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Clinical empathy facilitates a rich doctor-patient interaction in the clinical setting, while producing a sense of affirmative validation within the patient. However, as twenty-first century medicine aims to focus on patient-centered care, many patients report feeling increasingly disconnected from their doctors. A new emphasis on “compassionate care” has highlighted the missing element of empathy from this dynamic. Now medical educators are addressing this empathy crisis by turning to the arts for a solution. This paradox in healthcare has intrigued me and during this past year, I have been examining the concept of clinical empathy and analyzing the theories and practices behind it. Through the 2017 Honors Carolina Burch Fellowship, I had the incredible opportunity to travel to London to my continue my research for six weeks this summer.

Home to rich medical cultural and historical resources, such as the Wellcome Collection, Francis Crick Institute, and London Museums of Health and Medicine, London is a growing epicenter for the discipline of Medical Humanities and was perfect location to pursue my endeavors. More importantly, I could spend time and develop a close relationship with Performing Medicine, a unique London-based theatre arts program that works in partnership with U.K. universities and organizations to create courses for clinical training from creative disciplines for medical professionals, students, and caregivers. It is the only program of its kind in the entirety of the U.K.

Through my partnership with Performing Medicine, I was able to sit in on classes at Barts and The London School of Medicine and Dentistry, King’s College London School of Medicine, Guy’s Hospital, St. Thomas Hospital, and at Royal College of Physicians, conducted important ethnographic research through their course deliveries, networked with and interviewed medical professors and students, and observed their daily operations at their office located in London Fields. Watching Performing Medicine in action through their course deliveries was truly fascinating. Forum theater is the foundation for most of their teaching methods involving medical students. This technique requires an active involvement and engagement between both the actors and audience. During these deliveries, scenes of medical conflict were performed. At various moments, the actors would stop, turn towards the students, ask questions, and encourage discussion and reflection among them. For deliveries aimed towards physicians and caregivers, smaller exercises involving body movement in various spaces, listening activities, and role playing situations were used. To see how these individuals, who were solely focused on the pure objective science aspects of medicine, engaged in these activities showed me the importance of the arts in order to make medicine more personal again. Through this research, I rediscovered the beauty behind the human body and realized the urgent need for the humanities in medicine in order for it to return to its compassionate roots.

Manisha Mishra in London
Manisha Mishra at Performing Medicine in London

Another wonderful experience was attending two medical humanities conferences that luckily happened to occur during my time in London. The first one I attended, Storytelling in Healthcare, was in Swansea, Wales. Medical professionals, educators, social workers, researchers, artists, actors, and even Welsh government officials were in attendance and actively participated. Panels and workshops were designed to emphasize the value and meaning behind the narrative story, especially in how doctors can utilize patients’ narratives as tools to better understand illness and how arts-based therapy and interventions can help patients heal both physically and mentally in a more holistic manner. It was also at this conference that I also tried my first Welsh cake. A few weeks later, I was at Keele University, near Newcastle, England, attending the Association of Medical Humanities Annual Conference. While this conference was more focused on general applications and advancements of medical humanities, it made me appreciate how diverse and far-reaching this interdisciplinary field is.  During dinner table conversations, over some very traditional British dishes, I was able to meet medical students and learn about their first-hand experiences of clinical instruction, the challenges they face, the burnout they experience, and their future goals.

Another integral part of my summer was my time spent in the Wellcome Collection and Library. This unusual yet beautiful museum houses a mix of medical artifacts and artworks that explore the connections between medicine, life and art. Usually around mid-afternoon, after my work with Performing Medicine concluded, I would head over here, first taking the London Overground train to Liverpool Station and then Hammersmith and City line on the Tube to Euston Square. The Wellcome quickly became my second home. The cafe served as a great workplace, the Reading Room as a solstice from the busy streets of London, the Medicine Now and Medicine Man exhibitions as a candy shop for my curious mind, and the Wellcome Library as the powerhouse for my literature review research. I was able to read and learn more about history of medical advancements, culture, ethics, and education. Interestingly, I was such a frequent visitor that one day one the librarians demanded that I fill out a form to have a five-year membership to the library – and I’m glad I did.

Beyond the research, networking, and learning experience, I was exposed to a great deal of English culture. Apart from previously being in Heathrow Airport countless number of times for connecting flights, this was my first time out and about in the U.K. Due to the easy accessibility of public transportation, London became my playground. I had the opportunity to visit the British Museum, Victoria and Albert Museum, National Gallery, Museum of London, Tate Modern, and Tate Britain, just to name a few. I even found a hidden treasure, the Old Operating Theatre Museum, in which I saw the oldest surviving surgical theater in all of the U.K. I toured around Westminster, taking in the sights of Buckingham Palace, Westminster Abbey, Trafalgar Square, Big Ben, and Parliament. Camden Town, London Bridge, Whitechapel, Hackney, Shoreditch, Tower Hamlets were other areas within London that I explored and became quite familiar with. I also took day trips to Cambridge and Southampton to explore other parts of Britain too. However, my heart will forever lie near and dear to London Fields, the area that I called home for six weeks. Whether it was exploring Brick Lane, strolling through Columbia Flower Market on Sunday morning, paying a visit to Hackney City Farm, dropping by Broadway Market, grabbing coffee from Climpson and Sons, or taking a stroll through the park, London Fields was the perfect place to truly a get feel of what it means to be a true Londoner.

While I did not have any language barriers to overcome (with the exception of a few colloquial words and different spellings of words), I was quick to realize how differently life was carried out in the U.K. compared to the U.S. There was a similar hustle and bustle in the workplace, but one noticeable difference was the concept of self-care. Whether it was multiple cups of tea or coffee, a stroll in the park, a proper lunch break, or moment to talk to a colleague or friend, British work culture seemed to have a balance that American work culture is struggling to find. This year, in the midst of one of the busiest schedule I have had thus far, I have been constantly reminding myself of self-care.

While it is easy to go about all the things I did this summer, all the places I saw, and the people I met, the true meaning behind the Burch Fellowship is how this experience changed me. Whenever someone poses the question “How was London?” to me, I quickly respond back with “Life changing.” Simply put, this experience has made me a better person. I now have greater sense of independence and confidence. The sense of control I had gave me a sense of liberation, something that I seemed to have lost during college. More importantly through the experiences and interactions I had, I gained a better understanding of my goals and what I desire in life.

The Burch Fellowship allowed me to overall appreciate the beauty and meaning behind life experiences. Not everything can be taught in a classroom. Rather, students need to be given a chance to explore their passions and interests in an immersive and supportive exploratory setting. I have never had an experience like the one this past summer, and doubt that an opportunity as rich and meaningful will come again. I am forever grateful for every moment I experienced and for all the everlasting relationships that I formed in London. This trip was so defining that it inspired to me inquire into Medical Humanities graduate school programs in the U.K., something that I would not have considered a year ago.

 

I would like to personally thank to Mr. Lucius E. Burch III, Dr. Jane Thrailkill, Gina Difino, Suzy Willson, Bella Eacott, Performing Medicine, and HHIVE for making this project possible. More information about the Burch Fellowship can be found at http://honorscarolina.unc.edu/fellowships/burch-fellowship/ and about Performing Medicine at http://performingmedicine.com/.

 

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