Dec 5, 2013
01:08 PMHealth & Science
As Harvard Fellow, Connecticut Physician Seeks to Cure Healthcare's Ills—With Opera & the Arts
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Dr. Vincent P. de Luise has character of operatic proportions—he’s larger than life, not in physical stature but in his polymathic interests and talents, his command over essences of life ranging from medicine to Mozart, his hard-wired belief in the primacy of music and the arts as vital for a balanced life, and his determination to bring their transformative powers into realms that remain dark like the medieval night when most assume that they must—by definition—be enlightened.
Consider the “aria” that the Assistant Clinical Professor of Ophthalmology at Yale University (just one of his current appointments) delivered Dec. 5 in New Haven: With an Artistic Vision: An Ophthalmologist Looks at Visual Perception, the Arts and Eye Disease.
Here’s the description of the presentation from Yale: More than all the other senses, the brain's visual system largely defines how humans perceive the world. Herein lies an intriguing intersection between vision, perception, the arts, and eye disease. A brief overview of visual perception will be followed by a survey of visual archetypes in the history of art (the Lascaux cave paintings, the limestone bust of Nefertiti, the Pantheon, the “evil eye,” and linear perspective), which will lead into the optical problems of self-portraiture, David Hockney’s “Secret Knowledge,” “Vermeer's camera,” trompes l'oeil, eye disease and art, and will conclude with an analysis of the artists Monet, Goya, Seurat, van Gogh and O'Keefe, pondering the question: is eye disease an obstacle to, or the catalyst for, their creative genius?
(Above, Dr. de Luise at the home of Country Loft Antiques owner Carole Winer, left, talking about a Connecticut Summer Opera Foundation event; file photo by Laurie Gaboardi/The Litchfield County Times.)
It’s a big artistic/philosophical/medical mouthful, but for Dr. de Luise it’s just one narrative thread in a larger, denser and ultimately profound libretto that must be heard in the world of medicine if we and our progeny are to thrive during our lifelong series of duets with doctors and hospitals, an interaction that the way of all flesh ultimately renders non-elective.
The Adjunct Assistant Clinical Professor of Ophthalmology at Weill Cornell Medical College, who lives in Woodbury and is fostering young operatic vocalists through his role as president of the Connecticut Summer Opera Foundation, is attempting to fuel the transformation of physicians and medical professionals into caring humans who put empathy first and see patients as three-dimensional, complex people who defy easy diagnostic quantification.
Quite literally he’s out to save medicine from itself—and in the process save all of us (the chorus of humble, hopeful, vulnerable patients) from the vagaries of the Wagnerian realm that contemporary care uncomfortably resides in.
To do so, he first had to diagnose the full nature and extent of the illness. Here’s a fractional look at some of his findings, which he described over breakfast recently at Dottie’s Diner on Main Street (Route 6) in Woodbury.
Even as medical students (future) physicians are already showing signs of burnout—whose symptoms include disengagement, exhaustion and a questioning of purpose—and often in their third of four years.
That’s before their education is finished, before they begin to endure the rigors of residencies and internships—and, for current students, long before they’ll come up against the phalanx of very ill patients eagerly being funneled into the healthcare system by so-called Obamacare.
If the burnout doesn’t happen early in the cycle, the benchmark danger zone comes in the internship period, when most physicians are around age 30 and at the point of contemplating the next mountain as a Sisyphean character, that of building a practice.
Some of the status quo surely results from a collision of expectations and realities. Medicine, Dr. de Luise points out, is really a “high-end guild,” and physicians have expectations of pulling down $200,000 to $300,000 a year but are finding that the way the elements of the healthcare system are now aligned, it may take a flat-out pace every day to take home $150,000.
All in all, burnout is “an incredibly ominous opponent,” Dr. de Luise says.
It can easily defeat the well-being of what should be the most crucial elements in a physician-patient relationship: empathy flowing from the caregiver, for one, deep listening, time spent by caregivers being fully engaged in the “moment” of the interaction, and seeing the whole patient rather than just responding symptomatically to information gleaned from an iPad or other electronic device.
Enough said; the full range of issues plaguing the medical industry is well-documented and generally understood.
What about the solutions?
“We have to go back to the arts to find healing,” says Dr. de Luise, who also sits on the Humanities and Medicine, and Music and Medicine committees at Weill Cornell Medical College.
The building blocks underpinning this prescriptive are ancient, from the power of music and art that predate written communication to Aristotelian humanistic ideals like Eudaimonia—translated these days as “human flourishing"—combined with Hedonia, or pure pleasure, experienced in context of the flourishing. Together these elements are meant to create virtue of character and a feeling of true meaning and purpose, a level of engagement that Dr. de Luise calls “flow” in a classical mode.
Like a martial arts master becomes the movement itself, say, or a professional athlete is the ball—or, in this case, the physician is so in the moment, in “flow,” that he or she “is” the patient.
Wouldn’t that be something?
It’s not theoretical at this point. Similar approaches, or pieces of Dr. de Luise’s larger suite of aesthetic antidotes, are already in place at progressive-minded medical schools around the country.
Taking it to the next level is where Dr. de Luise comes in.
He is a 2013 Fellow participating in the Harvard University Advanced Leadership Initiative, and his just-completed final paper is entitled High Touch: The Course in Compassion: Rebuilding a Curriculum of Caring for Healthcare.