Each branch of medicine has its challenges. In palliative care, the burden of bad news falls on physicians.
“We’re often at the table when people hear the most devastating news they’ll ever hear in their lives,” says Dr. Warren Lewin, Palliative Care Site Manager at Toronto Western Hospital, University Health Network.
Other medical specialties have the happy balance of confirming pregnancy or announcing that a disease is in remission. Palliative care physicians treat people in their last, most vulnerable moments.
Helping practitioners in the field to develop their resilience in the face of burnout is essential.
So when Lewin heard about a Harvard Museums program that introduces doctors to the in-depth examination of the fine arts as a way to deal with stress, he contacted the Art Gallery of Ontario.
The practice is sometimes referred to as “watching closely” and involves spending more time with a work of art than the average of three to ten seconds that is the norm for most people walking through a museum. It consists of sitting quietly with a piece, contemplating it as a whole and in its parts, to talk about the thoughts, ideas and emotions that the work inspires.
It is not about learning which school it belongs to or the year it was painted, although this information is available to participants. It is about experiencing the work of art to the full, in a way that puts aside everyday concerns and heightens appreciation for beauty in general.
The goal is to help doctors learn to relax with art and to think in new and more creative ways.
Lewin contacted the AGO in January 2020. Melissa Smith, associate curator of community programs, set up a program for doctors that was ready to enter the museum, just before COVID-19 broke. It ended up being led via Zoom in June 2020.
It was so popular that Smith held three more.
“It was mind blowing, even though it was on Zoom. It was truly a great experience, ”said Dr. Shahar Geva Robinson, in her second year of an International Fellowship at the University of Toronto in Palliative Care.
Robinson, who is from Israel, attended a few art galleries in high school, but not as an adult. The study of medicine left little room for appreciation of the fine arts.
“I never really understood. Like, what am I supposed to do with the art? How am I supposed to appreciate it? Robinson said.
She says participating in the program has helped her develop her ability to pause and think.
“It helped me to be more contemplative on things.”
The original idea was invented by Dr. Hyewon Hyun, radiologist and nuclear medicine physician at Brigham and Women’s Hospital in Boston.
Hyun is also director of the Joint Nuclear Medicine Program that trains future physicians in nuclear medicine and molecular imaging, and has an interest in the art.
She began to think about the similarities and differences between the study of medical images and art.
“Either way, I’m trying to make sense of what I’m seeing,” Hyun says.
In 2018, she reached out to David Odo, director of academic and public programs at Harvard Art Museums, to design a program for medical imaging interns. It is still in use today.
In addition to providing training, the sessions create a calmer and safer environment, removed from the realities of life or death of medical work, where healthcare professionals can explore and discuss difficult issues as they go. arise, Odo explains.
Smith at AGO uses a variety of artwork to stimulate discussion. The first song from the first session she composed was “The West Wind” by Tom Thomson. Smith said she wanted to start with something that the attendees might be familiar with. Later, when they were more comfortable, she launched works that might be considered less figurative and more difficult, such as “Blue Reflections” by Kazuo Nakamura, 1962.
Physician burnout has been exacerbated by the COVID-19 demands placed on the profession, says Lewin.
During the pandemic, his workload increased so much that he felt like he was working 24 hours a day, 7 days a week. He fell asleep at his desk. Any semblance of balance was gone from his life. It took his partner to point it out.
“I think that’s how it happens to a lot of people. It invades you, ”says Lewin.
Dr. Daphna Grossman, Palliative Care Physician at North York General Hospital, co-leads the Wellness and Resilience Course for Residents and Palliative Care Fellows at the University of Toronto since 2015, inviting Lewin to co-direct in 2019.
“We know that building resilience and well-being is important in alleviating burnout,” says Grossman, who herself has worked grueling hours caring for COVID patients.
She remembers being burned eight years ago. She became irritable. She has lost interest in going out with friends. She was tired all the time.
It was his youngest daughter, then aged 12, who put everything in place.
“Do you need to stop working and take time off? She asked her mother.
Grossman said she realized, with shock, that she did.
Lewin and Grossman say preventing burnout among palliative care physicians is critical because the field is understaffed, a problem that is likely to worsen as the population ages.
Both doctors participated in the Zoom event.
“I loved it. And when I say I loved it, I hope you see it in all caps and bold,” says Grossman.
“We are so focused on our job all the time. We often miss these beautiful moments, and this has raised awareness. “
Lewin says he started incorporating art into some of his lectures and hung some art in his office. When residents come in, annoyed or overwhelmed, he sometimes invites them to look around the room and talk about something else, to allow time for a reset.
The program has also prompted doctors to engage with museums, Odo says. He’s now leading a series of shorter, more informal art breaks on Zoom for Doctors. They tell him that they now visit museums more, sometimes with their family and friends.
After participating in the program, Robinson purchased an annual pass to the AGO and visited several times. She adores the Monets, and is also inspired by a more modern art, such as the Andy Warhol exhibition.
“I was really inspired by his general approach to experimenting with everything. “