Docs, Nurses Learn Art of Medicine

How do doctors and nurses get better at diagnosing and assessing patients? Some take a trip to the Art Institute. Through a program called "The Discerning Eye,'' developed in 2005, hundreds of medical personnel have used the museum's vast collection to hone their observational skills, peering at paintings and sculptures to look, as instructor Sarah Alvarez put it, "outside the frame.''

Similar programs elsewhere have shown positive results. Researchers say that young medical professionals often are reluctant to trust their observations. That can lead to more expensive laboratory tests.

Rhonda Blender, a director at the University of Chicago Medical Center nursing program who developed "The Discerning Eye" with Alvarez, said many nurses drop out of the profession in their first few years, often because they don't trust their assessment skills.

"I don't care if you don't know a Monet from a Picasso,'' Alvarez said recently, beginning a three-hour class for about a dozen U. of Chicago nursing students. "I want you to have an open mind.''

Here's what the group looked at:

• A Flemish artist Frans Snyders painted an Antwerp marketplace in the early 1600s, presenting a riot of images that included an eviscerated deer, a trio of slumping rabbits, an open-mouthed boar, a string of dead birds and a slack-necked goose. Think of it as an emergency room -- on a very busy night, Alvarez said. "What happens when you walk into chaos?'' Alvarez asked. "Assess the whole situation before you make decisions.''
• Five panels painted in 1806 by Francisco Jose de Goya y Lucientes shows the capture of a Spanish bandit named El Maragato by a monk, Pedro de Zaldivia. In each painting, body language changes -- the bandit goes from the aggressor to the defeated; the monk goes from cowering captive to triumphant captor.
• Chicago area native Ivan Albright's "Ida" certainly doesn't look healthy. The rheumy woman in "Into the World There Came a Soul Called Ida" has not aged well. Diagnosis, class? "She's been rode hard and put away wet,'' said nursing instructor Randy Ball, before adding that Ida's leathery skin might indicate renal problems. One nurse notices a cigarette in Albright's picture. "A chronic lunger,'' she says. Ida's purple and blotched skin might indicate low platelets, says another. Varicose veins, balding, eczema, dermatitis were other suggestions. Her dusky skin might indicate a possible heart condition.

Like many paintings in which the artist has reused the canvas, a story might be found by looking beneath a patient's skin, Alvarez said.

One lesson: the artist is telling a story non-verbally. "If we're going to talk about being a good observer, it's hard to beat an artist,'' Alvarez said.

Another lesson: "Non-verbal communication is huge."

Source: Chicago Sun Times, Andrew Herrmann, 9/2/8