swifty, so I happily endorse Are You Ready for It by Taylor Swift. 40:53 40 minutes, 53 seconds It's got an amazing percussion section and uh as I'm turning onto Electric Road, uh it can help me uh keep going. 41:01 41 minutes, 1 second Uh, and then who can deny the power in the song Survivor by Destiny's Child. 41:06 41 minutes, 6 seconds Um, but I'm absolutely sure there are songs that I am not um listing for you guys that help you. Um, and I think uh 41:14 41 minutes, 14 seconds the question I would ask uh if I had you as a live audience is if you're saying none of the above, is there a song that helps you get ready? Um, and would you 41:22 41 minutes, 22 seconds be willing to share it with your colleagues? Um, 41:27 41 minutes, 27 seconds definitely everyone uh needs a different kind of impetus. Some people need a slow jam to get into work and some people need a little bit more. Um, it looks 41:36 41 minutes, 36 seconds like Lean on Me is the winner for today as the most popular. Hooray for Ben King. 41:43 41 minutes, 43 seconds All right, so I want to make sure we don't run out of time. Did you guys know that over 70% of doctors have musical training? I mean, how many of us were in 41:50 41 minutes, 50 seconds orchestra or band? How many of us took piano lessons? we wanted to list it on our um you know CV when we were applying to college and then med school showing 41:59 41 minutes, 59 seconds our continuity and engagement since we weren't all necessarily athletes. Um there are lots of musicians who are named Doc, but I read this great article 42:08 42 minutes, 8 seconds about Eddie Henderson who is a psychiatrist and also a jazz trumpeter. 42:12 42 minutes, 12 seconds Um and I think uh his um quote is worth repeating. I couldn't be a good doctor unless I was healed and music is the 42:20 42 minutes, 20 seconds thing that heals me. Music is like therapy. It puts me at ease with who I am. Then I can relate to other people and spread the joy. 42:30 42 minutes, 30 seconds Um there's actually an international association for music and medicine which has a journal called music and medicine um with collaborative studies undertaken 42:38 42 minutes, 38 seconds by a range of professionals. Um and especially the benefit of music for patients. Uh this article stood out to me. the effect of patients selected 42:46 42 minutes, 46 seconds music therapy on propifall consumption in a lapoli under total IV anesthesia randomized controlled trial. Uh so uh I 42:55 42 minutes, 55 seconds really want you to know that I think that music and medicine go together and I'm not alone. There's uh research behind me and an interdisciplinary 43:03 43 minutes, 3 seconds journal. Uh as far back as 1914, music was played through a gramophone to relax surgical patients. Uh rules were in ooh 43:11 43 minutes, 11 seconds sorry rules were in place for uh not playing jazz or sentimental tunes. You wouldn't want your surgeon crying. 43:18 43 minutes, 18 seconds Instead, soft soothing music was deemed acceptable. And a body of work suggests that surgeons actually perform better when music is playing. It can help 43:26 43 minutes, 26 seconds concentration and make surgeons operate faster. I will have to ask my dad later if that is true. Um but if you go on 43:33 43 minutes, 33 seconds Spotify, there is an operating room ultimate playlist. There is radiology radio. There's even acne healing binaural beats. Um, and research shows 43:42 43 minutes, 42 seconds that sharing music and musical experiences or making music with others leads to feelings of belonging and well-being. And we as a community certainly need that. 43:53 43 minutes, 53 seconds Let's see. So, I hope that with the pieces that we have looked at, the text, the source materials I've shown you, uh, 44:01 44 minutes, 1 second you have had, uh, a little bit of time to think about how you would paint yourself. uh you are more than your job 44:08 44 minutes, 8 seconds in medicine. Uh you are um potentially wearing a mask uh that people can see or that people cannot see at work. Uh you 44:18 44 minutes, 18 seconds are wearing the badge uh that says that you are in healthcare. Um but how can art help you find balance within your profession? How can it help your 44:26 44 minutes, 26 seconds students? How can it help um your patients? Um the saying of course is primum no cherry. Um, Sagundum Crayo is 44:35 44 minutes, 35 seconds my addition. Um, and I want you to prepare your own Lexi Calm kit. Uh, 44:40 44 minutes, 40 seconds whether it's a book or a movie or a poem or a picture or meme or a comic, a real, 44:44 44 minutes, 44 seconds a painting, a sculpture or a song that when you need it is available to you. 44:49 44 minutes, 49 seconds Um, and I hope that that will help you in your journey both as a provider and as a teacher. Um, I love me some Harry 44:57 44 minutes, 57 seconds Potter. Dumbledore said, "Words are, in my not so humble opinion, our most inexhaustible source of magic, capable of both inflicting injury, as we all 45:06 45 minutes, 6 seconds know, um when we tell someone that it is uh not benign, when we tell someone that the CT is positive, when we tell someone 45:13 45 minutes, 13 seconds that the test showed concerns, um but that our words can also remedy it by saying, "I'm here to give you help. I'm 45:20 45 minutes, 20 seconds here to help explain. Um we can talk this through." 45:24 45 minutes, 24 seconds Um, Albus Dumbledore also famously said in the last book, "Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?" 45:35 45 minutes, 35 seconds Thank you. Gracias Merci. That is my email. Please feel free to send me um questions or your favorite source material so that I can include it in a 45:43 45 minutes, 43 seconds future talk. Um, and I will now open it up to some Q&A um, and look forward to your questions. 45:59 45 minutes, 59 seconds And Dr. Gagan, as we wait for uh questions to come in through Slido, 46:03 46 minutes, 3 seconds there is one in the chat if you don't me uh if that's okay. Fantastic. Thank you. All right. 46:08 46 minutes, 8 seconds So, um most of the examples you have mentioned or illustrated have direct connection to being a physician or 46:15 46 minutes, 15 seconds caretaker, etc. But could artistic pursuits help in and of themselves without a direct link? 46:23 46 minutes, 23 seconds Oh, absolutely. I mean, this is why we have art class in kindergarten and we should have it as a mandatory part of 46:30 46 minutes, 30 seconds high school. Uh we know that uh self-expression is um deeply connected 46:36 46 minutes, 36 seconds to psyche and um happiness uh and our ability to handle the different curve balls that life hands us. So, um I tried 46:45 46 minutes, 45 seconds really hard not to always say the word doctor. I am a doctor, but I absolutely encourage everyone in every field. Um I 46:53 46 minutes, 53 seconds wish that uh teachers in math class felt like they could use poetry uh to connect with poems. Uh, one of my, um, high 47:01 47 minutes, 1 second school, uh, kids had a English teacher that used, um, the rap, um, uh, from Hamilton, uh, to talk about, um, how, 47:11 47 minutes, 11 seconds uh, students who may not necessarily see themselves in American history could see themselves. Um, I just think creative endeavors uh, are for everybody. 47:21 47 minutes, 21 seconds Oh, somebody raised their hand. Dr. Yep. 47:25 47 minutes, 25 seconds Yeah. Hi. Hi, Rachel. Thanks for that great talk. Um, 47:30 47 minutes, 30 seconds so I'm glad you included a section on music and you mentioned songs. 47:37 47 minutes, 37 seconds You didn't play a clip, you wrote the lyrics of the song there. 47:41 47 minutes, 41 seconds I did. I was worried about the it possibility of just complete and total failure, but I encourage everyone to listen. 47:48 47 minutes, 48 seconds Yeah. No, exactly. But I'm wondering um so some who are trained in music, you you 47:57 47 minutes, 57 seconds hear about people having music on to do homework or but some who are trained in music actually find that distracting 48:05 48 minutes, 5 seconds because they're concentrating on the musical aspects. My question for you is for about music without lyrics. 48:16 48 minutes, 16 seconds Many many of those types of examples I could see in narrative medicine why that might be difficult to communicate if 48:26 48 minutes, 26 seconds there are no words involved. But is is there any writing by narrative medicine 48:32 48 minutes, 32 seconds experts about that particular subset of music? Uh whether it be jazz or 48:39 48 minutes, 39 seconds classical or whatever uh form of music might be that how that 48:46 48 minutes, 46 seconds has does that come up in narrative medicine world? 48:50 48 minutes, 50 seconds Um it absolutely does. Uh we actually had a retreat a few weeks ago on Zoom uh where the um theme for the weekend was the movie Wicked for Good, the part two. 49:03 49 minutes, 3 seconds And we spent at least 20 minutes just talking about orchestration and how that sets the mood for the words that you 49:09 49 minutes, 9 seconds then hear from Alphaba saying that I'm going to defy gravity. Um so it I think would probably be rare because we are 49:17 49 minutes, 17 seconds kind of addicted to the words part. Um but we have absolutely looked at paintings that have no words, sculptures 49:24 49 minutes, 24 seconds that have no words and uh I am certainly new to the field. Um but uh absolutely um my favorite thing to listen to when I 49:32 49 minutes, 32 seconds was studying in college was the soundtrack to The Last of the Moheakans. 49:35 49 minutes, 35 seconds Um because if there was anything with words, I would stop studying and just start singing. Um so that was problematic. Um but instrumental music 49:42 49 minutes, 42 seconds and then even um you know some people listen to what's called green noise. So like the sound of crickets and rain um which is in itself poetry um on a good day. 49:54 49 minutes, 54 seconds Thanks. Thank you. 50:08 50 minutes, 8 seconds No other questions for a soundtrack. That is also an excellent soundtrack. 50:12 50 minutes, 12 seconds That one's pretty distracting though. I don't think I could do surgery with that. I think I might take out the wrong kidney if seen elsewhere was playing. 50:22 50 minutes, 22 seconds No other questions in the chat, but we do have folks sharing their their songs and their soundtracks, so that's that's nice to see. Oh. Oh, and then more comments. 50:32 50 minutes, 32 seconds I love it. I love it. Uh definitely Columbbo uh was a detective and I think that is a big part of our job, right? 50:40 50 minutes, 40 seconds Asking questions. Um, I have to say I loved Murder She Wrote and I definitely uh, you know, had that idea of like how could you just sort of be like, "Hey, 50:49 50 minutes, 49 seconds how's it going? What's going on with you? I'm not going to ask about why, you know, you have this particular injury." 50:55 50 minutes, 55 seconds Um, but I'm just going to see how you feel about it and see if you volunteer to me. Who did this to you? Who's who's the perpetrator? 51:06 51 minutes, 6 seconds Dr. Wicker, you have your hand raised. 51:09 51 minutes, 9 seconds I do. Thank you. That was so um that was a great session. I I did wonder clearly you're a talented writer and so you 51:19 51 minutes, 19 seconds really enjoy writing. I love writing as well. But I'm also wondering um is there a lot of research out there about the 51:28 51 minutes, 28 seconds folks who don't have a natural tendency to love writing or never did journaling or wrote poetry throughout their lives? 51:36 51 minutes, 36 seconds um that that this narrative by getting it out on paper really helped noviceses as well. 51:43 51 minutes, 43 seconds Absolutely. And I think you can look at the bookshelves of autobiographies by doctors. Um certainly if I didn't 51:51 51 minutes, 51 seconds mention it in this talk that was a huge error when breath becomes air is something I think everyone uh should read. And then uh to know that our 51:59 51 minutes, 59 seconds little scribblings, whether it's really a journal or not, um are just a really empowering way for us to capture what 52:06 52 minutes, 6 seconds what did I do today? Um and so one of the goals in any narrative medicine class is to say uh you know, you don't 52:14 52 minutes, 14 seconds have to be a writer. Uh you don't have to be a poet. Um and letting words come out of you um in any way, shape, or 52:21 52 minutes, 21 seconds form. uh letting emotions come out of you uh so that we can pay attention so that we can have representation so that 52:28 52 minutes, 28 seconds we can find affiliation um is good for everybody um and I think it's um been a 52:35 52 minutes, 35 seconds really interesting experience being in these classes with other people who are you know completely walking different um uh paths than me. One of my friends is 52:44 52 minutes, 44 seconds in Australia. she is a paliotative care doctor and um she had never written anything down other than patient notes 52:53 52 minutes, 53 seconds and she wrote us this poem and she said I don't even know what this is and we all said well it's a poem it's beautiful um so you know I sometimes have 53:01 53 minutes, 1 second teenagers who are like uh I'm not a runner but blah blah blah you know when I go running it makes my you know body feel strong and I'm like did you run 53:10 53 minutes, 10 seconds then you are a runner and you don't have to be published to be a writer and you don't have to be recorded to be a singer. Um I'm not going to sing for you 53:18 53 minutes, 18 seconds guys right now. Um but I love singing and that's the most important part. Uh and so for all of us to see the way that we express ourselves uh in whatever 53:27 53 minutes, 27 seconds form. My daughter's a dancer. I love watching her dance. When I ask her to talk about dance, she's like, I don't I don't know. Uh so I think for all of us 53:36 53 minutes, 36 seconds to tune into these options um and especially take a break from if our job is a lot of writing um that certainly um we might try something different. 53:46 53 minutes, 46 seconds Although in this age of AI some of us are writing less and that gives us a chance to write um what is called the parallel chart. Uh write things that we 53:54 53 minutes, 54 seconds would not want um anyone to read in a court of law but that help us sort of process what we just heard. um things 54:00 54 minutes that are just um unusual or uh shocking um we can understand better when they are written down. Um and so I I would 54:09 54 minutes, 9 seconds say that I think everyone can be a writer, but if you don't enjoy it, there are other ways. 54:14 54 minutes, 14 seconds Oh man, really lots and lots of wonderful suggestions. I hope everyone can see those. Yep. And another question too. 54:22 54 minutes, 22 seconds Oh yeah, sorry. Um I think we have time for this last one. So, how often have you suggested to patients to write or 54:30 54 minutes, 30 seconds express their feelings in their healing journey? 54:34 54 minutes, 34 seconds Um, because I do seem to be a magnet for teenage girls with depression, anxiety, I'm going to say it's 100% of days. Um, 54:43 54 minutes, 43 seconds but also I am a lactation consultant and I love talking to breastfeeding moms and I've encouraged them um, you know, I 54:50 54 minutes, 50 seconds don't care how many minutes you spend breastfeeding, but just was it a good breastfeed or not such a good breastfeed, a check or an X? And then, 54:56 54 minutes, 56 seconds you know, to write a little something about how hard you work today u to pat yourself on the back for doing something that is a lot of energy and it's 55:04 55 minutes, 4 seconds definitely not free. Um, so I talk to patients about writing a lot. I talk to them about reading a lot. I hand out books. I recommend songs. I recommend 55:13 55 minutes, 13 seconds movies. Uh I think I tell somebody to watch the movie Inside Out 2 almost every week to understand emotions um 55:20 55 minutes, 20 seconds that are going on inside their child or possibly their spouse. Um it's very very educational. 55:31 55 minutes, 31 seconds Oh, someone pointed out sixword stories. 55:33 55 minutes, 33 seconds I think that that is a fantastic suggestion. Um it is really really hard to tell a whole story in six words. Um, 55:40 55 minutes, 40 seconds but yes, it can be less daunting. Uh, 55:43 55 minutes, 43 seconds the other thing is to take a cue from what we were trying to do here. 55:46 55 minutes, 46 seconds Literally just set a timer for three minutes and just say, "I'm just going to write until the timer goes off." And it doesn't have to have a form and it doesn't have to achieve a product. I'm 55:55 55 minutes, 55 seconds just going to let words just fall on the page. Um, finding a prompt like what hurt today or what felt good today. Um, 56:02 56 minutes, 2 seconds you can keep it really basic. Um, but just making sure we're not trapping all that stuff up in our giant brains, um, 56:09 56 minutes, 9 seconds helps us to be better listeners, to be better storytellers. Um, and hopefully narrative medicine is something that we 56:16 56 minutes, 16 seconds can, um, talk about again often and soon. 56:22 56 minutes, 22 seconds Thank you so much, Dr. Gagan. What a wonderful session. uh wonderful suggestions in the chat and conversation and then just a great reminder for us 56:30 56 minutes, 30 seconds all to to be you know creative and and and writing things down that are that are meaningful. So if you 56:37 56 minutes, 37 seconds have questions um you know feel free to reach out to us and we can get them over to Dr. Gagan um and if you haven't 56:45 56 minutes, 45 seconds already make sure you complete the evaluation to give Dr. Gagan feedback on this on this session. So, thank you all for joining us today and have a 56:52 56 minutes, 52 seconds wonderful rest of your