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Why We Need the Humanities to Improve Health Care

When Dan Cohen founded Music and Memory in 2006, he had a simple idea: Someday, if he ended up in a nursing home, he wanted to be able to listen to his favorite '60s music. Well, his brainstorm paid off, not only for Cohen but for scores of others.
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Telling stories, listening to music, making and enjoying art -- these are human endeavors that effect our emotion and our spirit. These are also the elements we need to see more of in our health care system as it becomes increasingly mechanized. Not everybody knows how to tell a story -- or listen to one -- and many people involved in health care may not even think of their patients in terms of a life story. Most physicians are trained to solve medical problems without taking into account the specific psychological and personal history of the patient -- including their underlying values and spiritual needs.

The medical humanities help us focus more on meaning making than on scientific measurement. For example, the successful Music and Memory program is helping doctors and caretakers connect with patients with Alzheimer's disease. One 94-year-old nursing home resident, who sat all day slumped in a wheelchair, unable to communicate, suddenly lit up when he was given an iPod to listen to the jazz he so loved in his youth. He began smiling, tapping his feet, and communicating with his caregivers.

There is increasing interest in a new field of study, narrative medicine, which aims to help health care workers incorporate the life stories of patients, including their own unique value system, into their options for treatment, so that it fits the individual. When information can be shared this way, ethical decisions are made about the patient's care, particularly at the end of life, when treatment goals can be in harmony with the way the patient has lived their life through the beginning and middle. A one-year program at the School of Continuing Education at Columbia University offers courses guided by works of philosophy, film, art, and literature that bring us face to face with death, though in very different ways, such as Tolstoy's The Death of Ivan Ilych. By reading, attending movies, and viewing art, health care workers learn how to increase their reflective practice and observational skills. Courses in fine arts utilize observation and description of art as a means of enhancing visual diagnostic and communication skills. Narrative photography is about seeing the human story through the still image. A life drawing course helps people realize they have never really seen anyone as clearly as when they try to draw them.

Humanities in medicine courses, meant to develop understanding of the human side of health care are increasingly found in our medical education programs. Baylor University in Texas became the first university to offer an undergraduate degree in medical humanities. New York University Medical School has had a medical humanities resource on its website since 1994 offering students, doctors and patients lists of current books, plays and other works relevant to the medical humanities.

Stephen G. Post, PhD, founding director of the Center for Medical Humanities, Compassionate Care and Bioethics at Stony Brook University on Long Island, points out that Willem de Kooning, the well-known abstract expressionist who suffered from dementia and AD in his late years, continued to paint, though these late paintings become almost sublime, with simple, fluid lines, softer colors and lots of open (peaceful) space, compared with the more frenetic work that made him famous.

Arts programs are available to patients, as well as staff at the Mayo Clinic Center for Humanities in Medicine. Patients, staff, visitors, as well as community members are welcome to attend music performances, visual art exhibits, theatre and dance, and lectures.

When Dan Cohen founded Music and Memory in 2006, he had a simple idea: Someday, if he ended up in a nursing home, he wanted to be able to listen to his favorite '60s music. Well, his brainstorm paid off, not only for Cohen but for scores of others. His program with personalized music is now in hundreds of institutions in several countries. The city of Toronto gives an iPod to anyone with Alzheimer's disease, and the Toronto Alzheimer's Society has just released an evaluation of the impact of the music on 10,000 persons with dementia and their caregivers. The feature-length documentary film, "Alive Inside: The Story of Music and Memory," produced by Manhattan filmmaker Michael Rossato-Bennett to document his mission to bring personalized music to every nursing home in the country won the 2014 Sundance Award, as well as several others for best documentary, and will be shown in select theaters this summer.

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