In all human perceptual experience, nothing surpasses the ability of our visual sense to convey information and evoke emotions. Filmmakers masterfully harness the richness of the visual sense and couple it with auditory stimuli to create the ultimate storytelling experience – the movie.
Across the world, movies are enjoyed by people from all walks of life. No other art form pervades the consciousness of a person with such power and extent as cinema. During a movie, we are instantly transported into a dream-like state where we magically become connected with its characters, and the world they live in.
Due to their powerful visual impact, movies captivate the hearts and minds of viewers and exert greater influence than many other art forms. Movies are a mirror that reflects our everyday life experiences. They transcend age, gender, culture, time, geographical and professional boundaries. In a short hour or two, viewers are immersed in a cornucopia of social, cultural, and political themes, experiences and perspectives. Movies thus have the power to shape our attitudes and behaviours.
What do medicine and movies have in common?
Medicine and movies are both art forms that involve stories. Medical practice is a series of interactions with successive patients. Each patient brings a problem that is framed in the context of a unique life story. The doctor-patient relationship involves narratives of illness and suffering as well as the collaborative search for healing, relief and comfort.
Through the stories they tell, medically themed movies portray patients’ experiences with illness and suffering, explore ethical conundrums and the complex dynamics of the doctor-patient relationship – issues concerned with the humanistic aspects or the art of medicine.
Why should we bother about the medical humanities?
Modern medicine has been increasingly dominated by a biomedical approach. It is often practised within the constraints of increasingly corporatised systems driven by performance metrics. Clinical pathways designed to improve efficiency and promote evidence-based practice seldom adequately promote person-centred care. A growing disconnect between what our patients seek and the care we provide calls for us to reconnect with the humanistic roots of medicine and the art of healing the person behind the illness.
Humanism has been at the heart of the medical profession since its establishment. Humanistic values such as compassion and respect for others form the basis of the therapeutic relationship and integrate the psychosocial and biomedical aspects of care. The medical humanities draw on the arts to stimulate deep reflection about complex issues in healthcare. They imbue in us professional attitudes and behaviours which demonstrate an authentic interest in and respect for our patients as human beings.
How can movies improve medical practice?
In the face of the escalating threat of dehumanisation of medicine, movies can foster empathy and compassion in clinicians, helping us reconnect with the heart and soul of medicine – treating the person, not just the disease.
Movies provide an evocative window into the realities of medical practice. They open the door to a world of exciting possibilities for reflection about humanity, morality and mortality – all issues at the heart of medicine. Movies also provide a stimulus for doctors to introspectively reflect on our humanness – our feelings, vulnerabilities and self-doubts – and how we relate to our patients.
Movies that influenced my practice as a doctor
From Hollywood to Bollywood to Korean dramas, movies have played an integral role in my professional development first as a student, then a junior doctor, and now a psychiatrist.
A Beautiful Mind is a movie that left an indelible impression on me as a young junior college student and then-aspiring doctor. This biographical drama portrays how mathematician John Nash overcame schizophrenia to win the Nobel Prize for his revolutionary work on game theory. It transported me into the world of a schizophrenic patient – one far detached from reality, ravaged by hallucinations and paranoia – and allowed me to witness the anguish that it wreaks on patients and their loved ones. Despite witnessing the risk Nash’s illness posed to others and himself, his wife Alicia stays by his side and supports his decision to reject antipsychotic medications and work out a way of coping with his psychotic symptoms. In a poignant final scene, showing his victory over the illness which derailed his life, Nash delivers his acceptance speech for the Nobel Prize while still hallucinating. He integrates his identities as a mathematician and schizophrenic patient and delivers a moving tribute to his wife for her unwavering support throughout his journey of recovery.
As a psychiatrist, I would not suggest that sheer willpower and family support alone can overcome a severe and persistent mental illness such as Nash’s schizophrenia. However, an important lesson I learnt from this movie is how humanistic values such as empathy and respect for a patient’s autonomy in rejecting our best and well-intentioned medical advice can also facilitate the healing of the whole person.
Many other excellent movies and drama series which hold valuable lessons for doctors have impacted me in my professional growth as a physician and medical educator.
Munna Bhai M.B.B.S and Patch Adams, both movies set in medical schools in different parts of the world, ask hard-hitting questions about whether physicians should be cold, detached master technicians of our craft, and the extent to which timehonoured professional boundaries can be crossed to provide compassionate care to our patients.
Doctor Stranger is a Korean drama series about a genius cardiothoracic surgeon. As a child, Park Hoon and his father, a cardiothoracic surgeon himself, were tricked into North Korea and prevented from returning to the South as part of a political plot to prevent the latter from testifying in a malpractice suit. Park’s father trains him to become a doctor, inculcating in him the value of always putting the patient first. After his father was killed, Park flees to the South and begins working in a top hospital where his values are put to the test in the face of professional rivalry, political horse-trading and conflicts of interest. This drama presents a sobering reminder that as doctors we are equally human as our patients with problems, needs, dreams and aspirations of our own. However, serving our patients’ best interests must always be our foremost priority and motivation.
Using movies in medical education
Wit, a movie about an English literature professor’s struggle with and eventual demise from metastatic ovarian cancer, has been used as a tool to teach empathy in several medical schools. As Vivian becomes increasingly ill and undergoes more experimental treatments, she perceives that her doctors see her more as an object of experimentation and an illness to treat, rather than a person to save. The only one who seems to care for her as a person is one of the nurses on the team.
The Health Wellness Programme (Assessment and Shared Care Team), one of Changi General Hospital’s community mental health programmes, organises “Psychiatry in the Movies” events as a training and engagement platform to facilitate primary care physicians’ and other community partners’ learning about mental health conditions and associated practicerelated issues. Manchester by the Sea (grief and depression), Silver Linings Playbook (bipolar disorder), and Still Alice (Alzheimer’s disease) are some titles that have been screened. Following the movie, the audience is invited to share reflections on the conditions portrayed and the attendant professional, ethical and social issues. Participants regularly feedback that this is a relaxing yet impactful learning experience.
Concluding words
In her classic novel To Kill a Mockingbird, Harper Lee penned perhaps one of the most fitting definitions of empathy: “You never really understand a person until you consider things from his point of view... until you climb into his skin and walk around in it.”
It is a tall order to even begin understanding how another thinks, feels and behaves. As we strive to empathise with our patients, we could well use some help to bridge the growing chasm of misunderstanding between them and us.
Movies offer far more than mere entertainment. Through portraying medical themes ranging from illness and death to hope and recovery, movies provide an evocative lens through which we can consider the different perspectives of patients, healthcare workers, caregivers and society at large. By promoting deep thinking and reflection about complex practice-related issues, movies challenge paradigms, enhance self-awareness and shape our practice attitudes and behaviours, and in so doing encourage us to become more humanistic, personcentred doctors.