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reImagining Medicine

Reimagining Medicine

At the close of Reimagining Medicine's inaugural summer program, we reflect on the experience and how our students were affected.

“We don’t read and write poetry because it’s cute. We read and write poetry because we are members of the human race. And the human race is filled with passion. Medicine, law, business, engineering—these are noble pursuits and necessary to sustain life. But poetry, beauty, romance, love, these are what we stay alive for.”

– Robin Williams in the role of John Keating, Dead Poets Society, 1989

 

Reimagining Medicine 2018 Puppetry

They learned from over 25 patients, doctors, and artists about their passions, scars, and paths to healing.

As a college freshman, I embraced Mr. Keating’s dichotomy—medicine, a noble professional pursuit; poetry, the stuff of life itself. With 10 nimble fingers and good grades in biology and physics, I wanted to be a surgeon…but I loved Shakespeare and Dickinson, Morrison and Frost. The semester I took Chaucer and organic chemistry together, I abandoned the pre-med track and declared myself an English major. I wonder now why the two roads seemed utterly to diverge.

Had I encountered pediatric oncologist, author, and aspiring rock guitarist Dr. Ray Barfield as an undergrad, it might have been different. This summer, with the support of Provost Sally Kornbluth, the Trent Center for Bioethics, Humanities and History of Medicine, and Duke’s Initiative for Science and Society, Dr. Barfield (or Ray, as he prefers) invited 14 Duke pre-med students to confront that dichotomy and their own notions of what makes a good doctor and a good life.

Reimagining Medicine, an 8-week summer fellowship, paired hospital shadowing experiences with daily classes in history, ethics, storytelling, puppetry, improv, music, graphic art, and more. Students lived together in a freshman dorm, shared meals and rides, played cards and traded stories late into the night, and looked out for each other. They learned from over 25 patients, doctors, and artists about their passions, scars, and paths to healing. They went alongside chaplains, nurses, therapists, and families and witnessed the heart-breaking fragility and awesome tenacity of the human body and spirit. Everywhere, they tuned their attention and imagination to the people around them, and to the person within.

 

Reimagining Medicine 2018 Mindfulness

In the final week, students told their own stories

They spoke as patients:

It’s funny, our feet.
I took mine for granted until a giant-ass 250 pound tire
Fell on me
All at once
I became a pendulum
Swinging through the hallways on crutches
Eyes on me
It was a strange feeling, standing out
Even though I wasn’t even standing on my own two feet.

– Helena Wu

They spoke as artists:

“I grew up as a first generation Asian American. At home, my parents spoke completely in Mandarin to me. At school, I had to learn to operate in English, learn how to be a human being in American society, in the correct language. It was like a continuous ping-pong match in my brain, bouncing between English at school and Mandarin at home. But music and playing the piano were (and are) like breathing. Music allows my emotions to flow freely in the form in which they are conceived, without encountering the barrier of language. I didn’t have to know the English word for “frustration” or figure out what “hopeless” was in Mandarin to express those emotions. I could simply be them through music.”

– Irene Koc

They spoke about what they’d learned:

“Silence is beautiful. It is. And it belongs. Silence invites a deep relationship, doing something that even the modern marvels of medicine cannot do. In medical contexts, when you and I are at the most vulnerable of moments in our lives, sometimes silence speaks louder than any word, speech, or phrase ever can. We make silence our friend. When we have not the words to comfort, it comforts us. It’s the art of being with. Silence creates a beautiful art. Silence is healing.”

– Michael Shu

They spoke as aspiring doctors:

“My grandfather’s name was Anthony Joe Vines. He was born in Chattanooga, Tennessee, on October 6, 1943. He loved bell-bottom jeans, dancing, and celebrating, and of course he loved his family. He came up in the 60’s, listening to funk music and living in the counter culture. He believed that the world would take care of you if you loved everyone and lived freely. It seemed as if his primary goal in life was to spread joy, especially since the “real” jobs he had, came and went. […] As his health continued to get worse, I was able to see him more. Whenever I went to visit, he always cracked the biggest smiles and told me how proud he was of me. He told me he wanted me to take our family forward into the future. After he passed away, I carried his voice with me as a reminder of where I came from, and for inspiration going into the medical field.”

– Akeim George

 

Ray Barfield with students

He wants to share his story, and his ongoing journey, with other healers and would-be healers so that they might, together, reimagine medicine.

A Better Vision For Medicine

Earlier in his own career, Ray Barfield nearly left medicine. His preparation—hyper-competitive, exhausting, and isolating—as well as daily confrontation with suffering and death caused him to question the white coat he had worked so hard to earn. “Physician, heal thyself,” became an imperative. Headed into their junior and senior years, these students had already experienced the pressure-cooker. They described the pre-med environment at Duke as stressful, intimidating, cut-throat, and toxic. Today, doctoring with joy is just one aspect of Ray’s full and fulfilling life. He wants to share his story, and his ongoing journey, with other healers and would-be healers so that they might, together, reimagine medicine.

The inaugural class of RIM looked, in some ways, as you might expect: high achievers (average GPA of 3.7) with doctors in their families. Jobs in labs and lots of hospital volunteer hours. Majors in biology, neuroscience, chemistry, and global health. They were also wonderfully diverse—more women than men, more people of color than not, involved across campus in everything from tutoring children to Chinese dance to power lifting. The cohort included the founder of a non-profit, a runner just back from nationals, and several world travelers. The program provided each with a stipend to cover living expenses, on-campus housing, some meals, and program materials. What made the program sing was everyone’s willingness to set aside titles and achievements to explore with “beginner’s mind” what it takes to be an effective doctor and happy human being.

Bringing Duke Leaders Together

Ray has a knack for bringing people together, especially around a cause as compelling as transforming medicine. RIM was the joint effort of over 50 campus and community leaders across many disciplines—some in the planning stages, some in the classroom and hospital. Most worked without compensation, around busy clinical and academic schedules. Sometimes, they taught in their “official” area of expertise. Often, they shared personal interests that enlivened their minds, relationships, and careers.

They taught:

  • Mindfulness practices to increase awareness and manage stress
  • History of medicine in the US, to provide context and vision for improving the current system
  • Expressive writing, from stream-of-consciousness to poetry, trauma to peace-making
  • Drawing (doodling, cartoons, and portraits) to encourage close observation and perception
  • Puppetry to explore what it means to inhabit and treat a human body
  • Storytelling as the revelation of our shared experience and humanity
  • Improvisation to develop conversational skills and responsiveness
  • Ethics to discern and foster a sense of purpose in one’s life and calling

 

Reimagining Medicine 2018 Mindfulness

“Without a doubt, this is the single most transformative experience in my journey toward practicing medicine and in my life.”

At the end of 8 intense weeks, students described the RIM experience this way:

“Without a doubt, this is the single most transformative experience in my journey toward practicing medicine and in my life. My purpose has become something greater. My view on the world of medicine, shifted.”

“Shadowing allowed me to experience what we have been talking about. Bringing theory into practice. Additionally, it provided great opportunities to witness compassionate providers at work that will serve as role models for how I may provide compassionate patient care in the future.”

“I got to see health care from many different perspectives and understand and appreciate the important roles they all play. Not only did these opportunities help me see how much of a collaborative, team-based effort health care really is (with many different key players), but it reemphasized how important the aspect of ‘care’ is in health care.”

“I fully believe that every aspiring medical professional should participate in RIM, or something like it. Thank you so much.”

By consensus, the pilot of Reimagining Medicine was a big success. But this team intends to do more. Efforts to capture and build on the program’s unique curriculum continue. Ray promised students he would keep up with them through med school and beyond. Students want to continue learning together and looking out for each other. There’s interest in offering RIM to other groups—nurses, medical students, more undergrads—at Duke and on other campuses. There are practical questions to answer about the future of the program (funding, timing, replication), but where the passion and energy might lead, we’ve only begun to imagine.