the HEALER’S art ISSUE 7 2023
Rose Pagano, MS1 On the cover: Stitches the HEALER’S art ISSUE 7 2023 With deepest sympathy, we dedicate our publication to the 30 people injured or killed in the tragic 2023 Brooklyn mass shooting in Baltimore. May their memories inspire the world against gun violence.
“Make good art!” I first heard this advice from acclaimed author Neil Gaiman when he spoke at my daughter’s graduation from University for the Arts in Philadelphia in May of 2012. In his speech (https:// tinyurl.com/2z4cdtcb), Mr. Gaiman encouraged the students to take whatever, from an increasingly absurd list of catastrophes might befall them and use these things in their creative work. His is also a sound suggestion for the contributors to Creative Hearts. Somehow, for me it resonates with more sobering advice I received from my mother almost half a century ago, when I was unmoored after having lost a close friend to suicide. My mother, after providing days of comfort and support gently told me “Well, Annie, this thing which has happened is too terrible to understand; but someday you will find a way to take it and do something positive with it”. And she was right; over time my dear friend became part of both my long ago poetry and then my practice of psychiatry. As humans, and particularly as physicians, we come to interface with so many varieties of fear, pain and loss, as well as occasional small miracles. It is, simply, a lot. Making art (from writing to visual arts, to music, to dance and beyond) can allow us to process what we experience, can give us a venue to imagine new realities and possibilities, and can inform our work in the art of medicine. I think of physician authors from Arthur Conan Doyle and his iconic Sherlock Holmes, to Tess Gerritsen and her popular medical thrillers, to Abraham Verghese and his profound memoirs and sweeping stories, each generating some-thing positive from their physician experience and each, in their own way making good art. Thank you for the privilege of writing this forward, I cannot wait to see what you have created. Ann L Hackman, MD Division Director Community Psychiatry Department of Psychiatry University of Maryland School of Medicine a foreword Summer 2023
2 The Healer’s Art ◆ 2023 the Creative HeArts team In its 7th year, Creative HeArts continues to bring about our creativity and shared expression. I remain inspired to pick up my violin during the toughest months of medical school. Thank you to our amazing authors! ~ Michael Sikorski, MS4 I chose Creative HeArts because it is an embracing haven for the UMSOM community to share their creative voices. It also serves as a poignant reminder that art and humanism lie at the heart of science and medicine. ~ Toan Bui, MS2 I joined Creative HeArts, in order to experience the humanistic side of medicine, and help capture the myriad of emotions, stories, and breakthroughs that my classmates and I will accrue throughout our time here. ~ Bunmi Solano, MS2 I joined Creative HeArts because I believe it is important to promote artistic expression in medicine. Creating art is a beautiful way for us to reflect on our experiences in the medical field, and I am so proud of what my classmates and I have created and achieved so far. ~ Rose Pagano, MS2 Art has always been an outlet for creativity and expression for me. I joined Creative HeArts to continue this throughout medical school, and to promote an environment where the UMSOM community can reflect on their ~ Sarah Bejo, MS2
The Healer’s Art 2023 ◆ 3 Foreword.....................................................................................................................................1 The Creative HeArts Team.......................................................................................................2 These Seizures Are Real - Sam Kirsch, MS3 .......................................................................4 An Unlikely Connection - Sam Kirsch, MS3......................................................................5 MRI Vision - Ryan Curto, MS2............................................................................................6 A sign of higher power, if I’ve ever seen one - Jeffrey Kahn Blackman Yoseph Ephraim ben Eliezer v’Yonina Rivka, MS3 ....................7 Untitled - Dowon Kim,MS1..................................................................................................8 Formal 2023 -Dowon Kim,MS1 ...........................................................................................9 Pause. Breathe. Reconnect - Sarina Maini, MS1 ..............................................................10 Messages from my MS1 self - NK, MS3 ..............................................................................11 Bloom - Maggie Besse, MS4..............................................................................................12 A Mother’s Love - Tara Balasubramanian, MS3 ............................................................13 Mountains as Medicine -Annie Schindler, MS4.............................................................14 Step 1 = Family Support - Shirin Parsa, MS3 ...................................................................15 Jeepney - Jenina David, MS3..............................................................................................16 Essential Workers - Elif Kolanci, MS3................................................................................17 study spot - Jenna Kanner, MS3 ........................................................................................18 get well soon - Jenna Kanner, MS3 ...................................................................................19 Corner Window - Dominic Ventimiglia, MS4...............................................................20 Sketchbook - Nicol Tugarinov, MS3 and Marquis Berrey, MS3 .............................21 Daily Dose of Art -Euna Cho, MS1 ........................................................................... 22 Wings of Freedom -Toan Bui, MS1....................................................................................23 Pawsome Pals: A Collage of Our Furry Study Buddies -Christine Wan, MS1............24 Kaleido scope Quilt-Alexis Vetack, MS1..........................................................................25 B’more vibes -Jason Zhou, MS1.........................................................................................26 Stitches -Rose Pagano, MS1 ...............................................................................................27 Nature is Healing -Kimia Abtahi, MS4..............................................................................28 Untitled-Dr. Muhammad Huq, Faculty..........................................................................29 2022 In A Nutshell - Aldanah “Dana” Althwanay, PGY2 ...........................................30 Written in reply to “Perspective”-Isha Darbari, MS4......................................................31 Bookshelf..................................................................................................................................32 Table of Contents
4 The Healer’s Art ◆ 2023 These Seizures Are Real Sam Kirsch, MS3 Seizures are bursts of electric signals in the brain that result in abnormalities in the human body. There are many forms of seizures including the blank-staring absence seizure and the full-body-shaking generalized tonic-clonic seizures, often depicted on television in shows like Grey’s anatomy. These seizures can be medically diagnosed by EEG as altered brain wave activity. While my shelf exam questions hinted that not all seizures are epileptic, or contain abnormal brain behavior, I was a bit skeptical about the presentation. It wasn’t until today’s seizure clinic, where our last patient of the day, Mr. H., proved to me otherwise. Mr. H. was a 41 year old veteran from Pittsburgh. He was driven by his wife of five years down for this appointment today, and came into the room with a scowl on his face. “This downtown area can kiss my ass!” he stated, when asked how he was doing today. This was immediately followed by a surprised look from his wife, who explained that they had gotten into an argument while finding a place to park. When the resident who I was working with for the day asked him what brought him into the clinic today, Mr. H. replied “I have PTSD, anxiety, and depression.” He then proceeded to tell us about his journey from military to civilian life and the stressors that he has been dealing with. His stutter was obvious; the more emotional he became, the more his stutter grew. This was accompanied by robust right hand shaking. When his stuttering became so pronounced that he couldn’t get his words out he would hit the arm of his chair in frustration, which prompted his wife to try and comfort him. Eventually the resident asked Mr. H. to take three deep breaths, which helped temporarily calm the aura of anxiety and frustration that had filled the tiny clinic room. At last the questions were beginning to be answered, and the picture was becoming clear. After leaving the military, Mr. H. began having what seemed to be bouts of syncope when he became emotional or excited. His friends would make fun of him or it, but he seemed not to mind too much. After his PTSD and life stressors- getting laid off and his ex-wife making his life a “living hell” by not allowing him to talk to or see his kids- grew, he eventually experienced an episode of what seemed like generalized tonic clonic seizure which resulted in urinary and fecal incontinence. After this episode in 2018, Mr. H. experienced minor seizures until one episode landed him in the Erie Emergency department. One continuous EEG and an EMU stayed later and Mr. H. was given the often mysterious diagnosis of Psychogenic Non-Epileptic Seizures, or PNES for short. Mr. H. experienced trouble garnering the proper medical help. Is this diagnosis one that should be treated by a neurologist, a psychiatrist, a primary care physician, all of the above, or none? He was shuffled around like a deck of cards, and with each rejection and additional life stressor such as losing his driver’s license, his seizures became more frequent and severe. His wife stated, “the seizures kept evolving from day to day” as no two were ever the same, almost like snowflakes. He was now having three to eight seizures per day, each lasting up to five minutes, leaving Mr. H. sore, confused, tired, and sometimes a little bloody and bruised. His wife showed us a five minute video of a recent seizure. On the surface it appeared just like a generalized tonic clonic seizure, but when studied a little more closely, the signs of PNES were clear. His movements were asynchronous, his neck not fully turned, his severity waxed and waned, and so on. “These seizures are real,” the resident stated. “I am not taking that away from you.” It was at that moment that Mr. H. began to cry. I ran to the bathroom to grab him some toilet paper to wipe his face with. This is a man who experienced major trauma in Iraq and Korea, who has probably experienced more horrors than I can imagine, and has now developed so much anxiety and PTSD that he had subsequently developed PNES. His desperation was palpable. I felt for his wife, who has had to support him through his seizures for nearly 80% of their relationship. I wanted to give this man a hug, or at the very least pat his shoulder, but knew that wasn’t the best idea. Nevertheless, a physical exam was conducted, which was normal aside from some issues with coordination and a wobbly Romberg test. We discussed some strategies to keep Mr. H. busy and help create some purpose and happiness in his life, and set a follow up appointment. Eventually Mr. H. went on his way, headed back to Pittsburgh, and I went home, itching for a run to decompress.
The Healer’s Art 2023 ◆ 5 An Unlikely Connection Sam Kirsch, MS3 The first day of my internal medicine rotation brought on a medley of emotions and expectations. I waseager to learn, excited to be pushed on my critical thinking skills, and worried that I won’t be as refined asI would like. To be honest, the last thing on my mind was forming an unlikely connection with a patienton this rotation, as I was a man on a mission this time. I picked a random, ‘semi-active’ patient to take care of on my first day with the orange team at the VA. Iheard a one liner - a 68 year old man with recent intubation who is presenting with dysphagia andodynophagia- and went across the third floor to introduce myself and get a more thorough history. It was immediately apparent that this would not be the ideal interaction. To be blunt, the man lookedmiserable. He was cachectic, had arguably the driest skin I have ever visualized, and a scowl on his facethat just screamed “I am not having a good time.” With every few words this patient would gag on hisown secretions, which were blocked by a post-pharyngeal mass of unknown origin, and would use hissuction to help remove this badness. I was in and out, and did not want to bother him in his discomfort. The next few days with this patient were up and down. When his pain was intense, he would yell at me toleave the room, threatening me with his phone or fist if I were to auscultate him with my stethoscope.When his pain was controlled, he would be kind, apologize profusely, and we would even bond oversports. He was especially disappointed when the Astros beat the Phillies in the World Series. This rollercoaster relationship ended for us on my last day with the orange team, as he was also beingdischarged that day to a SAR, with the diagnosis of post-cricoid chondritis being treated appropriatelyafter much deliberation. We shook hands, and wished each other well. A few takeaway from my three weeks treating Mr. X: • Do not, by nearly any means, take what the patient says personally when they are in pain. Pain issuch a modifier in one’s demeanor, and can make us act, say, and do things that would not be innature. • Know when to interact with your patients ~ If they’re asleep after being interrupted multiple times, consider coming back later. ~ If they’re visibly upset or in pain, keep it short, ask two questions, listen, and get out. ~ If they’re willing to engage and tell you about themselves, take the extra minute and askthem questions. One or two moments will likely not make you late for rounds.
6 The Healer’s Art ◆ 2023 MRI Vision Ryan Curto, MS2 Spring 2022; Digital Art I created this as reflection of an experience I had during my musculoskeletal block while studying the anatomy of the hand and forearm. I remember attempting to understand all the intricate muscles, tendons, fascial layers, and pulley systems of the hand and trying to envision how this complex anatomy may function in my own hand. As I did so, I imagined I could peel away all the various tissue planes of my own hand and view these amazing systems at work! The experience left me not only feeling more confident in my understanding of hand anatomy but also wishing I had “MRI Vision” so I could actually see how these muscles and tendons worked together.
The Healer’s Art 2023 ◆ 7 A sign of a higher power, if I’ve ever seen one Jeffrey Kahn Blackman -- Yoseph Ephraim ben Eliezer v’Yonina Rivka, MS3 April 16th, 2023; Captured on my Google Pixel 4XL Pearlstone Park adjacent to the Meyerhoff Symphony Hall
8 The Healer’s Art ◆ 2023 Untitled Dowon Kim, MS1 The old man handed me a bag of chemicals. I don't remember if I earned it, or received it gratefully, or seized it viciously, or made to bear it regretfully. There must be a time when I clutched the bag tightly --a baby's fingers around its father's pinky. But since, I rolled with it along the hills that made me sneeze, jumped with it into the rivers that soaked me to my marrows, and wailed, smudged, bounced it against everything I knew. Sometimes, I even let others caress it gently as I fell asleep. But my hands are sweaty now, and I feel it slip. Will it thud? Splatter? I wish it would pop silently like a colorful soap bubble that floats gently through the park.
The Healer’s Art 2023 ◆ 9 Formal 2023 Dowon Kim, MS1 04/14/2023
10 The Healer’s Art ◆ 2023 Pause. Breathe. Reconnect. Sarina Maini, MS1 In the hustle bustle of life, there is always something to be grateful for. All we need to do is pause, breathe, and take a look at nature around us, a look at little beautiful moments throughout our days, a look at the sunset outside and a look at all that we have to be grateful for.
The Healer’s Art 2023 ◆ 11 Messages from my MS1 self NK, MS3
12 The Healer’s Art ◆ 2023 Bloom Maggie Besse, MS4 Spring 2023; Embroidery on canvas
The Healer’s Art 2023 ◆ 13 A Mother’s Love Tara Balasubramanian, MS3 Obtaining collateral from a loved one is rarely an easy conversation. On this day, I had a long conversation with the mother of a patient. Our patient had a long history of major depressive disorder with multiple prior attempts. The love this mother had for her child was almost palpable through the phone—as was the hurt she has experienced. I painted this piece later that day. The subjects are a mother standing behind their child. The vibrancy is synonymous with the love they have for one another while their figures are seemingly created by tears they have shed. Watercolor
14 The Healer’s Art ◆ 2023 Mountains as Medicine Annie Schindler, MS4 A compilation of some of the many adventures that stilled my mind and reminded me to look up. Featured: CO - Morrison • Vail • Copper Mountain • Mt. Bierstadt Frisco • Gore Range • Rocky Mountain National Park AK - Denali • Polycrome Pass UT - Bald Mountain OR - Pacific Coast WA - Olympic National Park
The Healer’s Art 2023 ◆ 15 Step 1 = Family Support Shirin Parsa, MS3 Spring/Summer 2023; On my laptop stand, I would often find these notes of encouragement from my mommy during my Dedicated study period. :’) Thank you so much for all your support to help me succeed in this exam. I am so grateful for you and love you so much!!! <3
16 The Healer’s Art ◆ 2023 Jeepney Jenina David, MS3 Jeepney – one of the most common and affordable public transport in the Philippines; often creatively designed with vibrant exterior colors and unique interior features. My family owned a jeepney back in the Philippines, which was named “Ina’s Pride” (taken after my nickname “Ina”). Our jeep (short for jeepney) was my family’s source of income and was a means of transport for many. Every day, my papa would leave at 4 am and get home at 9 pm, driving through major cities and dropping passengers to their destination. Through the polluted air, black smoke from dieselfueled vehicles, and hot humid weather, our jeep served as a temporary haven for passengers. My papa elevated the jeep’s interior by adding window tarps to block the smoke, mini electric fans to keep cool from the swelter, and a radio stereo to jam along current pop hits. Rain or shine, through floods and typhoons, rough roads or steep hills, our jeep braved through all of them for its purpose to transport people, gloriously shining with its colorful beauty. Our jeep served us and the people well for 12 years. I ponder about my medical school journey and how it has taken and demanded a lot from me. I wonder if I am like our jeep that has retained its shine through the daily scuffles. As I complete the end of my thirdyear core rotations, I look back at the challenge of overcoming STEP 1, all the long sleepless nights, the never-ending exams, the perpetual struggle for a balanced schedule, and the unrelenting self-doubts and worries if I’ll make it through. And just like my papa, I have woken up every day eager to surely finish and accomplish my purpose and goals. And in between the hectic schedule, I elevated my life quality by prioritizing close friends and family, my personal hobbies, and my faith. Here I stand near the end, though I am not sure if I am as strikingly beautiful as our jeep, I can say that my pride (Ina’s pride) lies on the fact that I continue to embrace each day and all the uncertainties of the journey that is medical school—equipped of course by my unique “interior,” excited to serve as a physician in the near future.
The Healer’s Art 2023 ◆ 17 Essential Workers Elif Kolanci, MS3 Summer 2023
18 The Healer’s Art ◆ 2023 study spot Jenna Kanner, MS3 Watercolor markers
The Healer’s Art 2023 ◆ 19 get well soon Jenna Kanner, MS3 Watercolor markers
20 The Healer’s Art ◆ 2023 Corner Window Dominic Ventimiglia, MS4 Spring 2023
The Healer’s Art 2023 ◆ 21 Sketchbook Nicol Tugarinov, MS3 and Marquis Berrey, MS3 --Grandfather! Grandfather! What are you doing? --I’m sanding, polishing, mitering, son. See these grains? --But why? --It’s my business, son. Look here – doesn’t this picture look beautiful? --Did you paint the picture, grandfather? --No son, that’s not mine. But it is pretty. --What’s yours then? --The frame is mine. See the fine joinery, the glint edges? That’s my work, the craftsmanship. --The picture is pretty. --Then I’ve done a good job, son. --Wait, don’t you want people to say the frame is pretty too, grandfather? How will people know you’ve done a good job? --You ought to notice the picture first, not the frame. If the frame overshadows the picture, then I’ve done a bad job. What’s important is that the frame serves the picture and brings out its qualities. --But all the work you put in, people won’t know! --When these hang in my shop and people say what a lovely picture! then I know I’ve done right. Our art takes skill practiced alone. So I put the work in now – lonely, tiresome, repetitive, and fine-tuning – and the polish and shine will serve the greater purpose later. --Well, the picture is pretty, grandfather. Digital Art
22 The Healer’s Art ◆ 2023 Daily Dose of Art Euna Cho, MS1 I have developed a digital platform that integrates artwork with self-reflective questions, aiming to evoke feelings of calmness and provide stress relief. The purpose of this project is to increase accessibility to the artwork through the use of digital media, particularly for individuals with limited time to visit art museums (e.g., busy medical students who have a strong interest in appreciating the arts despite their limited time). Additionally, the project aims to motivate people to engage in introspective questioning within a low-stress setting while simultaneously engaging with the arts. This project was built upon my literature review titled “Benefits of Art for Self-Expression & Reflection in Medical Education,” which emphasizes the impact of art on emotional management (Bushe et al., 2020; Hajar, 2019; Jones et al., 2017; Lyon et al., 2013), intellectual growth, and communication competency (Kirklin & Meakin, 2003; Lutz et al., 2016). Curating my personal art space with photographs I have taken brought back memories of art gallery trips, making this project hold a special place in my heart. >Follow @eunasartgallery on Instagram for art meditation! >Slideshow description of the project: https://docs.google.com/presentation/d/1Vh8vvWnx1Uzsq6r3Fri60iFXCnr2J-vuxrbElmybeaI/edit?usp=sharing
The Healer’s Art 2023 ◆ 23 Wings of Freedom Toan Bui, MS1 Summer 2023 Symbolizing medicine’s inherent humanism, the bird defiantly escapes from a cage constructed of words representing the darker aspects of medicine: discrimination, hatred, bigotry, abuse, and more. By embracing humanism in medicine, we shatter the chains that hinder its transformative potential, allowing it to soar and bring healing to all.
24 The Healer’s Art ◆ 2023 Pawsome Pals: A Collage of Our Furry Study Buddies Christine Wan, MS1 Baya MooMoo Lunamittens Cosette Yogi Remi Elsa Leia Petra Cordier Luigi Nugget Beni Lancelot Charles Fox Chance Mochi Mila
The Healer’s Art 2023 ◆ 25 Kaleidoscope Quilt Alexis Vetack, MS1 August 2022 - May 2023; 100% Acrylic Yarn. Measures 54” x 64”. Total time: 50+ hours “I love making blankets because I find the repeating pattern soothing. The bright colors brought me joy after staring at Anki cards each day. I love how big the project becomes and that when I look at this project in the future, I will think of my time as an M1.”
26 The Healer’s Art ◆ 2023 B’more vibes Jason Zhou, MS1 ‘5/21/23; Digital art My girlfriend and I collaborated on this together :)
The Healer’s Art 2023 ◆ 27 Stitches Rose Pagano, MS1
28 The Healer’s Art ◆ 2023 Nature is Healing Kimia Abtahi, MS4
The Healer’s Art 2023 ◆ 29 Untitled Dr. Muhammad Huq, Faculty
30 The Healer’s Art ◆ 2023 2022 In A Nutshell Aldanah “Dana” Althwanay, PGY2 My piece showcase the beautiful transition between seasons expressed by our nature collected through the year of 2022 amid training. It implies that we should all slow down and look around us to see how nature celebrate change. Those photos were taken throughout the year of 2022 and they showcase the beautiful transition of seasons expressed by our nature. This demonstrates that the only constant of this life is change! And that 1 year can add a milestone and be a turning point for you. December 2022; Digital
The Healer’s Art 2023 ◆ 31 Written in reply to “Perspective” Isha Darbari, MS4 Class of 2023 White Coat Reflections, p. 32. (Sept 7, 2019) https://online.anyflip.com/emjv/yfek Dear lil (M1) Isha, Firstly, I hope you can take the time to acknowledge how far you’ve already gotten. Although at times you may doubt it, you are here and in medical school for a reason. We all have our own strengths—in time you will discover, and in some cases intentionally develop, traits you would have once thought impossible. Just continue to find the lessons in each experience and treasure the time you have right now to focus on yourself and who you want to be. You’re right, it can be hard to remember the big picture sometimes. Believe it or not, even on rotations, it can still be easy to get caught up in evaluations or studying and forget that many families are going through some of their toughest life-changing experiences. Continue to pause, be present, and look for those moments that remind you of the shared human experience, then reframe your attitude to match. It’ll take intentional effort, but you’d be surprised how impactful a goal like talking to one single patient about life for 2 minutes each afternoon can be. It was funny reading your reflection as I embark upon residency (no spoilers— but I think you’ll be pleasantly surprised where you end up living :P). I know at times it seems like everyone has it all together, but really the journey of growth truly never stops. Not in a daunting way; rather, we’re lucky to be in a field that encourages us to continuously seek knowledge, empathy, and humility. Just keep focusing on how to increase the love to yourself and the community more, and the grades, evals, etc will follow. And regardless, test scores and timelines are not what define your worth (nor residency applications :P). P. S. You’re still friends with that smiley M1 you referred to. In fact, you both just came back from a classmate’s wedding, along with your other bestie who wrote the original entry alongside yours! I have a feeling you’ll continue to be great friends with many of the amazing classmates you met for years and years to come :) Tldr: still feeling very grateful, and ready for this next chapter of the journey! Love, (Soon to be PGY1!) Dr. Isha
32 The Healer’s Art ◆ 2023 The Creative HeArts team invites you to visit the online bookcase to view all of the publications, “The Healer’s Art” and “White Coat Reflections,” created by students of The University of Maryland School of Medicine. SCAN ME!
Copyright © 2023 All rights reserved. No part of this publication may be used, reproduced, edited, stored, or transmitted in any manner whatsoever without written permission from the publisher and authors of original works. Published August 2023 Printed in Maryland, USA Any donations to the Creative HeArts team go towards programming and future publications. fifffflffifl© ffl ffl fi