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"The Healer's Art" combats student and physician burnout

Medicine involves two complementary efforts—healing the injured or ill, and preventing the injury or illness in the first place. A new elective at DMS focuses on preventing an injury that many doctors suffer from in midcareer: a loss of their sense of self and of a feeling of purpose in the practice of medicine.

Called "The Healer's Art," and sponsored by Senior Advising Dean Joseph O'Donnell, M.D., the elective draws on the work of Rachel Naomi Remen, the author of Kitchen Table Wisdom and other books, the director of the Institute for the Study of Health and Illness (ISHI), and a member of the faculty at the University of California at San Francisco.

The course was offered at DMS in the spring of 2002 and will be repeated in the 2003 winter term. "We wanted to 'steal' from ISHI what they were doing," O'Donnell says. Dartmouth is in good company in doing so; in its "Best Graduate Schools" issue, U.S. News & World Report featured schools with programs like "The Healer's Art" that are trying to address the fundamental emotional issues of becoming, and being, a doctor.

The loss of the sense of why they chose medicine as a career usually besets seasoned practitioners, O'Donnell says, but the symptoms can appear as early as the first few semesters of medical school. DMS's course last spring brought together 11 faculty members and 44 students— drawn from all four years—in what O'Donnell calls a "discovery model that encourages honest and mutually respectful sharing of experience, beliefs, and personal truths."

Topics: Various topics are addressed in small groups, each of which has a faculty leader. The topics range from "sharing grief and honoring loss" to "allowing awe in medicine" and "caring for the soul."

"We ask the faculty members to talk about why they love medicine," O'Donnell says. The reasons are varied and often surprising. "Students and faculty alike have never heard it before." And talking about the grief and loss they have experienced in the course of becoming and being doctors helps both the faculty and students understand that loss is a part of life," O'Donnell adds. Sometimes their recollections are emotionally overpowering. "It can be about a 12,000- hankie performance," he says.

The demand for the elective, and associated continuing medical education courses, has been surprisingly high, O'Donnell notes, mirroring the experience at ISHI, which can accept only 20 to 25% of those who want to attend its programs.

Maybe a dose of preventive medicine—teaching students to deal with the emotional losses and sorrows of practice and to find joy in what they do—will help reduce the need for such programs in the future for those learning medicine today.

Megan McAndrew Cooper

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