Hannah Foote
Cell 2 Soul. 2006 Winter; 2(4):a12
Written after participating in an "Art Walk" led by Irwin Braverman, M.D., following the Cell 2 Soul Conference, November 12, 2006
"There is a room in the foreground, with an adjacent bathroom in the background. The room is large and poorly lit, although there is a
window on the right that seems to be allowing sunshine into the room. The tones of the room are "foresty": browns and greens and yellows. The picture on the wall above the bed is somewhat lodge-y as well. There are two suitcases, neatly packed, on stands next to the bed. There are no clothes in the closet, save a suit on a hanger. It is woman's suit: a skirt and a jacket. The bed is made, and a key, a
hotel-room key, and two travel cases sit on it. There is a medicine bottle visible in one of the open travel cases on the bed. There is nail polish and makeup as well. And there is more medicine, and a toothbrush, above the sink. A woman stands in the bathroom. She is naked, and bleeding from her vagina, though she looks too old to be menstruating. Her shoulders are slouched and her face seems to
droop; she looks distressed. Next to the bed is a nightstand with an open door; a bible and a telephone directory can be seen inside. There are clothes strewn on the floor: pumps, a jacket, and a blouse."
Gregory Crewdson, Untitled photograph from Beneath the Roses series, Winter 2005
(photo courtesy of Gregory Crewdson and Luhring Augustine gallery)
The description above the photograph by Gregory Crewdson may seem elementary, lacking interpretation and insight. Yet, it is exactly the type of observation expected when Dr. Irwin Braverman, of Yale Medical School, teaches his medical students to view art. Following the 2006 Cell 2 Soul Conference, where he presented the efficacy and background of his observational training model, Braverman demonstrated his method on an "art walk" at the Williams College Museum of Art.
Many of us came prepared to impress him with our ability to talk about art in an erudite way, and he merely asked us to tell him what we saw? This is just what he teaches Yale medical students to do: simply observe and describe. And this, he says, prepares his students in a unique way to be precise diagnosticians and, therefore, more effective physicians.
Dr. Braverman's method of teaching observation is not about acquiring a new set of academic jargon; it is about isolating and practicing the fundamental skill of "seeing." He does not use art as his subject because of its historical context or because it is full of allusions. In fact, he hopes that students will ignore these two otherwise important aspects of art, and focus instead on the more accessible: the location, the people, and the personal artifacts of the picture or painting.
Dr. Braverman does not set out to diminish the value of the question, "what does this mean?" Instead, he encourages students to first answer the question: "what does what mean?" In other words, Dr. Braveman encourages students to ask themselves what they are seeing before they attempt to understand the meaning of the work. He hopes that this skill will transfer to medicine, and that his students will be better able to appreciate all of the symptoms and physical findings of their patients before making assumptions about their diagnoses. Rather than observing only the most salient symptoms that confirm their preconceptions, he wants his students to develop complete clinical pictures of their patients before making a snap diagnosis.
After just a few hours with Dr. Braverman, I felt profoundly affected by his teachings on observing art. Initially, I looked for the "story" in a picture; by the end of the session, I was describing the work in complete detail before trying to interpret it. As a result, I felt more able to understand what I was viewing.
Dr. Braverman's theory that his observational method is translatable to other fields has proved to be true for me. While reading scientific articles, which I am often expected to critique and interpret, I have found myself using his approach: first describing the study in the most detailed way (avoiding the tendency to interpret isolated pieces of information to fit my expectations) and then asking what it means. This has allowed me to develop much more thorough understandings of papers, which has lead me to make more accurate interpretations. I can see how this skill is also transferable to the practice of medicine.
By encouraging physicians to thoroughly describe the presentation of a patient before making assumptions about a diagnosis, Dr. Braverman's method may help minimize error. This effectively increases the value of physicians' time with their patients. In this age of busy schedules, insurance companies and HMOs, anything that can do that is worthy of our attention.
Editor's Note: To read about Dr. Braverman's philosophy and approach to his Art Walks, please read Fine Art and Medical Diagnosis, by Irwin Braverman, M.D., in this issue.