A few days ago, I went to see art, and somehow got reminded about the “art of medicine.” Jesse Higman, a Seattle artist, was demonstrating his current medium and discussing his collection (Illuvium) at a local art gallery.* At that event, I had an opportunity to meet him in person and – along with other audience members – use his techniques for making art. I poured a liquid paint with mica flakes onto the black surface of a masonite board that had been engineered to have valleys and hills and just watched the art take shape. I talked to him a little bit about this seemingly less controlled form of making art and that I – of a mostly type A nature – might not have as much confidence in letting paint direct itself on the canvas.
Surprisingly, the flow of our conversation touched on the practice of medicine.
Higman philosophically drew analogies between being a doctor and being an artist and reminded me of an oft-referenced yet difficult-to-teach aspect of medicine. Despite the hard work and skill that is required in both disciplines, the ability to embrace and utilize the fluidity and unpredictable forces of our subjects or our medium is what allows us to perfect our craft.
Physicians, by virtue of a weeding out process that takes years, are high achievers who can often have issues with control. Our ideal patient remembers and follows all our directions explicitly, has great health insurance, does not have to worry about taking time off of work to see us, and has predictable responses to our treatment plan. This patient actually lives in the isolation of a textbook. Real life certainly doesn’t operate that way and to expect it to be so would result in frustration.
Certain subspecialties, such as anesthesia and intensive care medicine, are numerically driven or algorithm-dominant and lend themselves to more predictable results. (Note that patients being cared for in these examples are generally sedated). In a field like primary care, patients cannot be forced to be something that they are not. We will often prescribe or suggest or give our opinion to our patients. But to not take into account the underlying rhythm of an individual patient’s life can lead to failures of our treatments.
The art of medicine is about more than bedside manner. It also incorporates a certain level adaptability and creativity to work with the various situations before us. A patient who has a blood pressure of 150/90 is very different from another patient with a blood pressure of 150/90. I personally have found most satisfaction and better “results” when working with a patient’s current and individual situation, rather than dictating a one-size-fits-all set of instructions that takes into account only the disease itself. However, this involves paying attention to verbal and nonverbal cues, which can be difficult with the limited time doctors often have. I am by no means an expert at this, and it is something I continue to work on. As the American healthcare system increasingly places emphasis on certain numerical goals and “quality measures” (which are still a very important part of our care), my hope is that we don’t miss the trees for the forest and that we continue to value the art of medicine.
I admire Jesse Higman for the work he created. I also unexpectedly drew inspiration from his universality of thought and all-encompassing spirit, characteristics that enabled him to draw parallels between seemingly disparate individuals (him and me) and the fields of both Art and Medicine.
*(See my prior post to learn more about Jesse Higman and his work: https://pulsus.wordpress.com/2011/01/10/a-local-artist-who-defies-our-perception-of-disability-but-never-mind-that-its-the-work-that-moves-me/ ).