As Roland Spencer Jones writes, another of my assumptions – and an assumption it will have to remain, as the claim surely lies beyond the reach of proof – is that it is a good thing to be made more human. The last century has seen a sustained intellectual and cultural assault on the idea of the human, where ‘human’ means something like a morally self-regulating individual with a discrete and irreducible essence: the human subject of liberal political theory. The last century has also seen us humans at our most savage and inhumane. My point here was really a straightforward one: that as human beings we can improve morally, albeit slowly, and that in small ways the arts can assist, where improvement means that we are better able to recognise the real needs of others, to recognise that their claims on the world are equal to ours. ‘More’ in this sense just means better. Predictably of course the world is not short of counter-examples. A glimpse at Philip French’s recent biography of VS Naipaul, The World Is What It Is again shows that a great artist can coincide with a questionable human being.

Another theme in the responses is the old problem of the tension between the arts and sciences, the ‘two cultures’ that CP Snow made famous in his 1959 Rede lecture. Many of the respondents suggest that the tension is alive and well at med school and that medicine is in the scientific camp. Jim Moonie, who moved from the arts to medicine clearly feels the divide strongly and suggests, I think, that there is a danger that science alone can dull the senses to the human context of medicine, and, presumably, disfigure the therapeutic encounter. The pity in this is that medicine, so clearly situated at the juncture of the scientific and the human, should be ideally placed to dissolve this outmoded distinction.

One comment that I made that has been picked up in some of the responses relates loosely to the usefulness of a narrative approach to medicine, to the idea that an understanding of the contexts in and through which patients move, and out of which illnesses emerge, can deepen the therapeutic relationship and lead to better outcomes. This is the point at which, perhaps, the strongest claims can be made for the sympathy between certain, narrative based art forms and the practice of medicine. In her fascinating response, Deborah Kirklin goes so far as to describe patients as the doctor’s ‘text’. I have to admit to misgiving at this point. I take it the usage is metaphorical, but I am wary of seeing human beings as a tissue of signs – it is too easy for the human to leach out from among them. Human beings use signs and symbols in complex and fascinating ways, but I am not sure they can be reduced down to them.

In my original posting I made a modest claim for the arts, and, in addition to the enormous pleasure that art has obviously given to so many of the contributors, many share this view. There seems to be agreement that only those already interested in change will take up the possibilities that art can offer. Although this still feels right, even here I would be cautious. Our moral capacities are vulnerable. Put me under too much stress and I lose the ability to empathise. Art may make better doctors, but overwork can undo them.

The best way to make “better doctors”, more understanding and communicative doctors, is to let the young sprogs out, as of old, at the end of their Finals Examinations and join a well-regulated partnership of their peers in General Practice. They will come to no harm, do no or little serious damage and will learn how to communicate with their patients.

This will stand them in good stead in those future years when they will be dragooned back into hospital as cheap labour and an economic unit of the NHS.

Art? Now what exactly do we mean? Un-made beds in the middle of a Gallery? Music? Primary School stuff noise that is so popular as “art” with the BBC? Twanging, groaning and drumming?
Painting?

If you are a busy doctor, and how many can claim to be that today with their shorter working hours and high salaries for doing nothing, you need time for thought and time to think about what you are painting, in oils, poster-colour, etc.
Sculpting?

Come now!
Your patients, and art are going to suffer if you have to break off what you are doing, reluctantly to go out on a call.

Absolutely right!

____________________
Marvin

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However, art can make better doctors in terms of problem solving ability and thinking skills. A common attribute of great doctors and scientists is a special dimension of thinking and great problem solving abilities. Often in medicine, diagnosis and treatment can be simple but sometimes the odd case comes along that challenges our aptitude and intelligence. Most people will agree that such cases sometimes require lateral thinking. in other word, thinking outside the box. However, you don’t always have to think outside the box if your box is big and rich enough in the first place and this is where art comes in.

Many medical students and clinicians concentrate on updating their knowledge in science and medicine alone without considering other fields and areas. This basically gives limited resources to solve problems as they have similar arrows in their quiver and there is less variety in their approaches to problems. by indulging in art and other areas, doctors can become better as they become more creative and imaginative. These are important requirements for real ingenuity.

Atul Gawande, in his book ‘better ‘, talked about a doctor who got the idea for the stereostethoscope while listening to a church choir. I doubt if years of trawling through medical journals could have given him such an ingenious idea. Art including reading engages the mind and make us think in alternate ways. This, I believe is one great contribution that art can make to medicine in addition to the fact that it is therapeutic and enjoyable. At the end of the day, we don’t lose anything by indulging ourselves in art.

The core of my work turned to ‘The Gaze’ - this is constantly debated in art circles because the ’seeing’ is recognised as central to engaging with art. ‘The Gaze’ is also central to medicine - not just the seeing but the listening, examining, palpating, history taking, imaging, dissecting, healing etc- all of these are the medical gaze. I ended up writing my thesis about the medical gaze - how technology allows us to distance ourselves from the direct gaze but what we see is more invasive.

The term’ the gaze’ which is so central to medical disciplines remain an unrecognised term in medical fields.

Foucault is a great read for any Doctor.

A liberal arts education may breed snobbery and disrespect for others, just as it may breed universalism and love of others. It is an empirical question how often it does which.