From Looking for Missing Pieces to Recognizing the Bigger

Picture: What Health Workers can Learn from Art

Olaf Kraus de Camargo@DevPeds

March 3rd – 5th 2016, Hamilton Convention Centre

http://tinyurl.com/pickwell

Curing x Curating• Same Latin origin: curare = to take care

Understanding cure as elimination of illness makes us focus more on the diagnosis than on the person

Curating: selecting and exposing pieces of art – putting them in context

What could be the role of “curating” in health care?

The Power of Diagnosis• Power to the diagnostician:

Ability of prognosis (knowing before) (chance of dying, years of life left, ability to reach milestones, future opportunities on the job market)

The Power of Diagnosis• Power to the therapy provider:

Select access to care Specialize treatment Fend off competition (”not qualified”)

The Power of Diagnosis• Hope to the “patient”

Get rid of the disease (be “cured”)

The Process of Diagnosis• “Looking for missing pieces” – a process of ruling out

Did the child meet all the developmental milestones? Did the child grow within the normal range? Has the child presented with other health problems? Does the child have an abnormal physical exam? Is there a family history for a specific diagnosis?

The Art Institute of Chicago Gift of Frank B. Hubachek © Salvador Dali, Fundacio Gala-Salvador Dali / Artists Rights Society (ARS), New York, 2014

Appreciating Art• What is the first thing you see?

• Where do your eyes go next?

• Consider how the artist uses the elements: colour, texture, shape/form, line, and space

• Consider how the artist uses the following principles: balance, emphasis, and movement.

• Keep in mind how the medium/media, size, and style of art affect how you see it.

• Look again – what does it mean to you?

Meet Lars*• Boy, 4 years old

Ex-preemie of 32 weeks, birth weight 1665g (ICD10: P07.12)

Double-outlet-right-ventricle (ICD10: Q20.2)

Valvular and infundibular pulmonary stenosis (ICD10: Q24.4)

Global developmental delay (ICD10: F70.0)

*Kraus de Camargo O, Simon L. Die ICF-CY in der Praxis. Bern: Verlag Hans Huber; 2013

The Missing Pieces

The Missing Pieces

The Missing Pieces

The Missing Pieces

The Big Picture

Far from the Tree*

*Solomon A. Far From the Tree: Parents, Children and the Search for Identity, Scribner; 2012

Meet Lars*• Boy, 4 years old

Father is in jail Custody disputes between parents and CAS is involved Disagreements between professionals if Lars should be allowed to visit his

dad Required multiple hospitalizations Has difficulty to establish trusting relationships, shy, withdrawn Gets easily stressed in Kindergarten, educators are not sure what to expect

from him and how to support him*Kraus de Camargo O, Simon L. Die ICF-CY in der Praxis. Bern: Verlag Hans Huber; 2013

Appreciating People with Health Problems

• What is the first thing you see and hear?

• Boy, 4 years old Father is in jail

Appreciating People with Health Problems

• Where do your eyes and your mind go next?

• Who takes care of this kid? Custody disputes between parents and CAS is involved

Appreciating People with Health Problems

• Consider how life set up this person in front of you: her family, work, living environment

Gets easily stressed in Kindergarten, educators are not sure what to expect from him and how to support him

• Consider how life presents: balance, emphasis, and trajectory.

Disagreements between professionals if Lars should be allowed to visit his dad

Required multiple hospitalizations Has difficulty to establish trusting relationships, shy, withdrawn

Appreciating People with Health Problems

• Look again – what does it mean to you?

A 4 year old boy in need - How can I help? Importance of getting all professionals on the same page –

interprofessional collaboration Importance of identifying facilitators, strengths and

resilience in the family and the support system Importance of stable and trusting relationships

Health Professionals as Curators

• Appreciate persons beyond their diagnosis• See persons in the context of their life situation• Take care of persons by looking at the big picture

Thank you!

“Everlast” Part of “Tensor Teddy” by Michelle Bellemare, 2002