Psychiatrist Challenges Students to Think Outside the Clinical Box
One in an ongoing series
What is it like to hear voices that are only in your mind?
That’s the question Hilary O’Neill, MD, asks medical students who rotate on her inpatient psychiatric unit at Einstein Medical Center Philadelphia. Many of the 30 patients exhibit that symptom of psychosis.
But Dr. O’Neill doesn’t want the students to give her a straight answer. At least not a verbal one.
She tells them to answer with an art project in whatever medium they choose, from macaroni art to musical composition.
“They look at me like I have three heads,” says Dr. O’Neill, chief of inpatient psychiatric services at Einstein. “They’ve never been asked to do anything like this before.”
Dr. O’Neill says the project is an opportunity to reorient students from the perspective of scientific metrics to a humanistic realm. She wants them to identify with psychiatric patients as human beings, rather than manifestations of a diagnosis.
Creative Expression of Psychiatric Symptoms
“I think it’s easy to forget about the humanity of the patients when you’re finding algorithms all the time,” she says.
The students present drawings and photographs, create poems or posters – one student created a poem with quotes from the patients themselves.
Another student, who was conflicted between becoming a concert violinist or a physician, wrote a musical composition punctuated by discordant notes. Another student fastened pipe cleaners to a colander and attached index cards with words written on them.
On the day they gather to present their projects, Dr. O’Neill rewards them with pizza. (It used to be pot roast, but she got “tired of cooking.”) Her office is a gallery of their finished work.
“It’s been a real success every time,” she says. “They’re pleased with themselves. I’m pleased with them. They’ve done something they don’t usually do.”
Meraash Mahajuodeen, a medical student who did a poster for the project, says he “loved it.”
“It was a fantastic opportunity to express my emotions and thoughts without using words,” he says. “When you draw, you use a different part of your brain and you let your creative soul take over.”
An Unusual Path to Medicine
The unorthodox assignment isn’t out of character for Dr. O’Neill. Her own journey to becoming a psychiatrist was unconventional as well.
She was inspired to become a physician as a teenager who spent long months in the hospital with a grave illness. But when she got a “C” grade in college in a pre-med required course – organic chemistry – she switched her major to English.
“A ‘C’? I never saw one of those before,” she says.
After graduation, Dr. O’Neill worked in the computer field for 10 years, but frequently changed jobs because of the lack of opportunity for career advancement.
“Being a good computer person, people don’t want to lose you by promoting you,” she says. “I realized if I kept going the way I was, I’d turn 50 and have 25 jobs on my resume.”
So she decided to go to medical school, organic chemistry be damned.
“It was hard to give up the paycheck and live back home and go to school with people 10 years younger who can drink beer and play Frisbee all night and go to class the next day,” Dr. O’Neill says.
But she made it through. Dr. O’Neill has been at Einstein for seven years.
The art project was inspired in part by Dr. O’Neill’s impression that many medical students have limited interests beyond science. Some of them didn’t know Vladimir Nabokov – the Russian-American author of classics such as Lolita – from Danielle Steel, the best-selling author of pop fiction.
The art project seemed a brief and worthwhile detour from the narrow lanes of science, an exercise in empathy from which the patients could benefit. And some of the patients benefited directly from at least one of the compositions.
The student who wrote the musical piece played it for the patients – without the discordant notes.