“Why should an anesthesiology department support the medical arts and humanities?” During my 22 years as chair of the Stanford Department of Anesthesiology, Perioperative and Pain Medicine, I was never asked this question, since the value of supporting these activities was obvious to the entire department. In this article, I will discuss some of the activities that our department has supported and then the benefits of incorporating the arts and humanities into an anesthesiology department.
For the past three decades, Dr. Audrey Shafer has been the driving force in developing an internationally recognized program at the intersection of the arts, humanities, and medicine, not only in our department but also throughout the medical school and Stanford University. After finishing anesthesia residency at the University of Pennsylvania, Dr. Shafer joined our department with the goal of an academic career in clinical care, education, and research. Although successful in clinical pharmacology research, her interests evolved toward the humanities, and she started publishing this work in both anesthesiology journals and humanities journals. She recognized that the arts and humanities are directly linked to our role as physicians, and her multiple peer-reviewed manuscripts, poems, and award-winning books explored various aspects of that interface. She created the Medicine & the Muse Program, described as “the home for the arts and humanities at the medical school, with programs that support diversity and integrate the arts and humanities into medical education, scholarly endeavors, and the practice of medicine.” She cofounded multiple programs in creative writing, including Pegasus Physician Writers, mentoring undergraduates, medical students, and residents to use stories to enhance their communication skills and build community. She recruited Laurel Braitman, a New York Times best-selling author, to Stanford, initially as a writer in residence and now as director of writing and storytelling. She also recruited Jacqueline Genovese (now the executive director of the Medicine & the Muse Program) to lead the literature in medicine program.
Dr. Shafer has received multiple teaching awards from medical students. Stanford medical students must choose a scholarly concentration, and Dr. Shafer served as co-director of the Biomedical Ethics and Medical Humanities concentration. During their clinical clerkships, medical students have designated days for reflection, and Dr. Shafer also co-directed this program. Within the anesthesiology department, Dr. Shafer collaborated with like-minded faculty, residents, and staff to create the annual arts and anesthesia soiree evenings, taught creative writing to residents and faculty, and moderated sessions on challenging ethical issues. Nationally, she has served on multiple editorial boards and boards of directors related to literature and the humanities. In 2007, Dr. Shafer was promoted to Professor in the University Medical Line, equivalent to the tenure line at peer institutions. Promotion in this line requires research that has significantly advanced the field, so her promotion confirmed that the arts and humanities are relevant fields of research for an anesthesiology department. The medical school has recently expanded its commitment to the arts and humanities by establishing the Dr. Audrey Shafer Medical Humanities and Arts Fund (asamonitor.pub/3INhLzM).
I have had the opportunity to participate in many of the above activities. The readings and group discussions on literature in medicine gave me a deeper appreciation of both the patient experience and the physician experience. Attending concerts expanded the benefits of being part of a major university. The year-long Frankenstein@200 series of events made me reflect on the impact of technology and our interventions in the OR and the ICU. The university-wide COVID remembrance project made me remember the patients and their families I cared for in the ICU. The arts and anesthesia soirees showed me the talents of our residents, faculty, and staff in music, dance, writing, poetry, storytelling, photography, and even quilting and furniture-making and allowed me to know them on a more personal basis. Courses by our faculty, such as Critical Illness Patients: Physicians and Society, have emphasized the humanistic side of critical care. In this series of articles in the ASA Monitor, other members of the department will provide their personal accounts of these and other activities.
The arts and humanities are particularly relevant to us as anesthesiologists since the practice of anesthesiology can produce a feeling of isolation. In contrast to other medical specialties that involve continuous teamwork and prolonged periods of patient interaction, anesthesiologists may spend the majority of their time with a sedated or anesthetized patient and have extended periods with limited interaction with other health care providers. Although the OR environment includes multiple people, the anesthesiologist may be isolated on the other side of the drapes. As physicians, our daily contributions to outstanding patient outcomes are professionally fulfilling, but as social beings, we need to share our experiences with others. The arts and humanities are an opportunity for us to achieve this critical goal. The practice of anesthesiology requires creativity, and the arts and humanities teach us to be creative. Finally, anesthesiologists deal with pain, suffering, and sometimes death, concepts that are explored in depth in the arts and humanities.
“Although anesthesiologists find meaning in their profession, individual wellness requires involvement in other meaningful activities that refresh their lives. For many faculty, participation in the arts and humanities fulfills that need and allows them to continue their clinical, educational, academic, and administrative activities with greater enthusiasm.”
Some of the benefits of incorporating the arts and humanities in the department are listed below.
Recruitment of residents
Medical students greatly value the humanistic elements in the arts and humanities. In fact, the majority of medical students who apply to anesthesiology residency have had accomplishments in areas such as music, literature, painting, photography, and dance, and they find that these areas of creative expression bring enhanced meaning to their lives. These medical students are interested in a career in a medical specialty that supports continuing involvement in these areas. Our departmental activities in the arts and humanities have been a major factor in recruiting medical students into our specialty, and connecting them with Dr. Shafer has helped recruit the best applicants to our department.
Retention of faculty
There is a high rate of burnout among anesthesiologists throughout the country, especially with the COVID pandemic and the current shortage of anesthesiologists. Although anesthesiologists find meaning in their profession, individual wellness requires involvement in other meaningful activities that refresh their lives. For many faculty, participation in the arts and humanities fulfills that need and allows them to continue their clinical, educational, academic, and administrative activities with greater enthusiasm. In addition, activities such as creative writing or discussion of relevant literature provide important perspectives on our clinical and academic roles, thereby enhancing career development and satisfaction.
Diversity, equity, and inclusion
Participation in the arts and humanities provides an opportunity for our departmental family, including faculty, trainees, and staff, to share their accomplishments and experiences. The resulting community enhances our commitment to DEI and helps promote activities to further our departmental efforts in this area. Programs that combine diverse backgrounds and talents demonstrate the power of the arts to create community and commitment to diversity.
Connecting the department to the medical school and university
Although anesthesiologists are essential for surgery, deans and university leaders may not consider anesthesiology departments as essential to the educational and research missions of the school and the university. Other medical school departments such as medicine, pediatrics, and surgery do recognize the importance of the arts and humanities to their faculty and trainees, and the arts and humanities are obviously an essential component of the university. Therefore, having anesthesiology recognized as a leader in medical humanities elevates the status of the department throughout the medical school and university. Through her networking activities and programmatic contributions, Dr. Shafer has been an ambassador between the anesthesiology department and the medical school and university.
During the past three decades, Dr. Shafer has distinguished herself as a clinician, teacher, researcher, and leader. Her multiple activities in the arts and humanities in medicine, including directing the Medicine & the Muse Program at Stanford, her individual contributions in terms of poems, books, creative writing, and scholarly articles, and her extensive mentorship of undergraduate students, medical students, residents, fellows, and faculty, have made our department better in multiple ways. Our departmental investment in these programs has produced invaluable rewards.