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Archive for the ‘The Mind Edging the Cut’ Category

I was looking at the website of  my favorite art gallery The Fondation Maeght  where my children at various ages, have loved exploring all types of art on past holidays. The web being what it is I found that a tenor saxophonist Albert Ayler played his last concert in the beautiful surroundings of the Fondation on the 27th July 1970. Being a novice clarinettist  I had been looking at the Facebook page of an amazing  young New Orleans jazz clarinettist Greg Agid whose YouTube tutorials I have found very helpful. On his page I found a lighthearted link to a spoof jazz piano performance.Then of course an Albert Ayler  free jazz recording from the Fondation Maeght concert (called ‘Music is the Healing Force of the Universe!).

Of all performance, JAZZ appears to need the significant contribution of both cerebral hemispheres to be accomplished. It’s the balance of superb mathematical and practical technique (left brain) with the toying with possibility, impetuousness and risk taking of the right brain.

Of the performances I mentioned, Greg it appears to me has the balance of left and right brain function which epitomizes to me superb jazz, whereas Ayler was leaning on the left brain more to the expense of controlled technique, and of course the spoof pianist was all left brain mechanism and no right brained ‘soul’.   Hemispheric dominance is a preference, not an absolute. Ayler was a very gifted technical (left hemisphere) saxophonist but appeared to go ‘right’ to accomplish his free jazz expression.  All activity uses both hemispheres connecting through a thick band of nerve fibres (the corpus callosum).

Hemispheric dominance well explained with the ‘ballerina’ test in an article in the Australian Telegraph.

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An example of how music causes food for thought: a magnificent recital by  this youth choir from South Africa  in the 12th century Church of St Thomas  Salisbury last Friday evening. What made it such a memorable experience was not the superb performance but the fact that these young people were united in producing this emotionally very moving music. They came from  disparate social and racial backgrounds which a few years ago would have precluded their being together at all. Yet  they were one in creating a powerful  effect on an audience. There are no pharmacological drugs that would have this effect on such a group of people without side effects!!

http://www.youtube.com/watch?v=HV8s2PA47S0&feature=player_profilepage

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Having taught undergraduate medical students at Southampton University Medical School for over 20 years I have finally hung up my cap and gown ( or white board marker pen and flip chart) and will miss their wonderful naive enthusiasm,  hungry enquiry yet ruthless questioning. One of the precepts I endeavored to instill in them was the lifelong need to retain their natural humanistic communication skills.

On a friend’s blogsite Heroes not Zombies today I came across a link  to a discussion of a research review in the journal Academic Medicine how medical students appear to lose a degree of their empathy as they pass through medical school. Frighteningly one medic had suggested that there should be a split into ‘talking medicine ( that of general practice, primary care medicine) and ‘scientific’ medicine ( that of the surgeon and acute care specialist i.e. without the ‘talk’ bit).

Vaugn Bell of the “Mind Hacks” blog states:

The occasional reply to concerns about physician empathy is usually something along the lines of “what would you prefer, someone who is a good clinician or someone who is a nice person?”.

Despite the false dichotomy, the study make it abundantly clear why empathy is important in medicine, as it is associated with:

• patients’ reporting more about their symptoms and concerns
• physicians’ increased diagnostic accuracy
• patients’ receiving more illness-specific information
• patients’ increased participation and education
• patients’ increased compliance and satisfaction
• patients’ greater enablement
• patients’ reduced emotional distress and increased quality of life

I would want my surgeon or ITU physician to achieve that.

Empathic communication skills are taught in most medical schools now. Can empathy be taught?  What should be taught is:

  •  how not to lose empathy,( i.e. feeling for others) just because one is subjected to a rigorous scientific learning load
  • the means of  protection from the emotional trauma of dealing with the tragedies of life disease and death
  • not to let the science of medicine oust the art. As one respondent on the blog wisely said “

 ” I had an excellent GP who used to bemoan that many doctors forget (or never get) that medicine is an art as well as a science.

   That ’art’ should be include ‘treatment’ – the way that one human being (the doctor) treats another (the patient). And an understanding  that      suffering, whether one can physiologically detect it or not, is, nevertheless real.

To those with ‘difficult’ diagnoses this makes all the difference.

I understand that there are time limits and that medicine is an incomplete science that can be frustrating if there is not an easy answer.

A little humility and simply saying ‘I believe you but I don’t know what to do to help you and I am sorry that you are ill’ doesn’t take a great deal of effort.”

The art of medicine is a science that we do not yet understand.

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