IN LUKE FILDES’S 1887 painting The Doctor, a compassionate Victorian physician keeps a night vigil over a dying child by candlelight. It is a picture of the doctor as human carer, who makes up for his inadequate medical knowledge with a perfect bedside manner. For many, including those in the medical profession, the modern doctor faces the reverse situation: scientific advances at the expense of empathy for the patient.

Last week a new educational initiative was launched — the MAP Foundation — to address this problem. The foundation was set up by the artist Michele Angelo Petrone to help patients and health workers understand the value of the creative arts as a means of communicating the difficult issues relating to serious illness and dying.

When he was in his early 30s Petrone contracted Hodgkins disease — cancer of the lymph system. Ten years later he remembers clearly an early altercation with a nurse: “I was in great pain when I arrived at the hospital. I asked a nurse if I could have some drugs and she swung around and said: ‘What do you think this is, a sweets trolley?’”

While recuperating after a bone marrow transplant a year later, Petrone began to paint. The result was The Emotional Cancer Journey, a series of 21 canvases documenting the experience of his illness. The series has since toured dozens of hospitals and hospices around the country, and Petrone’s work has become the basis for numerous programmes nationwide which help undergraduate medical students, nurses, doctors and others to deal with the emotional needs of patients who are seriously ill.

This year Petrone was made an honorary lecturer at the Centre for Medical Humanities at University College London. As Dr Michael Baum, a visiting professor at UCL, explains, despite the advances in medical science, doctors are “in danger of losing their humanity”. Petrone’s workshops help to counter this.

Students attending such sessions choose two paintings each from the series and, in group discussions, talk about the feelings that may have given rise to them. They are encouraged to ask questions about what it is like to have a serious illness. “The workshops bring the emotional impact of cancer to the fore,” says Dr Lynne McAloon, a senior lecturer in cancer care education at the University of Northumbria. “In the past, nurses have been socialised into a culture of coping through professional detachment. Now they’re encouraged to reflect on their professional practice by exploring their feelings.”

UCL’s Centre for Medical Humanities, launched two years ago, runs a range of programmes for undergraduate medical students — who must now, as part of the core curriculum, take special study modules in humanities, ethics, law or philosophy — and established practitioners. The discipline of medical humanities has emerged only in the past ten years, after a General Medical Council blueprint in 1993 called for the arts and humanities to be incorporated into the medical curriculum to help foster appropriate attitudes on the part of doctors to patients.

As Professor Michael Richards, national cancer director (the Government’s cancer czar), explains: “It is vital that alongside giving doctors specific knowledge and skills, we develop their broader understanding of the humanities and society so as to help them listen to, talk to and understand their patients.”

There are now centres for medical humanities in other universities across the UK. But perhaps the most striking thing about the growth of the discipline is the respect it commands at the highest levels of the profession.

Dr Baum says that Petrone’s work does not provide just therapy, but also an important form of complementary care, which “enables patients to feel better while surgery is making them better”. What’s more, he says, the movement came “from the very top; from the professors, deans and Chief Medical Officer down”.

An improved ability to communicate is likely to help not only patients but doctors, too. According to studies by Guy’s Hospital, London, and the psycho-social oncology group at the University of Sussex, at least 25 per cent of doctors experience extreme emotional distress at some point. The British Medical Association and the Sick Doctors Trust in Surrey offer a full-time counselling service; while several publications promote the value of creative writing as a means of coming to terms with the trauma of treating seriously ill and dying patients.

“Doctors can’t get closer to the emotional needs of their patients if no one notices that they have needs too,” says Dr Lesley Fallowfield, a psycho-social oncologist at the University of Sussex. “One of the ways to help them is to give them a language in which to express themselves, like painting.”

However, for some, such as palliative carers, the work of medical humanities schools is not particularly new. “We are in the business of helping people to live when they face death, and our staff have always needed psycho-social training to cope in that environment,” says Anne Hooper, chief executive of Trinity Hospice.

The ability to relate empathetically to patients is what Petrone hopes may begin to permeate all levels of treatment, beginning with the simplest things. “It’s amazing,” he says, “how many doctors don’t even tell you their name.”

LINKS
www.mapfoundation.org

The Emotional Cancer Journey is showing at the Knapp Gallery, Regent’s College, Regent's Park, London until Sunday March 30 (020-7487 7447).

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