PRACTISING THE ART OF HEALING
An AGO program uses fine art to help doctors cope with burnout
Every branch of medicine has its challenges. In palliative care, it’s the burden of bad news that weighs heavy on physicians.
“We’re often at the table when people are told the most devastating news that they’ll ever hear in their lives,” says Dr. Warren Lewin, site lead for palliative care at Toronto Western Hospital in the University Health Network.
Other medical specialties have the happy balance of confirming a pregnancy or announcing that a disease is in remission. Palliative care physicians deal with people in their final, most vulnerable moments.
Helping practitioners in the field develop resilience against burnout is essential.
So when Lewin learned about a program at Harvard Museums that introduces physicians to looking deeply at fine art as a way of managing stress, he reached out to the Art Gallery of Ontario.
The practice is sometimes referred to as “close looking,” and involves spending more time with a work of art than the average three to 10 seconds that is the norm for most people walking through a museum. It includes sitting quietly with a piece, contemplating it as a whole and in its parts, to talk about the thoughts, ideas and emotions the work inspires.
It’s not about learning what school it belongs to or the year it was painted — although that information is available to participants. It’s about experiencing the artwork fully, in a way that pushes aside everyday concerns and sharpens an appreciation for beauty generally.
The goal is to help physicians learn to relax with art and to think in new and more creative ways.
Lewin reached out to the AGO in January 2020. Melissa Smith, assistant curator of community programs, put together a program for physicians that was ready to roll into the museum, just before COVID-19 broke. It ended up being conducted via Zoom in June 2020.
It was so popular Smith has held three more.
“It was mind-blowing, even though it was on Zoom. It was just such a great experience,” says Dr. Shahar Geva Robinson, in her second year of an international fellowship at the University of Toronto in palliative care.
Robinson, who is visiting from Israel, had been to a few art galleries in high school, but not as an adult. Studying medicine left little room for fine art appreciation.
“I never really got it. Like, what am I supposed to do with art? How am I supposed to enjoy it?” says Robinson.
She says taking part in the program helped her build her capacity to pause and reflect.
“It helped me be more contemplative about things.”
The original idea was the brainchild of Dr. Hyewon Hyun, a radiologist and a nuclear medicine physician at Brigham and Women’s Hospital in Boston.
Hyun is also the director of the joint program in nuclear medicine that trains future nuclear medicine and molecular imaging physicians, and she has an interest in art.
She began thinking about the similarities and differences between studying medical images and art.
“In both cases, I’m trying to make sense of what I see,” says Hyun.
In 2018, she reached out to David Odo, director of academic and public programs at the Harvard Art Museums, to design a curriculum for imaging physician trainees. It is still in use today.
In addition to providing training, the sessions create a calmer, safer environment, removed from the life-and-death realities of medical work, where health-care professionals can explore and discuss difficult issues as they arise, says Odo.
The AGO’s Smith uses a variety of artworks to drive discussion. The first piece in the first session she put together was Tom Thomson’s “The West Wind.” Smith said she wanted to start with something that might be familiar to participants. Later, when they are more comfortable, she throws in works that might be regarded as less representational and more challenging, like Kazuo Nakamura’s “Blue Reflections,” 1962.
Burnout among doctors has been exacerbated by the demands COVID-19 placed on the profession, says Lewin.
During the pandemic, his workload increased so much he felt like he was working 24-7. He was falling asleep at his desk. Any semblance of balance had disappeared from his life. It took his partner to point it out.
“I think that’s how it happens to a lot of people. It creeps up on you,” Lewin says.
Dr. Daphna Grossman, a palliative care physician at North York General Hospital, has been co-leading the wellness and resilience course for University of Toronto palliative care residents and fellows since 2015, inviting Lewin to co-lead in 2019.
“We know that building resilience and wellness is important in mitigating burnout,” says Grossman, who has herself been working gruelling hours to care for COVID patients.
She remembers burning out eight years ago. She became irritable. She lost interest in going out with friends. She was tired all the time.
Her youngest daughter, then 12, was the one who put it all together.
“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 likely to worsen as the population ages.
Both doctors took part in the Zoom event.
“I loved it. And when I say I loved it, I hope you’re seeing that in capslock and bold,” says Grossman.
“We focus so much on our work all the time. We often miss these beautiful moments, and it raised the awareness of that.”
Lewin says he has begun incorporating art into some of his lectures and has hung art in his office. When residents come in, flustered or overwhelmed, he will sometimes invite them to look at the piece and talk about something else, to allow time for a reset.
The program has also inspired physicians to become engaged with the museums, says Odo. He now runs a series of shorter, more informal Art Breaks on Zoom for physicians. They tell him they’re now visiting museums more, sometimes with their families and friends.
After participating in the program, Robinson bought an annual pass to the AGO and has visited several times. She loves the Monets, and has also been inspired by more modern art, like the Andy Warhol exhibit.
“I was really inspired by his general approach to experiment with everything.”