1. A Place for the Humanities
in Therapy

2. Agenda
intro what what not why graphic art poetry painting sculpture film music prose write end

4. From: Annals Graphic Medicine - Please Don't Use Patient Names

5. From: Annals Graphic Medicine - I'd Want a Natural Death

6. Annals Graphic Medicine - Is This What Depression Looks Like?

15. Blueberry Picking by Roz Levine We ran from an outbreak of polio Abandoned the Bronx for a summer hideaway In the shadow of the Catskill Mountains  Each day we traipsed craggy trails Stooped low beneath clear skies Plucked mounds of dark blues From bushes bursting with ripe fruit Filled our baskets to overflow It should have been all this: Sunshine on eight-year-old skin Fresh air on innocent girl soil Thoughts of jam on toast for breakfast Happy days of laughs with the family When anxiety overwhelms the mind Blueberry picking equates to worries Of prickly thorns and bee stings Sunburns and infected blisters Rattlesnake bites and botulism in jelly jars Everything, a gravediggers’ paradise

16. About the poet: "Writing has been one of the major tools to help me navigate a life filled with high anxiety, including several cancers and a multitude of surgeries. When I retired from my work as a school counselor several years ago, I decided that it was time to dedicate myself to my writing life and to honor the creative spirit within me. I am a member of the Los Angeles Poets and Writers Collective, founded by Jack Grapes. My works have been published in The Sun, On the Bus, Cultural Weekly, Poetry Super Highway, Silver Birch Press, Forever in Loveand Deliver Me." About the poem: "This poem was inspired by the atrocities that are occurring around the world and that create so much anxiety within me. I decided to get out of my head by tracing one of my earliest childhood memories related to anxiety--to document poetically how the simplest act, like picking blueberries in a beautiful mountain setting, was weighted down by my catastrophic thinking. I don't think I'll ever cease to be an anxious individual, but if I can make art from anxiety, I can live with that."

17. Mercy
We shiver. The room is not cold. We’re sweatered
up, red for you, blue for me. Artery. Vein. Going
and coming. We wait on needles. You roll up your
sleeve, expose a blue vein, pulse under winter skin.
Infuse: to pour into. Nearby, nurses lift the plumped
sacs, poisons mixed to pour fire into flesh. Yours.
Others’—eight stations of strangers propped, pillow-
chaired about the scrubbed room as nurses come
and go in these hushed halls of chemo, flicking
scarlet nails to re-start a clogged line. One—blue
scrubs, bluer eyes—stops before us, tray of sharps
held at her waist. Liz. She kneels by your side,
seeks your eyes—and mine—to assess the level of
our dread. Lays her hand on yours, murmurs we’ll
look after you, slips a swift needle under swabbed
skin. Anything, she looks at me. Call me for any
thing. Rising, she turns to attend to our neighbor’s
port You doze under meds. I watch, still on
edge, as she leans to retrieve a chart. Her sleeve
rides up, past her elbow’s pale skin. In the tender
flesh, the mouth of an old reddened scar. What’s
that? someone asks. Oh, that, she says, my step-
father. Stubbed his cigarette out on me. I’m not
meant to hear, but I have—I flinch. Sudden before
me—the child’s bared arm, her scrabbling feet as
she tries to escape. His grip. Her cry. How could
she turn burn to mercy? Wounded, she heals—
blessed, we dare to drink from the bitter cup.
Judith H. Montgomery
American Journal of Nursing, November 2016

18. JAMA Art and Images in Psychiatry

19. Le Suicide
Édouard Manet ( ), French. Le Suicide, c Oil on canvas, 38 × 46 cm. Foundation E. G. Buehrle Collection, Zurich, Switzerland. Photo credit: Erich Lessing/Art Resource, New York, New York.

21. “Wit”

22. Smetana, String Quartet #1, 4th Movement, “From My Life”
2:00-5:40 (hint…3:40ish…)

23. “Spirit Voices”

24. We sailed up a river wide as a sea And slept on the banks On the leaves of a banyan tree And all of these spirit voices rule the night Some stories are magical, meant to be sung Songs from the mouth of the river When the world was young And all of these spirit voices rule the night By moon  We walk To the brujo's door Along a path of river stone Women with their nursing children Seated on the floor We join the fevers And the broken bones The candlelight flickers The falcon calls A lime-green lizard scuttles down the cabin wall And all of these spirit voices Sing rainwater, sea water River water, holy water Wrap this child in mercy and heal her Heaven's only daughter All of these spirit voices rule the night

25. My hands are numb My feet were lead I drank a cup of herbal brew The sweetness in the air Combined with the lightness in my head And I heard the jungle breathing in the bamboo Saudocoes -- Greetings! Da licenca um momento -- Excuse me, one moment Te lembro -- I remind you Que amanha -- That tomorrow Sera tudo ou sera naoa -- It will be all or it will be nothing Depende coracao -- It depends, heart Sera breve ou sera grande -- It will be brief or it will be great Depende da paixao -- It depends on the passion Sera sujo, sera sonho -- It will be dirty, it will be a dream Cuidado, coracao -- Be careful, heart Sera util, sera tarde -- It will be useful, it will be late Se esmera, coracao -- Do your best, heart E confia -- And have trust Na forca do amanha -- In the power of tomorrow Lord of the earthquake My trembling bed The spider resumes the rhythm Of his golden tread And all of these spirit voices rule the night

26. ההוא יומא דנח נפשיה דרבי גזרו רבנן תעניתא ובעו רחמי ואמרי כל מאן דאמר נח נפשיה דר' ידקר
בחרב
It is related that on the day that Rabbi Yehuda HaNasi died, the Sages decreed a fast, and begged for divine mercy so that he would not die. And they said: Anyone who says that Rabbi Yehuda HaNasi has died will be stabbed with a sword.

27. סליקא אמתיה דרבי לאיגרא אמרה עליוני' מבקשין את רבי והתחתוני' מבקשין את רבי יהי רצון שיכופו תחתונים את העליונים כיון דחזאי כמה זימני דעייל לבית הכסא וחלץ תפילין ומנח להו וקמצטער אמרה יהי רצון שיכופו עליונים את התחתונים
The maidservant of Rabbi Yehuda HaNasi ascended to the roof and said: The upper realms are requesting the presence of Rabbi Yehuda HaNasi, and the lower realms are requesting the presence of Rabbi Yehuda HaNasi. May it be the will of God that the lower worlds should impose their will upon the upper worlds.
However, when she saw how many times he would enter the bathroom and remove his phylacteries, and then exit and put them back on, and how he was suffering with his intestinal disease, she said: May it be the will of God that the upper worlds should impose their will upon the lower worlds.

28. ולא הוו שתקי רבנן מלמיבעי רחמי שקלה כוזא שדייא מאיגרא [לארעא] אישתיקו מרחמי ונח נפשיה דרבי
And the Sages, meanwhile, would not be silent, i.e., they would not refrain, from begging for mercy so that Rabbi Yehuda HaNasi would not die. So she took a jug [kuza] and threw it from the roof to the ground. Due to the sudden noise, the Sages were momentarily silent and refrained from begging for mercy, and Rabbi Yehuda HaNasi died.

29. Trusting the Process
As a rookie psychologist, I knew I had much to learn. Burdened with perfectionism, I had self-doubts about technique and process. I so wanted to do it right.
One day I was assigned a young client—a girl of no more than twelve, whose grandfather was anxious to have her seen by a therapist. His wife was dying, and the child’s mother had no interest in raising her. To complicate matters, the relationship with the grandmother was full of resentment on both sides. Not ideal in any way.
I saw my young client every week for several months. I found it hard to engage her because she wasn’t really interested in being in therapy. She didn’t want to talk about home, or her mother or her grandmother. So I encouraged her to talk about school, and make-up, and boys, and anything she wanted. I had severe doubts that I was doing anything therapeutic.
The time was coming for my internship to end. I had the difficult task of informing her grandfather that I would no longer be working at the agency. Nor could I continue with the child elsewhere, according to agency rules. He was very upset.
During our last session, my young client just prattled on as usual, seemingly without any sense of loss due to our impending termination. But not me. Tears coursed silently down my cheeks. I couldn’t stop them. I couldn’t speak. I felt like a total failure as a therapist.
At the time I was also grieving recent knowledge of my own infertility. That this child had no more mother figures and that I could not have a child of my own were intersecting aches in my heart.
Later I went to supervision and confessed my failure to maintain proper therapist decorum. My supervisor quietly said, “That may be the first time in her life she had a woman cry tears of compassion for her. You’ll never know if you had any impact or not. Trust the process.”
In the decades since I have cried more than once while witnessing the pain of clients as they revealed traumas, losses, heartaches and injustices. Sometimes I cry because they can’t. I don’t try to hide tears. I don’t apologize for them. They are signs of solidarity, compassion, and love. We’re all in this together.
Gretchen Gundrum Seattle, Washington

30. Now…you…

31. Conferences
Examined Life, Iowa City Creating Spaces, Canada

32. Programs/Rounds
Columbia University Narrative Medicine Rounds Johns Hopkins Children’s Center AfterWards Caregivers-Mine-Medical-Narrative

33. MedArt Maryland

34. Journals
50+ med MANY non-med (eg The Atlantic) Academic Medicine American J of Nursing—Art of Nursing, Reflections American J of Psychiatry (and Residents’ Journal) Annals of Internal Medicine Bellevue Literary Review Cell2Soul Chest—Pectoriloquy Examined Life Journal JAMA—A Piece of My Mind, Poetry and Medicine J of Clinical Oncology J of Medical Humanities J of Palliative Medicine Neurology--Reflections NEJM The Intima Yale J for Humanities in Medicine (

35. Special things
Pulse (pulsevoices.org) Kent State University Press, Literature and Medicine series JAMA Art and Images AIM Graphic Medicine, AIM Story Slam Abaton, Reflexions, Stethos, many others… Cornell Medical College--Music and Medicine Initiative World Doctors Orchestra Yale Residency Writers’ Workshop American Society for Bioethics and Humanities (long journal list, long programs list)

36. A few good articles To See the Suffering
Beyond Dr. “Feel-Good”: A Role for the Humanities in Medical Education
Poetry’s Company: Where Medicine Leaves Us Alone
Healing the Healer: Poetry in Palliative Care
Poetry as Self-Care and Palliative Care
Poetry, medicine, and the International Hippocrates Prize
Can Poetry Console a Grieving Public?
Ode on a Stethoscope
Fiction as Resistance
Cultivating the Inner Life of a Physician Through Written Reflection
Doctors’ Condolence Notes
Stories Doctors Tell
Vignettes for Teaching Psychiatry With the Arts
Scalpel, Sponge, Show Tunes: When Doctors Moonlight as Actors
Narrative Humility
I Carry Your Heart
The Physician as Storyteller
The Craft of Writing: A Physician-Writer’s Workshop for Resident Physicians