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Mixing the empirical with the expressive: Medical Humanities Professor aims to remedy clinician burnout with the arts

Dr. Susan Hingle
SIU School of Medicine
Dr. Susan Hingle

Dr. Susan Hingle is a professor of Internal Medicine and Medical Humanities at SIU School of Medicine. She sat down with NPR Illinois’ student-intern Kyle Abraham to discuss her role as an
academic physician, practitioner of the humanities, and organizational strategist.

Tell listeners about your educational background. When and why did you pursue medicine? Were the medical humanities on your radar when you began your medical education?

I come from a medical family. My dad was an obstetrician gynecologist and my mom was a nurse. Surprisingly, even though I loved science in college, I didn't have any intentions of going
into medicine. I was going to be a social worker. I knew I wanted to do something that helped people. It was about my third year of college that I decided to go into the medical profession. I did not have medical Humanities on my radar until probably 10 to 15 years into my medical career.

Few of the listeners have actually heard of medical humanities as a discipline. What are the medical Humanities, exactly?

That's another great question. It's hard to define, but really the medical humanities is the intersection of art and culture with medicine. Some of the cultural pieces that maybe a little less
obvious would be things like philosophy. Another big piece of our culture is our political systems and things like that. Health policy and advocacy are also a key part of culture. It's where those
intersect with the profession of medicine.

If you are in medical humanities at an educational institution give me a little picture of that?

I mentioned policy and advocacy. We work a lot with our compliance department and our legal department. In medicine, people think of malpractice but there's so much more to law intersects with medicine. We have a medical-legal partnership within our practice and it helps patients with getting resources dealing with issues around housing. For example, they're having disputes with
their landlords that obviously can impact their health. If they are unhoused, that obviously impacts their health.

So, we have lawyers that we intersect with pretty commonly. Then, obviously on the art side we have writers, literature people. Medical humanities started at SIU in the early seventies and that was really uncommon for a medical school to have that holistic thinking. That's been a big part of school ever since its founding but most of it had focused more on the applied humanities, think physician advocacy, the legal side of things, and ethics.

The art piece has been a little bit more recent and a lot of that has come about because of the epidemic of clinician burnout. Chicago does have a medical humanities department; it is also more on the applied side. A lot of the humanities within medical education, there isn't a lot of it, but where it is has been on the East Coast and the West Coast.

How do you pass on the medical Humanities to your students? Do you teach classes in a seminar format or do you attend conferences with them?

So all of our students have at least a full week in their third year medical school and a full week in their fourth year. In the third year, it focuses on the physician-patient relationship. We talk a lot about ethical issues that they've come across during their clinical experiences. Then, in the fourth year, it focuses more on the physician and society, so policy, advocacy, and the legal
intersection piece. All of our students, at a minimum, get that.

We also have quite a few electives for students to choose from and the majority of our students take medical humanities electives, it's more than 50%. The electives are variable, some of them focus on communication, some on ethics, we do things related to ethical
issues that come up and care of marginalized populations, transgender patients. We have some feminist ethics electives that students can opt to take. We do some around books. There’s a
couple of books that lend themselves to deep discussions. We do some around “The Gene” and around “The Immortal Life of Henrietta Lacks”. We do some where students will do some
reading and then we will have discussion.

Sometimes they're only one or two students. It's usually richer if more students are in the group but that's the approach that we have taken as far as curricular content. We have other opportunities for students to get involved. They can be volunteers in the
medical-legal partnership that I mentioned. We do have an annual literary magazine, it's called Scope. Students, faculty, and community members are encouraged to submit their work. It's
visual art, photography, paintings, poetry, prose. It's another way for the art side of the humanities to be present in the lives of our learners and our community broadly.

When students take these classes, will they be challenged with their previous presuppositions? Or is it more of a “let's establish the rules” of how to navigate the legal system as a physician?

Definitely! One of the hallmarks of SIU is the concept of lifelong learning and the importance of integrating reflection into your everyday life. We want students to be thinking not only about the
content of what they're learning and what they're applying in the clinical settings but taking it much deeper than that and looking at the meaning of the work that they do and the challenges of the work that they do.

So, the classes are much more focused on that reflection, that deep thinking, the debate. When I was a student I thought there was always one right answer. In reality, there's lots of right answers. We get into the differences in that and get students comfortable with uncertainty.

How would you say being well-versed in the humanities has influenced your career in a direction that's not like you're strictly clinical colleagues?

I started out as a clinician-educator. I saw patients and I taught in the clinical setting. Eventually, I got very interested in medical education and so I continued more on the teaching side. That
was where the humanities started to come in as I became interested in the interactions between the clinicians and the patients.

At the time, there was also an emerging epidemic of clinician burnout. The genesis of that is people get so busy with the work that they're doing that they don't take that step back, they don't reflect, and they lose sight of the meaning in the work that
they do. The humanities is a great way to reconnect them with the meaning of the work that they do.

If you had to give advice to clinicians on how to carve out the time in their busy schedule to do things that are going to help them prevent burnout?’

There's a lot of things. One of them is to do something that makes them feel good every day, whatever that is to you. For some, that is reading. For others, it may be exercise. Even listening to music.

Physicians, in particular, are terrible at prioritizing themselves. It's even part of the oath that most physicians take. It's called the Hippocratic Oath. In the Hippocratic Oath, you basically
promise to put your patients above yourself, which on the surface sounds very noble. In reality, that's a big part of the unwellness within clinical communities and patients they don't want and
they don't deserve to have unhealthy people taking care of them.

There's the old adage “you're better to others when you're good to yourself”. I don't think a lot of physicians live that way and so they need to find out what it is that's going to help them to be healthy and well. So again, carving out time everyday even if it's just a little bit.

Do something that makes you happy that brings you joy. Another piece of advice would be to integrate reflection, whatever that looks like, into your daily routines. When you're driving home from work thinking about some things that went well, some things that didn't do well, and maybe why they didn't and what you could do differently.

There is this very simple exercise called “three good things”, it came out of Berkeley and it's exactly what it sounds like. It is reflecting on three good things and you can do it in lots of ways. You can write it down, you can think through it, you can talk to a family member or friend about it.

You're actually going to be a much better clinician, you're going to understand your patient’s challenges way better. Everyone's trying to fit the different pieces together. There are not too many people who are all in on your career and have nothing else they're responsible for or they're interested in doing. Our patients also face the same challenges so it helps you to be more empathetic.

What is the heart of the center for human and organizational potential?

We are at SIU to nurture an environment where people are able to learn, grow, and thrive. We came about because we were trying to reimagine professional development and we were trying to figure out how to attend to the well-being of our faculty. Then, very quickly, we learned that the issues that were important to faculty were also important to our learners and our staff. The scope of the work expanded quite a bit.

We also recognize that if people weren't developing professionally they weren’t going to be healthy and well and if they weren't healthy and well they weren't going to be able to develop professionally. Our work has three pillars: wellness, professional development, leadership and excellence. We have sort of some foundational concepts related to organizational change management and to coaching that overlaps all of the pillars.

In your mission statement, inclusivity is a catalyst for organizations to excel. What does this look like in practice? What is inclusivity, applied?

A big struggle in our nation right now is people feeling marginalized and excluded rather than included and not having a sense of belonging feeling disconnected. That's what we're trying to work on.

We are trying to have people not only satisfied with what they're doing but deeply engaged in it and feel like they're a part of something bigger. If you think about the mission of healthcare, it should create a lot of meaning. We are invited into people's lives at critical times.

They share things with us that they don't share with anyone else and they are very vulnerable with us and that’s a huge privilege.

Kyle is a student reporter for NPR Illinois.
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