What's the Point?

Arts and humanities in medicine with Professor Ian Fussell

Bryony Armstrong Episode 11

We tend to see medicine as a strictly scientific sector, but the arts and humanities are essential when it comes to educating our doctors and caring for patients and the planet. Doctor and Professor of Medical Education Ian Fussell joins me to talk about:

  • What is medical humanities
  • How and why we can use arts and humanities in medical education
  • The links between planetary health, medical health, and social justice
  • Why medical and scientific researchers need artists and humanities specialists
  • How the humanities helped the medical field during the Covid-19 pandemic
  • Medicine as an enabler of the arts and humanities

Find Bryony @BF_Armstrong
Find the pod @wtppod_
Find Ian at the University of Exeter Medical School

Artwork: Riduwan Molla https://www.canva.com/p/riduwanmolla/
Music: Madaan Mansij https://www.pond5.com/artist/mansij_tubescreamer

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.



Bryony Armstrong:

Hello, and welcome to What's the Point, the podcast where we discuss the need for arts and humanities today. I'm your host, Bryony Armstrong. We’re living in a time where the arts and humanities are under threat. And I know this firsthand, having studied both English and Math at university, and now doing a PhD in English. Each week, I'll be joined by a guest to talk about what arts and humanities do for the world. If you've ever wondered, what's the point of the arts and humanities, then this is the podcast for you. Hi, everyone, welcome back to What's the Point. My guest today is Professor Ian Fussell. Ian has worked as a doctor in Cornwall since 1990, and eventually became the deputy Medical Director for the region. He is also a professor of medical education at the University of Exexter where he is the Associate Pro Vice Chancellor for Education for the Faculty of Health and Life Sciences. Most importantly, for this podcast, he's an advocate for the use of arts and humanities in medical education, event medicine and planetary health. As we're about to hear, he's also a bit of a musician himself. I hope you enjoy the episode. So Ian, as a doctor, how did you become interested in the humanities?

Ian Fussell:

Yes, thanks for that question Bryony. It's a good question... because in fact, it was due to the humanities that I became a doctor at all. And that was... that was whilst I was back at school, which was... it was an inner city sort of comprehensive school in Bristol, actually, but there was a drama club. And... and I was part of that. And some of the teachers were involved with amateur dramatics, actually, you know, outside of the school, and in the summer used to take us down to the Minack Theatre in Cornwall, and we were extras in there sort of plays. I mean, it was amazing. We were at school going down to that place. And one time I met somebody there, in fact, she became my girlfriend. And her mum once asked me what my old level grades were, and I told her, and she said, with grades like that you could become a doctor, and she was actually married to a doctor. So that sort of set me on the path actually. So I've always... so funnily enough, that's, that's the kind of link and that link also led to me... spending well, really the majority of my career in the Southwest in in Cornwall, and you know, I now work in Exeter, but I still live I live down in down in Cornwall, which is, which is great.

Bryony Armstrong:

Yeah, you did it.

Ian Fussell:

I’ve always been interested, I've always sort of read widely, you know, sort of novels and so on and enjoyed art galleries and art. I'm a... I'm a musician. So I play music as well. So I've always sort of embedded the humanities very much in... in my life sort of naturally. So it seemed like a natural progression to try and bring that into my working life as well. That's awesome. What instrument do you play? Just out of I play... I play the guitar, and I play the bass guitar. And I've played in bands since I was at school, and I still do now. And... that's been wonderful, you know, that's given me…you interest.

Bryony Armstrong:

Yeah, I love that. Because it's like, we all know, some really interesting... and enjoyable sort of times. And want the doctors that we go and see to be rounded people who, you know, engage in art and culture and have sensitivities it still does. and can be personable as well.

Ian Fussell:

Well, we do, don't we, but what the danger is, of course, is that we value those attributes when... when we, when people come into medical school is stuff we like about people, but then the curriculums can get so crowded and so packed that the… you know, there's a risk that you don't tap into that, particularly during sort of medical school training. But... but we do do that, I do that at Exeter, which I can talk about as we go through the, through the interview.

Bryony Armstrong:

Yeah, yeah, please do. I was gonna ask, can you give us some examples of how you're now using humanities in medical education at Exeter?

Ian Fussell:

I suppose it might help to... define sort of the

Bryony Armstrong:

Yeah. And how do you do that? term medical humanities or health humanities, but I think I'll use the term medical humanities because we are

Ian Fussell:

How we do that? Yeah, so how do we do that? So talking about how we use it in a medical school. So... so this is a nice definition actually. So medical humanities is an interdisciplinary field that combines insights and methodologies from various disciplines including literature, philosophy, anthropology, history and the arts, to explore and enhance our understanding of healthcare, medicine and the human experience of illness. And that's a nice, a nice definition. So, you know, it really speaks to why we, why we value itself highly at University of Exeter Medical School. So it recognizes that medicine is not just a scientific endeavor, but also a So in year four, so medicine is a five year course. So in year deeply human one, which is influenced by social, cultural and ethical factors. So I think it helps to... to explore that a bit deep... a bit more deeply. So you can think of sort of medical humanities, as an academic discipline, for example, where you're... studying medicine history, for example, or the use of medicine in literature, or, you know, in in books and novels, or in art, you know, in sort of painting, sculpture, and so on. So we do that. Okay. So that's one of the sort of things that we do, and I'll tell you how we do it. But we can also think of... medical humanities as an activity, for example, looking at, you know, your scenes or art in Doctor surgeries, or in hospitals, and so on. So, so it appears in hospital, and in those sort of settings. And in the same... I four, compulsory and assessed... we, all students have to do suppose an extension of that is that art can be used as a therapy. Okay, so we see art therapy and like, it's like outside psychiatry, for example. It tends to be at the hard end of psychiatry, when a lot of other things have not worked. So it's a very challenging sort of field to be in. But of course, it's also an art therapy for doctors and clinicians. Okay, so... and I would say that for myself, you know, so being involved with music, for example, as we've discussed, is a very sort of therapeutic activity for me. And you will often find that a bit... well not often but you sometimes find people a bit cynical about all this sort of stuff yet, you know, you'll come to a weekend and this sort of hard nosed honestly a bit you know, it's a very generalists generalizing wrong statement. But for example, you might have a very sort of elderly surgeon who thinks this is all of that nonsense, but goes painting at the weekends, for example, but what we're really interested in, okay, at the University of Exeter, is how we can use the humanities to, to help in medical education. Okay, so help students become better doctors. And that harks back to what I said at the beginning, you know, by using sort of the arts and humanities to explore deep... more deeply into the human condition, and help develop sort of communication in so doing teamwork, empathy, professionalism, but most importantly, I think, is to develop students tolerance to ambiguity, okay, so that's a nice phrase to use. So, the way to sort of... try and describe that is that and I imagine you, if you can imagine to, I suppose that's not a good idea. So the best way, the best way I could sort of try and describe that is that... is that feeling of being out of your comfort zone, okay? Or, and being able to tolerate medical humanities special study unit. Okay, so this goes through that, okay? So tolerance to ambiguity is being out of your the entire year. And what the students do is they, they work comfort zone, and being able to manage that, and that's quite a with, with an artist, sometimes these are doctors but more often good skill to have as a doctor because things happen. You find they're people outside of the university that we you know, that we employ for this, this process. So they work in groups yourself in, in situations where you're definitely out of your of say four to six with an artist to create a piece of comfort zone. So what we what we like to do is, is try and work, okay. And then... it's assessed and it counts, okay? immerse our students into that, that field to understand that That's the first thing, okay? It's not an option. Everybody feeling and develop their coping mechanisms and their teamwork has to do it. And the really nice thing is that at the end of sort of attributes and so on. that sort of period of time, they, the students are then present their work at conference, okay, a student sort of.. a student conference, which is again assessed. So they're then standing up in front of their peers, sort of showing the work they've they've created, as well as write a short reflective piece. So we take it seriously. And I think that's, that's, that's the way way to really do this stuff is not to have it as a nice add on, but to really embed it into the, into the program. And then if you think about the four things I said about what, what that does, so, you know, some people, for example, do some anthropology or some looking at history, or literature and so on, sort of works very well. So maybe a reading group, for example, and so on, and people come back to things that they, they've lost their case, so, so they might not have read a novel since they had to do their GCSEs so they come back to it with a sort of mature perspective and so on. And I mean, I see students sort of grow up through that process, you know, in that year, sort of, is like the pen is dropping, in some ways.

Bryony Armstrong:

Yeah, I was gonna, I was gonna ask how students tend to react to it, like, do they... are they ever resistant at first, and they get into it?

Ian Fussell:

Oh yeah. Yeah, I mean, some people... I mean, I would say, almost without question... everybody really enjoys the experience by the end. Okay. I think some people engage in different in different ways. But, but it's a really positive experience. And the other really nice thing it does is it helps create a community of practice... for that group of students, which is a very important thing to have, as you go through a career, so you've kind of stood up and you've So it's a triangle, maybe. exposed yourself a bit really in front of your peers, who, you know, within a year, you're all going to be dispersed around the country, around the world but you've still got... got that, that thing that you can tap back into. So I run what myself, you know, I run one around music. And I love it. Okay, so I do this with a friend of mine, who's a music teacher and a drummer. And we get students to form a band... write some original material, record it, and then perform it in front of their, their, their, their, their peers. So it sounds like on the surface of it, you think about what's that got to do with medicine, it's got everything to do with with teamwork, getting out of your comfort zone, standing up... I don't know, you know, all those all those things. It really, really does that. And, you know, I've got got lots of examples. I mean, the example the band we've got going right now is a good example, actually, because we had... three students. One of the students was a decent drummer. The other two students, they're both, both... men really had no musical sort of talent. They wouldn't like me saying that. But one could play the guitar a bit. The other one could play nothing, okay. Chris and I thought, thought we've got our work cut out here because we normally ask people to come in that can play something and then we can work with something, anyway, so that these two became the singers. Okay, so Chris, and I then became the guitarist and basis backing band with the drummer. And I thought I wouldn't how this is gonna go. So one is a little into, one is the... one was an international student, so so he's not that singer. So he came on, and he sang, and they wrote lyrics. And then the other the other chap, wrote a rap, which was absolutely brilliant. You know, it was amazing. So now, in fact, that's coming up quite soon. Next week, we'll perform that that that song which he's write. So for those two students, you know, they're they're standing up, they're not singers, they're not musicians, but they're standing up in front of all their, their peers, singing a song that they've written.

Bryony Armstrong:

Amazing. I'm envisioning School of Rock, but like the doctor edition. So cool.

Ian Fussell:

Yeah, that's what we call it actually, we call it Medical School of Rock.

Bryony Armstrong:

I love it. I love it. I know, this is so interesting to me, because actually, I'm based at Durham, and there is a big medical humanities department here that's brilliant. But I think my engagement with them and my thinking about medical humanities has always been, like you said earlier, reading out the definition, thinking about the human experience of illness, and from what I've seen and read that's been very, like patient centered, and I've never really thought in this way about the human experience of practicing medicine and humanities, in actually being a doctor, not just being a patient.

Ian Fussell:

Yeah, yeah, I think that's that's, that's, that's right. And again, you know, it's very interesting to study sort of humanities in the history of medicine and so on, but to actually really sort of embed yourself in it, and to do it is slightly... it's different, isn't it it's taking sort of a step on. But yeah, you're right... you know Darren's got a fantastic Medical Humanities department, as as as you say, but it's yeah, now we've, we're really lucky, you know, and we embedded this so early in the program as we were writing the curriculum. And we've kept it in there, you know, and it's highly valued. And it does give, it does give our students currency actually, you know, because it's interesting to talk about. So you know, they can bring it into... into sort of interviews, applications, and so on. And I've seen that over the years, it really helped people.

Bryony Armstrong:

That's really cool. And have you had feedback, specifically from students, who have then gone into working in hospitals and different practices and come back and said, actually, this is an example of I can see directly how this has helped.

Ian Fussell:

Exactly, yeah, I have enough... had some really nice things off the back of it. There's a, there's a really nice magazine called Bushi. Meow, I think it's called. And that was one of our ex students. And she's... she created this... I mean it's not online, but it's also a physical sort of magazine. It's really good, you know. And and, you know, when they when they released that they, she contacted me to say, really, this is off the back of the sort of inspiration we had around, around this. So we see things like that, like that come through, which is which is great. Just waiting for a really famous branch to come out of it.

Bryony Armstrong:

Yeah, totally.

Ian Fussell:

I also said about using its currency, I've had that sort of feedback from students as well that they bought that into... to introduce particularly for sort of academic sort of posts or clinical fellow posts where they're involved in teaching as well.

Bryony Armstrong:

Right, yeah.

Ian Fussell:

That's really well.

Bryony Armstrong:

Yeah, I mean, I've had a bit of teaching experience at uni. And I do honestly kind of see it as like, acting or being a stand up comedian like I, I can see how doing some kind of like music or drama will then really help you if you're going to try and explain concepts to other people. Yeah. Yeah, absolutely agree. So I know, you obviously do all this awesome work with medical education. But you also do a lot of work with planetary health.

Ian Fussell:

Yeah

Bryony Armstrong:

And working with, is it like COP26 and COP27, and the G7 Summit. So I wanted to if you just wanted to talk a bit about that, as well. And give me some examples of how humanities is coming into that.

Ian Fussell:

Yeah, I'd love to talk about that. Thank you for, for that question. So... I think, you know, the first thing to sort of understand really, is that this sort of planetary health, social justice, health...human health are all in you know, they're all linked, you know, so you can't really have one thing without the other. Okay, so. So, as health professionals have a responsibility around those, around all all, three things. So that's, that's one starting point there. I mean, the other point to really, to emphasize again, is what I've said already, really about the humanities, having a having a purpose for helping and the you know, helping understand the human condition and so on. So... so really, this this work in earnest for us started during the pandemic, okay, so when... where everyone's working at home, and we felt that there was, there might be something nice to do in that, in that space. So so so we, the Met Office, okay, is in Exeter, so we work quite closely with the Met Office, and I was supposed to summarize it, it would be, wouldn't it be interesting to get climate scientists writing poetry? Okay, so that sort of like, sort of gambit. So we, so we we thought, okay, well, let's create some workshops. So we put some workshops together. And we had, we had some health professionals in there, we had a lot of climate scientists. And we had some we... they were run by, by a woman called Sally Flint, who teaches on our master's in creative writing, and she's a writer, she's a published writer, so she ran these write... writing workshops that we invited people to come into, and it was just awesome. I mean, you know, it was, it was... everybody needed a dose of humanities, I think. The workshops were really, really good. And, and from that work, fell out some poetry, which then was word crafted by Sally and some other writers into 12, I mean the short poems. And so we had, we have an anthology, and we thought, what should we do with this? And so then we, I mean, it just, it just sort of snowballed from that point on. So in Glasgow, COP26 was in Glasgow and that's the first time there was a science pavilion in what's called the Blue Zone, which is sort of in the central part of the whole COP26, which is like a mega conference, if you see what I mean. So this is sort of set around the sort of inside sort of conference space. And... yeah, so we managed to get a slot to present this work. So for COP27, we did a similar thing. But this time, we brought more student voices in, including students from, from Egypt, from... the American University of Cairo, mainly actually. And we wrote short stories then, in the same sort of process. And we, again, we got those published in English and Arabic, so they were translated. So it got translation into, into into the frame then. So we've got we've got a really good translation team that sort of did all this work. And we... one of the third major outputs was from that actually, was the again, the American University of Cairo had an amazing sort of director drama there. Professor Adam Marple, his name is, and he, he adapted the stories into a, a play, which then they, I mean they... amazing work, they auditions of professional actors and so on. And they put this on, we went to Cairo to see it, and it was just unbelievable how, how, how good it was. And then the play went to COP27. And the other thing we did is we managed to employ a, an amazing cubic artist called Rana, Rana Hemdan from Alexandria. And she painted a sort of eight meter by 12 meter mural, in Alexandria on a wall... that we yeah Rana, she raised money for. And that became kind of like the... that was based on one of the stories actually, but that became one of the sort of visual themes through the, through the work for COP. Ah yeah, going back a step for COP27, we had quite a lot of local artistic sort of... ramifications as well. So there's also a performance in Exeter, but we also had some... workshops which...like, I think they were in the Exeter Museum. For the students a bit like embedding humanities into the program, I've managed to embed planetary health as another special study unit in year two. So all of our students now have to sort of do a small project and do some thinking around planetary health, for the reasons that I've said before, you know, that that, you know, health has an impact in in many ways.

Bryony Armstrong:

Yeah. And I just, I love the fact that it's, you're talking about taking things into schools and museums and onto the stage because like, that is how most people engage with huge concepts and huge issues like health and planetary health. And I was actually interviewing someone a few episodes ago, Ladan Cockshut about... sort of the, like artistic economy in the Northeast and she was saying like, if you defund arts and humanities, then you're not gonna have people coming through who can do things like translate a play or write a script or put something into a museum. So once people in the science realm want to start doing that and engage the public, there are, there won't be people to turn to if we don't have artists or humanities specialists.

Ian Fussell:

Exactly. Yeah, exactly. And that, that... well, I think you come on to that sort of question so later, so you know, to sort of summarize that, the whole point.

Bryony Armstrong:

Exactly.

Ian Fussell:

We're making a very good case here Bryony.

Bryony Armstrong:

The namesake of the podcast, exactly.

Ian Fussell:

Yeah, yeah.

Bryony Armstrong:

Yeah, I also just caught in my ear that you said that kind of grew out of COVID, as well, and, and being at home, because, obviously COVID is the biggest medical issue that has faced the planet in recent years. And I think having been through that pandemic, probably a lot of people would observe that and maybe claim that humanities don't matter at a time like that, and that the only thing that matters is, is science. If we can even separate the two, and I think you've made the amazing case that we can't. So kind of what's your... like what's your take on that from, from your medical perspective?

Ian Fussell:

Whether, I mean, we, we've sort of, sort of said that but the humanities helped us understand the impact don't it, the impact on individuals and communities and give us insight, you know, into the sort of social, cultural and historical sort of dimensions of a, of a pandemic. So, you know, it's, it's clearly not just the science which is getting the... you know, is, is, is doing that. It needs more than that. Because you, you have to sort of feel it don't you and understand it a bit that the, the humanities can can help us with that, and give us perspective, different perspectives, you know, ethical dilemmas, you know, perspectives on public health policies and so on. The psychological well being, and we're still seeing... the ramifications of that ongoing aren't we, sort of psychological well being of people was... was highly impacted. And, you know, the humanities can help sort of foster empathy, compassion... I suppose help foster a sense of collective responsibility, resilience, and so on, and help, help us recover. So, you know, it's essential that you, you cannot have them in the, in the, in the frame.

Bryony Armstrong:

Exactly. So going back a little bit to the fact that you play guitar, and you're very into music. I know that you also work in events medicine, I think, am I right in saying that you help organize some of the first aid at Glastonbury Festival. So I just wanted to ask a little bit about sort of your experience of humanities in relation to events medicine, and like your experience of doing that. And this, I think it's an awesome example of kind of arts and medicine coming together in that way.

Ian Fussell:

Yes, thanks. That's a brilliant question. Well, the the, the, the medical cover at Glastonbury, let's talk about Glastonbury actually is for reading as well, and a few others, but for Glastonbury, it's run by a company called festival medical services. So they've got the contract, and they've had it since the very first festival to provide cover. Okay, so and it's not just, I mean, it's serious cover. Okay, so, so there's like a hospital, effectively there with some sort of branch hospitals and there's, there's full resuscitation, you can the nice advise somebody there, there's X-ray facilities, there's dentists, psychiatry, ophthalmology, and so on. So... anyway, there's general practice as well. So you, you know, I've been on, I've worked at G lastonbury on a shift, which is, you know, I'm surrounded by, I mean, must be one of the sort of most highly qualified set of people in the country, you know, working in, in that sort of environment at you know, at that time. So, so you're with a bunch of sort of very highly qualified consultants who are all in to be at Glastonbury. Okay, so, or like being in Glastonbury, because it's a nice place to work. So so they run the, they run the the medical cover, but they, so that that will include paramedics, first responders, nurses, physiotherapists... chiropodists, doctors, radiographers, and so on. So it's a very big, big team, okay, it's a big, a big team. And I thought it would be good to try and bring our medical students into the first aid or first responder sort of space there... and we did it, you know, so, so it started in 2013. We took six students up there, that was the first time I went up as well. So I worked, the students at that time, just needing the first aid, that work qualification, which was very easy to get, and, and they worked as sort of First Aiders, you know, so, so we started then. This year, we've got, I think, we've got about 20 to 25 medical students go in plus four nurses, and they... they now get trained as first responders, so they get qualification...and they, they're, they're the people that are walking around with sort of backpacks that out in the field of radios, and so on. And, and, and deal with stuff sort of as it happens, and it can be, it can be very serious. I mean, a lot of it is not a lot of it is sort of, I've got a twisted ankle or some grit in my eyes, but it can be at the other extreme, where people are really in serious trouble. So it's a, it's a, you know it's a massive sort of learning curve and sort of learning experience for our students, doctors and nurses. So yeah, in a way, it's then bringing together sort of interests of mine, which are sort of music, and so on with with health and seeing if we could find find a sort of space for that to happen. It's a lovely environment to work in because... people are happy.

Bryony Armstrong:

Yeah

Ian Fussell:

People want, they want to get back to having a good time. So it's, it's a, it's a really refreshing way to, to, to work actually as a clinician.

Bryony Armstrong:

Yeah. I mean, it's, it sounds like a huge operation. And also yeah, I think it's really something to be remarked on the idea that people are happy because it's like, if, if medicine is there to keep us alive and it's to keep us alive and doing the things that we want to do, like going to see music going to see art, like, they really go hand in hand. Like you can't just cut off arts and humanities and say that only STEM and stuff and medicine matters because like people want to live, to go and see their favorite band. Yeah, exactly. Exactly. So you alluded to this a little bit. But yeah, just to... round things off. I, you know, this, but I am curious to hear sort of, from your perspective, how you've come up against some of the like defunding and devaluing of humanities that goes on and whether or not that concerns you if you've witnessed any of that at all.

Ian Fussell:

Yeah, it does, it does obviously concerns me, you know, for all the reasons that we've been sort of talking about today, but I suppose... I thought about this question. I like this question. So I thought I should try and summarize that into a sort of statement. I would say that that arts and humanities education fosters empathy, understanding, enabling scientists and healthcare professionals to better connect with patients and society and ultimately improving the quality of care and research outcomes. Okay, so, so that I think that summarizes, summarizes it really, really nicely. So, you know, we, if we want to really do... science and healthcare well, we have to understand the sort of, you know, the, the context in which we're, we're working, and humanities helps us do that.

Bryony Armstrong:

That's, that sentiment is everything this podcast is about. So thank you so much for that. And thank you so much for this conversation today. Thank you for coming on What's the Point. I've loved talking to you.

Ian Fussell:

Thanks Bryony. I've really enjoyed it too.

Bryony Armstrong:

Thank you for listening to What's the Point. If you enjoyed this podcast don't forget to subscribe. You can also find us on Twitter at wtppod underscore and send us a DM if you want to get in touch. We'll see you next time with a brand new episode.

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