The Healer’s Art Elective: Where the Doctor Becomes Whole

By Patricia Zheng
Contributing Writer

Every year, eager, wide-eyed first years arrive in medical schools across the country to leave four years later numbed by cynicism and frustration. Luckily for us, every winter UCSF offers The Healer’s Art elective, which explores ways that we, as practicing physicians, can maintain a sense of wholeness during our training. This winter, first- and second-year medical students will once again be able to meet and examine topics including wholeness, loss, grief, awe and service.

As a first year, I did not realize the extent of my own conflict over compassion and objectivity until my first day of preceptorship in the emergency department. I spent my afternoon observing the interesting cases that trickled in, trying to watch impartially and to be of help. I was excited when I was asked to translate for a patient. To me the medical history seemed unremarkable. The patient looked healthy but complained of pain.

Later in the afternoon a surgeon came to ask me to translate again. Sure of the diagnosis his tests had revealed, he was matter of fact and eager to get his patient to the operating room as soon as possible. As I translated and heard myself say the grim diagnosis, I saw the patient’s chin starting to tremble and his wife starting to sob. I felt the thin wall of emotional resistance around me crumble, and my own eyes tear up.

I spent the rest of the evening waiting with the family through the surgery. It was one of the most privileged experiences of my life to be able to be with them as they struggled through this difficult time. As my preceptor drove me to the BART station, we discussed the traumatic events of the day and the place of compassion and emotions in medicine.

Indeed, while most of us entered the field of medicine because we want to care and heal, sometimes it seems like expertise is more central to the practice of medicine than compassion. Physicians are expected to provide medical care that is compassionate, but we are also expected to project an objectivity that is largely undemonstrative. This aura of impassiveness is often cultivated both to reassure patients of the strength of their physician and to detach the physician, who might otherwise get too emotionally involved.

In the face of such a dichotomy, medical students and practitioners often struggle to find a balance between their hearts and their minds. It becomes especially hard to be able to express compassion, to deal with grief, and to best reach out to their patients while maintaining an appropriate objectivity. Yet professionalism includes both compassion and objectivity.

It is comforting to know that we are not alone in the struggle to bring both heart and mind to our work. UCSF was the first of the 60 medical schools now offering The Healer’s Art, a course that addresses these deep, personal, challenging and significant questions. Under the guidance of Dr. Rachel Naomi Remen and a group of dedicated faculty, many who have taught the course for more than a decade, students can begin to understand that as doctors we can be whole human beings, just as our patients are.

The Healer’s Art elective course (number 171.01) offers 1.5 units of credit and consists of 5 Wednesday evening-sessions. We also welcome significant others to the sessions.
On January 7, from noon to 1, Dr. Remen will introduce the course with a one hour lecture (and lunch) entitled “Becoming Good Medicine – Realizing Your Personal Power to Make a Difference.” The lecture will take place in room N225 and is open to the public.

Please contact Julia Bruckner (Julia.Bruckner@ucsf.edu), Anne Kern (Anne.Kern@ucsf.edu), Stanley Liu (Stanley.Liu@ucsf.edu), Nadia Norton (Nadia.Norton@ucsf.edu), Janis Sethness (Janis.Sethness@ucsf.edu), Jenny Staves (Jennifer.Staves@ucsf.edu), or Patricia Zheng (Patricia.Zheng@ucsf.edu) if you have questions.