MCW Art Club

From the 7/24/2020 newsletter


Medicine and the Humanities

MCW Art Club

Teresa Patitucci, PhD (@DrRabbitHeART)

In this essay, Dr. Patitucci describes how art has been integral to both her life and her teaching of anatomy. She has curated a virtual space where the arts hold meaning for individuals as well as our entire medical community...

Creative expression is an important part of my life and many others’ around MCW. The sciences are often associated with analytical and academic pursuits, so it may be surprising to learn how many people in these fields are also highly creative. The arts provide both personal and professional benefits. For example, visual art can be helpful for cathartic reasons, but also for developing objective observation skills. Here I primarily talk about art for expression.

Personally, I have dabbled in several creative pursuits, including theater, singing, and dancing, but am primarily a visual artist. While I publicly share my visual art, I rarely sing in front of others. Students know me for my anatomical illustrations, my partner knows me for having oil paint all over me. My best friend knows I will sing to her when her fibromyalgia is acting up even if I’m shy about it. These activities are my lifeblood. In private, they are what I turn to when I’m overjoyed or overwhelmed with grief. I sing when I feel so full of a feeling it must exit my body – take a deep breath and make as loud a sound as my petite body can produce. This summer has involved a lot of singing. I draw or paint to create my own world, capture a memory, lean into a feeling, or frankly to zone out and relax.

Our attention is drawn to the fact that we are living in “unprecedented times” at every waking moment. From the global COVID-19 pandemic to heightened awareness of racial issues, tensions are running high. Additionally, many of us are spending more time at home than usual and craving connection with other human beings. Time for the arts to step in. When we all went into lockdown in March, I created a virtual MCW Art Club for anyone from MCW to post their creative endeavors, whether that means visual art, music, poetry, or short stories. This is a fully online club (Facebook, Instagram, Twitter) with the hope of building artistic community from a distance. All MCW personnel are invited to participate – staff, faculty, students from all campuses and programs. It has been amazing to see the talent across our campuses shared so far.

We have had participants share paintings, cultural art, pathology art, pieces of music from various instruments (originals and covers), anatomical art, miniature painting, wood burning design, knitting, and poetry! Several examples are shown below. Chris Knight from MCW Central Wisconsin commented on creating alibrijes this summer with his daughter (shown below), “Art is a very therapeutic escape. Doing a project with my daughter was special because she loves doing art and it gave her a significant distraction during quarantine. The fact that we could make it culturally relevant for our family added to it.”

You can view our collection or share your own work via our Facebook page “MCW Art Club” or using the hashtag #MCWArtClub on Instagram or Twitter. Of course, not all art needs to be shared. If you want your work shared, but are hesitant for whatever reason, you may send pieces to me for anonymous posting. I hope readers are encouraged to share their work in our digital club, but more than that, I hope you keep creating for whatever reason drives you.

MCW Art Club Sneak Preview:



An illustration by Dr. Patitucci

Listen to CeCi here. 

Listen to Chordae Harmonae here.

Teresa Patituci, PhD is an Assistant Professor of Cell Biology, Neurobiology, and Anatomy at MCW. She teaches human anatomy and neuroscience across multiple disciplines and encourages use of alternative teaching tools such as drawing and plastination. She launched a patination lab at MCW, a technique that preserves specimens for long-term use.

How to Be an Antiracist by Ibram X. Kendi Chosen as the MCW Common Read

 From the 8/7/2020 newsletter 

 

 

How to Be an Antiracist by Ibram X. Kendi Chosen as the MCW Common Read

 

Anna Janke, MCW Class of 2023

Associate Editor

 

Ms. Janke discusses the process and outcome of this year’s search for the book that will be the MCW Common Read…

 

It took us the entire school year to choose this upcoming year’s Common Read selection. Led by then-M4 Sophia Lindekugel, the Book Selection Committee read dozens of books suggested by MCW community members to pick a book that would be timely, readable for a wide audience, and actionable to spark meaningful change. As a lifelong reader and now a member of the Book Selection Committee, I really enjoyed reading books that opened my eyes to topics I had not explored in depth before, ranging from the opioid epidemic, to the Flint water crisis, to the individual and societal impacts of sexual assault.

However, after selecting a book with which we were all thrilled to announce, these plans were pivoted once we noticed, and joined in on, the outcry surrounding the deaths of George Floyd, Breonna Taylor, and far too many others. The MCW Common Read Leadership felt that it was necessary to shift this year’s Common Read to one that would center around race and race relations in America, shelving our previous selection for another year.

While the time allotted to select a book was now much shorter after the decision to pivot, many inspiring voices came forward to recommend titles that would spark discussions throughout the MCW community about race. It was humbling to realize that we have been late to join this movement; The MCW Office of Diversity and Inclusion (ODI), Student National Medical Association (SNMA), and the Center for the Advancement of Women in Science and Medicine (AWSM), among others, have been leading MCW for decades towards progress in health equity, workplace climate, and the dignity of every person.

In the end, we wanted as many community voices to be heard as possible for this year’s Common Read. We met with key stakeholders, including representatives from the aforementioned groups, to select three books from which MCW would vote. After 548 people weighed in, we are thrilled to have How to Be an Antiracist by Ibram X. Kendi as the 2020-2021 MCW Common Read.

While I am both elated and terrified to be a Co-Chair for this year’s programming, I am confident that the Common Read Leadership and the rest of the MCW community will come together to get our hands dirty and make mistakes so we can learn from those mistakes and take important steps forward in the lifelong journey that is Antiracism.

 

  

Anna Janke is an MD Candidate in the MCW Class of 2023. She serves as an Associate Editor of the Tranformational Times.

A View from Internship

From the 7/31/2020 newsletter

A View from Internship

Kim Tyler, MD, MS

Dr. Tyler, who recently graduated from medical school, shares her thoughts on developing a professional identity even as medicine goes through the upheaval of a pandemic …

Starting my intern year during a pandemic is not what I had in mind a year ago when I was preparing residency applications. I could never have anticipated what this first month of internal medicine residency would be like. I find myself thinking multiple times each day, “I should not be allowed to do this.” “Who decided that I was qualified to do this?!” “It is wild that they let me do this.” There is a constant tension between what I feel is expected of me and what I feel is within my abilities. I wrestle with “Impostor Syndrome.”

The first time a patient called me their “doctor,” for example, I nearly fell over. The first time I was summoned to pronounce a patient’s time of death, I stared at my pager wondering if they’d contacted the wrong person. A few weeks out of medical school, “doctor” is an identity I have not yet learned to accept.

As I move through my days, I experience twinges of incompetence. I fear that a patient might call me out. Of course, this is a familiar theme for many during the pandemic. None of us has the faintest idea where this is headed, and uncertainty lingers over all of healthcare. When the ICU fellow is questioned by a family member about treatment options for a COVID patient, does she feel the same doubt that I feel? Do even the most confident attendings have moments of distress? Perhaps some who have made careers out of medicine are being reminded of how they felt when they first started—now challenged by an illness in whose face previous medical knowledge seems inadequate. Is there, in this moment, an opportunity for all of us to acknowledge our hidden feelings of inadequacy and hesitation?

Sensing what it means to be a physician

Even though I am new to this, I believe I am starting to sense what it means to be a physician. In the quiet moments after a patient has confided a fear, a hidden addiction, or a smothering depression, I realize I am accompanying them on their journey. Even as I struggle to enter home healthcare orders, sort out conflicting lab results, or work through admission orders, there are times when I allow myself to just stop and be present in the spaces I inhabit with my patients. The specter of this pandemic highlights the importance of sitting with suffering even when we cannot relieve it.

Even in this time of great uncertainty – and in the midst of my first weeks as a doctor – I can see the beauty in simply and generously being present.

Kim Tyler, MD MS is graduate of the Medical College of Wisconsin Class of 2020. She is currently a PGY1 in the MCW Internal Medicine residency program.

A COVID-19 Conversation

From the 7/10/2020 newsletter

A COVID-19 Conversation 

Bruce H. Campbell, MD

A patient gets his news from different sources than does Dr. Campbell…

My patient and his wife have braved the outpatient clinic restrictions imposed by COVID-19 to return for his cancer follow-up. Over the past couple of years, I have operated on him twice, each time for a malignancy that keeps recurring. He is a delightful and – as even he would admit – a bit exasperating. He speaks his mind and has strong opinions about everything, including his medical care.

When the cancer recurred after the first operation, I suggested that he see one of the radiation oncologists to hear what she might have to offer. “No way. I had a terrible experience last time,” he said at the time. “Even if you recommend radiation after this next operation, I’ll say ‘no’ again. End of conversation.” So, we returned to the operating room for more surgery.

Now, a few weeks later, he is back in the office. I wear my mask and have him lower his so I can examine his mouth and throat. I am relieved. So far, so good. We review his CT scan. “The exam and the scan are both fine. No signs of cancer. Great news!” I say. “All is well.”

He nods and tugs up his mask again. “Good, good.” Then, he cocks his head and looks at me. “So, do you mind if I ask you a couple of questions?”

“Sure,” I say, although I’m not sure where this is heading. “Fire away.”

He glances toward his wife and then back to me. “What do you think of this coronavirus?"

I tense a bit. Based on his previous comments, I know precisely where he stands on the political spectrum. Uh, oh, I think to myself. His favorite media outlets are known for skepticism about wearing masks and maintaining social distancing. Nevertheless, he seems to be genuinely interested.

“Well,” I respond, “It’s dangerous. Based on the science, we should be very cautious. There’s too much risk of the virus spreading and people dying needlessly.” There, I hope. Maybe that’s that.

He starts down his list. “Yeah, but just in other places, right? I hear it’s not bad in Milwaukee.” In fact, our hospital doesn’t publish admission and ICU data, but I am able to tell him in general terms that the numbers of patients admitted and seriously ill with COVID-19 has been climbing over the past several days. “Really?” he asks. “I’m surprised.”

“It’s real,” I say.

“Well then, what do you think about these things I heard on the news?” I cringe slightly as he proceeds through the series of narratives that have found life on the internet. I try to keep up. No, COVID-19 is not like a “regular” flu. Yes, people are dying, and some who recover stay sick for a long time. It’s true that people don’t have to appear ill to be infectious. No, there is no evidence that it was a biological weapon developed in a Chinese lab. No, I’m not aware of any studies that show that more people will die of a stalled economy. No, I don’t believe that it will fade over the coming months and magically disappear after the presidential election. The best studies show that hydroxychloroquine does not extend hospitalized patients’ lives. Yes, masks, hand washing, socialdistancing, and staying home are the best ways to slow the spread. Yes, vaccines will be the best way to return to “normal” and they will take a long time to develop. No, I’m not surprised that Dr. Fauci and the other health experts change their recommendations from time-to-time since scientific evidence continues to evolve. I don’t believe that there is a “scientific deep state.” We go down his list and I do my best to address each concern.

I tell him what I know of the 1918 Flu Pandemic and how the “second wave” killed more than the first. Bringing it closer to home, I share how construction of some of our hospital buildings, which are on part of the old Milwaukee County Grounds, required the exhumation, study, and re-interment of more than two thousand people buried between 1882 and 1925, including many who died and were haphazardly buried anonymously during epidemics. It can happen again.

“Tamping down the virus is personal,” I tell him. “Two of my four children work in healthcare. I’m over sixty. We are all at risk and wearing a mask is the most gracious thing anyone can do,” I say. “It’s a gift we give to others.”

After a deep breath, I realize, gratefully, that they are both still engaged. They have asked honest questions and I have done my best to respond. I have discovered how challenging it is to encapsulate evolving science into respectful, careful, honest, and evidence-based answers for people who might not be inclined to believe people like me. On topics where there are knowledge gaps or shifting data, I see why they might be skeptical.

This is the first meaningful face-to-face conversation I have had with people who spend their days gathering news from sources other than the ones I peruse, and it differs from conversations on Facebook with folks that already agree with me. I am grateful they listened and appreciate the opportunity to better understand their perspectives, even if just for a moment.

“Thanks, Doc,” he says finally. “You gave us some things to think about. I don’t need to come back for a recheck, do I?”

“Well, I would like to see you again in a few months, but I would be happy to see you anytime. Call if anything changes, okay? I know you will.”

“You got it.” We all bump elbows and they stand to leave. “Oh, yeah. And doesn’t abortion kill more people than COVID-19?” 

“Oh, look at the time! Really good to see you both,” I say. I sense our conversation will continue.

Bruce H Campbell, MD FACS is a Professor of Otolaryngology and Communication Sciences and Associate Director of the MCW Medical Humanities Program. He is a member of the Faculty Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. He serves as Editor of the Kern Transformational Times newsletter.

North Avenue at Holton Street, Milwaukee - June 13, 2020

From the 6/19/2020 newsletter

North Avenue at Holton Street, Milwaukee WI 

June 13, 2020

Photo courtesy of Venus Coates, MBA

A Personal Call to Action

From the 6/12/2020 newsletter


A Personal Call to Action


Kathlyn E. Fletcher, MD, MA - Internal Medicine Residency Program Director

“With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right. Let us strive on to finish the work we are in; to bind up the nation’s wounds; to care for him who shall have borne the battle, and for his widow, and his orphan – to do all which may achieve and cherish a just and a lasting peace, among ourselves, and with all nations.”

Thus ends Abraham Lincoln’s second inaugural address. The speech was given as the Union was close to winning the civil war, much of the country (particularly the South) was in ruins, the country mourned over 620,000 lives lost to battle and disease, and just weeks before Lincoln would be assassinated by John Wilkes Booth. This speech is beautiful in its brevity and prescient in its call to action.


With George Floyd’s senseless and violent death, we see yet another stark example of structural racism. Like Lincoln’s second inauguration, this moment in our history presents a call to action. In this moment, action can be large or small. In this moment, action can be public or personal. In this moment, action can be a quiet commitment or a loud chant. But action is required by each of us who wishes to “bind up the nation’s wounds.”


In a recent New York Times column, David Brooks suggested that great leaders are able to use lessons from history and the humanities to guide their responses to crisis. He says that such leaders:

"...were educated under a curriculum that put character formation at the absolute center of education. They were trained by people who assumed that life would throw up hard and unexpected tests, and it was the job of a school, as one headmaster put it, to produce young people who would be ‘acceptable at a dance, invaluable in a shipwreck.’”

He goes on to say that we need our leaders to draw on both science and the humanities during crises like those we are facing:

“Right now, science and the humanities should be in lock step: science producing vaccines, with the humanities stocking leaders and citizens with the capacities of resilience, care and collaboration until they come. But, instead, the humanities are in crisis at the exact moment history is revealing how vital moral formation really is.”

I believe that we can reintroduce the humanities into our lives and become the leaders that David Brooks is describing. Many of us have liberal arts backgrounds already. For those who do not have a humanities-based education, it is not too late. I didn’t even read Pride and Prejudice until I was in medical school or To Kill a Mockingbird until residency.


In that spirit, we offer this opportunity to reflect on Lincoln’s words and join a discussion in our community about what we can do to make our offices, our committees, our divisions and departments, our institution, our city, and indeed our country a place of “a just and a lasting peace” for all people. I, for one, plan to start with a commitment in the spirit of MCW’s #IWill campaign. I will notice microaggressions in my sphere. I will call them out. I will listen more.


I will make mistakes, but mistakes will not stop me from trying to do better. Sometimes I will lead; sometimes I will follow. I will bring along as many people as I possibly can on the journey to create lasting peace for all people.



Kathlyn E. Fletcher, MD MA is a Professor and Residency Program Director in the Department of Medicine at the Medical College of Wisconsin. She is a member of the Curriculum Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.

Microaggression

From the 6/12/2020 newsletter


Microaggression

Bruce H. Campbell, MD



I hand out a short story to the fifteen residents and students. They follow along as one of them reads aloud:

“One last blow, and, blind as Samson, the black man undulates, rolling in a splayfooted circle. But he does not go down. The police are upon him then, pinning him, cuffing his wrists, kneeing him toward the van. Through the back window of the wagon – a netted panther.”

I am working to integrate narrative into medical education. On this early morning, the ENT residents and a few medical students concentrate – heads down, brows furrowed – as they take turns reading aloud “Brute” by Richard Selzer, a riveting first-person short fictional story first published in 1982 and republished in 1996. An exhausted young surgeon must repair the gash on a prisoner’s forehead in the middle of the night. Both the surgeon’s frustration and his admiration of the patient escalate as the roaringly drunk black man “spits and curses and rolls his head.” After one last, unheeded demand to “Hold still!” the surgeon calmly sews the man’s ears to the cart, wipes the blood from the man’s eyes, and grins victoriously down into his face, a demeaning gesture the surgeon profoundly regrets many, many years later.


The reading ends and everyone's eyes widen. The trainees are well on their way to becoming surgeons, and I watched them squirm as they read the story from the surgeon’s point of view. “So,” I ask the group, “what are your reactions?” After a pause, the discussion flows. Residents nod knowingly, recalling difficult, late night encounters with uncooperative, ungrateful people. “God,” says a resident close to completing her five-year training, “those situations are really frustrating. I know exactly how he feels.” Some of the students – having never been in the ER with a drunk – wonder aloud, “But what do you actually do?” and “Do you think this is a real story? Did this really happen?” I break off the discussion at the end of the hour. Several thank me as they file out. We have all been given something to contemplate.


A couple of days later, one of the senior residents, Tristan, and I are in the operating room. “Dr. Campbell,” he says, “Melissa was upset by the story.”


“Really?” Although Melissa is a junior resident, she should have already had similar encounters. “About the way the surgeon reacted?”


“Talk to her.”


Later that day, I track her down. “Melissa,” I ask, “do you want to talk?”


“Dr. Campbell.” Her gaze is steady and she speaks very evenly. “I was really disturbed when the writer portrayed the black man as an animal. It was awful.”


Oh, my goodness. Melissa has a mixed-race heritage. She is a gifted writer and a gentle soul.


“Tell me more.”


“I hated how the writer described the victim. I was upset. I called my parents to talk about it and they said I should talk to you. I wasn’t going to. I didn’t want to talk.”


“Sorry,” I reply. “Tristan ratted you out.”


We spend time talking through the reading and her reaction. Where I had always viewed the story through the surgeon’s eyes, she had immediately identified with the patient. “I apologize,” I say. “I have always seen the victim’s race as a placeholder.”


“Not for me,” she says.


As we talk, I think back. I have used “Brute” in teaching sessions before but cannot recall if other residents and students of color participated. If they did, were they upset, as well?


Without recognizing the harm, I have perpetuated a racist act of prejudice – a “microaggression” – a misstep that I commit more often than I realize. Melissa has reminded me that I am a late-career, white male surgeon who grew up in a certain time and place and bring my own preconceptions to every experience. Even as I continue to teach residents and students, I must remain open to what my trainees teach me, as well.


“I’ll find a different story next time,” I tell her. “Or maybe you can help me teach it in the future.”


She smiles. “I’ll think about that,” she says as she checks her pager. “Excuse me. I’ve gotta go to the ER.”


-------
The names have been changed.


Bruce H. Campbell, MD FACS is a Professor of Otolaryngology & Communication Sciences and is on the faculty of the Center for Bioethics & Medical Humanities at MCW. He is a member of the Faculty Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. He serves as editor of the Kern Transformational Times.

Black Lives Matter Artwork

From the 6/12/2020 newsletter

Black Lives Matter Artwork

Milwaukee Art Museum - 6/8/2020
Photo credit: Julia Schmitt

Lessons on Resilience, Empathy, and Magic from Life is Beautiful & Roberto Benigni in the COVID-19 Era

From the 5/8/2020 newsletter




Lessons on Resilience, Empathy, and Magic from Life is Beautiful & Roberto Benigni in the COVID-19 Era

Malika Siker, MD – Department of Radiation Oncology

In 1997, the Italian movie Life is Beautiful (La Vita è Bella) burst on our cinema screens and became an international sensation. In this story, a Jewish father named Guido is imprisoned in a concentration camp with his son Giosuè and goes to absurd and humorous lengths to shield Giosuè from fully realizing the monstrous reality surrounding them. Roberto Benigni, who co-wrote, directed, and starred in the film, played this epic role with conviction, compassion, and comedy, challenging viewers to wonder how far they would go to spare their child from ugly truths. I recall Guido’s charm, wit, and devastating wink, as well as how hard I worked to hold back tears as the credits rolled when first seeing the film as a college student. I am ashamed to admit that I was successful. Not a single tear fell.

The COVID-19 pandemic is not even remotely comparable to the horrors of Nazi Germany during World War II. There is no debate. Adolf Hitler and his accomplices murdered 17 million innocent people in Europe as part of a pogrom of deliberate and systematic extermination over six years. However, I have found myself thinking of Guido’s approach to life and have been inspired by his spirit as a physician, an educator, and a mother of young children navigating the COVID-19 crisis.

In Life is Beautiful, Guido’s efforts to protect his son and to fight for their survival brings meaning to his existence. In my cancer clinic, I come face-to- face with patients actively undergoing radiation therapy who are at high risk of COVID-19 complications. I spend my free time learning about COVID-19 so I can best protect and advocate for my patients to reduce their risk. It has been incredibly humbling to realize how little we understood when the virus reached our shores, and how much more we are going to need to learn to bring a decisive end to this current situation. The uncertainty and fear of the unknown are stressful, but I remember to stay RESILIENT for my patients.

Realizing how lucky I am to have completed my own educational journey without facing a pandemic, I am driven to use my privilege to help our students succeed. As a health science educator, I am motivated to ensure that our learners continue to receive an outstanding educational experience. They must quickly adapt to an unprecedented landscape where there are no guidelines. They are banned from their classrooms and libraries while studying and taking exams in new environments. They are frustrated and worried about their futures. Some are being robbed of seminal life experiences like graduation ceremonies. When Giosuè’s happy childhood is interrupted by war in Life is Beautiful, Guido feels EMPATHY for him and seeks to preserve Giosuè’s childhood during uncertain times.

As our family invents our own new traditions, I think about how Guido turns a dire situation into a comical child’s game. After a day of work, I come home to a bustling household as a mother to young children. With children’s activities and social events canceled, we spend more time together discovering and creating our own little enchanted world. We build forts, bake new delights, and indulge in spontaneous imaginative adventures together. We deal with schoolwork and household chores. Normalcy reigns while anxiety lurks. Our family has been given a beautiful gift. My children know there is an invisible enemy outside our walls, but we are determined to create a little MAGIC for ourselves to get through these days.

Roberto Benigni has said, “to laugh and to cry comes from the same point of the soul, no? I'm a storyteller: the crux of the matter is to reach beauty, poetry, it doesn't matter if that is comedy or tragedy. They're the same if you reach the beauty.” I reflect on his philosophy while juggling my roles as a physician, educator, and mother. To persevere in the COVID-19 era, I look for moments of resilience, empathy, and a little bit of magic. When I am unsure of what to do next, I think of Guido and allow myself, finally, to cry.


Malika Siker, MD is an Associate Professor of Radiation Oncology and the Associate Dean for Student Inclusion and Diversity at MCW. This essay will also be published in The Milwaukee Independent (http://www.milwaukeeindependent.com/).