Comments for BMJ blogs http://blogs.bmj.com/bmj BMJ Blogs Sat, 17 May 2008 16:01:27 +0000 http://wordpress.org/?v=wordpress-mu-1.2.3-2.2.1 Comment on Julian Sheather: Does art make people better doctors? by GEORGE CALDWELL http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29256 GEORGE CALDWELL Sat, 17 May 2008 02:50:37 +0000 http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29256 If General Practitioners take three months off to go and sit on a desert island then they should not be General Practitioners or even doctors. 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. If General Practitioners take three months off to go and sit on a desert island then they should not be General Practitioners or even doctors.

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.

]]> Comment on Liz Wager: Training and the placebo effect by Andrew Walker http://blogs.bmj.com/bmj/2008/05/13/liz-wager-training-and-the-placebo-effect/#comment-29253 Andrew Walker Fri, 16 May 2008 12:57:15 +0000 http://blogs.bmj.com/bmj/2008/05/13/liz-wager-training-and-the-placebo-effect/#comment-29253 A few weeks ago I led my fisrt workshop at the European Medical Writers Association meeting in Barcelona. The feedback from the delegates was largely positive in that most of them found it instructive and stimulating. That in itself was gratifying. What was unexpeted was the effect that the experience had on me, the trainer. I returned to work rejuvenated, full of new ideas and strategies fro dealing with the challenges of working in multidisciplinary teams. Thus I support your observation that in teh context of training, humans respond best to human contact but would like to add that the benefits can work both ways! A few weeks ago I led my fisrt workshop at the European Medical Writers Association meeting in Barcelona. The feedback from the delegates was largely positive in that most of them found it instructive and stimulating. That in itself was gratifying. What was unexpeted was the effect that the experience had on me, the trainer. I returned to work rejuvenated, full of new ideas and strategies fro dealing with the challenges of working in multidisciplinary teams. Thus I support your observation that in teh context of training, humans respond best to human contact but would like to add that the benefits can work both ways!

]]> Comment on Anna Donald: Mind and body by Karen A. http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29250 Karen A. Thu, 15 May 2008 10:05:59 +0000 http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29250 Thanks Anna, for another wonderful entry. The blog is a great thing to be doing and I think very quintessentially Anna - making wonderful ripples that touch and inspire and move so many, and connect us all. Thanks Anna, for another wonderful entry. The blog is a great thing to be doing and I think very quintessentially Anna - making wonderful ripples that touch and inspire and move so many, and connect us all.

]]> Comment on Anna Donald: Mind and body by Tom http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29248 Tom Thu, 15 May 2008 07:58:12 +0000 http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29248 Excellent post, again. Besos. Excellent post, again. Besos.

]]> Comment on Julian Sheather on the Wellcome exhibition “Life Before Death” by Dr.Viveck Atheya http://blogs.bmj.com/bmj/2008/05/09/julian-sheather-on-the-wellcome-exhibition-life-before-death/#comment-29245 Dr.Viveck Atheya Wed, 14 May 2008 15:38:38 +0000 http://blogs.bmj.com/bmj/2008/05/09/julian-sheather-on-the-wellcome-exhibition-life-before-death/#comment-29245 Ghastly Ghastly

]]> Comment on Anna Donald: Mind and body by Richard Smith http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29244 Richard Smith Wed, 14 May 2008 13:04:19 +0000 http://blogs.bmj.com/bmj/2008/05/14/anna-donald-mind-and-body/#comment-29244 The idea--indeed, conclusion from Michael Marmot's studies--that "you get sick according to how you perceive the world" is fascinating and profound. Would I be right to think that you view the world as one endlessly interesting and beautiful puzzle? And you are now, as you explain, your own experiment. That's why your bulletins from an extraordinary place are so compelling. But then again I reflect that it's not such an extraordinary place. It's a place that many of us can expect to be at some time in our lives--so it's not your place that's extraordinary but your bulletins. The idea–indeed, conclusion from Michael Marmot’s studies–that “you get sick according to how you perceive the world” is fascinating and profound. Would I be right to think that you view the world as one endlessly interesting and beautiful puzzle? And you are now, as you explain, your own experiment. That’s why your bulletins from an extraordinary place are so compelling. But then again I reflect that it’s not such an extraordinary place. It’s a place that many of us can expect to be at some time in our lives–so it’s not your place that’s extraordinary but your bulletins.

]]> Comment on Julian Sheather: Does art make people better doctors? by Jim C Moonie http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29242 Jim C Moonie Wed, 14 May 2008 10:23:31 +0000 http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29242 It was with delight and disbelief, in equal measure, that, less than two weeks after first writing on this blog, I realised my suggestion to introduce intercalated arts degrees to the medical curriculum had already happened. Not only that, it had happened at Bristol, where I trained and not only had it happened, but it had happened two years ago. Good thing then that I was so bored this evening that I happened upon those hallowed pages of Black Bag, the Bristol University Medical School Journal that I once edited (in the days before it went online) and read an interview with Dr Trevor Thompson, the 'then' new consultant senior lecturer and discovered that my suggestions had become fact. Not only that, they had become fact before I had even suggested them. Such is my power of perception. I feel like Marty McFly in Back to the Future with his copy of an old sporting almanac, or Nostradammus. I can, it seems, predict the future. I could have told you, for example, that the ST system would not be popular and I can tell you that Obama will be the next president of the United States. I can even tell you, so long as you live in the UK and I live in New Zealand, what happens in Neighbours for the next three months and when I next write I'll tell you when the world ends so you'd better watch this space. It was with delight and disbelief, in equal measure, that, less than two weeks after first writing on this blog, I realised my suggestion to introduce intercalated arts degrees to the medical curriculum had already happened. Not only that, it had happened at Bristol, where I trained and not only had it happened, but it had happened two years ago. Good thing then that I was so bored this evening that I happened upon those hallowed pages of Black Bag, the Bristol University Medical School Journal that I once edited (in the days before it went online) and read an interview with Dr Trevor Thompson, the ‘then’ new consultant senior lecturer and discovered that my suggestions had become fact. Not only that, they had become fact before I had even suggested them. Such is my power of perception. I feel like Marty McFly in Back to the Future with his copy of an old sporting almanac, or Nostradammus. I can, it seems, predict the future. I could have told you, for example, that the ST system would not be popular and I can tell you that Obama will be the next president of the United States. I can even tell you, so long as you live in the UK and I live in New Zealand, what happens in Neighbours for the next three months and when I next write I’ll tell you when the world ends so you’d better watch this space.

]]> Comment on Anna Donald: Making meaning in the now, for the now by Ghislaine Young http://blogs.bmj.com/bmj/2008/05/08/anna-donald-making-meaning-in-the-now-for-the-now/#comment-29240 Ghislaine Young Wed, 14 May 2008 07:21:30 +0000 http://blogs.bmj.com/bmj/2008/05/08/anna-donald-making-meaning-in-the-now-for-the-now/#comment-29240 Anna As with several others Richard Smith alerted me to this blog. Synchronicity or mere coincidence? I have been aware of thoughts of death ever since my father died in an accident when I was only a child. I realise that at a subconscious level I entered nursing because it appeared that doctors and nurses were on the other side of the "big divide". More recently a close friend has been diagnosed with pancreatic cancer. For a time I started to feel guilty whenever I laughed, relaxed or read a novel, when others were made to count every second. But as you so rightly say Anna "more life is just more" and all there is, is the present. My hero the metaphysical poet said so eloquently: "no man is an island entire of itself... any man's death diminishes me because I am involved in mankind, so never send to know for whom the bell tolls, it tolls for thee". Anna you are blessed because you are seizing every moment, you love and are loved in return. Its is more than any of us can ask for in life. I shall leave my final words to my all time favourite medieval hermit, Julian of Norwich, who speaks on the nature of the Divine: "Love was his meaning...Hold fast to this and you shall learn and know more about love, but you will never need to know or understand about anything else for ever and ever". Anna
As with several others Richard Smith alerted me to this blog. Synchronicity or mere coincidence? I have been aware of thoughts of death ever since my father died in an accident when I was only a child. I realise that at a subconscious level I entered nursing because it appeared that doctors and nurses were on the other side of the “big divide”. More recently a close friend has been diagnosed with pancreatic cancer. For a time I started to feel guilty whenever I laughed, relaxed or read a novel, when others were made to count every second. But as you so rightly say Anna “more life is just more” and all there is, is the present. My hero the metaphysical poet said so eloquently: “no man is an island entire of itself… any man’s death diminishes me because I am involved in mankind, so never send to know for whom the bell tolls, it tolls for thee”. Anna you are blessed because you are seizing every moment, you love and are loved in return. Its is more than any of us can ask for in life. I shall leave my final words to my all time favourite medieval hermit, Julian of Norwich, who speaks on the nature of the Divine: “Love was his meaning…Hold fast to this and you shall learn and know more about love, but you will never need to know or understand about anything else for ever and ever”.

]]> Comment on Julian Sheather: Does art make people better doctors? by Dr. Ravi Shankar http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29239 Dr. Ravi Shankar Wed, 14 May 2008 02:49:43 +0000 http://blogs.bmj.com/bmj/2008/05/01/julian-sheather-does-art-make-us-better-doctors/#comment-29239 I agree with the author that art can be helpful in creating better doctors. In South Asia at present, art does not play an important role in the training orientation of future doctors. In Nepal and most other South Asian countries students enter medical school after twelve years of schooling. It is mandatory that students study science subjects in the last two years of school. Admission to medical school is on the basis of marks obtained in an entrance examination concentrating on the science subjects. Scholastic ability is the only component measured in these examinations and there is no weightage for the ‘soft’ skills. There a few seats reserved for candidates on the basis of their extracurricular achievements but this is just a token. A token interview is conducted by many schools but has no role in candidate selection. Due to the tremendous academic pressure during the last three or four years of school students stop participating in extracurricular activities and are solely involved in their academic pursuits. The student body at the time of admission to medical school may come from diverse cultural and linguistic backgrounds but are very much alike scholastically. In the west, these days students from a diversity of cultural, social and educational backgrounds are admitted to medical school. This is not the case in Nepal and South Asia. In South Asia, due to various reasons, among them the British colonial legacy, English is the medium of instruction in medical schools. The majority of the textbooks and other teaching material are from a Western context. The majority of learning takes place in English from a very early age. English medium schools are becoming common in which the various subjects are taught in English and the national language and the mother tongue are only taught as second or third languages. I believe this serves to create a barrier between the English educated elite and their native countrymen. In Nepal, the undergraduate medical course (MBBS) is of four and half years duration followed by a year of rotating compulsory internship. The basic science subjects are taught during the first two years with regular clinical contact and this is followed by the clinical years of training. I had conducted a voluntary Medical Humanities module for interested students at the Manipal College of Medical Sciences, Pokhara, Nepal. I had used literature and art excerpts, case scenarios and role-plays to explore various aspects of the medical humanities. The module was started following the observation of medical students, faculty members and members of the community of a decline in the humanistic values of doctors and the felt need for a certain amount of teaching of the Medical Humanities (MH). The module introduced the students to the concept that art and literature can have a role in the training of future doctors. The learning was fun and the participants were free to exercise their creative faculties. Faculty and student participants learned together and explored various aspects of the doctor-patient relationship. Regular feedback was obtained throughout the module and through a focus group discussion with the participants at the end of the module. The participants were of the opinion that the module had helped them to become better doctors and had offered them a perspective about patients which is rarely stressed during medical; training in South Asia. Hard evidence for the fact that art is helpful in the creation of better doctors was lacking but indirect evidence supports this proposition. The participants of the module have started interacting with patients in a more empathic manner and have begun to consider the patient’s illness in the larger viewpoint of his/her family, community and society according to their clinical supervisors. In the west there have been studies which have shown that various student characteristics, especially empathy improved after a MH module. We plan to measure participant characteristics including empathy before and after a MH module in the future. At present the author is conducting a MH module for faculty members, doctors and dentists at the KIST Medical College, Imadol, Lalitpur, Nepal. The module has been well received by the participants. Thus indirect evidence seems to suggest that art has an important role to play in creating better doctors. Also as stressed by various authors learning is MH is an enjoyable pursuit and does not add to the stress and strain associated with medical school. Medical Educators in South Asia should realize that art and the humanities should be an important part of the curriculum like it is in the west. Dr. P. Ravi Shankar Department of Medical Education KIST Medical College Imadol, Lalitpur Nepal. Phone: 00977-1-5201496 E-mail: ravi.dr.shankar@gmail.com I agree with the author that art can be helpful in creating better doctors. In South Asia at present, art does not play an important role in the training orientation of future doctors. In Nepal and most other South Asian countries students enter medical school after twelve years of schooling. It is mandatory that students study science subjects in the last two years of school. Admission to medical school is on the basis of marks obtained in an entrance examination concentrating on the science subjects. Scholastic ability is the only component measured in these examinations and there is no weightage for the ‘soft’ skills. There a few seats reserved for candidates on the basis of their extracurricular achievements but this is just a token. A token interview is conducted by many schools but has no role in candidate selection.
Due to the tremendous academic pressure during the last three or four years of school students stop participating in extracurricular activities and are solely involved in their academic pursuits. The student body at the time of admission to medical school may come from diverse cultural and linguistic backgrounds but are very much alike scholastically. In the west, these days students from a diversity of cultural, social and educational backgrounds are admitted to medical school. This is not the case in Nepal and South Asia.
In South Asia, due to various reasons, among them the British colonial legacy, English is the medium of instruction in medical schools. The majority of the textbooks and other teaching material are from a Western context. The majority of learning takes place in English from a very early age. English medium schools are becoming common in which the various subjects are taught in English and the national language and the mother tongue are only taught as second or third languages. I believe this serves to create a barrier between the English educated elite and their native countrymen.
In Nepal, the undergraduate medical course (MBBS) is of four and half years duration followed by a year of rotating compulsory internship. The basic science subjects are taught during the first two years with regular clinical contact and this is followed by the clinical years of training. I had conducted a voluntary Medical Humanities module for interested students at the Manipal College of Medical Sciences, Pokhara, Nepal. I had used literature and art excerpts, case scenarios and role-plays to explore various aspects of the medical humanities. The module was started following the observation of medical students, faculty members and members of the community of a decline in the humanistic values of doctors and the felt need for a certain amount of teaching of the Medical Humanities (MH).
The module introduced the students to the concept that art and literature can have a role in the training of future doctors. The learning was fun and the participants were free to exercise their creative faculties. Faculty and student participants learned together and explored various aspects of the doctor-patient relationship. Regular feedback was obtained throughout the module and through a focus group discussion with the participants at the end of the module. The participants were of the opinion that the module had helped them to become better doctors and had offered them a perspective about patients which is rarely stressed during medical; training in South Asia.
Hard evidence for the fact that art is helpful in the creation of better doctors was lacking but indirect evidence supports this proposition. The participants of the module have started interacting with patients in a more empathic manner and have begun to consider the patient’s illness in the larger viewpoint of his/her family, community and society according to their clinical supervisors.
In the west there have been studies which have shown that various student characteristics, especially empathy improved after a MH module. We plan to measure participant characteristics including empathy before and after a MH module in the future.
At present the author is conducting a MH module for faculty members, doctors and dentists at the KIST Medical College, Imadol, Lalitpur, Nepal. The module has been well received by the participants.
Thus indirect evidence seems to suggest that art has an important role to play in creating better doctors. Also as stressed by various authors learning is MH is an enjoyable pursuit and does not add to the stress and strain associated with medical school. Medical Educators in South Asia should realize that art and the humanities should be an important part of the curriculum like it is in the west.
Dr. P. Ravi Shankar
Department of Medical Education
KIST Medical College
Imadol, Lalitpur
Nepal.
Phone: 00977-1-5201496
E-mail: ravi.dr.shankar@gmail.com

]]> Comment on Julian Sheather on the Wellcome exhibition “Life Before Death” by Aida Partridge http://blogs.bmj.com/bmj/2008/05/09/julian-sheather-on-the-wellcome-exhibition-life-before-death/#comment-29238 Aida Partridge Wed, 14 May 2008 01:34:35 +0000 http://blogs.bmj.com/bmj/2008/05/09/julian-sheather-on-the-wellcome-exhibition-life-before-death/#comment-29238 Very powerful.To confront such a topic is a must for all of us who are engaged in making decisions in matters of life and death. Soul searching to strive even harder for quality of life when life's demise is inevitable. Very powerful.To confront such a topic is a must for all of us who are engaged in making decisions in matters of life and death. Soul searching to strive even harder for quality of life when life’s demise is inevitable.

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