Academic Medicine, Vol. 88, No. 7 / July 2013 921 Commentary Now in my final two years as a medical student, doing my clinical training at a large teaching hospital in Boston, I have left the books and classrooms behind and am seeing patients, working with my hands, thinking on my feet. The USMLE Step 1 exam was a gateway to this moment: Having proven ourselves on paper, my classmates and I have finally been allowed to don our business casual, our Danskos, our short white coats, and participate in the care of patients. Medicine has finally become a physical reality for us. I am referring both to seeing myself as a being actually capable of effecting change in the hospital and to understanding the reality of disease, manifested in the wrinkles, crepitus, hacking cough, and pain of my patients. The wards of the Brigham towers are a reification of Natasha Trethewey’s poem “Myth” from her collection Native Guard 1 : ... So I try taking, not to let go. You’ll be dead again tomorrow. The Erebus I keep you in—still, trying— I make between my slumber and my waking. It’s as if you slipped through some rift, a hollow. I was asleep while you were dying. Within their walls, patients almost-die, die, and sometimes live; we physicians and students have the privilege of intervening, in any way we can, when they are most vulnerable, most human. Within the span of just a single academic year, I have learned more about people— their biggest failings and their most powerful triumphs—and more about what true love looks like, about just- perfect and dysfunctional relationships, about forgiveness and redemption, than I grasped in the 23 years that preceded it. But my epiphanies are not unique; I share them with classmates, fellow medical students. We medical students represent a special demographic: We are insiders enough to understand the language of medicine, yet also possessors of all the innocence and idealism that characterize outsiders to the profession. Unfortunately, I’ve seen that these qualities are gradually lost as we advance in the profession, such that interns are more pragmatic, residents a mixture of pragmatism and cynicism, and attendings the least sentimental of all. This is not always synonymous with meanspiritedness; quite frequently, good intentions tempered with years of experience yield excellent clinicians. But I think my classmates would universally agree that, paradoxically, the further some people go in training, the more hard-hearted they become, 2 and the less they are able to understand the patient’s perspective in a clinical encounter. A brilliant classmate of mine, Shekinah Elmore, 3 wrote, in a JAMA essay titled “The good doctor,” about her experience receiving a diagnosis of bilateral breast cancer at age 27, during the summer before her first year of medical school. Having survived rhabdomyosarcoma twice before in her youth, she was familiar with the terrain of cancer, yet the new diagnosis still left her dazed. Shekinah, confronted with the possibility of never realizing her dream of becoming a physician, went to an empty examination room and sat alone, silently crying. She noted that the oncologist gingerly approached her assistant and quietly asked, “Why is she crying?” In her commentary, Shekinah writes that the “mechanisms of heartbreak and loss are not on the docket of our formal education.” She wonders at the oncologist’s loss of imagination that impaired her from connecting with her grieving patient, and she discusses the hidden curriculum that is inevitably responsible for eroding the empathy of physicians in training. I am part of a group of physicians and students from various hospitals around Boston who have come together because of our shared interests in not simply the humanities—including, among others, art, literature, and music—but especially in how these disciplines inform the art of medicine. Because we have all been positively impacted by our own extracurricular involvements in the arts, we see value in incorporating elements of them into the standard medical curriculum. To this end, we are canvassing the medical community for perspectives and input, and we Abstract This is a commentary in which a fourth- year medical student argues for the relevance of the arts and humanities and the need to sustain medical students’ exposure to these through the medical curriculum. She writes that the point of incorporating the visual arts, literature, music, and other arts into the curriculum is not necessarily to “teach” professionalism but, rather, to offer students a viable, lifelong tool to reorient themselves as they move along in their training. The advantages that the humanities offer are multifactorial: They offer a space for discussion about topics such as death and dying—and coping with dying patients—such that students can feel safe and objective in sharing thoughts; they remind students of the patient experience; they eloquently distill muddy feelings into nuanced words; and they serve as an anchoring point for a state of mind that nurtures reflection over the disdain encouraged by the “hidden curriculum” of the wards. The author closes the commentary with excerpts from literature. Ms. Mullangi is a fourth-year medical student, Harvard Medical School, Boston, Massachusetts. Correspondence should be addressed to Ms. Mullangi, 107 Avenue Louis Pasteur, Boston, MA 02115; telephone: (909) 993-3401; e-mail: samyukta_mullangi@hms.harvard.edu. Acad Med. 2013;88:921–923. doi: 10.1097/ACM.0b013e3182956017 The Synergy of Medicine and Art in the Curriculum Samyukta Mullangi