In These Times, Season 4: The Art of Healing (Episode 1)

Alex Schein:

In the early 1820s, Mary Shelley, the writer of Frankenstein, was struggling with loss. The loss of friends, of her young children, of her husband, Percy Bysshe Shelley, along with the belief in her own romantic era ideals. In her 1826 novel, The Last Man, she created a dystopian world defined by loss in the form of a pandemic that sweeps through Europe in the 21st century. Her protagonist, one of just a few survivors of the plague, searches for meaning in this world, concluding that there is about one solution to the intricate riddle of life, to improve ourselves and contribute to the happiness of others.

In 2022, as COVID-19 lingers on, the climate threat looms larger, and war returns to Europe, there seems to be no answer to when this era, defined by loss, will end. As individuals, and collectively, we're experiencing a heightened need to learn to cope and define meaning. And many of us are finding that making sense of the intricate riddle of life, and extracting meaning out of adversity, is one of the things that art does best. Adversity motivates the creation of art, and works of art offer a foothold for those seeking a way of moving beyond tough times.

In this season of In These Times, we talk to scholars, musicians and poets, and other members of creative communities, to explore the link between making art and making meaning, and how creativity shines a light on the way out of adversity, past and present. In these times, knowledge is more important than ever. In this episode, Aaron levy, a lecturer in English and art history, talks about how the arts and humanities can serve as tools for life. Then, Dr. Levy is joined by Lyndsay Hoy, a physician at the Perelman School of Medicine, to discuss a project that uses art to bring healing to the medical community. Welcome to episode one, The Art of Healing.

Aaron Levy:

You know, I grew up surrounded by artists and activists, folks like the amazing singer songwriter, Pete Seeger, great playwright, Robert Whitehead, and innumerable others were all kind of part of the community that profoundly shaped me. I also had the extraordinary privilege to have meaningful time with my grandfather. For many years, he lived well over a hundred years, and throughout my upbringing, I had innumerable opportunities to listen to him, to learn from him. And that shaped me in deep and profound ways that I still work through to this day. That he was a sole survivor of his family, he fled Europe in the '30s, and that always instilled in me, from like an incredibly young age, an attentiveness to how fragile and vulnerable life is, but also the lifelong challenge of finding meaning, and finding solace, in the wake of unspeakable loss.

Alex Schein:

That was Aaron Levy. Dr. Levy is a senior lecturer in the departments of English and the history of art, where he's taught since 2002. He's also the executive director and chief curator of Slought, a nonprofit organization and network he founded on the Penn campus. In his work at Slought, and through numerous other collaborations, he has explored a range of sociopolitical issues, as well as the healing potential of the arts.

Aaron Levy:

I've always seen the arts humanities as really indispensable to imagine justice, and to making democracy. I don't know that this is the typical way that we often talk about the value and the importance of the arts humanities in the classroom, or on a college campus, but think they can be an incredibly important and impactful pathway to harnessing the power of university and community collaboration, and fundamentally to elevating stories and histories of the struggle for justice in the communities that surround us, that we're part of here in Philadelphia, but also beyond Philadelphia. One of the things I've been trying to do over these past two decades of teaching, and organizing, and curating, and programming, is to kind of reframe the arts humanities as having always been about the pervasiveness of suffering in people's lives. You know, a novel can be viewed as an opportunity to enter into the life of another, to see the world through somebody else's eyes.

But I've also found in my kind of meandering pathway through literature, and through the arts, something that goes maybe a little deeper. I see the history of literature in the arts as a history of individuals grappling with uncertainty, with anguish, with hopelessness, and all often with pain, and how they navigate those burdens is something that I think can enable us to navigate our own. So I've always had a very applied... I suppose I would call it that, like an applied relationship to the arts managers. I want to approach them as tools to help us live, and to help us cope with our own pain and suffering, and the inequities that we all have the capacity to organize around, and seek to mitigate.

Alex Schein:

Dr. Levy pursued his interest in the intersection of the arts and healing through collaborative projects at the University of Pennsylvania's Perelman School of Medicine, that wound up launching at, what it turned out, was a critical moment. The beginning of the pandemic.

Aaron Levy:

So several years ago, I had the opportunity to pitch to the CEO of the health system, Kevin Mahoney, kind of a vision for a more integrated approach to art and healing at Penn, and at Penn Medicine. You know, I saw that as building upon kind of a longstanding interest in this space, but also one that would respond to the unique challenges at this moment. One of the projects that came of that opportunity is the Penn Medicine Listening Lab. And it launched just before the pandemic, it really found its calling, found its meaning, amidst the pandemic. And as my collaborators and I kind of grappled with, and sensed, the really insurmountable kind of individual and collective enemy that was emerging, the profound grief and loss that was becoming embedded in people's lives, and particularly for those at the front lines in healthcare. And so if we had a vision for how art, and storytelling, and healing, could come together in a healthcare context, it really took a pandemic for us to understand how urgently needed this was, and could be.

Alex Schein:

The website for the Penn Medicine Listening Lab describes the project as a storytelling initiative that embraces the power of listening as a form of care. The site is home to a library of audio stories written and recorded by Penn Medicine staff and patients, who share their experiences and reflections surrounding healthcare. Experiences that had added intensity in the context of COVID.

Aaron Levy:

The community that we formed, that this project has always been steered by, is a community of patients, of caregivers, of clinicians, of staff members. And that community is so connected, right? And so it really was a question of whose stories could we elevate, which stories at a particular moment might be healing, both for the storyteller, and the community that was meant to reach and impact. You know, it was so evident to us that there would be a biomedical approach to the pandemic, right? That there would be diagnoses and treatments, there would be vaccines one day, and so much else, but that the arts humanities could play a role in thinking about how we psychosocially cope and heal from the pandemic. The project reached a turning point with a story recorded from Mathew Beshara early in the pandemic, called 56 Days. The story went viral, it really resonated in a very deep and profound way with many employees, and Penn Medicine.

Matthew Beshara:

My name is Matthew. I'm a minimally invasive surgeon in the gynecology department at Penn, where I'm an associate professor. I contracted coronavirus very early, and then I rapidly deteriorated. During the first week, I had a weird cough. I was fearful that it was coronavirus, and it was. By Saturday, the 14th of March, I was in the Pennsylvania Hospital emergency room to get a chest x-ray, thinking I was just going to stroll in there, and stroll back out. And that quickly turned into the need to admit me. I stayed at Pennsylvania Hospital for a week, and I was on a variety of medicines, but my oxygen requirements were rapidly increasing. The 27th of March, they recommended that I'd be intubated, because they didn't feel like it was safe for me to continue the way I was. They started talking about transferring me to HUP, which I think was the right decision.

Aaron Levy:

He ended up spending 56 days in the ICU. And when he regained his consciousness, he found himself in a state far different from where he had begun. He was no longer able to practice medicine as he had practiced it previously, and he was facing all sorts of cognitive, and visual, and other impairments, and mobility challenges. You know, getting to know Matt, getting to support him through that process was transformative, and difficult, and deep. Each of the nearly 50 stories that we've recorded and released through the Listening Lab are similarly transformative. These are not just stories of individuals lived experience, they're stories shared from someone who is struggling with inner grief, and profound sense of vulnerability and uncertainty. There's a therapeutic dimension to sharing, but also to feeling heard and feeling listened to, and that's integral to the work, and I think integral, again, to how I conceptualize the value of the arts humanities in times of crisis.

Alex Schein:

Dr. Levy me feels that in the classroom, students aren't always encouraged to engage with the arts in a way that helps them appreciate the full potential that works of art can have in processing trauma and loss.

Aaron Levy:

In kind of a typical art history seminar, again, we talk about art as something that can be source of edification, as something that emerges from the past, and maybe carries a certain beauty or resonance today. But in this work, we're really turning to the arts, with the hope of contesting the dehumanizing tendencies of modern life. We've all lived through so many kind of traumatic developments in these recent years, from the opioid crisis, and the gun violence epidemic that's such a horrible scourge that

the city is grappling with right now, to the pandemic of course, and the racial justice awakening, and now Ukraine.

Aaron Levy:

All of this is incredibly hard to fathom. The losses are often talked about in incredibly abstract ways. It is very easy to become desensitized, and to participate in the dehumanizing logic that is so common today. So I really see the arts, and humanities, and visual art in particular, as a way to counter that desensitization, to resist the tendency to dehumanize others in the way that we often do, as we scroll through the news on our phone, flipping away from one misfortune as we read about the next.

Alex Schein:

Over the years, Dr. Levy has pursued a number of collaborations that involve storytelling, the visual arts, and other media, and each of these projects are learning opportunities for him. He described some important lessons he drew from one of his major projects from 2010, the Perpetual Peace Project, which explored the problem of international peace through a series of symposia, exhibitions, lectures, and films.

Aaron Levy:

One of the fundamental insights that I took from those years of working on the Peace Project emerged when I was in Rwanda. I was working with a group of young students, they were the first students to attend a new architecture school. They were all orphans, and they were all forbidden from talking about the genocide, and talking about what had occurred, talking about their ethnicity, and so much more. And we found that it was possible to use the arts humanities to talk about what it often cannot be talked about in society. And this became a defining and kind of dimension to the project, and the work that followed. There are certain times when it is not possible to name a certain issue or crisis, or to address it frontally, for one reason or another.

And often the arts humanities can create openings through which change can occur. They can become an incredibly potent way to indirectly work through, either a personal or a social issue, that otherwise can't be addressed, and they can be the vehicle through which people can come together across the many divisions that we're also attentive to today. Divisions that are often so pronounced that we don't even know how to talk to one another anymore. So I always just want to go back to the arts humanities in these moments, and to think of them as not irrelevant, but essential to the work ahead.

Alex Schein:

It's this sense of possibility in the arts and humanities, the capacity to help us bridge divisions, and create openings for change, that makes them so relevant in difficult times, when what is needed most is hope.

Aaron Levy:

The amazing writer, philosopher, Ernst Bloch, once remarked that, "The most tragic form of loss isn't the loss of security, it's the loss of the capacity to imagine that things could be different." And one of the challenges today is that, as we reckon with so many cascading losses, and as grief has become such an incessant part of our lives, we've lost our capacity to remain hopeful, and to imagine that, as Bloch says,

things could be different. And this is where the arts humanities come in. This is why we need to be able to turn to the arts humanities in times of crisis.

Alex Schein:

In addition to the Listening Lab Project discussed earlier, Dr. Levy's work with Penn Medicine included a project organized around and the healing potential of the visual arts. To hear more about this initiative, called RX/MUSEUM, we talked further with Aaron, along with his chief collaborator on the project, Dr. Lyndsay Hoy.

Lyndsay Hoy:

My name is Lyndsay, and I'm a clinical assistant professor in the Department of Anesthesiology and Critical Care at the Perelman School of Medicine here at Penn. I do a lot of work in the medical humanities space, as well as physician wellbeing, and physician wellness. And I'm a faculty co-director of RX/MUSEUM with Dr. Levy.

Alex Schein:

The initiative presented a curated series of 52 artworks with accompanying essays intended to speak to the interplay between art and medicine. Once a week, the community of over 1,200 subscribers would receive an email including the featured artwork and commentary, to support the participants in their own process of personal reflection.

Aaron Levy:

So RX/MUSEUM is, at its simplest, a weekly prescription of art and reflection for clinicians. It's also an invitation to seek meaning through the everyday ritual of arts engagement, and in trying to join art history with contemporary reflections within a medical context, we're really trying to translate arts experience into relevant learning for clinical practice. An essential conceit of RX/MUSEUM has always been that the arts occupy an essential role in supporting physician wellbeing, through lifelong learning. And in collaborating with a healthcare system, museums across Philadelphia, and other civic institutions, to work toward this shared vision, we're trying to bring the museum to the physician with 52, really thoughtfully curated artworks, and accompanying essays. All in an effort, again, to embed the arts into our daily lives.

Lyndsay Hoy:

Our initial objective was to integrate the arts into clinical spaces, and really try to accommodate physician's demanding schedules, all of which took on newfound resonance and urgency as physicians started to face unprecedented trauma, and then of course, museums and other civic institutions started to close their doors. This is during the onset of the pandemic, which coincided with the launch of RX/MUSEUM. And so in response to some of these challenges, Aaron and I envisioned RX/MUSEUM to be a durational online curriculum of sort, that modeled a ritualistic practice of self-care during what was quite an unimaginably difficult time for so many. And a secondary goal was the desire to interrupt, transiently of course, the incessant productivity that's demanded of so many clinicians today, by asking our readers to spend a moment contemplating humanistic themes, such as reconciling uncertainty in medicine, and fostering community and belonging for patients and providers.

Alex Schein:

RX/MUSEUM was conceived prior to the onset of COVID, but the projects goals aligned perfectly with what the caregivers needed, as they tried to cope with the tsunami of suffering that the pandemic caused.

Aaron Levy:

The pandemic kind of drove home the urgency of this work for both of us. The pandemic has been a time marked by profound loneliness and vulnerability for so many. It's also kind of reminded us of the power of community, and the role that the arts can play in providing a lens to intimately explore the work of caring for others. And so we saw, in those early days, and weeks, and months of the pandemic, an opportunity to work together to foster kind of conversation, and around healing, and the ways that we can work compassionately care for one another.

Aaron Levy:

We both believe, passionately, that interdisciplinary projects across the arts and medicine are essential to supporting personal transformation, but also institutional change, especially in times of moral distress. And we're also cognizant of the extraordinary breath of suffering from the COVID 19 pandemic. And that suffering has yet to be fully understood, and measured, and treated. So RX/MUSEUM is at once for us a model for how this integration of the arts humanities and medicine can occur. But it's also, again, an invitation to seek meaning through the everyday ritual of arts engagement. Encounters with art, with artworks, much like encounters with patients and with each other, can catalyze connection, and they can become an incredible wellspring for healing and shared joy to unexpectedly emerge.

Alex Schein:

The 52 essays and artworks that formed RX/MUSEUM's weekly curriculum have since been captured in a book, published jointly by the project's partner institutions, including the Barnes Foundation, the Philadelphia Museum of Art, and the Slought foundation, along with Penn Medicine, and the Health Ecologies Lab, another initiative headed up by Dr. Levy. In an introductory chapter to that publication, Dr. Hoy and Levy distilled a set of 10 reflections from the artworks and essays, what they describe as meditations on the inherent value and applicability of the arts and humanities, to medicine and its practitioners.

Lyndsay Hoy:

Number one is the arts are an intercessor between one's own pain, and the burdens of the world. They help us to mediate despair and hope, the intimate and universal.

Aaron Levy:

Number two is the arts are an antidote to disillusionment, and a means to reaffirm the meaning and dignity inherent to dedicating one's life to the care of others.

Lyndsay Hoy:

Number three, at a moment when health systems and institutions are increasingly committed to racial justice, the arts are essential in visualizing society's contradictions, inequalities, and forms of oppression.

Aaron Levy:
Number four, the pursuit of meaning and fulfillment through the arts can be transformative in itself.

Lyndsay Hoy:

Number five, the arts and humanities reveal the continued tension between reason and irrationality, certainty and uncertainty, that is endemic to this moment, and medical practice more generally.

Aaron Levy:

Number six, the arts and humanities help us strive for agency, and forge communities of support in times of crisis, or in hostile circumstances.

Lyndsay Hoy:

Number seven, just as a painting is incomplete without its viewer, so too a society and a culture are without art.

Aaron Levy:

Number eight, the arts help us become more comfortable with the public expression and reception of grief and pain, both as a medical community and as a society.

Lyndsay Hoy:
Number nine, artworks are visual analogs of care.

Aaron Levy:

Number 10, the arts and humanities foreground, vulnerability, and presence, as key elements of authentic connection.

Alex Schein:

Dr. Hoy describes how one particular artwork from the Barnes collection provides inspiration for reflections around these themes.

Lyndsay Hoy:
So going back to the first reflection, which reads, "The arts are an intercessor between one's own pain, and the burdens of the world, and they help us to mediate despair and hope, the intimate and universal." This reflection was inspired by a 15th century vote of panel called Bishop and Saints, and this is from the Barnes collection. In the post Byzantine church, art was a vehicle to bear witness to the burdens of the world, and we think it serves a similar purpose today. In this piece, three saints are depicted: St. Roch or St. Roco, the early Christian martyr, Saint Sebastian, and then Saint Remigius, who were all believed to offer protection from the plague, and we were very taken by this work for its parallels with the present pandemic. Nearly every figure in this panel has some relationship to the bubonic plague, which is what was happening at that time in Europe, either as a survivor or a savior. The panel was likely displayed in a side chapel, or other highly visible location... public location, as a devotional aid for churchgoers.

So at a time when literacy was rare, and a resurgence of the bubonic plague was becoming more prevalent, transmuting the stories of the plague saints in this way would've resonated strongly with viewers. We wrote this essay in the spring of 2021, as we were transitioning into a new chapter of the pandemic, one less marked by disease and fear. The panel felt to us like a visualization of how we could move forward, without forgetting the losses of the pandemic, and that an arts viewing experience could be both cathartic and didactic. In this essay, we pose the questions of how can the arts commemorate the extraordinary grief carried by some, and the transformation likely experienced by all of us. We also ask how can the arts remain a means to navigate a new normal, and help us collectively reenter society? As depicted in this panel, what are some ways that the arts can move us forward in hope, however marked we may be by scars and loss? And then finally, how can the arts give representation to otherwise invisible struggles, and in so doing, help us heal?

Alex Schein:
And Dr. Levy illustrates the process using another example.

Aaron Levy:

So prescription 10 reads the arts and humanities foreground, vulnerability, and presence as key elements of authentic connection. And this prescription emerged in large part from our reflections on the work of Vincent van Gogh, and his painting The Postman, which is a portrait of Joseph-Étienne Roulin. It's from 1889, and it came to us through our partner at the Barnes Foundation on this project. And in this painting, van Gogh reflects on the restorative power of connection, and the restorative power of intimacy, and friendship. And throughout the pandemic, touch has become distanced for many of us, the typical ways in which we communicate with each other, and that we forge and find community, have more often than not been compromised. So throughout this project, we've also thought a lot about the restorative power of relationships, and the ways that friendship often conveys a feeling of being cared for, and can contribute to the complex matrix of things which impacts healing.

Aaron Levy:

To tell you a little bit more about this amazing artwork, in 1888, van Gogh moved to Arles, France, where he struggled with... really profoundly struggled with isolation and loneliness. And one of his few reprieves was found in his friendship with this postmaster, Joseph-Étienne Roulin, and the two men quickly forged a very close relationship, that deepened following an altercation with the artist Paul Gauguin in 1888, which prompted van Gogh to famously slice off part of his ear in a manic episode. And it was Roulin who remained a constant, who provided solace to van Gogh in the aftermath, and even had visited him in the asylum. And so in this artwork, we felt that van Gogh was in effect asking us to gaze with duration and tenderness at his friend, and at friendship itself. And this portrait it survives both Roulin and van Gogh.

And so we see this portrait, not just as an artwork, but as a tribute, as a testament to their amity, their friendship. In the humanities, the French philosopher Jacques Derrida's work is so foundational, and has been so foundational for me over the years. And in one of his books, The Politics of Friendship, he writes that, quote, "We continue to know our friend, even when they're no longer present to look back at us," end quote. And what he's saying there is that friendship is always bound by ethical obligations, and in a lifelong friendship, one will inevitably bury the other. And so for all of us that are part of the RX/MUSEUM team, The Postman is, at its core, a representation of a caring relationship. And in that sense, it's a model for caregiving, and for caring for others.

Lyndsay Hoy:

We love this piece, this is one of my favorite pieces in our collection. And in discussing the work, one of the other things that came up was how do we value friendship in an academic medical context? And as a collaborative, we kind of came to the consensus that it is really... friendship as an entity is really ill to find, despite its significant role in career development, and in individual wellbeing. So we explored how that can be maybe fortified, or built upon, in perhaps non-traditional ways. And in our essay, we ask about meaningful ways in which friendship can be transformative and empowering, both personally and professionally. And then moreover, how can medicine better recognize and foster those critical informal networks of support, particularly for individuals traditionally isolated, excluded, or marginalized by the academy, and how can that become fertile ground for driving change, from an organizational and institutional standpoint?

Alex Schein:

Dr. Hoy notes that projects like these are not a solution to the pressures endemic to the practice of medicine today, but they do represent an important response to the need for connection, humanity, and meaning that all of us, including our doctors, experience.

Lyndsay Hoy:

Aaron and I are cognizant of the fact that the arts and humanities, and RX/MUSEUM, and other like- minded initiatives, are not a silver bullet solution to the enumerable challenges facing physicians and other healthcare providers today. But we do very passionately feel that the arts are a vitalizing portal into shared experiences, and that it has the capacity to reveal a lot of things, perspective, and growth, as well as being present with one another. So we've really tried to highlight how an immersive arts experience can be an antidote of sorts to the languishing and isolation all by so many today.

Alex Schein:

This concludes episode one of In These Times, The Intricate Riddle of Life. Please join us for episode two, Joy and Plague, where we'll talk to a scholar of English literature about another era defined by loss, the black death of the 1300s, and how authors reported and responded to it.

The OMNIA Podcast is a production of Penn Arts and Sciences. Special thanks to Dr. Lyndsay Hoy, and Dr. Aaron Levy, who generously shared their time and reflections for this episode. I'm Alex Schein, thanks for listening.

Subscribe to the OMNIA Podcast by Penn Arts and Sciences on Apple iTunes, or wherever you find your podcasts, to listen to all seven episodes of season four of In These Times, The Intricate Riddle of Life.