An opportunity for hope?
By William B. Lawson MD, PhD, DLFAPA
I am old enough and fortunate enough to see and appreciate the changes that have occurred over the past half century in the health care system, especially regarding mental health. I still vividly remember visiting a state mental hospital where a great uncle spent much of his life. The building had all of the negative aspects of an institution including limited resources and communal showers. But then chlorpromazine (thorazine), a drug used for treating certain mood disorders, was invented and he was able to spend the rest of his days at home with his family. Fast-forward several decades, when I began my career as a psychiatrist, I was part of a team that completed a study with clozapine, the first antipsychotic that was demonstrably superior to others. Again, I saw the wonders of medical technology as people with severe mental illness once relegated to back wards in chronic institutions were able to engage in meaningful relationships and live productive lives. Relative to the rest of medicine, treatment of the mentally ill is relatively young and the wonders of new advances and treatment long seen in antibiotic therapy and cancer treatment are still emerging in psychiatry.
Continue reading The Changing Health Disparities Landscape
Dr. Susan Rather discusses medical art education in HI’s Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley
In the late 1990s, dermatology Professor Irwin M. Braverman of Yale School of Medicine concluded that his medical students were relying too much on high-tech imaging and not enough on their own visual skills to diagnose skin conditions. Dr. Braverman wanted to ensure that reliance on technology did not supplant traditional diagnostic skills, and hoped that better doctor-patient interaction and keener medical observation would diminish the need for so many diagnostic tests. To help students develop their visual skills, Dr. Braverman designed, in collaboration with the education curator at the Yale Center for British Art Linda Krohner Friedlaender, an elective course in which students would study narrative paintings (paintings that tell a story) and describe the works of art as thoroughly and objectively as possible. Students received no external information about the paintings, not even painting titles. In 2001, Jacqueline Dolev—an alumna of the course—Ms. Friedlaender, and Dr. Braverman published research on the course’s effectiveness in the Journal of the American Medical Association. Students who completed the course, they reported, had improved observational skills and perceived more details about their patients compared to students who had not enrolled. These results suggest that students’ visual diagnostic abilities would have also improved, thereby boosting the efficiency of their patient care.
Continue reading Training the Medical Eye through Art History
Dr. Cynthia Franklin discusses therapeutic intervention in schools in HI’s Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley and Clare Callahan
As Professor and Associate Dean for Doctoral Education in the School of Social Work, Dr. Cynthia Franklin currently works with at-risk students, most visibly at Austin’s Gonzalo Garza Impendence High School, where she implements solution-focused brief therapy (SFBT). Developed by Steve de Shazer and Insoo Kim Berg in the late 1970s, SFBT, as Dr. Franklin described it in the HI Faculty Fellows Seminar, is “a brief therapeutic intervention”—taking place over only four to six sessions—that strives so build solutions to patients’ current and future problems, on the individual level and within “groups, families, communities, and organizations.” Specifically, SFBT works through the co-construction of meaning between patients and therapists and specific action-oriented techniques.
Continue reading How a Twentieth Century Philosophy of Language Can Advance Health, Well-Being and Healing in Schools
Dr. John Roberts discusses aging and decline in John Updike’s writing in our Faculty Fellows Seminar on Health, Well-Being, Healing
By Saralyn McKinnon-Crowley
Last week’s Faculty Fellows Seminar in “Health, Well-Being, Healing” focused on questions of dying and, specifically, how new life-prolonging technologies compel one to rethink what it means to die. Dr. John Robertson of the School of Law presented his current research on Left Ventricular Assistance Devices (LVADs) and the later poetry and prose of John Updike. Dr. Robertson is especially interested in Updike’s short story “The Full Glass”—written shortly before Updike’s own death in 2009—about aging and decline. Updike’s protagonist reflects on a small detail of his daily life, filling his bedtime glass of water, to think about the end of life without directly confronting the experience of dying. Dr. Robertson’s work-in-progress on this material is entitled “Writers at the End—John Updike’s ‘The Full Glass,’” which he hopes to publish in the journal Literature and Medicine. Although “The Full Glass” does not address machines or surgical implants (such as LVADs), Updike’s writing reflects on the quality of life from the perspective of an elderly man.
Continue reading The Technology of Living and Dying