Oh, true apothecary

That we would do we should do when we would, for this ‘would’ changes, says Shakespeare’s Claudius. In other words, do what you think you should when you think of it, or you may never do it…

It seems to me that Medicine has changed a fair amount since I retired. Not only has science advanced, but so has our way of looking at the world. Our way of framing a problem has expanded, and no longer totally excludes extra-Magisterial endeavours.

Boundaries, are dissolving -or at least being redrawn. Who would have thought that we might look to, well, spirit, as an aide de camp? Or exercise as a legitimate medication? I have written about the latter in an essay I published in 2015 about Quebec doctors’ ability to write prescriptions for exercise: (https://musingsonwomenshealth.com/2015/09/12/the-uber-obvious-in-medicine/) but I am pleased to see that the tradition continues -in Montreal, at any rate: https://www.smithsonianmag.com/smart-news/canadian-doctors-will-soon-be-able-prescribe-museum-visits-180970599

‘[A] select group of local physicians will be able to prescribe museum visits as treatment for an array of ailments… “We know that art stimulates neural activity,” MMFA [Montreal Museum of Fine Arts] director Nathalie Bondil tells CBC News. “What we see is that the fact that you are in contact with culture, with art, can really help your well-being… members of the Montreal-based medical association Mèdecins francophones du Canada (MdFC) can hand out up to 50 museum prescriptions enabling patients and a limited number of friends, family and caregivers to tour the MMFA for free…  MdFC vice president Hélène Boyer explains that museum visits have been shown to increase levels of serotonin, a neurotransmitter colloquially known as the “happy chemical” due to its mood-boosting properties. But creativity’s healing powers aren’t limited to tackling mental health issues; art therapy can also help those undergoing palliative care for severely life-threatening diseases or conditions, like cancer, or suffering from diabetes and chronic illness.

‘According to Boyer, the uptick in hormones associated with enjoying an afternoon of art is similar to that offered by exercise, making museum prescriptions ideal for the elderly and individuals experiencing chronic pain that prevents them from regularly engaging in physical activity.’ Of course, there is the usual exculpatory caveat ‘that the museum visits are designed to complement, not supplant, more traditional methods.’ But still, a step forward, don’t you think? It’s a recognition that there are more things in heaven and earth than are dreamt of in our philosophy, if I may slightly paraphrase Hamlet.

“Why do you always want to drag me along to these things, Julie?” I was sitting in the warm and welcoming sunshine on the magnificent array of stone steps of Vancouver’s Art Gallery when the elderly couple hesitated near the bottom. The man looked the worse for wear and was leaning on his cane, already out of breath. Both of them were bedecked in grey hair, but while the woman sported a cool red cotton print dress, the man seemed dressed for church -he was wearing a heavily creased brown woolen suit, a white shirt, and red tie.

She stroked the lapel of his suit, trying to smooth out some of the wrinkles perhaps, but more likely trying to get him to smile. “You need to get out of the house once in a while, Edward,” she said, and then gently touched his cheek. “Ever since you broke your hip, you’ve just been sitting on the couch…”

“It’s hard to get around, Julie,” he said, somewhat irritably. “And I don’t fancy letting everybody in the neighbourhood see me with a cane.”

Even from several steps above, I could see her roll her eyes. “Do you really think they care, dear? They’re not exactly glued to their windows waiting for you to come on stage, for heaven’s sake.”

He stared at her angrily for a moment and then shrugged when she failed to react. “I get tired easily nowadays, Julie,” he said in a husky sort of whine.

She reached out and grasped his hand. “You get grumpy easily, nowadays, sweetheart.” I could see her squeeze his hand reassuringly. “You haven’t been yourself since the operation, you know. And it’s not like you to be tired all the time.”

She seemed so earnest and caring, I could see his expression soften. Clearly, they’d been married for a long time. “Well, I…”

“Come on, Eddie we’re almost there,” she whispered loudly and winked at me when she saw me watching them.

“Well, I guess since we’ve already come all this way…” He shrugged and allowed her to lead him slowly up the steps past where I was sitting. “I just hope there’s some place to sit in there…” was the last thing I heard him say as they inched their way ever upwards.

I promptly forgot all about them as the sun warmed my face while I read the pamphlet about the exhibition on current display. I was looking forward to a lazy afternoon of wandering through whatever was on offer this time. I hadn’t visited since the Musqueam artist, Susan Point’s Spindle Whorl exhibition and I remembered standing transfixed, in front of the hypnotic, wheeled patterns of her Coast Salish art.

But the sun coaxed me into staying on the steps and watching the world amble past -on a warm day, the people outside are sometimes as intriguing as the art inside. I don’t know how long I sat there, but eventually the need for a coffee and a muffin roused me from my aerie on the steps, and I sauntered into the Gallery Café to see what I could find.

There was a table emptying inside, so I carried my tray over to it and sat down. I was just tucking into the muffin when I heard a familiar voice at the next table and recognized the two who’d been standing below me on the steps.

But Edward didn’t seem as grumpy now, and Julie was smiling from ear to ear. “Well, dear, what did I tell you?” she said, stirring some milk into her tea.

“You didn’t tell me I’d see the original painting of that reproduction we have hanging in the living room wall, sweetheart…” He gazed fondly at her for a moment. “It’s my favourite painting, you know…”

Her smile grew even wider, as if, of course she knew. “Surprise, eh?”

“I’ll say,” he said, his eyes alive and twinkling. “Maybe we could look around for some other paintings by him.” He reached across the table and fondled her hand.

“Well, there’s that place on Granville -you know, the one up near the hospital? They may have some reproductions,” she said, leaning over the table and stroking his cheek with her free hand. “Want to have a look tomorrow?”

“That’s a great idea, Julie.” He stared at his cane for a moment. “Maybe we could walk -it’s not that far, is it…?”

“No it’s not, sweetheart,” she whispered, and touched his cheek again. “No, it’s not…”

 

 

 

 

 

 

 

 

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The Art of Medicine

The purpose of art is washing the dust of daily life off our souls’, as Picasso said. I suppose he was on to something there, but I rather fancy Francis Bacon’s take on it: ‘The job of the artist is always to deepen the mystery’. The reproductions that hang on the walls of my office have certainly deepened mine –well, to be accurate, more the patients who comment on them.

Of course not all of my visitors even look at the walls; they’re often too fixated on describing their symptoms, and watching for my reaction. Trust is awarded or subtracted in the first few moments of an interview of course, but once the merit badges have been allotted, and rank assigned, their eyes often wander to more interesting things. For some reason, I can’t seem to monopolize their attention once they have decided to relax. But, of course, art is therapeutic as well -although perhaps less helpful for most gynaecologic conditions than some more hopeful alternative practitioners might wish.

And yet it does provide a certain continuity that my more regular customers seem to appreciate. Some of them have developed unusual affinities for, say, a certain painting hanging on a particular wall. Or the smile of a character in a photograph… I’d like to think that it is actually a recognition of my taste in art, my ability to select soothing yet interesting subjects that reflect my own philosophy of life. In fact, I think Janet, one of my more perceptive patients, described it best. She was biding her time as I struggled to fill out some laboratory forms for her. And to stay awake I suppose, she began to look around the office. I glanced up once, after trying unsuccessfully to correct an egregious mistake on the screen, and saw a puzzled expression writing itself on her face. When she noticed my attention, she immediately erased any traces of concern and replaced them with those of a frustrated teacher.

And then, when she saw my eyebrows raised inquisitively, she blushed as if caught in some secret and embarrassing act. “You certainly have a…” There was a moment’s hesitation as she rummaged desperately for a more neutral word than she was about to utter. “…An eclectic taste in art…” Her eyes inadvertently strayed back to a reproduction that I’d hung on one wall. It depicted two young girls standing side by side looking in opposite directions while only partially covered by some sort of blanket or quilt. Their faces were beautiful, although one looked a bit worried about something. I saw it as, I don’t know, youthful hope, or maybe the puzzle of growing up.

“I was just thinking of an art gallery,” she said, trying to smile -and yet I could almost see the ‘buts’ slinking in the shadows behind her eyes. I sat back, hoping for a compliment. Redemption. “But, you know…” Her eyes darted from one picture to the next like sparrows looking for a roost. “…They don’t seem to illustrate any particular theme. Nothing connects one to another…” She focused her attention on a large photograph of a man holding a baby and indicated her target with a nod of her head. “I mean, you have a man with a baby in this one –nice photograph, I suppose- but then, on the wall behind me, there’s the coloured line drawing of a peasant woman leading a horse…”

I’d never experienced a critique of my art before and I didn’t know whether to feel honoured, amused, or embarrassed. I chose embarrassed. “I…ahh… Well, they just seem to accumulate over the years. I mean, I didn’t choose them to illustrate a particular theme, or anything…”

Her face believed me, and her smile tried to plaster over any unpleasant criticism. It tried to exculpate me from my tasteless choices. Her eyes, however, no longer sparrows, were birds of prey and I could see her fighting with her need to be honest and yet not cast aspersions on me. On my world. On my ability to be her doctor.

“Maybe move the Woman with the Horse to the examining room and the…” She suddenly had second thoughts. “No, I don’t think the IUD picture would be suitable in here…” She closed her eyes for a moment, trying to reconfigure things in her head. “I like the smiling woman –it’s a Rosamund isn’t it?”

The drawing was on a far wall and I had to squint to see the signature. I couldn’t quite make it out, so I was forced to shrug. I mean, who looks at signatures?

“What about that green apple picture hanging in the hall..?” It was amazing how much she’d noticed. “No, actually it adds a light touch to the corridor –sets a mood, as it were.” Her eyes alighted briefly on one of my diplomas, flitted to me, then on to her lap when she saw me watching. I could see her trying to disguise a sigh. She was not successful.

She’d told me she’d come for a consultation on the menopause and yet she was aggressively adamant that she was coping perfectly well with The Change  -and she continued to insist this even under what I thought was careful questioning. Apart from a recent and bitter divorce, things were completely under control -better than they’d ever been, in fact. I glanced at my computer screen again, and then accidentally refreshed it, for some reason. There was now a note that my secretary had just added to the referral letter section -her doctor had faxed the information to me a few minutes before before. Janet had requested a second opinion when her GP had suggested she might need to go on hormone replacement therapy for her menopausal symptoms. She’d become enraged at his lack of judgement and his inability to keep up with the current medical literature. She wanted –no, demanded– to see someone who wouldn’t judge her on insufficient evidence and wouldn’t assume that her every foible was attributable to insufficient hormones. Apparently she’d suggested that he needed them more than she did. And he’d assumed she would neither give me an accurate history nor deliver the note he’d written.

She saw me scrutinizing the screen as I started scrolling through it, and a mischievous smile captured her immediately. “Still can’t find his referral letter?” she asked, with what was another uncamouflaged smirk after one more quick look around the room. “He gave me a hand-written letter in a sealed envelope for you…” I studied her expectantly when she decided to prolong the suspense; she was not a happy woman and I fully expected her to unleash the eyes again. “I don’t think he has a computer; and anyway I threw the letter away,” she added in answer to my unspoken question. “I read it, of course, but it was all nonsense.” Her lips parted slightly in what was either a broken grin, or more likely, a sneer. I could see her hands tighten into fists in her lap. “Never trusted the man,” she said, looking again at the two little girls in the picture. “No taste.” She turned to look at the Woman and the Horse on the wall behind her and then sighed loudly.Theatrically -no attempt at a disguise…“Unlike you…”

We both laughed, but I’m not sure at what. Or at whom…