Volume 36

July - 2022

Cover: Who Has Our Ear

I painted this piece throughout the winter of my intern year. For this piece I experimented with colors, depth, and layering. Art contributes to my wellbeing by allowing me to solely focus on creation and the piece in front of me. I am able to be fully in the moment.

Letter from the Editors:

Welcome to Art of Emergency Medicine, an online blog featuring amazing works of art created by your Emergency Medicine colleagues, along with their own stories of wellness and inspiration. Each month we try to focus on a new topic within wellness, and this month we wanted to cover an abstract concept that when practiced and accepted can lead to growth in both skills and mental wellness- vulnerability and how we can practice vulnerability in our day-to-day lives.

Vulnerability has been discussed by many people, but specifically Dr. Brene Brown describes it as “uncertainty, risk, and emotional exposure”. It is described as the path to growth which provides self-awareness and knowledge. That being said, vulnerability can be uncomfortable- it forces you to admit your mistakes, identify your lack of knowledge, and frankly, can be moderately terrifying. Because of this, we don’t act ourselves. To avoid the stress of vulnerability we tend to do whatever we can to prevent it from happening: we strive for perfection, we turn down our emotions, we prepare for failure. By turning down our emotions to reduce fear, we also reduce our joy. While these things make us feel safe in the short-term, these actions can ultimately stunt our emotional and intellectual growth.

So how can we experience our vulnerability and use it to our advantage to create a growth mindset?

• Embrace “I Don’t Know”

  • Realize that it is ok not to be perfect, we do not have limitless amounts of knowledge and we are all at different steps in our journey within medicine. You are within your rights to identify the gaps in your knowledge and be comfortable with their presence. Do not stop there though, strive to fill those gaps after they are identified. 

• Make Yourself Uncomfortable

  • Vulnerability is uncomfortable, but it can be utilized to engage in new projects, learn new skills, and develop talents. Don’t simply keep the status quo, it may seem like this is simply stagnation, but really knowledge decreases over time, skills wane, and this results in backwards movement. 

  • Normalize your discomfort, put yourself into uncomfortable situations and take on those passion projects you have been debating for months or even years.

• Put Your Discomfort in Perspective

  • Utilize mindfulness, recognize the emotions you are experiencing acutely, whether they are contributing to your improvement or associated with anxiety and preventing your growth. Attempt to focus on those that will support your growth. 

  • Realize that this discomfort is only temporary, you are expected to not excel at new skills, tasks, or projects. Set for yourself realistic and stepwise expectations to guide your progress through the task. Understand that it will be difficult, but this difficulty will not be forever. 

  • Decrease your focus on internal stimuli and your own insecurities, attempt to prevent yourself from projecting these thoughts onto others and your interpretation of interactions with them.

• Create Community

  • None of this implies that you need to go through this alone. Develop your community, find your people, and find those who will support you in your journey. Everyone is at different stages in their journey and development and everyone is on the continual path of growth. Find comfort in sharing stories, shared struggles, and, most importantly, your successes. 

We hope this will make you confident in experiencing vulnerability and as opposed to interpreting as something to be avoided, will allow you to embrace it, switch to a growth mindset, and improve yourself at work and in life.

Bella

This is Bella, a beloved pet and companion of one of my closest friends. I did this piece during the height of the pandemic in 2020, quarantined at home with not much else other than my thoughts to keep me busy. I hadn't picked up a pencil and paper to sketch since starting medical school--what was once such an integral part of my life had become a forgotten hobby, something I couldn't imagine carving out time for when I had so many other "important" things to do. But here I was, back home, with nothing but time.

I'm not that creative—I don't do abstract art and I'm horrible coming up with "original" ideas. I like to think of my drawings more as...autobiographical. I draw not only what I see, but what I know to be the personality, the demeanor, the uniqueness of each "thing" I draw. I hope in "Bella" you can see the regal, beautiful old soul that I see. I hope you can see that she was wise, loyal, loving, and loved. Bella passed away on March 12th of 2022, but I hope her spirit lives on in this mixture of pencil and paper.

When everything in medical school seems to be on a timeline with a specific purpose and goal, art has given me a much needed escape from the day-to-day anxiety of being a student. No timeline, no one evaluating my work, no stress: just me, pencil, and paper. Over the years I've learned that finding time to pursue the things that make me happy outside of medicine actually made me value being in medical school more; I realized I didn't have to give up pieces of myself to become a doctor.

Sunrise in Chicago

Years ago I was driving down Lake Shore Drive for an early morning shift, and what caught my eye was that the sunrise was not only beautiful but the sliver of moon was the same yellow shade as the clouds around it. I had a few minutes and pulled into Monroe Harbor -- an oasis I drove past all the time but wasn't familiar with. I was trying to capture the moon and failed but got this beautiful sunrise and have had a print of it in my office since.

Lup-Dup

The lighting in the room appeared dim, ideal for a death, at least that’s what I had imagined the lighting would be like. Death and dark always went together. It makes sense. Darkness always has a way of bringing closure to things. And here I was, just past 2 AM, the rounds of my eyes feeling as if they were being snapped closed like a triggered venous flytrap. In my mind I was halfway to Vonnegut’s planet of Tralfamadore, I was in a giant artificial dome, all the local alienoids are watching me, and I am just sitting here being human and they are in awe. Oh silly, tralfamadorians, if only other human beings thought I was that interesting. 

I slid open the glass door, peering into the dim room as I entered, a woman, stood like a statue over what was now a corpse, I momentarily pondered who was who. “Here comes the sun,” by the Beatles, was playing in the background. “...it’s alright..dododododododododododododo...” progressed as I shuffled hesitantly into the room. How thoughtful it was to play such a happy song at the end of a man’s life. Why didn’t anyone think of this before. Bravo, I wanted to clap out loud, but restrained myself. I also wanted to cry, I get that way from time to time. Only I never actually cry. I think its a mechanics issue. It always happens the same way. Emotion rushes in to me, begins to fill me from the tips of my toes up. I feel the energy rising, my synapses firing in harmony, the sensation of a chill creeping along my back as if it has been hiding for decades. I feel my facial expression begin to change, like someone has strings strategically attached to my facial muscles and they are putting considerable force on them in a upward and outward direction. Just then, as if I haven’t waited long enough for this glorious moment, where my emotional potential can finally spill out in physical way, the feeling is gone.   

The music continued to fill the 6 ears in the room. 4 living ears and 2 dying ears. Scratch that, not 2 dying ears, 2 dead ears in fact. Actually, that’s why I was here in this room, at 2 AM, to declare a man dead. I wondered at the moment though, what if this man’s ears could still appreciate the beauty of the Beatles perfect pitch, or what if his eyes could still see how much the statue overlooking his rotting body loved him? I felt like he was missing out on the greatest moment’s of his life. But where was my head, where were my manners? The charm of the Beatles had taken me someplace else and I was far away. Come back man, come back, you’re a doctor for Christ’s sake, speak up or pat someone’s shoulder or something. 

The music faded as the song came to a close. The woman in the room continued to maintain a steady gaze on the now deceased. I assumed that he was her father. Mainly because she continued to hold his hand, in the sort of way you usually see when a young daughter grasps her father's hand looking for solace in a time of distress. A firm grip, trusting and at the same time looking for guidance. I tapped the woman's shoulder with a single finger. I felt that two would be too abrupt. She turned to acknowledge me, squeezing down firmly on his hand, only to realize for the first time there was no reciprocation. "Was he comfortable...when he died?" the woman asked me. Her transference of trust onto my shoulders felt heavy. "He died without pain" I said. "I could tell by his heart beat on the monitor that he was in peace." A wave of relief bubbled up as if from her insides, and poured out of her, tears and all. She released her father's hand and it began to make its way towards me. I looked down and she held her hand out, eager to feel the comfort that was no longer available to her. I reciprocated her gesture, our hands locking in firm understanding. My nod to her at the time, a confirmation of both my understanding of her emptiness and my inability to fill it. "Thank you." She squeezed and I squeezed back. The silence in the room appeared soothing for her as she contemplated the uncertainty that lied ahead. We released our handgrip and stood for an additional moment in silence. The IV pump was the only audible ambient noise at the time, it's pump wheel turned, over and over again, like a cassette tape that had come to the end of the reel. "I have to examine your father now. I'm sorry..." She nodded in acknowledgement, and turned her head away from my gaze. Her feet shuffled on the floor as she made her way out.

The door shut behind her, I stood at the foot of the patient's bed, my shadow cast over him. I approached the still, lifeless body that lied just in front of me. An odor of flesh that no longer breathed began to overwhelm my senses. I drew back the white cotton sheet from down over his head, revealing the man's dying expression. He appeared tired and worn out, but his brow was un-furrowed, for he no longer worried. A sensation became palpable inside me, like something was stuck and wanted to escape. I took my stethoscope and placed it on his chest to listen for his heartbeat. I waited and waited...but nothing came. 

I wrote this short story during my first year in Emergency Medicine residency. I had been seeing a lot of death and sadness on my ICU rotations for the first time and this piece helped me to deal with the emotions I was going through during this time. I had been reading a lot of Haruki Murakami and Kurt Vonnegut at the time so I think that is what gave it a bit of a surreal feel.

Untitled

A Roseate spoonbill with her little tiny ones.

Monthly Infographic:

Practicing Vulnerability

Do you want to see your art shared with the community? Don’t forget to submit today!

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This Months Featured Artists:

Diana Halloran, MD

I am an emergency medicine resident from Florida and am completing my residency at Northwestern. I have been painting and drawing since high school and I majored in Studio Art in college. Painting and creating visual art is a passion of mine which I am striving to continue during residency. See more of her work on Twitter.

Giuliano De Portu, MD

I was a professional photojournalist and went to medical school at 33. Currently still doing imaging for fun! You can see more images at www.giulianodeportu.com.

Jaqueline Tran

Hello! I am an M4 applying into EM this cycle. Art for me started with pencil and lined notebook paper sketches of my favorite Disney movie characters. Fast forward through years of oil painting and watercolor training, and pencil and paper is still my favorite medium.

My work today consists primarily of sketches of furry friends--whether it's my own dog, a family member's new puppy, or a friend's recently passed, beloved companion, pets have always been such a gift in our lives. Bringing them to life on paper is a fun challenge that I'm always ready to embrace.

Michael Macias, MD

I am an Emergency Medicine Physician working in southern California and I am passionate about clinical ultrasound, medical education, and using design to improve health care! I got into various forms of art during my undergraduate education, mainly acrylic painting and photography, with the occasional short story. My main focus recently is digital medical education which has helped me to continue to feed my creative appetite! Open up further discussion via his Twitter.

Seth Trueger, MD

EM physician at Northwestern, interests in social media and health policy. Play some guitar (#DocsWhoRock) and occasionally I snap a photo I like. See more of his work on Twitter.

You can learn more about the artists featured in this and other volumes at our contributors page!