Doctors and Art and School

Medical students have begun coming to the Columbus Museum of Art where I lead tours. And this has been happening across the country—medical schools partnering with art museums to help their students develop the human side of being a doctor. What exactly can happen when medical students do their rounds at an art museum?

  • From their first year in medical school, students are taught to observe. And art museums are all about visual literacy. On art tours, students are invited into a deeper seeing: to notice what at first is not apparent, to recognize patterns and anomalies, and then to make meaning of what they see. This training of the eye in the museum can find use by the bedside.
  • Art helps to develop empathy. Paintings and sculptures invite people out of themselves to consider what comes from the mind of an artist. Such interaction with art gives medical students practice in becoming more open and mindful of others. It helps them see their patients as more than bodies.
  • The arts can bring relief for medical students under chronic pressure. In a museum, these students often find company on the journey. Art, after all, shows the pressures, hopes, and fears common to human experience. Learning to reduce their own stress will help medical students see the benefits of easing the anxiety of their patients.

More than ever, I’m convinced that art should be included, not only in medical school, but in every curriculum. All students can benefit from seeing well, from showing empathy, and from finding relief from tension.


To Sit with a Struggle

“Need help?” I asked.

But April shook her head.

“No, Mrs. Swartz,” she said. “I want to struggle more on my own.”

This was an important sign of growth for April, an honor roll student who earned A’s with little effort. As April bent back over her advanced Venn perplexer diagram, her forehead furrowed again.

April was using language I had given her with the Struggle Continuum. Far too often, April had been on the easy side of the continuum, and she shied when she encountered anything left of comfort.

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“You need to get accustomed to the alert stage,” I had told her. “It’s okay not to know an answer immediately—to feel uneasy, to struggle. This activates your brain in new ways. You don’t need help until you get to the anxious stage.”

April understood. She ran track and often heard no-pain-no-gain talk. Her coach was always telling her to embrace the pain and then run past it.

Being able to place herself on the Struggle Continuum, helped April take charge of her learning. And she was competitive enough to ask for help only when she reached the anxious stage.

The longer I taught, the more strategies I found to help students tolerate struggle. Here are some tools:

  • Normalize struggle.

“This won’t be easy,” I’d tell students before handing them a problem. You’ll need to grapple with it. See what you can do.”

Rather than discourage students, this approach seemed to give them freedom to struggle.

  • Model struggle.

During the Venn perplexer unit, I worked on one, as well, at home in the evening or at lunch breaks. I was challenged, students knew, and they asked to see my progress. My bafflement made them more willing to struggle.

  • Encourage collaborative struggle.

Some students preferred company as they struggled. They worked best when they talked with each other, figured together, and faced the possibility of failure with a friend.

  • Practice struggling with low-stakes problems.

The hardest problems I gave students were not evaluated. Subtracting the worry of a grade point average increased student willingness to tackle yet another logic puzzle or mind bender or acrostic.

  • Give struggle strategies:
    • Try a new route. If one approach doesn’t work, come at the problem another way.
    • Translate the problem into another form—a list or chart or picture or conversation.
    • Do something else and then go back. A fresh look sometimes makes concepts clear.
    • When you feel anxious, get help.

A willingness to move beyond comfort, to grapple, to sit with a struggle is an important skill for life.

Slopes in Learning

I climbed a mountain this week. The path up wasn’t far, only about a tenth of a mile. But it was rocky and overgrown and steep, maybe a ten percent grade. A quarter of the way up, I found a walking stick. And from the half-way mark on, I had to stop to breathe, actually pant, far too often for my liking. I had thought my morning workout on the treadmill was keeping me in shape.

Climbing that mountain made me think of a couple of students, Penny and Jon.

School days were steep climbs for Penny. Her sleep was disrupted by fighting parents, the food at her house ran out before the end of the month, and her glasses were lost.

“My mind must be broken,” Penny whispered to me once.

She had just looked at Jon’s paper. At the desk next to hers, Jon, whose parents sent him to academic camps in the summer, was concluding his persuasive essay.  Penny, with a hole already erased into her paper, was on the second sentence.

What was an easy climb for Jon, was a steep learning curve for Penny. She needed support along the way: a walking stick and time to stop and breathe. The essay I assigned was good for most of the class. But I learned that afternoon that the assignment was not good for Penny and not good for Jon. Penny was too stressed to learn, and Jon was bored, doing again what he could already do.

Gradually, I learned to differentiate for students on the edges—to give, for example, graphic organizers to help Penny get started and to add a research component to Jon’s assignment.  In a classroom, after all, there should be some evenness in the learning curve.


Sharing the Talk

It happened too often in too many of my classes for too many years. I’d ask a question or invite a discussion, and the same students would plunge right in. Over and over these few offered right answers and insightful ideas. They were quick-thinking extraverts, the producers of meaning for the class.

The trouble was that the consuming students didn’t learn much by listening in. Students learn best when they actively interact with content. They’re more likely to remember, to connect concepts, and to make academic language part of their vocabularies.

But, aside from squelching the quick-thinking extraverts, how could I make spaces for the introverts? For the more reflective students, who were slower on the uptake? I found that asking three-stage questions helped.

Stage 1: Reflect and Record—In this stage, I’d pose a problem: What evidence in the text can you find that . . . ? What changes would you make to revise . . .?  What would happen if . . .?  How would you improve . . .?  Then I’d give students time to think alone and to write or diagram or sketch their responses. I often played instrumental music as they worked. This, I found, provided a curtain of privacy, making them less aware of each other. In this stage, no voices are heard.

Stage 2: Triad Talk—During this time, students shared what they prepared. And instead of one person speaking to a whole group, many are spoke to smaller groups. Three in a group worked well. Pairs, to me, seemed less dynamic. But with more than three in a group, voices tended to get lost. This is the stage of many voices.

Stage 3: Full Forum—After the preparation of the first two stages, whole class discussion became richer. More students contributed comments, and even their listening was more active—alert postures, nodding heads, and smiles or frowns. Often I started this stage with the question: What did you hear someone say that would be good for others to hear?  Students grew more willing to speak out after they heard others affirm their thoughts. In this stage, many hear one voice at a time.

Usually, the less I said and the more students said, the more they learned. After all, when students tried to explain to someone else, they understood better themselves. And often it was easier for students to learn from each other than from me. They brought different learning styles to each other and provided a safe place to ask questions and try out ideas. Together, they produced meaning.

Language of the Unheard

I found I needed a way to think about vandalism and violence at school. My instincts toward fear and anger didn’t work. These feelings separated me from students, making me suspicious and defensive, creating a distance between us instead of the openness needed for teaching and learning.

And, strangely, what helped me most was thinking of vandalism and violence as miniscule versions of the 1967 riots. I was a kid then, living in Flint, Michigan, one of the sites of the more than 150 urban disturbances that broke out during that “long hot summer.” I remembered what Dr. Martin Luther King Jr. later said—that a riot doesn’t develop out of thin air and that a riot is the language of the unheard.

So at school, when I saw words I didn’t even want to think about etched into desktops, when we huddled in a darkened classroom because of a gun in the school, when protest graffiti was painted on walls, and when I tried to break up a fist fight in the hall, I tried to turn my mind to this question: Why?

“Seek to understand why those individuals have taken to the streets,” King had said. And though I don’t like or condone violence and though I believe violence and vandalism in school deserve consequence, still I tried to understand—what were the messages behind the vandalism and violence? What had I failed to hear in my classroom? What had we failed to hear in our school system? In our town?

Some students, I learned held grudges against the in-groups, who they felt excluded them and against teachers who favored those in-groups over them. Some students were bored, feeling that the school didn’t give them opportunities to learn what they wanted to learn in ways they needed to learn. And some students were angry because of what was happening at home. These students saw school as an enemy, not as a place where they were included and valued. In these students, I could see despair that linked to anger and then to action.

And though I never found magic answers, I noticed a handful of ways to make a space for disenfranchised students, to hear from them, to open two-way, not one-way, communication:

  • A graffiti wall: An art teacher in our school turned a long hallway into a venue for graffiti art. And students used this wall to ask for social change, to express their feelings, to express their creativity.
  • Two simple words: I discovered the words “tell me.” When I wanted to connect with a student who had been aggressive, these words worked. They invited communication without condemning connotations. These two simple words helped me reach students.
  • A book: S. E. Hinton’s The Outsiders is a coming-of-age novel that describes the conflict between two groups in a town: the lower-class Greasers and the well-to-do Socials. Hinton, who was seventeen years old when The Outsiders was published, shows the grittiness of conflict but also points toward hope. “Stay gold,” my students said to each other after reading the book.
  • Journals: When I gave students a chance to write about what was important to them—and without censure or editing—I understood them better and I found bridges toward them.
  • School breakfasts: When I’m hungry, I’m not nice—and neither are students. I noticed a change in the emotional climate of our school when all students were invited to free breakfast every morning. In class, students were not distracted by hunger. And in hallways their blood sugar levels were high enough to give them a chance at walking away from a fight, not throwing the first punch.

We can, and should, use cameras in school hallways, have consequences for destructive behavior, and clean away offensive graffiti. But we should also pay attention—listen for language that is not often heard.

I’ve Got It Covered

On Labor Day this year, I checked off a life goal. I walked across Mackinac Bridge. By dawn, thousands of us had gathered at the foot of the bridge.

“How does this work?” someone beside me asked.

But I didn’t know either, this being my first time. And then, far ahead of us a man climbed a ladder with a bullhorn.

“Now we’ll find out,” said my fellow walker.

And for the next ten minutes, the bullhorn man explained. At least, that’s what I think he was doing. But I’m not sure because the sound of the bullhorn was too weak to reach back into the crowd. Still, I was amazed at how people kept leaning forward, trying to hear.

“What’s he saying?” my new friend asked. But I shrugged. And when he climbed down, most of us were still uninitiated. He had, however, covered the material.

And I’ve found that, in the classroom, there’s something secure about covering curriculum. I liked to map out the year, to know that by the end, I had led students through the necessary lectures and texts, that I had stayed true to the syllabus, that I had taught the course.

Only sometimes students didn’t seem to hear, like my meaning was too weak for them to hear. They stared at me blankly or answered by rote without seeming to understand. I was like the bullhorn man at the bridge, speaking but not in ways my students could hear. I needed to use their learning styles, their experiences, their skills to help them engage material, not be so concerned with what came out of my mouth. What mattered most was what happened in their brains, not what happened in mine. What counted was the meaning they uncovered, not the material I covered.

I Was Wrong

You can’t teach without making mistakes. At least I couldn’t. I’d get tangled up in a math problem or forget to enter a grade or get stuck in a logic puzzle. Often I pronounced words wrong. I learned to read at a young age and I read about topics I didn’t discuss with people. So I pronounced words my way in my head. And I said them my way, too.

When I blundered like this, I had some options. I could try to cover my mistake with fancy footwork or brush it off like it didn’t matter. But I found that what worked best was to acknowledge my mistakes and to thank students and parents for pointing them out.

I wanted to call forth the best in my students. So I felt I needed to be my best, but part of being my best was admitting my mistakes. And good things happened when I did.

I’d call parents and say, “You know, after reading your e-mail, I got to thinking, and I want to make some changes.”

Or I’d say to students, “I can tell that lesson plan didn’t work. What would have helped? What should I try tomorrow?”

When I was too hard on a student, pronouncing judgement without understanding, I’d ask the student to stay after class. “What you did was wrong,” I’d say. “But what I did was wrong, too. What can we do to get things right again?”

Admitting mistakes, I found, helped to build an educational community. Students could see that teachers are learners. And when I thanked a student for pointing out one of my errors, the class could see that students are also teachers. Feeling valued and knowing that their input counted, students became more willing to risk questioning a teacher. We were, after all, learning together.

And when I acknowledged failure with a parent, we became partners—collaborators working together for the good of the student. And between us we built trust, both of us human, both of us trying and failing and learning and trying again—all for the sake of the student.

Sometimes confessing fault took more courage than I thought I had. I felt vulnerable and more accountable. But the more I owned up, the more I could see that one of the biggest mistakes teachers can make is to think they have the right answers all of the time.

Learning to Drive a Stick-Shift

I learned to drive a stick-shift car in a hilly city. When our old car died, I agreed to buy a stick-shift because gasoline prices were rising and because, when I watched my husband, changing gears looked easy. But what seemed effortless from the passenger seat felt complex behind the wheel.

I had more control, I found. I could choose when to shift gears instead of the car deciding for me. But in the driver’s seat, too much needed to happen at the same time. I had to remember when to put a foot on the brake and on the clutch and when to release the clutch and to do that slowly. I had to keep the car from stalling and from rolling backward down the street from the traffic light at the top of the hill. I had to master the interplay between the clutch and gas pedals to keep from lugging or racing the engine. For weeks the car lurched and bucked like a bull. Beside me drivers glared, and behind me horns honked.

Learning to drive a car with a manual transmission reminded me of my first year in the classroom. Teaching is so simultaneous. At the same time I conjugated verbs with the class, one student passed a note to another, an announcement came over the loud speaker, the guidance counselor brought a new student through the door, the boy in the back row waved one hand frantically and pointed to the restroom pass with the other, and an office helper came for the attendance sheet.

Nothing came to me automatically that first year. I had to think about every move, teaching without instinct, without having the feel. And I had to keep teaching, despite the jolts of the sudden starts and stops and even with disapproving looks from more experienced teachers and irate phone calls from parents who didn’t want a first-year teacher for their kid.

By degrees, the habits of teaching became more instinctual. I learned to retrieve a passed note without pausing in a read-aloud, to nod to a waving hand while I answered the door, to delegate attendance sheets to a trusted student. I was more able to anticipate how to keep parents happy and how to seek advice from experienced teachers instead of irritating them.

And I found that I loved a profession layered with activity, pulsing with multiple rhythms. Teaching, I discovered, wasn’t boring.

How I Got Myself to School on Days I Didn’t Want to Go

Teaching was my dream. Through my school years I collected ideas from my teachers. I’ll do this when I’m a teacher, I thought—or, not this, for sure. I taught my younger siblings to read before they went to school, just for the pleasure of seeing words move from the page to their minds and out of their mouths. I pursued teacher training against odds, diapering babies and stretching money as I completed class after class. And finally one day I held my college diploma, the paper I needed to teach.

So imagine my dismay, when in my first year of teaching, I woke up some mornings wishing I didn’t have to go to school. I’d hear the clock alarm and groan. I didn’t want to answer a thousand questions again or smell thirty adolescent bodies fresh from gym or attend a faculty meeting about test scores.

But I discovered early on that a dragging teacher has no chance for a good day. And gradually, over the years, I developed some tricks of the mind to get myself to school. Here are a few:

  • I got to school early, closed the door, and turned up the volume on upbeat classical music. The beat brought the energy I needed for the day.
  • I tried to remember I wasn’t entitled, that other people with dreams lost them in concentration camps or prisons or slavery. My day could be different, dream bereft.
  • I thought of one student, who needed me that day. This took my mind off my needs, gave me purpose, and redirected my emotion.
  • Just start the day, I told myself. You’ll feel better after you start.
  • I brought a treat for my students. Buying doughnuts for homeroom changed the tone of their day and mine.
  • I wore my favorite outfit. Dressing well pepped me up—giving me energy to joke with students and step spritely in the classroom.
  • I looked back to one of my favorite teachers from long ago. Miss Bordeaux, for example, knew I liked to write and understood that I took critique as a gift. I looked forward to my returned essays, with her editing marks slashed across them and her knowing look as she watched me read them. Today, I’ll be Miss Bordeaux for Cassia, I’d think. And this gave me energy.
  • I’d look to a colleague for inspiration. One year, for example, I taught next to a primary music teacher. Mrs. Jones, I knew, went home each evening to care for a mother with a freshly amputated leg. Most mornings, she’d be in tears as she fumbled with her door key. But all day, through the walls, I’d hear the bouncy music of her small students and see them leaving her room in smiles. If she can do it, I can do it, I’d think.
  • Later in my career, especially, I’d look ahead to my retirement. When I sit on my rocking chair, I’d tell myself, I want to rock with a good conscience, knowing I’ve helped and with fond memories, knowing I’ve loved.
  • And I drank caffeine, lots of it.

With these methods, I’d fool myself, on bad days, into thinking I wanted to teach. And then, part way through the day, I’d remember again why I wanted to teach.