Narrative Medicine Monday: Standardized Patient

Artist Kerry Tribe’s latest installment at the San Francisco Museum of Modern Art, Standardized Patient, brought back memories for me of medical school. The article on Tribe’s work by Hyperallergenic describes her as “interested in memory, language and awkward connections.” The relationship between patients and doctors-in-training certainly consists of awkward connections. I remember the standardized patients we worked with to learn how to take a basic medical history, how to perform a physical exam, even how to do pelvic and rectal exams without as much fumbling and hesitation inherent in such a personal exam. All the standardized patients I encountered were professional and helpful, giving valuable feedback and helping us prepare for a new component of the medical licensing exam: that of a standardized patient interaction. For this portion of the exam we flew down to California (the closest location for those of us training in the Pacific Northwest) and stood outside nondescript doors in our short white coats, much like the medical students in the last photo of this piece. I remember feeling terrified at what this patient, this actor, might judge me on. Was I too friendly? Not personable enough? Did I make enough eye contact? Ask the right questions? Perform the right physical exam? Give the correct reassurance and explanation?

Tribe’s installment “captures the atmosphere of a hospital: that draggy kind of feeling, as though everything is tired and washed out, as if you are waiting for something.” She shows the uncertainty of physicians-in-training: “We can see the tentativeness of the prospective doctor, as they question one SP about how her boyfriend has treated her and see how the doctor tries to comfort her.” I like that Tribe captures the nuances of medical training, that “[w]atching this display of effort creates empathy for the doctors as well as the actors. Seeing the feelings of both — impatience, kindness, concern — flash across their faces, you almost forget they’re acting….”

Writing Prompt: If you’re a physician, recall a particular interaction with a standardized patient during your training. What did it feel like? What did you learn? As a patient, were you aware that your physician trained with actors as patients? Does this seem strange or is it encouraging to you? What kind of focused training on communication or empathy might be helpful for your doctor today? Write for 10 minutes.

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The Artist’s Way

At the beginning of the year, I stumbled into a group working through Julia Cameron’s prolific The Artist’s WayThe premise is that we’re all created to be creative, that along the way our artistic self becomes “blocked” and, through a process of exercises and exploration, we can unleash our underlying creativity, transforming our own life in the process. It’s an involved undertaking, which I tackled in characteristic too-fast-out-of-the-blocks fashion.

I had heard of Cameron’s book but didn’t know much of what it was about when I agreed to commit myself to the group and the process. I’ve found the “Morning Pages” Cameron endorses a cathartic free-form journaling that does serve to unearth our core stumbling blocks and greatest desires in life. I’m recalling previous passions and brainstorming ways I could incorporate these childhood joys into my adult life: writing and playing music, performing elaborate plays, detailed needlework, making bracelets, dancing.

I have to admit I was skeptical at first. Despite being a life-long journaler with a history of a strong spiritual faith, I initially found some of her observations and suggestions new-agey and impractical. What modern professional parent has time to write three pages every morning and take their inner artist on a weekly date? I’ve since come around, appreciating the thematic chapters and exercises, the encouragement and confidence instilled that we are all creative beings, most content and most ourselves when we find ways to weave artistry into our lives.

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