It is not widely known that the analysis of psychoanalysis and
psychology is a developing field of study. One which covers the topics of
empathy, consciousness, subtle interactions and topics of interest to
people wishing to increase awareness is on line through the Coursera
Network, see Title above. It is a serious study of the history of
mysticism and religion and it's influence through the practices of various
school...
It is not widely known that the analysis of psychoanalysis and
psychology is a developing field of study. One which covers the topics of
empathy, consciousness, subtle interactions and topics of interest to
people wishing to increase awareness is on line through the Coursera
Network, see Title above. It is a serious study of the history of
mysticism and religion and it's influence through the practices of various
schools of thought such as Kaballa or Christianity and Communism on
psychology. The Coursera Courses are free on line through the MOOC Network
which is a network of universities running courses globally as part of an
ethical approach to providing higher education to anybody with access to a
computer. One huge advantage to studying the course is that individuals
with high degrees of scholarship and knowledge also input through open
forums. The degree of empathy and integrated thinking by individuals from
many backgrounds and disciplines is extremely interesting.
We are impressed by Dr Jeffery and colleagues' innovative styles of
medical education in the context of communication skills, self-awareness
and ethical thought1. However, it is difficult to be convinced that short
theatre workshop alone would affect the same results across an entire
cohort of medical students for reasons we will detail here. The module
does however offer a refreshing method in critically engaging studen...
We are impressed by Dr Jeffery and colleagues' innovative styles of
medical education in the context of communication skills, self-awareness
and ethical thought1. However, it is difficult to be convinced that short
theatre workshop alone would affect the same results across an entire
cohort of medical students for reasons we will detail here. The module
does however offer a refreshing method in critically engaging students in
the complexities of the patient-doctor relationship.
A primary limitation in this study is that selection of the SSC drama
module was voluntary. The students who have chosen this drama module are
therefore not likely to be reflective of the medical student population in
general. In addition the numbers participating are small, with only nine
students across two years of enrolment, two students of which had
expressed the option to be "a mistake" or their "last option". This
highlights underlying obstacles to participation which have not been
explored in the context of this article; the ability to engage medical
students in what many regard as "soft skills" in comparison to other areas
of their curriculum. Furthermore the article details that within this
arguably atypical group, the primary concern on the first day was that of
assessment criteria. This is reflective of the pervading culture of
medical schools which is often focused towards passing exams. Therefore in
this case formal assessment may guide input and direct student learning to
that which students feel will impress the examiner. It is therefore very
difficult to make objective assessments on what the students gained
without subjective bias of the module convenors.
We feel this SSC module is a step forward in addressing this deficit
within medical education and in a new and enjoyable way. It starts a
process of critical thinking amongst the students which if, as the author
recognises, can become embedded in clinical practice, will benefit both
patients and doctors alike. We believe the focus on increasing self-
awareness in this module should form part of the mandatory curriculum.
Medical schools as an institution thus need to adopt anthropological
approaches, whereby they cultivate young doctors who consider social
relationships, cultural norms and the micro and macro politics that
influence health and well-being and the experience of illness.
1.Jeffrey E, Goddard J and Jeffrey D (2012). Performance and
palliative care: a drama module for medical students [in] Medical
Humanities, (38), pp110-114.
I was pleasantly surprised when I read your article highlighting the
need for role of Theatre in Medical Education. I have been conducting
Theatre workshops to teach complex medical topics over the last couple of
years and wanted to share with you the work that has gone in so far.
Please have a look at my website www.medicaltheatre.com
to have a feel of what we have been doing. Our current...
I was pleasantly surprised when I read your article highlighting the
need for role of Theatre in Medical Education. I have been conducting
Theatre workshops to teach complex medical topics over the last couple of
years and wanted to share with you the work that has gone in so far.
Please have a look at my website www.medicaltheatre.com
to have a feel of what we have been doing. Our current focus is to improve
education on pain.
Ian C. M. Williams' article on the use of comics as a suitable medium
for medical narratives is a timely evaluation of the potential of the
comicbook form to address several medical issues. For a medium that is
roughly over a hundred years old (although some scholar might argue that
comics had their roots in the inception of printed cartoons, whereas
others trace back their origins as far as the Bayeux Tapestries or even...
Ian C. M. Williams' article on the use of comics as a suitable medium
for medical narratives is a timely evaluation of the potential of the
comicbook form to address several medical issues. For a medium that is
roughly over a hundred years old (although some scholar might argue that
comics had their roots in the inception of printed cartoons, whereas
others trace back their origins as far as the Bayeux Tapestries or even
prehistoric cave paintings), comics have surely evolved in content,
variety of subject matter and format. As noted, comic studies are
relatively new, but a number of books have been published, there are post-
graduation courses focusing in comics theory (as the one offered by Opet
in Curitiba, Brazil) or literary studies of comics (as the University of
Dundee's, Scotland, that began last year), theses, Manchester's University
International Comic Conference and even two peer-review periodicals;
Studies in Comics and The Journal of Graphic Novels and Comics.
As a practicing neurologist and life-long comics reader I had the
opportunity to present last year at the 29th International Epilepsy
Congress a poster based on Joshua Hale Fialkov and Noel Tuazon's graphic
novel Tumor entitled TUMOR - A GRAPHIC NOVEL REPRESENTATION OF
GLIOBLASTOMA MULTIFORME AND MULTIPLE SEIZURES TYPES. This is the story of
a private detective who is diagnosed with GB, while solving his last case.
A variety of seizure types and other symptoms, such as confusional state
and space-time disorientation are presented in graphic form from the
standpoint of the main character/patient, providing a layman's
interpretation of seizure semiology.
Again, as mentioned in William's article, comics provide a rich
source of material for medical studies. Even the so-called mainstream
comics have featured characters with multiple medical conditions, such as
Barbara Gordon's spinal injury in The Killing Joke, which ultimately led
her to become the paraplegic heroine Oracle; David Lapham's Young Liars,
where the main female character suffers a bullet wound to the frontal lobe
and looses impulse control; or Sue Dibny's death in Identity Crisis as a
result of a brainstem stroke caused by the murderous Jean Loring's
stepping over her basilar artery in microscopic size.
Also, several characters are Medical Doctors, such as Marvel's Doctor
Strange, Gotham City's Dr. Leslie Thompson, the X-Men's Dr. Cecilia Reyes
or JSA's Dr. Mid-Nite. There will be more articles on the interaction
between comics and Medicine in the coming years for sure.
We thank Dr. Ntanda for his interesting remarks, but we disagree with
them. We think temporal lobe epilepsy is the most plausible diagnosis
because Chopin had paroxysmal crisis as he was disconnected from reality.
Sand and Mme Streicher narrated it quite precisely. To the best of our
knowledge he had neither alteration in his mental status, nor problems
in orientation, nor cognition deficit, thus a confusional state see...
We thank Dr. Ntanda for his interesting remarks, but we disagree with
them. We think temporal lobe epilepsy is the most plausible diagnosis
because Chopin had paroxysmal crisis as he was disconnected from reality.
Sand and Mme Streicher narrated it quite precisely. To the best of our
knowledge he had neither alteration in his mental status, nor problems
in orientation, nor cognition deficit, thus a confusional state seems not
a good option. On the other hand, synaesthesia is a quite simple process
in wich a sensory stimulus produces a normal sensation in the stimulated
sensory pathway and the stimulation of other sensory pathway. The
synaesthetic sensation appears automatically, like a reflex, and it is
always the same within each synaesthete. Chopin had complex visual
hallucinations, not the perception of colours when he was playing;
moreover, he had other symptoms consistent with epilepsy during the crisis
such as piloerection, fear, paleness, and sweating. A lot of gifted artits
were synesthetes: Rimbaud, Baudelaire, Scriabin. Rimsky-Korsakov,
Messiaen, Kandinsky, to quote a few.(1) (2) Chopin was not one of them. It
is true that synaesthesia could be secondary to temporal lobe epilepsy,
but we do not know of any account of Chopin complanining about it
throughout his whole life.
(1) Marti i Villalta JL. Musica y neurologia. Barcelona: Lunwerg.
2010.
(2) Mulvenna CM. Synaesthesia, the arts and creativity: a neurological
condition. In Bogousslavsky J, Hennerici MG (ed): Neurological disorders
in famous artists. Part 2. Basilea: Karger. 2007.
I read with interest Caruncho and Fernandez postulation of Chopin
possibly having temporal lobe epilepsy, and resultant complex
hallucinations.
I was struck by a few other explanations which could account for these
bizarre phenomena. He was in a state of poor health, and could have had a
few subacute confusional state in clear consciousness.
Secondly it is not uncommon for truly gifted people such as Chopin to have
synaes...
I read with interest Caruncho and Fernandez postulation of Chopin
possibly having temporal lobe epilepsy, and resultant complex
hallucinations.
I was struck by a few other explanations which could account for these
bizarre phenomena. He was in a state of poor health, and could have had a
few subacute confusional state in clear consciousness.
Secondly it is not uncommon for truly gifted people such as Chopin to have
synaesthesia, a a process in which one type of stimulus produces a
secondary, subjective sensation( for example when some color evokes a
specific smell)What could be in favour of this is considering that in some
of the accounts these events happened while he was playing music.
What isn't in doubt was that these "hallucinations" did not impede him
from being one of the greatest musicians of all time.
We thank van Bodegom and Engelaer for their interesting letter. They
pose a fundamental philosophic and practical issue in modern medicine:
causation. Nevertheless, we did not intend to elaborate a causal network
of the diseases of Chopin. Our aim was to find an explanation to a few
biographical accounts of the composer and make a retrospective clinical
diagnosis. Our diagnostic guess is a syndromic one as we can't provi...
We thank van Bodegom and Engelaer for their interesting letter. They
pose a fundamental philosophic and practical issue in modern medicine:
causation. Nevertheless, we did not intend to elaborate a causal network
of the diseases of Chopin. Our aim was to find an explanation to a few
biographical accounts of the composer and make a retrospective clinical
diagnosis. Our diagnostic guess is a syndromic one as we can't provide any
causal diagnosis.
We do believe that Chopin suffered from temporal lobe epilepsy, but we do
not know of any clue to conclude if his epilepsy was primary or secondary.
We do not know if he could have had febrile convulsions during his infancy
or childhood, or an arteriovenous malformation, or mesial temporal lobe
sclerosis, or any other cause of secondary epilepsy, and we will never
know. Notwithstanding, we know of some possible seizure triggers, such as
fever, late nights, playing difficult music, and so on.
We agree with van Bodegom and Engelaer that a single cause of disease is
not appropriate for explaining most of the human diseases. Chopin suffered
from other diseases that ultimately caused his death. Analising his health
status and the relationship among his sufferings is an interesting topic,
but it was not the aim of our article.
One of the best episodes (and probably most shocking to thousands of
people of all ages)of a medical programmes in UK dealt exactly with the
need to reassure people about the huge variation in genitalia. Shocking
because genitalia are so taboo that a penis still cannot usually even be
shown on TV. The programme continues to run a web site so that people can
see different genitalia for themselves and also to share experi...
One of the best episodes (and probably most shocking to thousands of
people of all ages)of a medical programmes in UK dealt exactly with the
need to reassure people about the huge variation in genitalia. Shocking
because genitalia are so taboo that a penis still cannot usually even be
shown on TV. The programme continues to run a web site so that people can
see different genitalia for themselves and also to share experiences and
worries . It simply does not work for healthworkers to assume it is
reassuring to somebody being examined that they 'have seen hundreds of
them, it means nothing...' when there is such a strong taboo about
exposing private parts of the body. This programme gave people of all
ages the chance to look at real human beings who were at ease with their
different bodies including their genitalia. It is to be expected that
reactions would be different and they did range from shock, disgust,
curiosity, embarrassment to positive acceptance and healthy interest
instead of secretive voyeurism or anxiety. It was also the case though
that even after seeing how much variation is normal, many youngsters, boys
and girls,preferred a cosmetically enhanced version of the stereotypical
most ideal bodyshape to variations on that,including a majority preference
for certain size and shape genitalia. Some would still choose surgery to
conform. Hopefully when the issue is so complex, as many healthworkers as
others will access the programme and web site as well as using what are
often rather dehumanising descriptions or photographs of parts of bodies.
The doctors who ran the programme are to be congratulated for breaking the
taboo which causes so much distress.
I would like to commend the authors for implementing an interesting
and pertinent educational programme on spirituality. As a primary care
doctor seeing patients in the Middle East, I am aware of the wide range of
complaints Muslim patients will attribute to spirit or 'jinn' possession,
ranging from infertility, to headaches, to depression and so on.
Our approach in dealing with such health beliefs in Muslim pati...
I would like to commend the authors for implementing an interesting
and pertinent educational programme on spirituality. As a primary care
doctor seeing patients in the Middle East, I am aware of the wide range of
complaints Muslim patients will attribute to spirit or 'jinn' possession,
ranging from infertility, to headaches, to depression and so on.
Our approach in dealing with such health beliefs in Muslim patients
must take into account that such beliefs are a core part of Islamic
teachings. Dismissing such concepts as superstition leads to discordance
between the doctor and patient. I am sure this is the type of theme you
cover in your course.
However a further question that wasn't explicitly addressed, is how
far do we go in challenging or sanctioning traditional spiritual
treatments that patients may wish to use? If a patient for example wants
to have the Quran read to him (a common traditional treatment for jinn
possession), is it the physician's job to discourage him from this? Can we
allow him to use such spiritual treatments alongside the medication we
prescribe?
If the answer is yes, on the basis that listening to the Quran will
not have any adverse effects on the patient, what about other treatments?
Cupping (blood letting) is another popular alternative therapy that has
been specifically recommended in Islamic texts. Where do we draw the line?
I would welcome feedback from the authors on this topic, as I feel
this is an important discussion that will have bearing on the practice of
many physicians across the world.
Please note author's change of email address.
Conflict of Interest:
None declared
It is not widely known that the analysis of psychoanalysis and psychology is a developing field of study. One which covers the topics of empathy, consciousness, subtle interactions and topics of interest to people wishing to increase awareness is on line through the Coursera Network, see Title above. It is a serious study of the history of mysticism and religion and it's influence through the practices of various school...
We are impressed by Dr Jeffery and colleagues' innovative styles of medical education in the context of communication skills, self-awareness and ethical thought1. However, it is difficult to be convinced that short theatre workshop alone would affect the same results across an entire cohort of medical students for reasons we will detail here. The module does however offer a refreshing method in critically engaging studen...
Dear Dr. Kohn
I was pleasantly surprised when I read your article highlighting the need for role of Theatre in Medical Education. I have been conducting Theatre workshops to teach complex medical topics over the last couple of years and wanted to share with you the work that has gone in so far.
Please have a look at my website www.medicaltheatre.com to have a feel of what we have been doing. Our current...
Ian C. M. Williams' article on the use of comics as a suitable medium for medical narratives is a timely evaluation of the potential of the comicbook form to address several medical issues. For a medium that is roughly over a hundred years old (although some scholar might argue that comics had their roots in the inception of printed cartoons, whereas others trace back their origins as far as the Bayeux Tapestries or even...
We thank Dr. Ntanda for his interesting remarks, but we disagree with them. We think temporal lobe epilepsy is the most plausible diagnosis because Chopin had paroxysmal crisis as he was disconnected from reality. Sand and Mme Streicher narrated it quite precisely. To the best of our knowledge he had neither alteration in his mental status, nor problems in orientation, nor cognition deficit, thus a confusional state see...
I read with interest Caruncho and Fernandez postulation of Chopin possibly having temporal lobe epilepsy, and resultant complex hallucinations. I was struck by a few other explanations which could account for these bizarre phenomena. He was in a state of poor health, and could have had a few subacute confusional state in clear consciousness. Secondly it is not uncommon for truly gifted people such as Chopin to have synaes...
We thank van Bodegom and Engelaer for their interesting letter. They pose a fundamental philosophic and practical issue in modern medicine: causation. Nevertheless, we did not intend to elaborate a causal network of the diseases of Chopin. Our aim was to find an explanation to a few biographical accounts of the composer and make a retrospective clinical diagnosis. Our diagnostic guess is a syndromic one as we can't provi...
One of the best episodes (and probably most shocking to thousands of people of all ages)of a medical programmes in UK dealt exactly with the need to reassure people about the huge variation in genitalia. Shocking because genitalia are so taboo that a penis still cannot usually even be shown on TV. The programme continues to run a web site so that people can see different genitalia for themselves and also to share experi...
I would like to commend the authors for implementing an interesting and pertinent educational programme on spirituality. As a primary care doctor seeing patients in the Middle East, I am aware of the wide range of complaints Muslim patients will attribute to spirit or 'jinn' possession, ranging from infertility, to headaches, to depression and so on.
Our approach in dealing with such health beliefs in Muslim pati...
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