Art, Medicine, Edema

Introduction

As a locum tenens neurologist, my day at Hennepin County Medical Center is rigorously problem focused. First thing in the morning, the residents describe the essential details of each case. Presentations begin with the patient's symptoms and physical examination findings, followed by innumerable laboratory and radiology test results. Treatment options depend upon our interpretation of the data.

Data Analysis and Therapeutic Algorithms

For example, a patient who complained of sudden right-sided weakness and difficulty speaking might have a brain tumor, bleed, or stroke in the brain's left hemisphere, among other possibilities. Neuroimaging with a CT or MRI would likely discern the etiology. Therapeutic options, always limited in neurologic disorders, depend upon the patient's age, comorbid disorders, and wishes. Each day is all about data collection, analysis, and the decision-making algorithms that follow.

Avoiding the Black Hole

To veer into the emotional context of our patients risks getting lost in a black hole of despair. Every patient could appropriately be described as "unfortunate," whether it is a 28-year-old woman with a brain tumor, a 65-year-old man with a stroke, or a 37-year-old man with HIV and meningitis. Dwelling on their misery would accomplish little. The best way for us to address these life challenges is to offer encouragement, compassion, and competence.

Color Guide

Situated in downtown Minneapolis, Minnesota, Hennepin County Medical Center consists of an amalgamation of multiple buildings. Like many modern hospitals, it has grown without grand design. Impromptu bridges and tunnels connect adjacent structures, and new buildings have sprouted where space allowed. Color codes guide visitors and staff, as it's often unclear where one building ends and another begins.

Most of my patients are in hospital wards in the purple and orange buildings. An elevated walkway over Chicago Avenue joins these two buildings, and my team traipses from one to the other several times a day. The view through the tinted windows reveals a corner of the massive US Bank Stadium and an unwelcome billboard advertising a malpractice attorney's services. The hallway wall is an ever-changing gallery of photographs or artwork, but we rarely pause our work for such diversions.

An Oasis in the Hospital

One day, a picture on the wall caught my attention. It was part of an exhibit by Anita White, "Drawing Through Crisis With Courage and Humor." The title captured the spirit of the images. Anita White's husband had chronic lung disease and required multiple admissions for life-threatening emergencies. Her response? Create a "mobile studio" and graphically record her husband's medical journey from the bedside. She explains why in her artist's statement:

As a documentary drawer my sketchbook was always open and my pen was ready to draw in the moment. Through drawing my way through ambulance rides, ER and many hospitalizations I sought to bear witness to Josh's medical challenges, to honor those who helped us and to seek out the Divine Hands that are always there. It was a tough journey and I found once again that "Nothing is So Scary You Can't Draw It!" Drawing helped me keep track of the facts and allowed me to navigate the deep philosophical waters one comes to with medical uncertainties and crisis.

I contacted her to learn more. After 6 months of this medical odyssey, her husband improved and settled into weekly follow-up visits. She wrote in an email, "I continue caregiving my brother and husband. The word I also relate to is 'Shomer,' which is Hebrew for the one who watches over, or guards. I see a loved one's body, soul and spirit as they endure tough times."

Conclusions

My pace between the purple and orange buildings slowed during the weeks Anita White's drawings graced the long corridor. The colorful images were inspirational and comforting. Inspirational because they documented a spouse's bravery, optimism, and love. Comforting because they illustrated the resilience of the human body and the possibility of a patient's recovery. The artwork offered an uplifting reminder that my residents and I did much more than gather facts and apply algorithms. It couldn't always be seen, but we were part of every picture.

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