Highlights from Foundations week 2019

On July 7, 2019, students from all across North American arrived in Hanover to check in for the exciting week ahead.

On the last day, participants participated in a Moth Minute, where they shared a few thoughts about how the week had changed them, their perspectives, or things they took away from their experience.

While they spoke, Eisner award-winning comic artist, writer, publisher, illustrator Ricardo “Liniers” Siri drew each of them.

Jazz, vampires, and tackling rugby dummies are not traditionally part of undergraduate health care studies. But the aspiring health care leaders who attended the Dartmouth Health Care Foundations Summer Institute are not interested in traditional approaches. Over the course of an intensive week, faculty and clinical experts guided students through a week of exploring how the humanities can offer new perspectives and strategies for improving patient care and creating a generation of resilient and compassionate health care professionals.

“To achieve real transformation in health care, our future leaders are going to have to be able to think holistically about science and the humanities. We designed Foundations to support students to think critically and creatively about health care,” says Director of Professional Education Manish K. Mishra, MD, MPH.

Day 1 Topics- Interdisciplinary Approaches to Health Care; Principles of Addiction; Lived Experiences of Addiction

Co-Directors Manish Mishra and Elizabeth Carpenter-Song, PhD, kicked off the week with an interactive exercise in which students worked collaboratively to describe “healthcare” in one word. Their diverse answers laid a strong foundation for the themes discussed during the remainder of the week.

Later in the morning, Alex Magleby ‘00, former Dartmouth rugby captain and head coach of the USA Olympic Rugby team, used a tackling exercise to illustrate important lessons for future health care professionals.

Magleby discussed how team dynamics on the rugby field can provide important lessons for students and health care professionals about giving and receiving feedback, productive responses to setbacks, and learning to support others.

The day ended powerfully with a patient’s own story of heroin addiction, as students explored the physiological processes and lived experiences of addiction.

Day 2 Topics- Faith and Care in Harlem; What is an Opiate?  99 Faces and changing the culture of mental illness; Managing Addiction in the Emergency Room

On the second day of the intensive, Vaughn Booker, PhD, Assistant Professor of Religion and African and African American Studies led a session on the work of jazz legend Mary Lou Williams who created the Bel Canto Foundation to help musicians suffering from substance abuse return to performing.

Booker’s scholarship illuminates how cultural creativity can be an important component of practices of care, comfort, and healing for marginalized communities. 

The day continued at Dartmouth-Hitchcock Medical Center with emergency department physician, Matthew Babineau’s unflinching insights into the lived realities of providing emergency care to patients with opioid addiction. 

Then Marianne Barthel, Director of the Dartmouth-Hitchcock Arts Program, led participants through the 99 Faces Project designed to reduce the stigma of mental illness.

Finally, John T. Broderick, Jr., JD, Dartmouth-Hitchcock Senior Director of External Affairs and Former Chief Justice of the NH Supreme Court shared his family’s journey of understanding mental health and learning how to deal with the signs of emotional suffering.

“The biggest thing this program has given me is confidence and hope—hope that, despite the complex issues facing health care today, the program offered real examples of how, when people from all fields work together, positive change can occur, both globally and in our local communities, for the most vulnerable populations..” – Adina Hari, student

Day 3 Topics- Re-thinking Opiates in a Global Context; Music and Medicine; Culture of Biomedicine and Marginalized Populations; Medical School and MPH Admissions Panel

Students connected via Skype with Smriti Rana, the program director for Pallium India, and M.R. Rajagopal, MD, widely considered to be the ‘father’ of palliative care in India, to discuss how Pallium is working to improve access to pain-relieving medicines in India. Rajagopal challenged students to attend to the “global burden of suffering” in their future careers in health care.

Later that day, Eisner Award winning Liniers, Argentine cartoonist, spoke with students about what success looks like, which is not always what one anticipates.

Anne Sosin, Director of the Dickey Center talked about the ways that the poor live and die in the U.S. and how to bring global health to these marginalized populations. Medical anthropologist Elizabeth Carpenter-Song, PhD, gave a detailed account of health care experiences among marginalized rural populations to provide insight into how the culture of biomedicine may contribute to the persistence of health disparities.

Day 3 ended with a lively panel discussion led by Aileen Panitz, Director of Admissions at the Geisel School of Medicine, and Courtney Theroux, Director of Admissions at the Dartmouth Institute for Health Policy and Clinical Practice.

“We heard from so many brilliant speakers that hailed from all sorts of backgrounds ranging from healthcare to art, writing and music. These varied viewpoints allowed for a better picture to be painted of what healthcare is and how it can be included in so many different ways.” —Lucas Blackmore, Student

Day 4 Topics- Introduction to Motivational Interviewing; Mindfulness; Learning about Addiction by Studying the history of the Vampire; Improvisational teamwork

Caitlin Barthelmes, Director of the Student Wellness Center at Dartmouth, introduced students to Motivational Interviewing and methods for maintaining mindfulness throughout the day. Students practiced mindfulness through exploration of the surrounding woods and hills.

That afternoon, Museum Education Consultant, Hood Museum of Art, Dartmouth College, and Neely H. McNulty, Hood Foundation Associate Curator of Education, used museum art to teach participants to look beyond the surface and to think about what is behind what we see.

Mary Flanagan, PhD, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth, talked about how the image of the vampire —a historically marginalized creature that behaves in conflicted ways, —provides a metaphor for studying addiction. The discussion focused on how critical reading and character development can help health care professionals to respond compassionately to those who are suffering.

The 4th day ended with Adjunct Assistant Professor Donald Glasgo, and Director, Barbary Coast Jazz Ensemble, Emeritus and members of the Rusty Berrings Brass Band talked about improvisational teamwork. Their musical foray culminated in a kazoo performance including the students.

Day 5 Topics- Health care is “Broken”; Disrupting Education in Order to Create Patient-Centered Community Services and Social Capital

The last day built on the core themes of the week to identify ways in which contemporary global health care is “broken” and to develop strategies for addressing urgent challenges.

Students connected via Skype with Dr. Agnes Binagwaho, MD, PhD, former Minister of Health of Rwanda and the vice chancellor for the University of Global Health Equity in Kigali, Rwanda. Binagwaho invited students to model their advocacy on her renowned work creating patient-centered services through community engagement and participation.

The lesson of the importance of providing care that meets the needs of communities was then extended by Professor Glyn Elwyn, MD, PhD, who discussed patient preferences as a guide for health care. Elwyn presented the approach of Shared Decision Making, giving students a specific framework and method for placing patient preferences at the center of care.

In the afternoon, students shared what they aspire to carry forward with them from the week in the format of a “moth minute.” Certificates were given to participants in a short ceremony accented by the impromptu accompaniment of kazoos from fellow classmates.

Certificates were given to participants in a short ceremony accented by the impromptu accompaniment of kazoos from fellow classmates.

“The greatest part about this program was meeting so many like-minded students from around the country with so many great ideas. They offered new perspectives into the inequities built into the healthcare system that gave me hope for its future. I was surrounded by brilliant people hoping to use their career in medicine to make changes, which was empowering.”—Jasmine Myftija, student

Check out lots of pics from the week on Flickr.

tdi.dartmouth.edu/foundations

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Necessary Injuries: Reflections on Sacrifice from a Former New England Patriot and an Orthopedic Surgeon

January 2019

Tonight, Brian Barthelmes, former New England Patriots Center and James B. Ames, Orthopedic and Sports medicine surgeon visited us in Dartmouth Hall. In the spirit of the upcoming Superbowl, the night kicked off (Punt intended) with pizza and wings from Ziggy’s. Dr. Manish Mishra introduced himself and co-director Dr. Elizabeth Carpenter-Song. He opened the seminar with a brief overview of the purpose of the seminars which is to create a new career approach for people who want to go into healthcare—research, clinical care, or policy.  Mixing humanities and health care is not new, but our approach is new. Our goal is to help people interested in health to develop their values in that work and be courageous in it. Particularly before you get into a health care space so you don’t end up adopting other people’s values, which may not map to your own intrinsic values. Supporting that is achieved by creating a community, by open dialog, and having monthly seminars where we model folks involved in the health care and those involved in other things to show how, regardless of what you are doing, your principles and values are being developed now before you enter the workforce.

Dr. Mishra asked us to consider a framework: understanding arts and humanities is critical to being in this difficult terrain. Arts and humanities teach you important things that go well beyond the fact and teach you how to navigate those facts.  Hold on to what you are interested in and use that as your springboard to get a better sense of self. “Know thyself “(Socrates).

Brian Barthelmes is a guitarist, artist, illustrator, and tattoo artist. Dr. Jamie Ames is an Orthopedic surgeon who dabbled in education. Brian grew up in rural Ohio, in Amish country. He didn’t like football but got into it because that’s what his dad did.  His mother was a swimmer; dad was a coach, so sports is what you did. In college, life feels out of control between school and sports, so he decided to learn the banjo. School, football, and parents had control of his body and his time, but they didn’t have control of his playing banjo. At the end of college, he didn’t know what he wanted to do but knew he didn’t want to go back to Ohio. He went on to talk about the intensity of being a professional football player including the time that was spent away from family, the mental intensity of the game, the demands of practices, and the toll on his body. Music and art are safe places for him mentally, it kept him balanced and aided in his success.

Dr. Ames went to Ivy league schools, spent 11 years in pre-professional training but spent a year post-college in Colorado experiencing life differently as a teacher.  He took the lessons he learned there with him and learned to look at his work differently.  His goals as then, continue to change constantly.  You must check your values and say yes to those things that speak to you to be able to do the job well.  He is constantly making decisions what he wants to do.  If you say yes to everything or aren’t open to change, to follow what inspires you, you will burn out quickly.

Brain said that the stress eats away at your ability to focus. If you don’t know yourself, then you don’t know how to prevent it.

Neither of these guys could have gotten into this professional space without holding on to what was important to them.

ECS: what are strategies that you used to reframe to find joy in that struggle?  Brian: always checking what my motivation was. Protecting his friends became his motivation for a while. Jamie: coming back to a place where I had trained, suddenly all eyes on you. Expectations are high.  Being able to fall back on friends from other walks of life who could care less about my struggles was hugely helpful. Reach outside of it and reach other folks. You have to create opportunities outside of these spaces for yourself.

MKM: how do you protect yourself against conflicting values that others wish to expose you to?  Jamie: you know that everyone struggles, no one comes out unscathed.  Brian: people come from every walk in life, some are overconfident, know yourself and your motivation, so you don’t get lost in that shuffle.

Brian: when I stopped playing football, I didn’t know what I wanted to do.  I had to take a giant leap of faith, and I’m really glad that I took that chance


Today was Brian’s birthday, so we thanked him for spending it with us with a cake.

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The Journey Begins

Thanks for joining us!

Dartmouth Health Care Foundations gives students a strong base of knowledge from which to engage in current health care conversations and begin to lead change. Dartmouth develops essential skills for thought leaders in all aspects of public health, especially next-generation health professionals will learn the foundational skills needed to gain a well-rounded understanding of health care domestically and overseas.

There are two components to this journey:

1. During a week-long, on-campus seminar in July, participants delve into the connections between health care and humanities working closely with experts in the field–both local and global.

2. Each month, experts from the Arts, Sciences, Humanities, & global leaders will guide you to think holistically & creatively about healthcare using a humanistic approach.

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