The Art of Medicine

🕔Oct 04, 2011

Living in the operating area of the Northern Health Authority, which stretches from Quesnel to the Yukon border and from Haida Gwaii to the Alberta border, means knowing a thing or two about not always having access to the latest and greatest in health care.

Some of us have to fly south to deliver our babies. Some of us have no family physicians in our communities. Many of us do without specialists and most of us know we are not likely to partake in groundbreaking medical research that just might find a cure for the ailments we may be living with.

We do not, however, consider ourselves too hard-done-by.

We embrace our health care providers, including doctors in Hazelton who have won the Order of Canada and nurses working in Kitsegukla who take the time to learn how to build Gitxsan bent-wood cradles. We have begun to take heart in homegrown solutions like group doctor appointments in Fraser Lake and the Northern Medical Program in Prince George, designed with the intent of training doctors in the North for the North.

Still, some pretty stark health disparities exist among us, one of the most glaring being between First Nations and non-First Nations peoples in the region. In 2009, the Provincial Health Officer provided a bleak reality check: since 2001, BC’s Aboriginal peoples experienced ‘worsening trends’ in 10 of 57 well-being indicators, including increased rates of HIV/AIDS, use of prescription drugs, poor housing, low birth weights, and the number of children who live as governmental wards. Since 1992, Status-Indian men maintained the lowest life expectancy of any group in the province, dying almost 10 years earlier than non-Aboriginal women, the people who live longest in the province.

Rare experience
What homegrown solutions might address these disparities? That’s the question at the heart of a project that took place in Nak’azdli—45 min north of Vanderhoof, next to Fort St. James—last summer. Born from the idea that medicine is both a science and an art, the project looked at the potential of artistic expression—including painting, sketching with pastels, music, creative writing, and mask-making—as a way for people to feel better, voice new insights into their health in innovative ways, or articulate ideas about what is needed for their healing and well-being.

Held amidst swarms of mosquitoes at the local Kwah Community Hall, and replete with a locally catered lunch of salmon and strong tea, the Art Days project was also about two undergraduate medical students, in partnership with the Nak’azdli Health Centre, being immersed in a northern First Nations community.

It’s an experience very few of the province’s future doctors ever have. “It is one thing to sit in a didactic lecture setting and hear about the marginalization of certain populations, particularly Aboriginal communities, and another to spend time on a reserve and experience first-hand the differences and similarities in culture,” note students Allison Nakanishi and Annika Klopp. “The project fills a gap in our training—one reason we jumped at the opportunity to organize Art Days.”

Nakanishi and Klopp also highlight another reason they chose the summer-long project: “Since our acceptance into the UBC Medical Program, our brains have been bombarded with everything from heart murmurs to microscopic images of liver cells; there is just no time left in our curriculum to discuss the role of art in healing.” For the two students, the project was “a journey not only examining the value of art creation on the health and well-being of Nak’azdli community members, but also a journey of self-exploration and reflection.”

Put the agenda away
Both Nakanishi and Klopp agree that medical students are often accustomed to a tight schedule with little or no spontaneity and flexibility. Following the rhythms of a community with everyday realities like berry picking in the morning, however, demands a new understanding about time, being on time, and the perceived importance of things like research projects.

“We spent two weeks wandering around pretty much every Dollar Store in Prince George. There was that same plastic smell in each store. At last, all the supplies were bought, the agenda planned down to half-hour increments, and we were on the road heading for Nak’azdli. We arrived early so we could check in at the Band Office, set up the art production tables and make sure the caterers were ready to go.

“The ‘day’ was supposed to begin at 11. At 11:05 no one had showed up yet, and by 11:20 we were getting a little worried. There was enough acrylic paint to cover the interior of a house! We held tight until noon and slowly people started to trickle in. By 12:30, the maximum number of participants, 18, were completing warm-up exercises and translating feelings onto paper with eyes closed. It was a bit nerve-wracking at first, not knowing if anyone was going to show up, but it all seemed to work out, especially once we put the agenda away and just went with the flow.”

Having spent the weeks leading up to Art Days exploring the connection between art and health, it became apparent to both Nakanishi and Klopp that the use of creative arts in the realm of health promotion is an up-and-coming idea in medicine. Art making, especially in a group setting, can be a powerfully inclusive and healing experience. An increasing body of evidence links self-esteem and social involvement in enhancing people’s health and quality of life.

Breathing room for the spirit
In particular, community-based art production with marginalized populations is being utilized more frequently as a therapeutic intervention. Why not, then, organize Art Days for one of the most marginalized populations in the province—First Nations people? The destructive impact of colonialism on health has resulted in a disproportionate need for healing among many First Nations peoples and creative art production may help address this need.

The late John Updike eloquently summarizes the therapeutic benefits of art: “What art offers is space—a certain breathing room for the spirit.” A burgeoning body of research suggests that participation in the arts has not only individual psychosocial benefits, but physical benefits as well; for instance, making art can reduce heart rate, pain, and discomfort. Nakanishi and Klopp believe this could lead to a reduction in the use of pharmaceuticals, time for medical procedures and time spent in hospitals, which would ultimately reduce the cost of our health-care system.

Andrew Burton, the founder of Street Spirits in Prince George, agrees. “The greatest potential for the arts lies in the area of prevention and health promotion.” It is the development of skills and abilities in people, and awareness in the community, that can influence behavioural changes that have the potential to positively affect community health.

This homegrown project just might, in the end, have a positive impact on the Nak’azdli community. It is certainly a chance for two undergraduate medical students to bump up against a different culture and gain new perspectives and insights. One of those perspectives now includes an appreciation for the resiliency of community; this, Nakanishi and Klopp feel, is often overlooked in their curriculum because attention is given instead to the remarkable health disparities between Aboriginal and non-Aboriginal populations. “It is opportunities like Art Days that, at the end of our medical schooling, will prove incredibly valuable,” say Klopp and Nakanishi.