Students ‘reflect’ on the meaning of medicine with annual arts journal

  By Kevin Fryling

When they reached into the pocket of the coat signifying their new profession at the White Coat Ceremony on Aug. 11, the 335 members of the Indiana University School of Medicine Class of 2016 discovered a special message from their fellow students and teachers.

Nestled in the folds of each crisp white coat is Reflections, a journal of art and inspiration compiled and edited by medical students. The journal, which began as a collaborative project between the Medical Education and Curricular Affairs and the Relationship-Centered Care Initiative in 2004, is designed to serve as guide – a source of inspiration and a reminder of what inspired them to pursue medicine.

"Classically, this has been a guide to first years – not strictly a logistical guide or academic guide but a spiritual and emotional guide," said Drew Oehler, a fourth-year medical student in internal medicine and the journal’s editor. "When they find themselves in the pits of despair – or the pits of their textbooks – they can open up this book to think about the remarkable things that medical doctors experience every day."

Reflections is produced by the Creative Arts Therapy Student Interest Group in the Office of Medical Student Service-Learning, advised by Jeffrey Rothenberg, M.D., M.S., associate professor of clinical obstetrics and gynecology. CAT SIG took over the publication from MECA several years ago.

The change also brought a shift in the position of editor from a paid internship to volunteer position. "It takes an extremely dedicated student to make this happen each year," Dr. Rothenberg said. But support continues to flow from various sources, including a contribution from the IU School of Medicine Arts Committee in 2011 and a recent contribution of $5,000 from the IU Health medical staff to "support the continuation of the publication and illustrate a commitment to the creative arts and humanities in developing well-rounded physicians."

The journal’s emphasis on the wide range of the events and emotions experienced by medical students and practitioners is reflected in this year's theme, Diversity, as well as the variety of the works in this and past issues, including  poetry, prose, photography, painting, drawing and sculpture contributed by medical school students, faculty, residents, fellows, alumni and staff. Each year, Reflections receives about 50 submissions with approximately 25 works selected in the print publication.

Works featured in past issues include sculpture by Dr. Rothenberg, who is also an accomplished blown glass artist; an emotional work of fiction from a medical student about the need to inform a patient they are suffering from a terminal illness; and a personal essay. by a medical student whose father was once asked to care for a convicted criminal, that reflected upon the professional obligation to care for all patients equally. This year’s issue includes works produced by medical students working alongside children undergoing art therapy at Riley Hospital for Children at IU Health, photos taken on medical mission to Ecuador and essays on the changing face of medicine as the field has grown to welcome women and minorities.

Each issue also includes an introduction on the year's theme from a member of the faculty. This year's issue features a reflection upon the term "diversity" from Richard Gunderman, M.D., Ph.D., professor of radiology and imaging sciences and pediatrics at the IU School of Medicine and professor of philosophy at the IU School of Liberal Arts at IUPUI.  Previous year's introduction writers include Dr. Rothenberg; D. Craig Brater, M.D., dean of the IU School of Medicine and vice president of clinical affairs at IU; and Thomas Inui, M.D., Joe and Sarah Ellen Mamlin Professor of Global Health Research and Medicine.

Oehler’s own artistic submission last year was a photograph of Lake Michigan that starkly contrasts the lake’s natural beauty with a ruined factory on the waterfront.

"I was reminded of the balance that exists in medicine, where anything can happen at any time," Oehler said. "The hospital never closes.

"Anything can serve as a source of inspiration," he adds. "Physicians have a privileged view into some very personal things. We’re at the crux of the deepest human experiences – the most profound human experiences – so physicians tend to be around when very striking things happen. We’re no less sensitive to a striking event than anyone else."

Reflections not only provides insight into these experiences – life, death, health, illness – but also a way for students and faculty to understand one another in a different light.

"Although it’s mostly driven by the students, the journal’s also an important opportunity for faculty and students to interact in a very different way," Dr. Rothenberg said. “We’re not in the operating room, we’re not at the lectern, we’re not even at the bedside; we’re actually engaging with our students at a very human and artistic level. This is a celebration of a different side of us as doctors and medical students."

Moreover, Dr. Rothenberg notes "Reflections" serves as a useful recruitment tool – a document that illustrates the IU School of Medicine’s commitment to instilling a sense of humanity in future physicians, not simply being a place to memorize facts about the human body. He works to get the publication into the hands of everyone from visiting lecturers to attendees at conferences such as the annual meeting of the Association of American Medical Colleges. Also among the receipts of the publication are the parents of the medical students at the White Coat Ceremony.

“Some of the submissions really reflect a deep understanding of medicine at a very different level; it makes a real impact on the medical students' families," Dr. Rothenberg said. "It shows that their child is really going to a very special place to learn to become a doctor.”

In the future, Oehler aims to leverage the Reflections website – which has been heavily redesigned in the past year – to feature additional content beyond what appears in the print version, including music and video. Oehler points to the IUSM Orchestra, established in 2010, as an example of how many medical students that have talents extend beyond art, poetry and prose. He or his successor also will aim to encourage more submissions from outside the School of Medicine.

"I think the website is one of the biggest things we could do to keep this going," he said. "I would like to make the journal a central point for all the great creative work that comes out of the IU School of Medicine, and also want to get more involvement from the other health science schools, such as nursing and dentistry. Reflections has the potential to foster deeper connections and relationships between our schools."

Members of the Reflections editorial board include Oehler; Dr. Rothenberg; Dr. Gunderman, Richard Frankel, Ph.D., professor of medicine at the IU School of Medicine; Fran Brahmi, Ph.D., of the Ruth Lilly Medical Library; and Meg Moorman, clinical assistant professor of family health at the IU School of Nursing. Design is provided by Oehler and the IUSM Office of Visual Media.

To explore this year's issue of Reflections, visit the Creative Arts Therapy Student Interested Group website.