April 4, 2003

Felts Lecturer examines art of medicine

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Dr. Irwin M. Braverman discusses a painting at the Felts Lecture Tuesday in Light Hall. (photo by Anne Rayner Pollo)

Felts Lecturer examines art of medicine

If every physician could imagine his or her patient as a painting in a frame, diagnosis might be faster and more accurate.

Years ago, being called a “diagnostician” was the highest accolade a physician could receive, said Dr. Irwin M. Braverman, professor of Dermatology at Yale University School of Medicine, who presented the ninth annual Philip W. Felts Lecture in the Humanities on Tuesday. His topic was “Art and the Art of Medicine.”

“Over the past 25 years, the diagnosis skills of a physician have slowly deteriorated as imaging technology has improved and physicians are being asked to see more patients in a shorter period of time,” Braverman said. “We are now trying to bring back observational skills.”

Braverman recently established a program at Yale University Medical School called “The Doctor-Patient Relationship.” It’s a collaborative effort with curators at the Yale Center for British Art, focused on teaching first-year medical students about the importance of observational skills. It has spawned similar efforts at Brown, Cornell, Duke and Stanford where students have initiated similar programs after hearing about Yale’s.

The program, in its sixth year, uses paintings to teach students the importance of observation, a skill they can translate into better observing and describing a patient’s appearance when taking a patient history.

“The clinical eye is closely related to the artistic eye…Consider your patient in a frame, all attention focused on the person without external distraction,” Braverman said at the lecture.

On Tuesday morning, seven medical students accompanied Braverman and Drs. John A. Zic, assistant professor of Medicine, and Bonnie M. Miller, associate dean for Medical Students, to Cheekwood Museum of Art for a demonstration of the Yale-based class.

“You should describe what you see in a painting in such a way that someone not in the room will have mental image of the person in the painting,” Braverman said. He told the students to describe only what they’re seeing, not what they believe might be happening, unsubstantiated by details.

The students studied at Cheekwood and commented on an 1892 painting “Portrait of the Schiff Children” by Julian Story. They were told they should not describe the oldest child in the painting as appearing sick, but should describe her features — sallow eyes, downcast mouth, and posture.

“We’re learning right now how to do histories, and how hard it is to describe how someone looks. This is very timely information to have,” said Adriana Schmidt, a second-year medical student who suggested Braverman for the Felts Lecture after reading an article about him in The New York Times.

During the lecture, Braverman showed a slide of the painting “The Death of Chatterton” by Henry Wallis and showed how a close inspection of the details of the painting led to knowledge about what has actually occurred, the death of a young poet.

The lecture is named for Felts, who served as Vanderbilt University School of Medicine’s assistant dean of Student Affairs from 1975 until 1988. Felts was an accomplished gourmet cook who cooked often for students at his rustic home, “The Mountain.” He loved opera, music and writing, and knew the students by name, remembering them long after medical school.