Virali Shah, MBA is a medical student at Albany Medical College in Upstate New York. Early into her medical training, Virali discovered how art, including visual and literary forms, was a powerful tool to externalize complex emotions, depict abstract ideas related to medicine, and create awareness of important issues surrounding healthcare. Her artwork “Recharge” and Field Notes essay “The New Hangman” appear in the Fall 2020 Intima.
As a society, we are driven by visuals. Advertisements. Social media. Logos. Paintings. Pictures. It is a 21st-century skill to be “visually literate.” Interestingly, evolution also agrees since toddlers learn how to interpret images before they learn how to speak. Only recently, however, the role of visual literacy has expanded into modern medical training.
Historically, the visual arts were perceived as foreign to the healthcare field, serving no purpose beyond filling the walls of hospital floors. The marriage of visual arts and medicine has produced new opportunities for students to learn about empathy, physician-patient communication, health equity, and clinical diagnosis. These are concepts that require training beyond the pages of a textbook. They require intimate visual and social interaction. Narrative medicine was the first to recognize the newfound influence of art—an abstract tool for inspiration, reflection and growth—in a space consumed by jargon and standardization.
So how can art be used as a learning tool for medical students?
Take for instance trigeminal neuralgia. In medical school, I was taught that trigeminal neuralgia, also known as tic douloureux, is the “repetitive, unilateral, shooting/shock-like pain in the distribution of the trigeminal cranial nerve.”1 Pain attacks can increase in “intensity and frequency over time” and can be triggered by “chewing, talking, or touching certain parts of the face.” While I knew the definition of trigeminal neuralgia, I did not understand the gravity of this rare illness until I observed Karl Kroeppler’s powerfully evocative painting, “Intractable 2” (Spring 2019 Intima).
©Intractable 2 by Karl Kroeppler. Spring 2019 Intima: A Journal of Narrative Medicine
I stared at Kroeppler’s painting for several minutes, initially unaware the depiction was trigeminal neuralgia. My first thoughts.:“Migraine? Paralysis? Burn?” I dug deeper. The burnt orange color, the only bright color used by the artist, symbolized pain inflicted on precisely half of his face. “The trigeminal nerve senses pain and temperature on the face” I thought. I kept searching for more clues. The man is screaming on the floor with arms pronated out by his sides and legs crumpled. He is not touching his face. His eyes are deviated towards the side of burnt orange. It dawned on me that Kroeppler illustrated a pain so paralyzing that it brought a grown man, with lost control of his limbs, to the floor.
Diagnosis: trigeminal neuralgia.
After analyzing Kroeppler’s painting, “Intractable 2,” I was able to blend the verbal definition of trigeminal neuralgia with a profound visual definition. Similarly, medical schools, such as Yale Medical School and Duke University, are employing this strategy of visual arts training into their curriculum. A study by Harvard Medical School found a significant 38 percent increase in total number of sophisticated artistic and clinical observations by medical students after completing a visual training course.2
A picture may be worth a thousand words, but a patient is worth an infinite more. The movement of perceiving patients as viable paintings, piecing together valuable context clues in emotions, body language, and visual symptoms to aid in clinical diagnosis and care, is only beginning.
References:
1. Le, Tao and Bhushan, Vikas. First Aid for the USMLE Step 1 2020, Thirtieth edition. New York: McGraw-Hill Education, 2020.
2. Naghshineh S, Hafler JP, Miller AR, Blanco MA, Lipsitz SR, Dubroff RP, Khoshbin S, Katz JT. Formal art observation training improves medical students' visual diagnostic skills. J Gen Intern Med. 2008 Jul;23(7):991-7. doi: 10.1007/s11606-008-0667-0. PMID: 18612730; PMCID: PMC2517949.
Virali Shah, MBA is a medical student at Albany Medical College in Upstate New York. Early into her medical training, Virali discovered how art, including visual and literary forms, was a powerful tool to externalize complex emotions, depict abstract ideas related to medicine, and create awareness of important issues surrounding healthcare. She is trained in oil and acrylic painting and was a docent at a memorial art gallery for four years. Currently, Virali is leading an intersectional project on narrative medicine, dance, and health equity at her school to research the benefits of arts training in medical education. She is featured in the Doctors Who Create “Creativity in Medicine” Podcast and is a contributing writer for the published, peer-reviewed book “Diary of a Med Student.” Her artwork “Recharge” and Field Notes essay “The New Hangman” appear in the Fall 2020 Intima
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