(crickets chirping) (gentle music) (crickets chirping) - Recently, my older son passed from metastatic cancer.

He was five days shy of his 33rd birthday.

(gentle music) (crickets chirping) And that loss affected me just like it would anyone.

(gentle music) (crickets chirping) - My mom got sick, and she ended up getting diagnosed with pancreatic cancer, which is like kind of a death sentence.

I had no idea at the time.

- My mom also got really sick, pulmonary fibrosis, and ended up having a double lung transplant.

- I find myself getting really frustrated with my dad's care team sometimes, and I get what it's like to be on the other side.

- So many doctors have no idea what it's like to live in a single parent home, to be near the poverty level.

- You didn't come to your appointment, because you didn't care, well, they couldn't come to their appointment, 'cause it was a three-hour trip for them by bus or something, right?

It's thinking about the story in a different way, thinking about trying to really understand what an individual faces on a day-to-day basis.

- You have to be very analytical about it, and professional, because it is your job, but at the same time, you are still affected.

- We want our students to understand and feel that their patients are human.

They are human.

- It's when we don't have a way of coping with all the emotions, and all the trauma that it takes to take care of a patient.

When you don't have an outlet for that, it's really hard.

So if you can find even a little glimmer of hope in an outlet -- - It's important for the physician to find their own humanity.

(gentle ambient music) - Medical education traditionally, we have always told people to compartmentalize.

- We think about it as pure science, you have a disease, how the disease impacts the human body.

The humanities really brings that personal experience of a patient or the physician to the interaction.

- My first year of medical school, I'm shadowing in the ER, and a patient comes in, actively coding, like the EMS is doing CPR, they roll the person into the trauma bay, and it's a flurry of activity, and that person ultimately died, it was the first time that I had seen or heard bad news given, and I was just in the corner, bawling, bawling, bawling, bawling.

Now, I personally have given bad news, I have seen someone pass away despite medical efforts and intervention, and I haven't reacted like I did that first time.

No one really pulled me aside or talked to me like as a medical student.

- Physicians, nurses who work in very acute care settings, like the emergency department, seeing extensive trauma, you really need to have the time to understand how you yourself are being impacted.

(traffic whirring) They're one of the top teams in the All Star Breaks, but the Cubs beat them in the series they just played.

- Well, that's a given.

- Well, not a given.

(Judi laughing) So Judi and I have known each other for 23 years.

This one has poems in it.

- Yeah.

- And also essays.

- Nice.

Our children actually went to grade school together, and we started to really understand we had a very similar type of worldview.

- It was just a natural thing for us to work together.

- That would be hilarious.

- No, that is not a medical community, but ... - Wanting to take care of other people, wanting to support other people's work, other people's passions and dreams, and really how do we collaborate -- - To develop this course.

I'm Dr.

Farion Williams.

- I'm Judi Marcin.

- And I Co-Direct - - The Medical Humanities course.

- At Washington State University.

- Good morning.

- Good morning.

This artist, Omari Maynard, has been doing this project called "In Her Honor" since 2019.

Omari's wife passed away giving birth.

He started doing these portraits of people that have been lost during childbirth.

- There is a perceived dichotomy between art and medicine.

- He literally has hundreds of portraits.

He'll get a picture from this family that lost somebody in childbirth, and do kind of a portrait in their honor.

- There is just this ongoing rumor about how great the class is, and it's passed down from generation to generation.

- They have the choice of doing a kind of own voices, what we call "own voices", which is looking at particularly documentaries, poems, stories that are written by folks who have a specific lived experience, and then the students kind of built a project around that.

- Can you guys see that okay?

So this is some of what he does.

(gentle music) And like I said, he literally has hundreds upon hundreds of these, unfortunately, because it is somebody that has been lost, and he does this in a way to kind of honor their families, and their stories, and make sure to include their name very obviously there, just to put a face to the statistics.

- Some people will explore it through poetry, some people will explore it through prose, some people have made music videos.

(somber rap music) ♪ South Korean special ♪ ♪ Of raising little boys ♪ ♪ Is hit them when they're wrong ♪ ♪ And I was wrong a lot ♪ ♪ I feared Dad growing up ♪ ♪ And I loved Mom more ♪ ♪ But Dad had his reasons ♪ ♪ He saw through the seasons ♪ ♪ That Son, in the States, when you sit at the table ♪ ♪ You can't sit at the head ♪ ♪ 'Cuz equality is a fable ♪ ♪ Excel in your studies ♪ ♪ Be a doctor or a lawyer ♪ ♪ Then you'll be their boss ♪ ♪ And they can't look down on ya ♪ - Being able to see students have space and time to create is huge.

♪ 'Cuz her one and only son called ♪ ♪ Son thank you for the call ♪ ♪ Made my day, how is life ♪ ♪ Studying's really hard, right ♪ ♪ Are you eating right ♪ ♪ How's your wife, don't get into fights ♪ ♪ Are you treating everybody kind ♪ ♪ Mom, I try, but in the States ♪ ♪ They see kindness as weakness ♪ ♪ And meekness as weakness ♪ ♪ And weak as beneath them ♪ ♪ They see us as beneath them ♪ - The student also has to submit two original writings, we de-identified the patient, so for patient privacy.

- So even if the writing isn't the most beautiful writing that ever existed in the universe, is their message still getting across?

Can we see the effort that they've put into making this story whole?

- "I'm driving to the hospital.

It's 5:00 AM, and it's pitch black out.

I'm tired, but coffee and Red Bull are waiting for me.

I say hi to the residents, and we get ready to round.

Our first stop is the pediatric ICU.

I've never been there before.

It feels heavy and busy.

Overnight we had a new admit.

He's 12 and was in a car accident with two other adults.

He had severe orbit injuries and a skull fracture."

- "Louise was a well-known character of the clinic.

At least once a month, she would come waddling in with her walker, old takeout bags hanging from its handles, filled with trinkets.

She would bestow as gifts to anyone who spoke with her."

- "This guy's name is Larry, and today, his life is about to change.

We ask him if he has any questions, and he looks at me and responds in a very quiet voice, 'Do you have to cut off my leg?'

I was gutted."

- [Grace] "I see his mom reading to him through the glass, photographs of him playing baseball, lined sterile cabinets.

He hasn't gotten better.

Every morning we ask about pressures, and doses, and so many numbers, and it's always the same, sometimes worse."

- "I held her, tears dampening the shoulder of my short white coat that had been ceremoniously given to me two years prior, signifying the beginning of medical school.

Leaving the room with Louise's gifted trinkets in its pockets, I became frustrated with the narrative of medicine that was sold to me.

What tools had I been taught that could allow me to help this woman?

Life never gifted her a chance, a moment of peace or ease."

- "What is life like with one leg?

Will there be people to help?

How will Larry get around?"

- "We're supposed to be putting in a G-tube later.

The senior resident thinks it's too much, that his family should let him go.

I scrub in and stand with his hands gingerly on the crisp blue sheet.

I feel so, so warm.

I'm asked to close, so I place a single stitch in his belly button port site.

I can only think about his death, that it feels imminent, and that the suture I just placed will be buried with his tiny body."

- "She ended her own life two weeks later.

Some say this is the easy way out, a permanent solution to a temporary problem.

I do not think Louise lived a single day in her life that was easy, and her problems were never temporary.

She was the most patient of patience, waiting for the day that doing the right things would reward her, but they never did."

- "My job was to make sure he was safe during surgery, and give him the best chance of recovery, but was that enough?"

(gentle ambient music ending) - That was good, Ben.

- You're a good writer.

- Yeah.

- We have so much data that shows art, music, literature make us better people, not only that, they help us be better thinkers, they're more creative problem-solvers, and it's important, because we are taking care of diverse people, in diverse healthcare settings, with diverse problems, and we need to have that very complete picture of humanity.

- Music and art allows us to feel feelings, and often, experience, you know, a feeling, or subject like through somebody else's eyes.

- Finding that path of creativity and self-expression will really help prevent physician burnout.

I can write poetry.

I can practice this narrative medicine thing that we learned.

I can actually paint stuff.

We really want physicians to be able, we know their health matters.

- There is an art to medicine.

- So you just like don't know who is gonna be, who's really gonna shine.

- I think we're on the cusp of changing to like embracing a little bit of a softer approach to medicine.

- Each regional dean does a little thing of like a two minute, you have two minutes to speak.

- To shout out to your people?

- To shout out my people.

(participants laughing and chattering) I always got in trouble in medical school, because I took too long with patients.

That was the thing that always got me in trouble.

(Judi laughing) They're like, "You have no time management skills."

I was like, "Well, I can manage my time, I just wanna talk to people longer than you're giving me to talk to."

How do I find enough time to spend with patients, to understand their stories, to understand what's actually going on, and then I still have to get the work done, because I have other patients that I have to see, who I still need to listen to, and understand their stories.

- I do think that there is more and more of a move towards really talking about how our work, and our, you know, patient encounters really do affect us.

- Compartmentalize was the last thing I needed to do, I needed to understand, I needed to come to terms with what I was seeing every day.

- You have this ability to like, "I don't know, show, be vulnerable, be human with your patients, and show that you can do those things, and also be like incredibly competent and skilled."

- I think that our humanness is the single thing that cannot be replaced.

- All I can do is the very best I can, and you know, hope that I can leave that impact that I've seen other physicians leave.

- And now both of our moms get to watch us graduate from medical school -- - Heck, yeah, they do.

- Because medicine, like we got a lot of the good side.

- It's pretty incredible.

- Yeah.

(crickets chirping) - One of the things my son loved to do was go to the farmer's market.

And so my wife, Cindy, and I went to the farmer's market, it was a couple weeks after his passing.

And at the farmer's market, there were fresh flowers, and specifically beautiful, big peonies.

And so we bought some bouquets of peonies, and took to his grave.

And this piece just a few months later, this is the piece that the student turned in from her narrative medicine week.

"I met this patient at my favorite time of year, the start of peony season.

No, not when the stems start to get those big marshmallow-like petal buds, but when all of the conditions are right in the spring for sprouts from the bulb to finally emerge from the soil.

It really is a disservice to only think of them in the six weeks they are beautiful.

Danny is a teenage male I met in a children's hospital in my third year of medical school.

He was diagnosed at a young age with a genetic disease, which caused progressive muscle degeneration.

Everything about him was exactly like I learned in the preclinical part of medical school, a living, breathing textbook.

He could not speak or point, not for a lack of trying, so his hazel eyes and the minuscule facial muscle movements he had left communicated for him.

We saw Danny every morning on rounds.

His room was always empty.

The beautiful eastern-facing room had the shades up, so the morning sun was shining directly on Danny's face and in his eyes.

Every day I took my place at the foot of the bed, his hazel eyes locked on me.

I didn't maintain eye contact for very long in the first few days.

Day after day, the routine repeated itself.

Danny's heart improved.

The room and its activities stayed the same.

I started to notice those minuscule winces in his eyes when the talking medicine bridge discussed going home with hospice care.

Did he know he was dying?

After the team wrapped up and left his room, I stayed behind.

I was annoyed at the 'Moana' DVD intro repeating itself, begging someone to press play.

Was he?

I was blinded by the beautiful spring sun coming in through the window.

Was he?

I locked my blue eyes with him this time, asking these questions, and absorbing his tiny movements, indicating yes or no.

I turned the volume down, and pressed play on 'Moana', pulled the shades down, adjusted the fan, and got him a warm blanket.

My last day of the rotation was the day he was discharged.

He was headed home with hospice.

I was headed to plan my annual trip to the peony garden."

(gentle music) (birds chirping) (crickets chirping) (cricket chirping fading)