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Arts Make For Good Medicine

There is a recent article in the Boston Globe about Harvard Medical School requiring its students to take arts courses that bears reading. (h/t Thomas Cott)

The Yale School of Medicine, for instance, requires students to scrutinize paintings in a museum to improve their skills at observation and empathy — a program that has been replicated around the country, including at Harvard and Brown. At Columbia, incoming medical students are required to complete a six-week narrative medicine course.


They are “a tool to help doctors understand people and their conditions.” They help doctors see beyond the disease, the “narrow biological aspect,” to the illness, which includes anxiety, fear, and the whole human experience of being sick, he said.

If there were ever a good illustration of the benefit of arts participation and practice to society, helping doctors be more effective diagnosticians, communicators and bring more empathy to anxiety inducing interactions with patients is pretty compelling.

And if it can do this for highly trained medical professionals who work under extremely stressful environments, well then it can probably provide similar benefits to elementary and high school kids as well.

I am not making an unwarranted leap of logic when I say this. The med student quotes in the articles could as easily be attributed to a high school learning environment. Insert the term high school in the following sentence and you can probably find something similar in an interview with a high school student.

“Medical school is so intense,” she said. “There’s a lot you have to suppress in yourself.” The more students learn to express their feelings through the arts, she said, “the less traumatized you will be.”

I was especially struck by a piece about the Comics and Medicine course at Penn State College of Medicine linked to in the Globe article.  I had never thought about the use of graphic novels to help doctors to understand the point of view of their patients, but also as a medium to tell their own stories.

Now they are registering based on recommendations from other students. Trey Banbury, a fourth-year medical student at Penn State who took Green’s course, said he was surprised when a comic helped him understand what mania looks and feels like for psychiatric patients.

“The graphic novels we were asked to read were simply incredible,” he said. “There are many things that cannot be said, but have to be shown.”

Students in Green’s class are required to do two things: read graphic novels and talk about them, and create their own graphic narrative. “What I help them do is take a story from their med school experience and turn it into a comic,” Green said.

Expert designers and artists are brought in to help students craft their comics. Like many in the course, Banbury had no prior experience in drawing. His comic, Perspective, shows how med students struggle with the stressors of medical school.

There are many layers to the benefits here. First, the doctors gain insight into what their patients are experiencing from reading graphic novels. Then they have to deal with the challenge of explaining themselves to an another person who will execute their comic, much as a patient has difficulty communicating their problems to a person who is not experiencing them.

As the large Baby Boomer generation ages, the type of skills these exercises develop in doctors will become increasingly important.

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Are You Running Your Arts Org According To A 19th Century Social Movement?

Last month Non-Profit Quarterly had a piece on four impulses that shape non-profits. These impulses often contradict each other to some extent which results in the internal philosophical conflicts those of us in the non-profit arts often experience.

While the results are familiar to many of us, you may not be aware of some of the underlying causes and historical movements which have shaped general perceptions and expectations of non-profits.

The four impulses author Lester Salamon identifies are voluntarism, professionalism, civic activism, and commercialism. He describes tensions between them as this:

“They are not-for-profit organizations required to operate in a profit-oriented market economy. They draw heavily on voluntary contributions of time and money, yet are expected to meet professional standards of performance and efficiency. They are part of the private sector, yet serve important public purposes.”

On occasion it is noted that the 501 (c) (3) section of the tax code doesn’t mention the arts at all. The stated purpose is for “religious, charitable, scientific, literary, or educational purposes, or for testing for public safety, or to foster national or international amateur sports competition, or for the prevention of cruelty to children or animals.”

When Salamon discusses the historical precedents of the four impulses, most of the examples revolve around the charitable care of medical, mental health and economic problems. In the context of this history the reason why the tax code might primarily focuses on caring for social issues and doesn’t mention the arts becomes a little clearer.

The end result is that the arts have essentially inherited the political and social expectations of the entire sector. For example, Salamon notes that conservatives idealize non-profits as charity performed by passionate volunteers supported by private donations rather than government support. Liberals, he says, focus on the limitations of non-profit effectiveness to call for more government involvement.

Salamon provides an extensive chart mapping out how the four impulses manifest in areas like objectives, strategies, operating & management styles, and organizational structure. Even though non-profits have proven to be very resilient, you can see how trying to serve the different impulses can result in a hodgepodge approach that may rob the organization of its effectiveness.

For example, in terms of management styles. When working with volunteers who are donating their time, there is a need to be informal and flexible. However, to address legal and fiduciary requirements, a level of professionalism is needed which involves formal rules and processes. Yet in the arts especially, people want to arrive at decisions collaboratively by group consent (civic activism). But then there is an expectation of commercial viability (run like a business) which can demand a tight, disciplined structure that can respond to a changing operating environment.

I can think of some examples of commercial entities who have managed to be successful about adopting the positive outcomes described above, but I can’t think of a non-profit arts organization that has been able to do all of those things well. The general consensus is probably that non-profit arts organizations fall short of having the discipline to adapt to changing environments and maintain commercial success.

Though to be fair, that describes a great number of commercial businesses as well. Many non-profit arts orgs never really aspire to economic success. Often increased funding/revenue means the ability to expand access while maintaining the same profit/loss balance (or defraying some of the existing deficit). That is an outgrowth of the four impulses.

I am not necessarily advocating that non-profits decide which impulse(s) they need to jettison in order to operate more realistically. Though it may be valuable to at least engage in some examination and consideration. Knowing the history that influences the philosophy of non-profit operations can help you recognize if you are saddling yourself with expectations that really aren’t valid to your particular endeavor.

Essentially, now that you know that they grew out of 19th century social service theory that has no relation to what your organization is all about, are you perpetuating some unproductive practices because you thought that is what good non-profits are supposed to do?

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Can You Care In An Unreasonable Way?

Seth Godin says he figures Apple computers reached their peak about three years ago.

Since then, we’ve seen:

Operating systems that aren’t faster or more reliable at running key apps, merely more like the iPhone…

Geniuses at the Genius Bar who are trained to use a manual and to triage, not to actually make things work better…

Software like Keynote, iMovie and iTunes that doesn’t get consistently better, but instead, serves other corporate goals. We don’t know the names of the people behind these products, because there isn’t a public, connected leader behind each of them, they’re anonymous bits of a corporate whole.

Compare this approach to the one taken by Nisus, the makers of my favorite word processor. An organization with a single-minded focus on making something that works, keeping a promise to users, not investors.

Mostly, a brand’s products begin to peak when no one seems to care. Sure, the organization ostensibly cares, but great tools and products and work require a person to care in an apparently unreasonable way.

If you are nodding your head in agreement upon recognizing that Apple’s achievements have sort of leveled out, stop a second and think about whether you are running things to make them better or just to triage and serve organizational goals.

When I read the sentence about the software not getting better but serving other corporate goals, Trevor O’Donnell’s posts about marketing reinforcing the arts organization’s image of themselves, rather than reinforcing the customer’s image of themselves having a good time, came to mind.

Obviously there is more involved with offering consistently better experiences to those who participate in the events and services you provide than good marketing. Good service, good marketing, good environment are all interdependent.

It is difficult to recognize issues that exist when you are close and involved with them which is why the Apple example is so useful. When we realize that some elements of a highly successful company have leveled off, it becomes a little easier to perceive parallels in our own operations.

The real challenge comes in the last sentence of Godin’s I quoted. What are the areas in which you and your staff can care in unreasonable ways?

What does that mean? What does it look like for your organization? Your customers can probably give you a hint if you ask (they may be already telling you, emphatically and unsolicited).

There may be people in your organization already invested in something with an unreasonable degree of care who are assets to your organization. It may not be necessary for everyone in your organization to all care about the same thing in order for you to be successful.

Given the number of hats worn by people in non-profit arts organizations, it would be a blessing if you had even a few employees that exhibited unreasonable care in different areas in a manner that was balanced within the organization and within themselves. (Trying to channel unreasonable care into all your areas of responsibility is likely to drive you crazy).

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You Want To Do Better, But Aren’t Sure How

A week ago I wrapped up my final post about the arts entrepreneurship training programs being developed in colleges and universities by pointing out that there was still the unmet need of artists who had already embarked on their careers.

I think the challenge faced by artists is summed up pretty well in the comments section of an article in The Guardian titled “Creating wealth: how artists can become inventive entrepreneurs”

Here is screenshot of the comments:

guardian snip

While there is a constant refrain that artists and arts organizations need to handle themselves in a more business-like manner, there aren’t a lot of sources of information and training that is tailored to the needs of creatives.

Wendy McLean’s comment is a reaction to the fact the story was framed as coming from members of the Guardian’s Small Business Network group, but when she went to sign up, the questions asked gave the impression it wasn’t really suited to her at all.

As the second commenter OddBodkin points out, any time you spend trying to distill lessons from generic information sources in order to discern what might be applicable to your situation, that is time you aren’t spending on your core creative focus.

It can be difficult to create a training program that is suited to artists. A regular schedule of classes may not work well for people with varying rehearsal and performance commitments that have them traveling all over a region or for artists who get so focused on creating they don’t look up until 11:00 pm.

Online resources that one can consult at their own pace can be very helpful, but guidance and clarification from a live person is just as valuable. Networks of colleagues can solve this problem, but frequently you simply don’t know what you don’t know.

I don’t have any clear cut solutions to suggest. You know I will share them when I find them.

There are good resources like Fractured Atlas that are revved and ready to help creative folks develop their careers.

I also want to put a plug in for ArtsHacker. (As you may know I am a contributor there.) While the site offers tips generated by the writers, it also solicits questions and problems readers for which readers would like solutions.

When the site opened about 11 months ago, I thought we would be fielding bunches of questions before long but there haven’t been too many. I know you all have burning questions you want answered, so get asking!

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