Monday, 9 December 2013

Reflections on Perfroming Medicine: The Anatomy Season

There's been an overwhelmingly positive response surrounding Performing Medicine: The Anatomy Season in Cardiff including 5* reviews for performance piece An Anatomie in Four Quarters. Having attended most of the Season's events, medical students Kitty Hardman and Sophie Fitzsimmons reflect on the benefits they feel they've gained from viewing medicine from a new, arts-based perspective. Often viewed as worlds apart, Performing Medicine: The Anatomy Season clearly appears to have exposed the wealth of new ideas and insights that originate when art and science collide. 

Sophie Fitzsimmons:

This week, I attended the Inside Information workshop, which showed me one way the arts could be integrated into the medical curriculum.

In a very mixed audience that included singers, doctors, and students of art, medicine and drama, we moved around three different sessions all based around the anatomy of the throat.

The first two sessions covered familiar territory – the first was a demonstration of the basic anatomy behind voice production; and the second showed how this anatomy was put into action in a clinical situation in which an acutely ill patient was assessed, managed and incubated. However, the final session was with an opera singer, who explained how singers used knowledge of anatomy and physiology to guide their technique. I was fascinated by her non-clinical ways of describing anatomy in action – ‘sing through the back of your head’ – allowing an increased awareness and control over the position of one’s body. Could learning more about these intuitive descriptions of anatomy as well as the technical ones we are so used to teach us new ways of explaining difficult concepts to our patients?

The Cardiff Anatomy Season has exposed me to a range of different viewpoints on the body and on medicine, many of which I had never considered before. Perhaps the most important message I took away was a reminder of a layperson’s perception of the body and of the vulnerability patients feel when in our hands and trusting that we doctors know how their body works better than they do themselves; something it is easy to lose sight of after almost 6 years of medical school.

This is why I believe it is so important to try and integrate alternative ways of thinking about medicine into the curriculum. Ultimately, medicine is about understanding people – not just their anatomy and physiology, but also their fears, their hopes, their ideas. It is far too easy to become a ‘fact machine’ while at medical school and only learn what is required to get by; to forget what it is like to know nothing of the inferior vena cava or abductor pollicis brevis, and that there are in fact other ways of perceiving the body.

Events and performances such as those created by Clod Ensemble can help us to become well-rounded, thoughtful and better doctors, who not only think more deeply about what we do but also (most importantly) about how our patients feel.

Many thanks to Prof Judith Hill, Clod Ensemble and the Wales Millennium Centre for encouraging me to get involved with the Anatomy Season.

Kitty Hardman:

The anatomy season has been a thought provoking and exciting time for me. Several weeks ago I would have doubted whether science and the arts were genuinely compatible, but sitting here now and reflecting, in particular over last week’s workshops: Inside Information and The Poetic Body, I know that these two supposedly opposite interests are not only compatible but beneficial to one another.

During the Poetic Body workshop we explored the neutral mask as pioneered by Jacques Lecoq. This, and an ensuing conversation with Clod Ensemble’s co-artistic Director Suzy Willson, showed me how theatrical skills can be integrated into medical teaching. The neutral mask explores physical awareness and the mannerisms and emotions that are portrayed by our bodies. So much communication is expressed in body language and so much of medicine is about communication. I really hope that in being more aware of how I express myself I will become a clinician that patients feel at ease with and are able to communicate openly with. 

The Inside Information workshop was fascinating. It showed the range of perspectives that are applicable to a single subject and through this how you can arrive at a better understanding of that subject. It was great to be taught about the vocal chords by Ros Evans (WNO opera singer). A singer’s stance was based a lot more on the functionality of the voice and I could also see that I would have really benefited from this kind of approach when I was first learning the anatomy of the head and neck.  

I am sorry that the season is now over but immensely grateful that it came to Cardiff and hopeful that it will return in the future- maybe as a feature of the medial curriculum- that would be fantastic!

Thursday, 5 December 2013

Introducing our The Poetic Body workshop leader, Aurelian Koch

Workshop details
The Poetic Body
Fri 6 Dec | 10am – 5pm | Wales Millennium Centre

Aurelian trained at the Ecole Jacques Lecoq in Paris, where he also studied at the LEM (Laboratory for the Study of Movement), a course relating movement to architecture.

In 1993 he co-founded Bouge-de-là Theatre in Oxford, where he was Joint Artistic Director for 12 years. He produced, designed and toured 7 professional shows and worked with young people on over 80 projects, of which over 15 were devised shows. 

Aurelian has also designed for other companies, among them Foursight Theatre and Pop-up Theatre. 

In 2002, Aurelian completed a three month animation course in Bristol and has since worked with Aardman Animations. In 2005, he was appointed as the lead artist in the development of the new Pegasus Theatre building, working in collaboration with the design team to implement the public art aspect of the project. 

Aurelian now teaches spacelab at LISPA (London International School of Performing Arts). 

He is currently collaborating with composer Dan Stern and the London Sinfonietta on ‘I Know Waiting’, a piece combining dance and classical music, to be performed at Bath Festival in May 2014.

He is also involved in the production of Fahrenheit 451, a large-scale outdoor production in development for Summer 2015.

Tuesday, 3 December 2013

Medical students Kitty Hardman and Sophie Fitzsimmons reflect on An Anatomie in Four Quarters

The performance, like Tuesday's conversation, challenged the subject of perception. After each quarter we increased our closeness to the performers and ended by being invited to walk amongst them as they danced on stage. In the beginning we saw how the dance developed from a singular foetal like body to a group dance with tribal aggression.  Moving down, and increasing our closeness, silence fell as the orchestra walked on, uniformed and ordered, they descended into the pit.  

The subsequent dance mirrored the development of a more controlled style. Moving seats again we were invited to sit surrounding what looked like an old dissection table, upon which the body of an outstretched woman lay. The singularity of her voice and song contrasted with the power of the numerous musicians in the orchestra and confounded the sense of her isolation and vulnerability. The performance finished with the audience seated on stage, looking upwards to the audience seating. We watched as the performers took their bow and the curtain fell on us.  

Within the doctor-patient relationship, it is always the clinician in control. In this experimental piece by Clod Ensemble the audience took on the part of the patient as we were directed and moved around the theatre; not knowing why, or really understanding what was going on. This is probably very similar to many patients’ experience in hospital. If the arts can teach us more on this, it might not only lead to better understanding and communication between clinician and patient but to a broader understanding on what it is like to have an illness.

I really look forward to see if the Inside Information and The Poetic Body workshops continue on theme of perception and hope that I might glean some skills, which I might be able to apply to my future studies and practice.

 - Kitty Hardman

I really didn’t know what to expect from An Anatomie In Four Quarters – however, I was hoping it would give me a new perspective on the body and human anatomy, and it did not disappoint in this respect.

The show was a varied display and exploration of the movements the human body is capable of – with a clever juxtaposition of the vibrant, warm, alive bodies of the dancers with the clinical or scientific ways of viewing the body (giant projections of x-rays showing various movements of the skeleton which the dancers mimicked; a beautiful ethereal scene with a singer singing mysterious words from a table at the bottom of the auditorium evoked the old anatomy theatres of the Enlightenment).

Throughout the show we moved ever closer to the dancers, finally ending up on the stage among the performers (my favourite part of the show) so we were actually able to walk among them and view their movements close up. Each dancer explored a unique set of actions, and it was fascinating to be able to watch the movements and body parts I had learned about in my anatomy classes in such an exciting setting.

The next event I’m going to will be the Inside Information workshop on Wednesday. It’s going to be another varied evening, and I’m really looking forward to being able to apply some anatomy both to a new clinical situation (anaesthetics) and also to my hobby of singing!

  - Sophie Fitzsimmons

Friday, 29 November 2013

Sophie Fitzsimmons and Kitty Hardman review Tuesday night's conversation 'Anatomy Acts'

Sophie Fitzsimmons

This ‘conversation’ event brought up fascinating points that really made me think differently about my medical education and practice.

The first speaker, Dr Gianna Bouchard, an academic who lectures on drama, gave a brief overview of the history of anatomy (specifically dissection) as performance – from the ‘anatomy theatres’ of the Enlightenment to the modern-day spectacles of Gunther Von Hagens. This talk brought me back to my time in the dissection room at the start of medical school – how privileged and excited I felt not only to be carrying on a medical tradition hundreds of years old, but to be allowed to explore this body which had been given for the purpose of my education.

The second speaker, Prof Roger Kneebone, a surgeon, brought up two themes that really captured my interest – firstly, the concept of surgery as a carefully choreographed dance or show, with the patient as both participant and audience (a concept that could indeed be expanded to the whole of medicine); and secondly, of the importance in medicine and surgery of learning through experience. No real body will ever be as perfect and tidy as the glossy images in our textbooks; the cadavers we encounter during dissection (though imperfect, messy and ‘real’) are not the same as a warm, breathing, living person. The practice of medicine is impossible to communicate fully through words and images – the real learning we do through our hands and the co-operation of our patients.

The final speaker, Brian Lobel, a performer and writer inspired by his experiences as a cancer patient, gave an account of his experiences and feelings while going through various medical investigations. It was eye-opening to hear about a patient’s changing view of their body in illness as well as their feelings of passivity while in the hands of the doctors – a viewpoint that is vital for doctors to understand (but one that is sadly rarely discussed) and one I am keen to explore further. 

These absorbing talks brought up many more issues than can fit into one blog post! I’ll just finish by saying I am very much enjoying thinking about medicine and the body from these new angles, and I’m looking forward to continuing this alternative exploration of anatomy during the main event (An Anatomie In Four Quarters) this weekend. 

Kitty Hardman:

Last night’s conversation between Dr Gianna Bouchard (principle lecturer in drama at Anglia Ruskin University), Brian Lobel (play write and performer) and Professor Roger Kneebone (surgeon, clinician and educationalist at Imperial College London) saw a great convergence of medioscientific and artistic minds.

I was fascinated by the points made on focus and perspective. In one regard the patient is the principle focus, as depicted by images of surgeons huddled around the boxed off fleshy square of the patient but in another sense the personality of the patient is completely out of focus; unconscious with no voice. Discussion about the patient, their body; their illness continues without them being involved or even aware. However, as Professor Kneebone pointed out, the advancements in medical technology will see a shift in this perspective. A patient receiving vascular treatment under interventional radiology may not only be awake with a voice but also conscious of the instantaneous benefit that the procedure can bring.  I am fascinated as to how the medical profession will respond to this change in the patient-physician dynamic and am intrigued to see if my future medical education will reflect this.

I can’t wait to see the performance: An Anatomie in Four Quarters to see the coming together of music, performance and art under the spectacle and wonder of the human body.