The Role of Humanities in Therapy: Exploring Artistic Expressions for Healing
A Place for the Humanities
in Therapy
1
Agenda
intro
what
what not
why
graphic art
poetry
painting
sculpture
film
music
prose
write
end
2
3
F
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Annals Graphic Medicine - Is This What Depression Looks Like?
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15
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16
Mercy
We shiver. The room is not cold. We’re sweatered
up, red for you, blue for me. Artery. Vein. Going
and coming. We wait on needles. You roll up your
sleeve, expose a blue vein, pulse under winter skin.
Infuse: to pour into
. Nearby, nurses lift the plumped
sacs, poisons mixed to pour fire into flesh. Yours.
Others’—eight stations of strangers propped, pillow-
chaired about the scrubbed room as nurses come
and go in these hushed halls of chemo, flicking
scarlet nails to re-start a clogged line. One—blue
scrubs, bluer eyes—stops before us, tray of sharps
held at her waist.
Liz
. She kneels by your side,
seeks your eyes—and mine—to assess the level of
our dread. Lays her hand on yours, murmurs
we’ll
look after you
, slips a swift needle under swabbed
skin.
Anything
, she looks at me.
Call me for any
thing.
Rising, she turns to attend to our neighbor’s
port. . . . You doze under meds. I watch, still on
edge, as she leans to retrieve a chart. Her sleeve
rides up, past her elbow’s pale skin. In the tender
flesh, the mouth of an old reddened scar.
What’s
that?
someone asks.
Oh, that,
she says,
my step-
father. Stubbed his cigarette out on me
. I’m not
meant to hear, but I have—I flinch. Sudden before
me—the child’s bared arm, her scrabbling feet as
she tries to escape. His grip. Her cry. How could
she turn burn to mercy? Wounded, she heals—
blessed, we dare to drink from the bitter cup.
Judith H. Montgomery
American Journal of Nursing, November 2016
17
JAMA Art and Images in Psychiatry
https://sites.jamanetwork.com/art-and-images-in-psychiatry/index.html
18
Le Suicide
Édouard Manet (1832-1883), French.
Le
Suicide
, c 1877-1881. Oil on canvas, 38 × 46
cm. Foundation E. G. Buehrle Collection,
Zurich, Switzerland. Photo credit: Erich
Lessing/Art Resource, New York, New York.
19
20
“Wit”
https://www.youtube.com/watch?v=72SM8E0h2Ts
21
Smetana, String Quartet #1, 4
th
Movement,
“From My Life”
https://www.youtube.com/watch?v=0R80gVfx6i8
2:00-5:40 (hint…3:40ish…)
22
“Spirit Voices”
https://www.youtube.com/watch?v=tqd_4Kh5OxM
23
We sailed up a river wide as a sea
And slept on the banks
On the leaves of a banyan tree
And all of these spirit voices rule the night
Some stories are magical, meant to be sung
Songs from the mouth of the river
When the world was young
And all of these spirit voices rule the night
By moon
We walk
To the brujo's door
Along a path of river stone
Women with their nursing children
Seated on the floor
We join the fevers
And the broken bones
The candlelight flickers
The falcon calls
A lime-green lizard scuttles down the cabin wall
And all of these spirit voices
Sing rainwater, sea water
River water, holy water
Wrap this child in mercy and heal her
Heaven's only daughter
All of these spirit voices rule the night
24
My hands are numb
My feet were lead
I drank a cup of herbal brew
The sweetness in the air
Combined with the lightness in my head
And I heard the jungle breathing in the bamboo
Saudocoes -- Greetings!
Da licenca um momento -- Excuse me, one moment
Te lembro -- I remind you
Que amanha -- That tomorrow
Sera tudo ou sera naoa -- It will be all or it will be nothing
Depende coracao -- It depends, heart
Sera breve ou sera grande -- It will be brief or it will be great
Depende da paixao -- It depends on the passion
Sera sujo, sera sonho -- It will be dirty, it will be a dream
Cuidado, coracao -- Be careful, heart
Sera util, sera tarde -- It will be useful, it will be late
Se esmera, coracao -- Do your best, heart
E confia -- And have trust
Na forca do amanha -- In the power of tomorrow
Lord of the earthquake
My trembling bed
The spider resumes the rhythm
Of his golden tread
And all of these spirit voices rule the night
25
ה
ה
ו
א
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נ
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נ
פ
ש
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ד
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ב
י
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ז
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ו
א
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כ
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מ
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ן
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A
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A
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w
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d
.
26
ס
ל
י
ק
א
א
מ
ת
י
ה
ד
ר
ב
י
ל
א
י
ג
ר
א
א
מ
ר
ה
ע
ל
י
ו
נ
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'
מ
ב
ק
ש
י
ן
א
ת
ר
ב
י
ו
ה
ת
ח
ת
ו
נ
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'
מ
ב
ק
ש
י
ן
א
ת
ר
ב
י
י
ה
י
ר
צ
ו
ן
ש
י
כ
ו
פ
ו
ת
ח
ת
ו
נ
י
ם
א
ת
ה
ע
ל
י
ו
נ
י
ם
כ
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ו
ן
ד
ח
ז
א
י
כ
מ
ה
ז
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מ
נ
י
ד
ע
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ל
ל
ב
י
ת
ה
כ
ס
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ח
ל
ץ
ת
פ
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ל
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מ
נ
ח
ל
ה
ו
ו
ק
מ
צ
ט
ע
ר
א
מ
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י
ה
י
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צ
ו
ן
ש
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כ
ו
פ
ו
ע
ל
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ו
נ
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ם
א
ת
ה
ת
ח
ת
ו
נ
י
ם
The maidservant of Rabbi
Yehuda
HaNasi
ascended to the roof
and
said: The
upper
realms
are requesting
the presence
of
Rabbi
Yehuda HaNasi,
and the
lower
realms
are requesting
the presence
of
Rabbi
Yehuda HaNasi.
May it be
the
will
of
God
that the lower
worlds
should
impose
their will
upon the upper
worlds.
However,
when she saw how many times he
would enter the bathroom and
remove
his
phylacteries,
and then exit
and put
them
back
on, and
how
he was suffering
with
his intestinal disease,
she said: May it
be
the
will
of God
that the
upper
worlds
should impose
their will
upon
the lower
worlds.
27
ו
ל
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נ
ן
מ
ל
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י
ב
ע
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מ
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ק
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ה
כ
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ז
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א
מ
א
י
ג
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[
ל
א
ר
ע
א
]
א
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ש
ת
י
ק
ו
מ
ר
ח
מ
י
ו
נ
ח
נ
פ
ש
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ה
ד
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ב
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A
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m
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.
,
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y
w
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d
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28
Trusting the Process
As a rookie psychologist, I knew I had much to learn. Burdened with perfectionism, I had self-doubts about technique and
process. I so wanted to do it right.
One day I was assigned a young client—a girl of no more than twelve, whose grandfather was anxious to have her seen
by a therapist. His wife was dying, and the child’s mother had no interest in raising her. To complicate matters, the
relationship with the grandmother was full of resentment on both sides. Not ideal in any way.
I saw my young client every week for several months. I found it hard to engage her because she wasn’t really interested
in being in therapy. She didn’t want to talk about home, or her mother or her grandmother. So I encouraged her to talk
about school, and make-up, and boys, and anything she wanted. I had severe doubts that I was doing anything
therapeutic.
The time was coming for my internship to end. I had the difficult task of informing her grandfather that I would no longer
be working at the agency. Nor could I continue with the child elsewhere, according to agency rules. He was very upset.
During our last session, my young client just prattled on as usual, seemingly without any sense of loss due to our
impending termination. But not me. Tears coursed silently down my cheeks. I couldn’t stop them. I couldn’t speak. I felt
like a total failure as a therapist.
At the time I was also grieving recent knowledge of my own infertility. That this child had no more mother figures and that
I could not have a child of my own were intersecting aches in my heart.
Later I went to supervision and confessed my failure to maintain proper therapist decorum. My supervisor quietly said,
“That may be the first time in her life she had a woman cry tears of compassion for her. You’ll never know if you had any
impact or not. Trust the process.”
In the decades since I have cried more than once while witnessing the pain of clients as they revealed traumas, losses,
heartaches and injustices. Sometimes I cry because they can’t. I don’t try to hide tears. I don’t apologize for them. They
are signs of solidarity, compassion, and love. We’re all in this together.
Gretchen Gundrum
Seattle, Washington
29
Now…you…
30
Conferences
Examined Life, Iowa City
Creating Spaces, Canada
31
Programs/Rounds
Columbia University
Narrative Medicine Rounds
http://www.narrativemedicine.org/events/category/rounds/
Johns Hopkins Children’s Center
AfterWards
https://www.hopkinsmedicine.org/news/articles/In-AfterWards-Program-
Caregivers-Mine-Medical-Narrative
32
MedArt Maryland
33
Journals
50+ med
MANY non-med (eg The Atlantic)
Academic Medicine
American J of Nursing—Art of Nursing, Reflections
American J of Psychiatry (and Residents’ Journal)
Annals of Internal Medicine
Bellevue Literary Review
Cell2Soul
Chest—Pectoriloquy
Examined Life Journal
JAMA—A Piece of My Mind, Poetry and Medicine
J of Clinical Oncology
J of Medical Humanities
J of Palliative Medicine
Neurology--Reflections
NEJM
The Intima
Yale J for Humanities in Medicine (https://www.facebook.com/YaleHumanitiesInMedicine)
34
Special things
Pulse
(pulsevoices.org)
Kent State University Press, Literature and Medicine series
http://www.kentstateuniversitypress.com/2010/the-poetry-of-nursing/
http://www.kentstateuniversitypress.com/2011/tenderly-lift-me/
http://www.kentstateuniversitypress.com/2014/when-the-nurse-becomes-a-patient/
JAMA Art and Images
https://sites.jamanetwork.com/art-and-images-in-psychiatry/index.html
AIM Graphic Medicine, AIM Story Slam
http://annals.org/aim/channel?articleTypeIDs=14671&ft=Graphic%20Medicine&fl_HasAOE=false
Abaton, Reflexions, Stethos, many others…
Cornell Medical College--Music and Medicine Initiative
World Doctors Orchestra
Yale Residency Writers’ Workshop
American Society for Bioethics and Humanities (long journal list, long programs list)
35
A few good articles
•
To See the Suffering
•
Beyond Dr. “Feel-Good”: A Role for the Humanities in Medical Education
•
Poetry’s Company: Where Medicine Leaves Us Alone
•
Healing the Healer: Poetry in Palliative Care
•
Poetry as Self-Care and Palliative Care
•
Poetry, medicine, and the International Hippocrates Prize
•
Can Poetry Console a Grieving Public?
•
Ode on a Stethoscope
•
Fiction as Resistance
•
Cultivating the Inner Life of a Physician Through Written Reflection
•
Doctors’ Condolence Notes
•
Stories Doctors Tell
•
Vignettes for Teaching Psychiatry With the Arts
•
Scalpel, Sponge, Show Tunes: When Doctors Moonlight as Actors
•
Narrative Humility
•
I Carry Your Heart
•
The Physician as Storyteller
•
The Craft of Writing: A Physician-Writer’s Workshop for Resident Physicians
36
Dive into the intersection of humanities and therapy through various artistic mediums like graphic art, poetry, painting, sculpture, film, music, and prose. Explore how these forms of expression can provide a unique avenue for processing emotions, thoughts, and experiences in a therapeutic context. Delve into the power of creativity and artistic engagement in promoting mental well-being and self-exploration.
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A Place for the Humanities in Therapy 1
Agenda intro what what not why graphic art poetry painting sculpture film music prose write end 2
From: Annals Graphic Medicine - Please Don't Use Patient Names 4
Annals Graphic Medicine - Is This What Depression Looks Like? 6
Blueberry Picking by Roz Levine We ran from an outbreak of polio Abandoned the Bronx for a summer hideaway In the shadow of the Catskill Mountains Each day we traipsed craggy trails Stooped low beneath clear skies Plucked mounds of dark blues From bushes bursting with ripe fruit Filled our baskets to overflow It should have been all this: Sunshine on eight-year-old skin Fresh air on innocent girl soil Thoughts of jam on toast for breakfast Happy days of laughs with the family When anxiety overwhelms the mind Blueberry picking equates to worries Of prickly thorns and bee stings Sunburns and infected blisters Rattlesnake bites and botulism in jelly jars Everything, a gravediggers paradise 15
About the poet: "Writing has been one of the major tools to help me navigate a life filled with high anxiety, including several cancers and a multitude of surgeries. When I retired from my work as a school counselor several years ago, I decided that it was time to dedicate myself to my writing life and to honor the creative spirit within me. I am a member of the Los Angeles Poets and Writers Collective, founded by Jack Grapes. My works have been published in The Sun, On the Bus, Cultural Weekly, Poetry Super Highway, Silver Birch Press, Forever in Loveand Deliver Me." About the poem: "This poem was inspired by the atrocities that are occurring around the world and that create so much anxiety within me. I decided to get out of my head by tracing one of my earliest childhood memories related to anxiety-- to document poetically how the simplest act, like picking blueberries in a beautiful mountain setting, was weighted down by my catastrophic thinking. I don't think I'll ever cease to be an anxious individual, but if I can make art from anxiety, I can live with that." 16
Mercy We shiver. The room is not cold. We re sweatered up, red for you, blue for me. Artery. Vein. Going and coming. We wait on needles. You roll up your sleeve, expose a blue vein, pulse under winter skin. Infuse: to pour into. Nearby, nurses lift the plumped sacs, poisons mixed to pour fire into flesh. Yours. Others eight stations of strangers propped, pillow- chaired about the scrubbed room as nurses come and go in these hushed halls of chemo, flicking scarlet nails to re-start a clogged line. One blue scrubs, bluer eyes stops before us, tray of sharps held at her waist. Liz. She kneels by your side, seeks your eyes and mine to assess the level of our dread. Lays her hand on yours, murmurs we ll look after you, slips a swift needle under swabbed skin. Anything, she looks at me. Call me for any thing. Rising, she turns to attend to our neighbor s port. . . . You doze under meds. I watch, still on edge, as she leans to retrieve a chart. Her sleeve rides up, past her elbow s pale skin. In the tender flesh, the mouth of an old reddened scar. What s that? someone asks. Oh, that, she says, my step- father. Stubbed his cigarette out on me. I m not meant to hear, but I have I flinch. Sudden before me the child s bared arm, her scrabbling feet as she tries to escape. His grip. Her cry. How could she turn burn to mercy? Wounded, she heals blessed, we dare to drink from the bitter cup. Judith H. Montgomery American Journal of Nursing, November 2016 17
JAMA Art and Images in Psychiatry https://sites.jamanetwork.com/art-and-images-in-psychiatry/index.html 18
Le Suicide douard Manet (1832-1883), French. Le Suicide, c 1877-1881. Oil on canvas, 38 46 cm. Foundation E. G. Buehrle Collection, Zurich, Switzerland. Photo credit: Erich Lessing/Art Resource, New York, New York. 19
Wit https://www.youtube.com/watch?v=72SM8E0h2Ts 21
Smetana, String Quartet #1, 4th Movement, From My Life https://www.youtube.com/watch?v=0R80gVfx6i8 2:00-5:40 (hint 3:40ish ) 22
Spirit Voices https://www.youtube.com/watch?v=tqd_4Kh5OxM 23
We sailed up a river wide as a sea And slept on the banks On the leaves of a banyan tree And all of these spirit voices rule the night Some stories are magical, meant to be sung Songs from the mouth of the river When the world was young And all of these spirit voices rule the night By moon We walk To the brujo's door Along a path of river stone Women with their nursing children Seated on the floor We join the fevers And the broken bones The candlelight flickers The falcon calls A lime-green lizard scuttles down the cabin wall And all of these spirit voices Sing rainwater, sea water River water, holy water Wrap this child in mercy and heal her Heaven's only daughter All of these spirit voices rule the night 24
My hands are numb My feet were lead I drank a cup of herbal brew The sweetness in the air Combined with the lightness in my head And I heard the jungle breathing in the bamboo Saudocoes -- Greetings! Da licenca um momento -- Excuse me, one moment Te lembro -- I remind you Que amanha -- That tomorrow Sera tudo ou sera naoa -- It will be all or it will be nothing Depende coracao -- It depends, heart Sera breve ou sera grande -- It will be brief or it will be great Depende da paixao -- It depends on the passion Sera sujo, sera sonho -- It will be dirty, it will be a dream Cuidado, coracao -- Be careful, heart Sera util, sera tarde -- It will be useful, it will be late Se esmera, coracao -- Do your best, heart E confia -- And have trust Na forca do amanha -- In the power of tomorrow Lord of the earthquake My trembling bed The spider resumes the rhythm Of his golden tread And all of these spirit voices rule the night 25
' It is related that on the day that Rabbi Yehuda HaNasi died, the Sages decreed a fast, and begged for divine mercy so that he would not die. And they said: Anyone who says that Rabbi Yehuda HaNasi has died will be stabbed with a sword. 26
' ' The maidservant of Rabbi Yehuda HaNasi ascended to the roof and said: The upper realms are requesting the presence of Rabbi Yehuda HaNasi, and the lower realms are requesting the presence of Rabbi Yehuda HaNasi. May it be the will of God that the lower worlds should impose their will upon the upper worlds. However, when she saw how many times he would enter the bathroom and remove his phylacteries, and then exit and put them back on, and how he was suffering with his intestinal disease, she said: May it be the will of God that the upper worlds should impose their will upon the lower worlds. 27
] [ And the Sages, meanwhile, would not be silent, i.e., they would not refrain, from begging for mercy so that Rabbi Yehuda HaNasi would not die. So she took a jug [kuza] and threw it from the roof to the ground. Due to the sudden noise, the Sages were momentarily silent and refrained from begging for mercy, and Rabbi Yehuda HaNasi died. 28
Trusting the Process As a rookie psychologist, I knew I had much to learn. Burdened with perfectionism, I had self-doubts about technique and process. I so wanted to do it right. One day I was assigned a young client a girl of no more than twelve, whose grandfather was anxious to have her seen by a therapist. His wife was dying, and the child s mother had no interest in raising her. To complicate matters, the relationship with the grandmother was full of resentment on both sides. Not ideal in any way. I saw my young client every week for several months. I found it hard to engage her because she wasn t really interested in being in therapy. She didn t want to talk about home, or her mother or her grandmother. So I encouraged her to talk about school, and make-up, and boys, and anything she wanted. I had severe doubts that I was doing anything therapeutic. The time was coming for my internship to end. I had the difficult task of informing her grandfather that I would no longer be working at the agency. Nor could I continue with the child elsewhere, according to agency rules. He was very upset. During our last session, my young client just prattled on as usual, seemingly without any sense of loss due to our impending termination. But not me. Tears coursed silently down my cheeks. I couldn t stop them. I couldn t speak. I felt like a total failure as a therapist. At the time I was also grieving recent knowledge of my own infertility. That this child had no more mother figures and that I could not have a child of my own were intersecting aches in my heart. Later I went to supervision and confessed my failure to maintain proper therapist decorum. My supervisor quietly said, That may be the first time in her life she had a woman cry tears of compassion for her. You ll never know if you had any impact or not. Trust the process. In the decades since I have cried more than once while witnessing the pain of clients as they revealed traumas, losses, heartaches and injustices. Sometimes I cry because they can t. I don t try to hide tears. I don t apologize for them. They are signs of solidarity, compassion, and love. We re all in this together. Gretchen Gundrum Seattle, Washington 29
Nowyou 30
Conferences Examined Life, Iowa City Creating Spaces, Canada 31
Programs/Rounds Columbia University Narrative Medicine Rounds http://www.narrativemedicine.org/events/category/rounds/ Johns Hopkins Children s Center AfterWards https://www.hopkinsmedicine.org/news/articles/In-AfterWards-Program- Caregivers-Mine-Medical-Narrative 32
Journals 50+ med MANY non-med (eg The Atlantic) Academic Medicine American J of Nursing Art of Nursing, Reflections American J of Psychiatry (and Residents Journal) Annals of Internal Medicine Bellevue Literary Review Cell2Soul Chest Pectoriloquy Examined Life Journal JAMA A Piece of My Mind, Poetry and Medicine J of Clinical Oncology J of Medical Humanities J of Palliative Medicine Neurology--Reflections NEJM The Intima Yale J for Humanities in Medicine (https://www.facebook.com/YaleHumanitiesInMedicine) 34
Special things Pulse (pulsevoices.org) Kent State University Press, Literature and Medicine series http://www.kentstateuniversitypress.com/2010/the-poetry-of-nursing/ http://www.kentstateuniversitypress.com/2011/tenderly-lift-me/ http://www.kentstateuniversitypress.com/2014/when-the-nurse-becomes-a-patient/ JAMA Art and Images https://sites.jamanetwork.com/art-and-images-in-psychiatry/index.html AIM Graphic Medicine, AIM Story Slam http://annals.org/aim/channel?articleTypeIDs=14671&ft=Graphic%20Medicine&fl_HasAOE=false Abaton, Reflexions, Stethos, many others Cornell Medical College--Music and Medicine Initiative World Doctors Orchestra Yale Residency Writers Workshop American Society for Bioethics and Humanities (long journal list, long programs list) 35
A few good articles To See the Suffering Beyond Dr. Feel-Good : A Role for the Humanities in Medical Education Poetry s Company: Where Medicine Leaves Us Alone Healing the Healer: Poetry in Palliative Care Poetry as Self-Care and Palliative Care Poetry, medicine, and the International Hippocrates Prize Can Poetry Console a Grieving Public? Ode on a Stethoscope Fiction as Resistance Cultivating the Inner Life of a Physician Through Written Reflection Doctors Condolence Notes Stories Doctors Tell Vignettes for Teaching Psychiatry With the Arts Scalpel, Sponge, Show Tunes: When Doctors Moonlight as Actors Narrative Humility I Carry Your Heart The Physician as Storyteller The Craft of Writing: A Physician-Writer s Workshop for Resident Physicians 36
