Integrating the Humanities into the Medical School Curriculum is a Smart Idea

Podcast Transcript

Dr. James K. Stoller:

Hello, and welcome to MedEd Thread, a Cleveland clinic education institute podcast that explores the latest innovations in medical education and amplifies the tremendous work of our educators across the enterprise.

Dr. Mari Knettle:

Hi, welcome to today's episode of MedEd Thread, a Cleveland clinic education institute podcast. I am your host, Dr. Mari Knettle, Medical Director of the Center for Health Professions Education here at Cleveland Clinic in Cleveland, Ohio. Today, I'm very pleased to have Katherine Burke, Director of the program in medical humanities join us. Katherine, welcome to the podcast.

Katherine Burke:

Hi, thanks for having me.

Dr. Mari Knettle:

I'm glad you're here. Why don't we start out with you telling us a little bit about yourself and where you're from.

Katherine Burke:

Well, I grew up outside Chicago in a kind of in a suburb called Des Plaines, Illinois. Not famous for very much. Home of the very first McDonalds. It's probably what it's most famous for. I have a background in theater. I used to be an actor and a director.

And my background kind of moved into theater and social justice. I became very involved in an organization called Pedagogy and Theater of the Oppressed when I was teaching, uh, at Purdue University for several years. And I became very involved in applied theater for social justice.

So, that's my, my kind of passion for mixing things like the arts and social justice work. And education kind of comes from that. I'm a former actor. I'm a singer. I have a 15-year-old daughter named Vivian who is also very much into music and performance as well. So, that's a little bit about me.

Dr. Mari Knettle:

You have a very interesting background.

Katherine Burke:

Mm-hmm.

Dr. Mari Knettle:

How about more on your professional background and how you came to be at, uh, Cleveland Clinic.

Katherine Burke:

Sure. Well, it's an interesting, uh, path to coming to Lerner College of Medicine. I was involved in this intersection of theater and social justice, and I was teaching as an adjunct instructor at Kent State when there was the 40th anniversary commemoration of the shootings at Kent State in 2010.

And so, I collaborated on a play that commemorated that event using the oral history archives at Kent State, as its text. And, that play was, it's called May 4th Voices. And it was eventually filmed, and you can find it on YouTube, if you'd like to look it up. It's really a wonderful educational piece. But that collaboration led to another collaboration with the med students here at the Lerner College of Medicine where I was kind of brought in to do some theater exercises with the med students.

And the founder of the program in medical humanities here is Dr. Martin Kohn. And he just kind of scooped me up and kept me around, uh, and kept finding reasons to bring me back. And eventually we got a grant from the Cleveland Foundation to, uh, run a program in medical humanities and kind of community engagement.

And, uh, I was brought on to run that program. And then eventually they just hired me to work with the student's full time. And now, Dr. Kohn retired a couple of years ago and I took over his spot as the director of the program.

Dr. Mari Knettle:

Okay. So, now you're the director of the program in medical humanities for the Lerner College. But can you tell us, what does that mean? What do you do for Cleveland Clinic and the college?

Katherine Burke:

Well, there are a few things that I do. I coordinate the art and practice of medicine courses, which incorporate humanities, ethics, health systems, and social determinant of health. And, then I also do a kind of extracurricular programming, where we bring in speakers and events that examine health, illness, wellness through the lens of the arts and humanities as well.

I coordinate several programs that are part of our curriculum. For example, there is a program in year one called devising healthy communities, which partners up medical students and community organizations and artists and other kinds of, uh, facilitators to build relationships between our medical students and people in the neighborhoods surrounding Cleveland Clinic.

So, for example, we had a program at the VA last year that was a poetry program. We had a poet who led people that are students and veterans in poetry exercises and writing poems. We had a program at, Edwins Restaurant where our students worked alongside the people and Edwins.

And, if you're not familiar with Edwins, it's a place that only hires people who are formerly incarcerated. We had a gardening project in Fairfax called Bells Purple Oasis where our students got their hands dirty and got in the ground and helped to plant a community garden in Fairfax.

And, we also had a collaboration with, uh, Hip Hop Youth Empowerment Organization called Refresh Collective where the students at Refresh Collective taught our medical students how to lay down a beat, how to write lyrics, how to rap, and then our students recorded their own collaborative rap.

Dr. Mari Knettle:

Katherine, those sound like such amazing and fun opportunities for both the medical students and for the community. But, before we go further in the conversation, I think for those who don't know, it would be helpful to define medical humanities. Can you do that for us?

Katherine Burke:

Sure, I can give it a shot. Medical humanities are a field that lies at the intersection of medicine, health, wellness, illness, all the things that we associate with medicine. And in fact, sometimes people actually call it health humanities, which people in the field really, for the most part, prefer that terminology because it's kind of de-centers the medical profession. So, you don't have to be a medical professional to engage in health humanities, right. But we are at a medical school, so that's primarily where our focus is.

So, it's between medicine and the arts and humanities. So, for example, literature, history, philosophy, visual art, performing arts. So, there are all kinds of examples of medical humanities or health humanities. We think of, like, illness narratives. We think of poetry that examines different health and wellness issues.

There are myriad physicians, nurse writers and poets. There are so many, uh, physicians who are also artists of some kind. There are patients who express their patient experience through visual art, through poetry. So, examining all these things can kind of help us to make meaning of these very big, weighty issues that often occur around issues of health and illness.

Dr. Mari Knettle:

So, how does integrating humanities into the curriculum change the student experience?

Katherine Burke:

So, by centering the humanities in this curriculum, we're saying that we think that it's important that the students have an opportunity to reflect and to make meaning of this very challenging experience of being a medical student, of becoming a physician.

We give them this opportunity to read short stories, to engage with poetry, to do reflective writing themselves, and to get a better understanding of how this experience and how their individual experiences as a student in the hospital are forming their professional identities.

Dr. Mari Knettle:

So, how would you say that integrating humanities into the curriculum changes the way that doctors actually practice?

Katherine Burke:

We know that there's a lot of burnouts in medical professions, in, in the health professions, especially now. We see a lot of burnouts in this kind of aftermath of Covid. So, the humanities can be one way that healthcare professionals can stop and reflect on their experience and to make meaning of their experiences. I had a wonderful opportunity yesterday to engage with health professionals across Cleveland Clinic Enterprise in an event called Helping Caregivers Heal.

And we examined a poem and then offered them the opportunity to write a little something themselves and to share their writing group. And so, by using the humanities and by using these things as kind of a metaphor, as a lens through which you can look at your own experience, you can get a little bit of an aesthetic distance from your experience. And you can kind of look to the side of it a little bit and get a different perspective.

So, there are lots of things that the humanities can do for us just as individuals. We can appreciate them. We can appreciate understanding history. We can appreciate philosophy. We can appreciate the arts. But really, for me I think it's that opportunity to use it as a metaphor to examine these very big issues.

Dr. Mari Knettle:

I think you've done a really good job of telling our listeners what humanities are. You've established why they're important. But let's look now at something a little more granular. How can medical humanities be integrated into the continuum of medical education?

Katherine Burke:

It certainly can be a challenge to do that because the students have so much to learn. There is so much science. There is so much that they need to know to be a good doctor. But I think that offering the opportunities throughout the curriculum to pause and reflect using their own writing, using a poem, using an, uh, experience that's outside of the curriculum I think is really important.

Two things that we have coming up that are examples of this are, uh, well today as a matter of fact, we are going over to the art museum with third year students so that we can have some close looking and reflective time with the art, focusing on the issues of art and empathy, and to offer some kind of opportunities for mindfulness while in the art museum.

And then, another event that we have coming up is called story slam where we have medical students, not just from Lerner, but from Case Western Reserve University and Ohio University, Heritage College of Osteopathic Medicine, coming together to read their own poetry together, to read short stories that they've written or reflective writings or songs or performances that they've done.

And so, continually offering this, these opportunities to engage with the humanities, to stop, to reflect, and to think about who they're becoming are, I think, very important.

Dr. Mari Knettle:

I think you made a really good point about how much technical information there is to learn in a medical student curriculum. How do you ensure that the humanities aspect is impactful for students, that these learning experiences aren't something that the students perceive as getting in the way of what they need to study?

Katherine Burke:

That can very much be a challenge. But I think that one of the things that we try to do is to make bridges between our curriculum in the humanities and the science curriculum that they're learning. So, for example, the students engage in problem-based learning, and they have a case that they work on in the second year in which the patient has anorexia.

And so, during that week that the patient, you know, that their patient in their PBL case has anorexia, we read a poem that's called Ellen West. And, this poem is, uh, by Frank Bidart. And, it is about a real person, some real people, but there are several voices in the poem and one of them is the physician and one of them is the patient.

And so, we look at what we can learn about the patient's experience of having anorexia through the lens of this poem. At the same time, we also have a historian come in and talk to us about the history of food refusal, going all the way back to the Saints who would fast.

So, that's an example of what we try to do to link the humanities curriculum to the science curriculum so that the student's kind of have a, another lens to look through.

Dr. Mari Knettle:

I imagine you run into a lot of misconceptions about humanities in medical education. What would you say are the major misconceptions that you run across?

Katherine Burke:

I think one major misconception is that we are touchy feely. That, uh, the students sometimes have referred, I've heard it, never to my face, but I've heard that students call it touchy feely Tuesdays. Uh, and so, that's one of the things that I think is a misconception. that the humanities are really just there for entertainment or pleasure or enjoyment. And, while that is true that, you know, it is a wonderful thing to go to the theater for the sake of going to the theater and having a great time at the theater.

But what we want to do is really use these opportunities, use these events as ways to think deeply and reflect about these issues. So, an example of that is that there's a one man show written by Cleveland Playwright Greg Vovos starring a Cleveland actor Christopher Bohan called How to be a Respectable Junkie that was performed at Dobama Theater. And every year, our students, we ask Greg and Chris to come in and to perform this play for our students.

And, it is based on a, a real story of a man in Cleveland who is addicted to heroin. And so, during the time that our students are learning about addiction, we have this play. And it's a real opportunity to empathize with somebody who is addicted to heroin. And it's a very moving play.

Dr. Mari Knettle:

Sounds like it would be moving. What do you think are the major challenges to integrating humanities into medical education?

Katherine Burke:

I think that one of the major challenges that a lot of other medical schools face is getting buy-in from the administration, from, you know, getting buy-in from your deans to say that, you know, the humanities have a place in our education. Very fortunately, here at Lerner, that is not the case. Our deans are very committed to our students having experiences with the humanities. They have made a huge effort to have it centered on their education and to promote humanities.

We're very fortunate to have recently gotten a grant from the John P. Murphy Foundation to fund a fellowship in medical humanities here at Lerner College of Medicine. And so, it's, that's just an example of really how fortunate we are. I think that one of the other challenges is that because the medical humanities can address so many issues that people want our curriculum to address all the issues.

And there's just not enough time in the year to address absolutely everything. We do try very hard to address issues of health justice, of LGBTQ health, of disability, of racial justice, of social determinant of health, and health inequities. And so, we try to, to address all of these issues through the lenses that humanities. But it can be a challenge because there's so much that can be addressed.

Dr. Mari Knettle:

I think that's the same challenge we face in talking about medical humanities today. We're nearing the end of our time for this podcast, and I wanted to give you the opportunity to add anything else that you think that our listeners should hear.

Katherine Burke:

I would invite people to engage with the medical humanities, with health humanities themselves, to pick up a poem, to pick up an illness memoir, to do some reflective writing themselves, to go to the museum and look at art, and think about this intersection of health and illness and wellness and medicine and the humanities and the arts.

We are all affected by all of these issues. None of us can escape from illness. None of us can escape from end-of-life issues. None of us is immune from disease. But we can make meaning of these big issues if we take the time to reflect. And the arts and humanities are one way that we can do that.

Dr. Mari Knettle:

Okay. I have one final question for you, and that is what do you like best about living in Cleveland, Northeast, Ohio?

Katherine Burke:

Hmm. So, I'm not originally from here. But I've been here for about 13 years now. And I love the parks. I love the parks, and especially the national park. My daughter and I love to ride our bikes on the Towpath and to stop for ice cream, and then to put our bikes on the train and get a lift back to our car.

So, I really love it, and especially this time of year, the weather is so beautiful. The leaves are starting to change. There are so many festivals and opportunities like that, that happen. So, I think that the national park is one of my favorite things.

Dr. Mari Knettle:

I couldn't agree with you more. Thank you so much Katherine. This has been a great podcast. To our listeners, thank you very much and we will see you on our next podcast. Have a wonderful day.

Dr. James K. Stoller:

This concludes this episode of MedEd Thread, a Cleveland clinic education institute podcast. Be sure to subscribe to hear new episodes vis iTunes, Google Play, Sound Cloud, Stitcher, Spotify, or wherever you get your podcasts. Until next time, thanks for listening to MedEd Thread and please join us again soon.