ARE PATIENTS accompanied or abandoned in their role as a sick person? This was a key question that Prof Maura Spiegel from Columbia University, New York, put to delegates at a conference on the Narratives of Health and Illness across the Lifespanin Dublin earlier this month.
The idea of a patient being abandoned in a hospital system that is increasingly complex in terms of specialisations, technology and bureaucracy isn’t as ludicrous as it might seem initially. And, this conference showed how the introduction of the arts into healthcare settings and medical education can ease a patient’s journey in myriad ways.
Spiegel spoke about how she uses film, literary texts and reflective writing practices to cultivate the art of listening among medical students.
“An ill person needs a space to get things said and to ask questions,” she said. “This requires self-awareness among doctors and writing is an enormous resource to help them gain access to their own experiences.”
At the conference, she set everyone the task of writing for three minutes about one of their personal scars and then sharing what they had written with the person beside them.
“Talented writers should write about childbirth and stillbirth because their writing helps us understand our experiences,” said Prof Patricia Crowley from the Department of Obstetrics and Gynaecology at Trinity College Dublin (TCD). She spoke about how important it is for medical students to see their patients’ whole lives and relationships and not just their medical conditions.
“We need our sensitivities reviewed, our preconceptions challenged and our imaginations expanded and fiction writing helps us to do that,” she said.
Dr Amanda Piesse from the Department of English at TCD gave some beautiful examples of how children's picture books tackle themes of ageing and death. Books such as Babette Cole's Drop Dead, John Burningham's Granpa and Peter Dickinson's The Gift Boatexamine relationships between grandparents and grandchildren with magical sensitivity.
Prof Graham Mulley, emeritus professor of Elderly Medicine at St James’s University Hospital, Leeds, spoke about the negative stereotypes of ageing. “Most old people are well. Loneliness only affects one in 10 – it’s important to differentiate between solitude and loneliness – and people are no more likely to become depressed in old age than they are in youth or middle age,” he said.
“Medicine has an unfortunate tendency to see old people as social problems whereas a social problem in old age can be a medical problem crying out for a diagnosis,” said Mulley. “Ageing is not a time bomb, it’s a gradual process.”
Meanwhile, Prof Suresh Rattan, professor of biogerontology at the Department of Molecular Biology, the University of Aarhus in Denmark, gave a recipe for living well in old age. It included having an optimistic nature and a sense of humour, being adaptable, socially interactive and a seeker of solitude.
Other speakers at the conference looked at the benefits of introducing art and music therapy into healthcare settings. Bill Ahessy, music therapist at the Meath Community Unit (formerly the Meath Hospital) for older people in Dublin city centre, spoke about how choral therapy enhances the immune system, improves mental health and self-expression.
“In modern society, the original geographical communities aren’t there,” he said. “This choir created a community for people in the local area and in the care units to come together every Friday to sing.”
The choral group for older people, which started in January 2009, still gets together.
Catherina Brady is the only full-time art therapist employed in Ireland. Based in St Loman’s Psychiatric Hospital in Dublin, she works with people who have all types of mental health problems. She described art therapy as a transformative experience for many people attending the classes.
Psychiatrist Dr Ian Daly added that art had the capacity to transmute our inner problems into expressions of shared values.
“Art therapy has major clinical benefits,” he said. “It lifted people out of their miseries and brought people together – thus breaking the cycle of isolation.”
The role of art classes in reducing the physical pain and depression of sufferers of rheumatoid arthritis was outlined by Dr Ronan Mullen, a rheumatologist at the Adelaide and Meath Hospital. The outpatients who took part in the ARThritis Art programme at the hospital became more sociable and relaxed as a result of their participation, he pointed out.
Hilary Moss, the director of Arts and Health at the Adelaide and Meath Hospital (the conference organisers), spoke about how aesthetics is such a neglected area in acute hospitals.
“When I first started working in this area, I was struck by the lack of music and how colourless a healthcare environment can be,” said Moss, who has since introduced concerts into the hospital and art onto the walls of its corridors.
Moss showed examples of how painting murals in children’s emergency departments make the settings more comfortable for children.
She added that even the everyday aesthetics of hospital experience such as the cups, plates, texture of bed linen should be looked at again.
Finally, Prof Des O’Neill, geriatrician and director of the Centre for Ageing, Neuroscience and the Humanities (ageandknowledge.ie) at the Adelaide and Meath Hospital, said ageing was a time of growth and loss. “It’s the most rich and complex time of life with a mixture of disability and extraordinary growth,” he said.
Drawing examples from the visual arts and music, he said that often creativity was at its “most outstanding and most radical” in older years.
“The benefits of ageing include better strategic thinking and wisdom, and older people contribute hugely to society through their civic engagement and social responsibility,” he said.
The Narratives of Health and Illness across the Lifespanconference was organised by the National Centre for Arts and Health at the Adelaide and Meath Hospital in Tallaght. artshealthwellbeing.ie
