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PCMD Medical Humanities Conference 2016

18 Apr, 16 | by cquigley

 

Ian Fussell

Community Sub Dean UEMS

 

In 2002, The Peninsula Medical School (now Peninsular College of Medicine and Dentistry (PCMD)) became the first UK medical school to integrate the medical humanities as core curriculum.

Every year since, year four students engage in a six-month project alongside and mentored by an artist. The culmination of the project is a conference organised by the students displaying and presenting their work.

The work thus created has become increasingly sophisticated over the years, as evidenced by the 2016 conference that just took place in Truro (April 2016). In fact, it was probably the highest quality of work seen to date and would not be out of place at any international medical humanities conference.

The morning session was opened by Professor Alan Bleakly, the current President of the Association for Medical Humanities and a leading world expert in the field. This was a particularly poignant conference as 2016 is the final year that it will be run under the auspices of PCMD following the disaggregation of Exeter and Plymouth Medical Schools. It may have been this, or the unsettled future that the current students are facing, that gave this year’s presentations an extra edge.

Following a superb talk by Alan that encouraged a political voice, we were treated to three songs written and performed by “Dull to Percussion”, a band formed in the “Medical School of Rock” module. The songs were indeed political, satirising the split between the universities and included a protest song aimed squarely at our Health Secretary. Search iTunes or Spotify to listen for yourself, and watch “A Song for a Hunt” go viral.

The day was then jam-packed and it was impossible to experience all that was on offer. The range of skill and talent was breathtaking. We were lectured on the human cost of the western desire for sweetness by students from the anthropology module, and invited to debate “Do Christians make better doctors” by the Christian ethics students. This year a number of new Special Study Units (SSUs) were run. They were also extremely good and included a collaboration with Truro’s Hall for Cornwall team.

The students worked at the theatre, but more impressively wrote a play on mental health in medical students. We were treated to a premiere performance – “Permission to be Human” should be performed at every medical school in the country. There was also a monologue by a shy mature student who helped us understand alcoholism and PTSD in war veterans. The mood was lifted by a hilarious stand up routine; how can dislocating your shoulder be so funny?!

There were a number of writing modules, including poetry. The audience was encouraged to write poems in a short workshop. Another new module was “Writing the Knife”, which generated superb short reflections on memorable clinical incidents. One piece called “Quayside” was outstanding and deservedly won a prize. Read it here https://memorablemedicmoments.wordpress.com/author/memorablemedicmoments/ and add your comments.

There was so much more to the students’ work, and this short piece cannot cover everything. However, I do want to mention a some other excellent pieces: working with clay exploring the professional masks doctors wear; pottery boxes representing the mess that doctors get into as they progress through their careers; moving and uncomfortable films that depicted a child’s journey through a hospital; the doctors strike shown as a frightening political movement; dopamine photography; a project on how we smell; and life drawing in conjunction with Falmouth Art School. At the end of the day we were “kettled” into a small room, and forced to party…

The aim of this SSU is to develop student’s tolerance to ambiguity. But the SSU achieves much more than this: it helps students develop a community of practice; it also fosters development of resilience and peer support; and importantly, the students have fun while exploring other perspectives on life and illness. I am extremely proud of our medical students and feel very privileged to work with them in this way. I hope that both Exeter and Plymouth continue with medical humanities in their developing curricula.

 

 

 

The Reading Room: This Living and Immortal Thing

13 Apr, 16 | by cquigley

 

And so it goes…this thing called life

Fergus Shanahan

 

9781783781676

 

This Living and Immortal Thing

By Austin Duffy

Granta Books, 2016

 

If authors write what they know, then Austin Duffy knows a lot, but This Living and Immortal Thing, his first novel, blends experience with fiction and offers more than informed opinion and insight to medicine, science, life and death. This is a story. The story teller is an Irish doctor who has left a childless, stagnant marriage to specialise at a famous cancer centre, recognisable as Memorial Sloan Kettering in Manhattan. As a post-doctoral trainee, he is comparatively mature in his mid-forties, and contemplates life and events in his new surroundings. Thinking of his younger brother Donal back in Ireland, he notices that America differs from home in having relatively few cases of Down’s syndrome. “They would not have allowed him to be born…with their blood tests and ultrasounds and amniocentesis needles…” His brooding juxtaposes several contrasting images: the bustle of the city ignoring a lone street protestor; the urgency of the clinic versus the controlled environment of the research laboratory; and a bored, hung-over clown employed to entertain sick children, bald from chemotherapy, reminds us that for the hospital staff illness is routine, but for the patients it is crisis.

At first, there is a trace of glibness in the narrator’s clichés but these are progressively replaced by more heartfelt prose that unfolds like a diary. His jadedness is jolted by the freshness and allure of Marya, a young Russian immigrant who volunteers as a translator in the hospital. Their dialogue is clipped, droll and loaded with sexual energy. She uses irreverent and refreshingly direct language. “So what sort of doctor are you anyway?” “You’re like, what…forty five? Are you homosexual?” He reveals his story with typical Irish reserve. But this is no ordinary flirtation; she has a secret. She seems hurried and doesn’t bother with his name – ‘post-doc’ will do. Post-doc is both intrigued and attracted, and his scientific mind repeatedly notes that men are seldom distracted from sex for long, regardless of the context.

“…doctors, they’re so stupid!” exclaims Marya, frustrated after witnessing a tactless communication of bad news to a patient. “I don’t translate word for word but only some….”  Silently, post-doc reflects how difficult it is to explain things properly though a translator but also easier because one is removed and less responsible for one’s words. He likens it to a high altitude bomber out of range from the sights and sound of the horror inflicted below. He is dispassionate about his experiences with terminally ill patients: “For the most part,” he says, “there is nothing to do except sit across from them and be kind.” In a commentary on communication, the eminent medical scientist Robert Brook once defined a physician by the following equation: physician = emotion + passion + science. Post-doc surely has emotion and recently switched from clinical to laboratory science, but may have lost his passion.

While grieving the physical and emotional distance from his own potential progeny, his care for the experimental animals is tender and touching, with each identified by name. He is opinionated about what it takes to be a good scientist, and is respectful but deeply critical of his supervisor Dr. Solter. Like all good scientists, post-doc is attentive to detail, painstakingly recording his observations, with a measure of humorous humility when Henrietta, his favourite mouse, is pronounced to be male by the visiting vet.  On the sole occasion when post-doc says something kind about Dr. Solter, it is to concede how well Solter communicates with the next of kin of a terminally ill patient. Curiously, he doesn’t seem very excited about the promise or impact of his own research; he bores a group of students when he is called to explain his project. Perhaps this is disillusionment or perhaps it is the key point: the scientific method is slow and repetitive and gives the lie to the popular misconception that science is fun.

There is, of course, no mystery about where the story will go, but this doesn’t detract from the parallels between the laboratory mice and the patients, the cancer cells and the frozen embryos from post-doc’s marriage, and a vigorous new cell line from a once vibrant donor. Along the way, the story is speckled with informed commentary on topics ranging from cancer to clinical arrogance. Some of post-doc’s asides are authoritative, like those on the poetry of W.B. Yeats and the music of Brazil. Others are enigmatic: “There comes a time when all there is to do is worry” and “Illness makes for an oddly insubstantive discussion,” whereas other pronouncements are quirky: “Generally you are better off when things are not resolved at all. You only have to ask any one of my previous patients that. It is rarely in your interests.”

If this is a book about cancer, then it is also about life, death, loss and replacement, and a book about medicine. With each, there is uncertainty. Medicine is the art and science of managing uncertainty. Post-doc has moved from the clinic to the research laboratory where it is “more controlled and predictable…in contrast to clinical work, where you have only an illusory or – at best – superficial control over things.” When questioned by Marya, he is vague on the reason for his change: “Humans are tricky, I suppose… Unpredictable.” In the research laboratory: “You set your own conditions and, to a large extent, the future is predetermined.” Is this self-serving? Is post-doc a reliable narrator? Later, he claims: “Given the choice I would take uncertainty over certainty every time.” He believes that a true scientist’s mind should move slowly and should “question everything.” He is critical of people like Solter whom he believes “has too much certainty” to be a natural scientist and whose mind is “moving too quickly for science…” Since childhood, post-doc has had a searching mind and was described by his school teacher as “a fan of distraction.” Now, he wants to slow things down in his life, to focus and to cope with the passing of time, and this, in his view, is as good a reason as any for going into the laboratory, where he can focus on the continual cycle of life, death and replacement.

This is a book that I expected not to like, much of it too familiar to me. Now, I miss the accented penetrating language of Marya and the distractions of post-doc.

The Reading Room: ‘Deaf Gain’

8 Apr, 16 | by cquigley

 

Deaf Gain: Raising the Stakes for Human Diversity

H-Dirksen L. Bauman and Joseph J. Murray, Editors

University of Minnesota Press, 2014

 

Reviewed by Dr Paul Dakin, GP Trainer in North London with research interest in the representation of d/Deaf people

 Deaf

This book challenges the commonly held notion that deafness is an existence marked primarily by loss of hearing and a condition that needs to be treated or corrected. Deaf Gain proposes an alternative in which deafness is seen as an evolutionary divergence carrying specific advantages for both non-hearing and hearing communities. Claiming that “Deaf Gain can change the ways in which we appreciate the gifts of all humans” (xxxii), the book argues for a shift in the dominant hearing world view from a perception of what is missing towards a positive recognition of the contributions and advances derived from the experiences of Deaf individuals and Deaf culture.

The basic concept of Deaf Gain was originally formulated in a series of presentations organised by two of the editors, Baumann and Murray, in 2009. These presentations took place at Gallaudet, the world’s only Deaf University, situated in Washington DC.

The 500 page volume was generated out of the resulting discussions and seminars and represents the work of 45 authors mainly based at Gallaudet. The 27 chapters that constitute Deaf Gain are not too long, and are on the whole easy to read, informative, and well researched. The book is arranged in sections that consider applications of the underlying concept around specific themes such as philosophical, language, sensory, social and creative.

The overwhelming approach is positive, optimistic, and even heroic. The concept of Deaf Gain turns on its head the usual idea that deafness should be defined through narratives of suffering and isolation. “The Deaf community has gone to great efforts to deabnormalize deafness. To combat the abnormalizing notion of seclusion due to deafness, we get Deaf cultures. To combat the abnormalizing characterisation of deafness as hearing loss, we get Deaf Gain” (p33).

This may well be true for a minority of people who are non-hearing. The book is written mainly, though not exclusively, from the perspective of the American Deaf Community, most of whom would be deafened at or near birth, and whose first language would be American Sign Language (ASL). Their experience would resonate with other signing communities, such as British Sign Language (BSL) in the UK, although it is not as large, active, or vocal as its counterpart in the USA.

But it should be remembered that the vast majority of individuals who experience deafness are not born Deaf or become deafened at a young age. They actually lose hearing in later life, perceive their experience in terms of communication difficulties with the majority community to which they have always belonged, often feel isolated, and would most certainly characterise deafness as a process of loss.

Claims are made early on concerning the evolutionary advantages of deafness on the basis of the persistence of the deaf gene. Again this is less likely to apply to the majority of people who become deafened later in life. I’m not convinced that just because a gene persists this inevitably means it has enhanced evolutionary potential. For instance, the cystic fibrosis gene is not rare, but its evolutionary rewards, if any, remain unclear. Parallels are also made between the advantages of deafness and those of bipolar disease and Huntington’s chorea, a suggestion that seems rather self-defeating, as I have never come across individuals with these conditions who celebrate such devastating diseases.

Other potential benefits of deafness are more readily and obviously explained. Evidence is given to show that Deaf people have better visual acuity, pay more attention to facial features and to peripheral vision, enjoy greater manual dexterity and enhanced tactile senses, and have improved spatial memory compared to their hearing counterparts. It could be argued that this is not a genetic facility at all but an increased functionality due to loss – an example of when one sense is absent, the brain develops others to compensate. People who have severe visual impairment are traditionally believed to have developed greater abilities to hear and to sense movement, and to even display ‘second sight’. Many people have folk beliefs about the loss of sight leading to enhancement of other senses or even ‘supernatural’ ones. This ‘benefit’ or ‘privilege’ isn’t conferred to those who have lost their hearing but perhaps should be.

An appeal is made to historical records showing how much deafness and Deaf people have contributed to our understanding of the development of language and have pushed forward inventions such as Morse code and the telephone. Deaf people are revealed to be quick learners and good employees, with large companies such as Firestone and Goodyear actively recruiting staff from within the Deaf community. Instances are given of societies around the world in which both hearing and non-hearing people use sign language, with a resulting increase in social cohesion.

The information presented from neuroanatomical studies is fascinating. There is evidence for the gestural origin of language. When children acquire language, spoken or signed, they do so in a similar way. The brain learns communication using similar processes regardless of whether it is visual or auditory, although the right hemisphere is more active with signing. Teaching a hearing baby simple signing conveys advantages in visual processing, language acquisition, vocabulary, and reading.

Creative gains include the notion of Deaf Space in which architecture takes ‘possession of space’ for Deaf people by emphasising vision and touch as the primary means of spatial awareness and orientation. These benefits are available for all, and include emphasis upon exciting features such as building around a common collective space, an emphasis on the placement of light and mirrors, and soft intersections that have destination points within immediate view.

In summary, the book proposes that the world as a whole benefits from the attributes, abilities, perspectives and contributions that arise from deafness, Deaf individuals, and Deaf culture. The concept of Deaf Gain promotes deafness as a positive for the entire community, hearing and non-hearing, not as a genetic or disease abnormality but as “a biological variety in the human race, like skin color or gender” (p287).

I enjoyed reading Deaf Gain, and recommend it as a resource. Although I have reservations about some of its assertions, it catalogues a wide body of evidence and presents well-argued opinion. It is an excellent addition to the understanding of deafness and to the promotion of Deaf culture.

Khalid Ali: ‘Let’s talk about death: a review of ‘Last cab to Darwin’, Australia 2015’

31 Mar, 16 | by Ayesha Ahmad

Let’s talk about death: a review of ‘Last cab to Darwin’, Australia 2015

5*, Directed by Jeremy Sims based on stage play by Reg Cribb

Dubai International Film Festival (DIFF) December 2015, possible release in UK cinemas 2016/17

The controversial subject of ‘euthanasia and assisted suicide’ has been a rich source for films; ‘Whose life is it anyway? USA, 1981, directed by John Badham’, ‘The sea inside, Spain, 2004, directed by Alejandro Amenabar’, and ‘Million Dollar baby, USA 2004, directed by Clint Eastwood’ have all explored the ethical, legal and moral complexities of ‘the right to die’ from a patient’s perspective.

more…

Ayesha Ahmad: ‘Lahore is an Illusion, Lahore is Everywhere’

27 Mar, 16 | by Ayesha Ahmad

The mango tree faded many shadows ago, its fruit became stones and the branches became a skeleton. Yet, the roots remained, and they embrace the soil in the womb of the earth.

images-1

This was the cradle of my family’s birth.

Now, blood is watering Lahore’s gardens.

In sorrow, I remembered these words given to me a few days ago by my father.

 ‘Lahore is an illusion, Lahore is everywhere’

I wondered about them for sometime afterwards and I did not realise the gift that these words were to become.

more…

Franco Ferrarini: The Past: a Friend or Foe? Different Perspectives from ‘Spectre’ and ‘45 years’.

27 Mar, 16 | by Ayesha Ahmad

The Past: a Friend or Foe? Different Perspectives from ‘Spectre’ and ‘45 years’.

Spectre- directed by Sam Mendes, UK, 2015

45 years- directed by Andrew Haigh, UK, 2015

By Franco Ferrarini, Gastroenterologist and film reviewer

In the words of the French philosopher Henri Bergson: ‘The pure present is an ungraspable advance of the past devouring the future. In truth, all sensation is already memory’. In this view the present, as we usually think of it, is virtually non-existent as the past connects directly with the future. Two recent, but very different films, ‘Spectre’ and ‘45 years’ provide thought-provoking insights into this relationship.

more…

The Reading Room: Short-list for the 2016 Hippocrates Prize for Poetry and Medicine

22 Mar, 16 | by cquigley

 

Fragility of the human form: short-list for the 2016 Hippocrates Prize for Poetry and Medicine

 

The Hippocrates Initiative for Poetry and Medicine – winner of the 2011 Times Higher Education Award for Innovation and Excellence in the Arts – is an interdisciplinary venture that investigates the synergy between medicine, the arts and health.

Poets from New York and the UK are among the finalists for this year’s prize. Short-listed in the Open Category are Owen Lewis, child psychiatrist and poet from New York, and from the UK poets Anne Ryland from Berwick-on-Tweed and Jane McLaughlin from London.

Competing for the UK NHS 2016 Hippocrates first prize are paediatric cardiologist Denise Bundred from Camberley, former consultant haematologist Karen Patricia Schofield from Crewe and GP Chris Woods from Bury.

Find out more about the shortlisted poets.

The judges also agreed 16 commendations in the NHS category, and 17 commendations in the Open International category from Australia, France, England, Ireland, Scotland, New Zealand and the USA.

Find out more about the commended poets.

The winners will be announced at an awards ceremony in London on Friday April 15, 2016.

Check out the Medical Humanities poetry section here.

 

 

Ayesha Ahmad: Introduction to Global Humanities—Through Creation, Violence Will Die

15 Mar, 16 | by Ayesha Ahmad

Against the backdrop of violence, I have been examining through my research the qualities of our human condition that perpetuate both our survival and our spirit.

As an introduction to an ongoing series on Global Humanities, I will be discussing ways we can counter the dominant narrative of violence.

Our globalised world, or rather, the collective ‘Other’, is met through encounters from suffering—the patients that enter our clinical settings, the individuals that sacrifice their lives to reach the shores of safety, and the images that we only ever see from afar of stories that breathe suffering.

more…

Encountering Pain: hearing, seeing, speaking – Call for Abstracts

15 Mar, 16 | by cquigley

 

Encountering Pain: hearing, seeing, speaking

 

A free two-day live event and international conference at UCL

Friday 1st and Saturday 2nd July 2016

Pain is not only expressed linguistically but through bodily movements, emotional reactions, and artistic expressions.

How do we respond when we encounter the pain of another? What happens when our own bodies encounter pain?  What tools do we possess when attempting to communicate pain and are there forms other than language for expressing it?

During these two days, we will explore a range of international and interdisciplinary approaches that can help us better understand encounters with pain both within and beyond the clinic. This event is aimed at those: living with pain, caring for someone in pain, treating or researching pain,  artists whose work touches on pain and others exploring alternative means of communicating and assessing pain.

The event will divert radically from the traditional academic conference format to encourage exchange between different groups affected by pain.

Call for Abstracts

Deadline 18th March 2016

Abstracts are invited from individuals or groups responding to the general theme of communicating and/or encountering pain. These may be conventional conference presentations and posters, visual arts or interactive sessions.

While particularly encouraging papers reporting research findings we also welcome those exploring innovative practices at the interface of the humanities, art and medicine.

Papers are invited (but not limited to) the following themes:

  • pain encounters within any healthcare context
  • pain encounters within alternative settings
  • pain encounters within a range of cultural contexts (for example explorations of how different cultures and people in different times attempt to make sense of human and animal suffering)
  • current and historical visualisations of pain
  • the value of the arts to democratizing medicine and breaking down existing hierarchies
  • assessing pain by non-conventional methods
  • alternative ways of recording and reporting pain narratives
  • the implications of patient pain narratives for other areas of medicine such as psychiatry and neurology
  • neural mechanisms for pain
  • pain as emotion
  • pain as identity
  • the meaning of pain and its lived experience, in the past and present

Please send a submission of no more than one page of A4, which you are free to use in any way you wish. Guidelines for submissions can be found under the Conference Deadlines tab, however for scientific abstracts (only) please follow the conventional format: Title, Background, Aims, Method, Results, and Conclusion. Conflict of Interest: Authors must declare any financial support received or any conflict of interests on their abstract.

Abstracts must be no longer than one A4 page, font no smaller than 11 pt.

Please send to encountering-pain@ucl.ac.uk by 18th March 2016.

Please include an email address.

Successful applicants will be notified by 18th April 2016.

https://www.ucl.ac.uk/encountering-pain/abstracts

For more information on the research projects that gave rise to this event, please see the links below.

www.ucl.ac.uk/slade/research/projects/pain-speaking-the-threshold

Khalid Ali: London Human Rights Watch Film Festival 9-18 March 2016

7 Mar, 16 | by Ayesha Ahmad

London Human Rights Watch Film Festival

https://ff.hrw.org/london, 9-18 March 2016

Various venues across London

Over a period of 10 days, London will host the ‘Human Rights Watch Film Festival’ showing 20 feature and documentary films. The opening night will screen ‘Hooligan sparrow’, a documentary in Southern China following a group of activists campaigning to unravel the truth behind the rape of a group of young school girls. ‘Mustang’ the closing night film from Turkey tells a story of five sisters fighting their family and community to have control over their education and choice of future husbands. Women as fighters for political reform in the Arab world feature in the documentary ‘The trials of Spring shorts’.

 

BMJ

 

‘Hooligan sparrow’ opening the London Human Rights Watch Film Festival, 10 March 2016

The history of gay rights in different parts of the world are seen in: ‘Larry Kramer in love and anger’ which chronicles his fights as a novelist and activist to push the AIDS agenda into public health policy in the USA, and ‘Inside the Chinese closet’ which portrays real stories of fake marriages between gay men and lesbian women trying to conform to their community’s social and religious rules that do not tolerate homosexuality.

The plight of international refugees is seen in ‘Mediterranea’, ‘Desperate journey’, ‘If the dead could speak’, ‘At home in the world’ and ‘The crossing’; telling heart-breaking real and fictionalised accounts of violations of humanity towards asylum seekers from Burkina Faso, Syria, Somalia, Eretria and Iraq.

If you are interested in films focusing on Palestinian/ Israeli issues, you might want to watch; ‘P. S. Jerusalem’ about a family trying to start their life in Jerusalem, or ‘The idol’ a fictionalised account of the story of Mohammad Assaf, Palestinian winner of ‘Arab Idol’ TV music competition.

British conflicts between the residents of Tottenham, London and the Metropolitan Police that followed the killing of Mark Duggan in 2011 are analysed in ‘The hard stop’.

The rise of fundamentalism is uncovered in ‘Among the believers’ a documentary filmed in a school in the Red Mosque in Pakistan.

Most of the films screening will be followed by Q and A discussion with the film-makers.

 

 

 

Related reviews

http://blogs.bmj.com/medical-humanities/2015/05/26/khalid-ali-fil-review-mediterranea/

 

Address for correspondence

Dr Khalid Ali, Screening Room editor

Khalid.ali@bsuh.nhs.uk

 

 

 

 

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