Issue 7 • Spring 2018

ISSUE 7 • SPRING 2018

contents

3 From the Editors 4 Songs of Old, Lives of New 7 Social Determinants of Atrocity 9 Lost in Translation 11 Arts-Based Storytelling: Engaging Clients in Meaningful Recovery

14 An Interview with

Dr. Catherine Morley

18 An Interview with Dr. Yvette Lu 22 Art and Healing 24 Uncertainty and Altruism: From the Perspective of a Stem Cell Donor and Recipient

26 Embracing the Arts:

Transformation & Inclusion

29 The Conversation Canada 31 The Voices Inside Your Head

The Success of a Novel Therapeutic Software for Auditory Verbal Hallucinations

33 One Drag at a Time 36 A Pivotal Question Can

Lead to a Change in Outlook

39 They Tell Me Things 40 Tobacco Child 41 Shared World, Divergent Reality 42 Galaxy of Narratives 43 Staff

Cover art by Heather Zhao

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FROM THE EDITORS Throughout the planning of this issue, we knew we wanted to choose a theme that encapsulated The Muse.

What we didn’t know was that it wouldn’t be the theme that shaped the pieces in this issue, but rather the pieces that came to shape the interpretation of this theme for us, our staff, and hopefully, for you, our reader.

We have received a compilation of pieces from across Canada, from as close as Hamilton, to as far as Vancouver and Nova Scotia. Perhaps this magazine is a crossroad in itself, with the intersection of so many stories, opinions, disciplines, and places. We have pieces ranging from artificial intelligence in healthcare to the power of music while facing death. The diversity of these pieces reveals to us that health is not black and white, nor is it left or right. With the time that we have dedicated to leading this medical-humanities initiative, we have come to understand more and more that health does not depend on a sole factor, but rather a collection of paths that come together as one.

Dear Reader, Crossroads.

What does this word really mean?

Multiple images come to mind: Train tracks intersecting, street posts with arrows pointing either direction, a dichotomous decision, a single choice that takes away the other.

Although the word itself is not often used, we face crossroads in our daily lives. We face it in the seemingly simple everyday decisions: Coffee or tea? Sweater or t-shirt? To go to class or sleep in?

But the word, crossroads, can describe much more than a difficult decision. It can describe intersectionality, just as it can describe divergence. These multiple definitions lie within the beauty of language, where one word can represent a variety of situations, states, and emotions. And this beauty is what storytelling so aptly captures.

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Our experience has been one of give-and-take. It was a crossroads of the work of our diverse platform and team – with Bloggers, Events, Social Media and Advertising, Graphics and Layout, and Editors. Without the hard work and passion of our members, The Muse would not be what it is today. We would also like to thank our supervisor, Dr. Ellen Amster, for her continued support and guidance.

Lastly, of course, this magazine would not exist without you, our reader. We can only hope that with the content we produce, that you would be encouraged to view healthcare with a wider lens, zooming out from the microscopic molecules to the bigger picture of arts, relationships, and mosaic cultures. Although, molecules themselves may share their own stories. What is your story?

Until next time,

Katherine Kim & Nikki Wong

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Songs of Old, Lives of New

By Michael Averill Art by Grace Huang

If your eyes have landed on this page, warm greetings! As a Vancouver-based storyteller, songwriter, and wandering minstrel, I welcome you to my contribution to the “Crossroads” issue of The Muse.

I was asked to share the story of how I ended up developing music-based workshops centered on grief and loss, so here we go.

I had chosen to spend time with, and the experiences I had had. From that point on, I figured, if this is it for me, it’s been a good run, and I’d welcome whatever was next to come. However, if things went well, every day forward would be a bonus. Might as well make the most of it and stop being afraid of the insignificant worries I had allowed to form into unnecessary stress.

I moved to Vancouver from Kelowna, BC in 2001 to study Human Kinetics at UBC, and to compete for the Track and Field team. During my time there, my life revolved around sports, friends, and learning about health and wellness. It is also where I overcame my fear of performing in public. I quickly learned how powerful music could be with regards to fostering community and connection.

Through my studies, I became a personal trainer, and worked in the industry over a period of 7 years. It sounds like a healthy career choice, but truthfully was the unhealthiest period of my life. I was chronically sleep deprived, was physically exhausted, and had internalized all of my mental struggles and problems.

It all came to a head in 2009 when an unusual little mole on my arm turned out to be cancerous. It didn’t seem like a big deal at first, but upon being cut out, it was found to have burrowed deep enough to have potentially trespassed into my lymph

system. I had to wait a couple of weeks for the surgery to confirm that possibility, which brought forth unavoidable thoughts of my own mortality.

This situation forced a rapid evaluation of what I had done with my life up to age 28, and if I was satisfied with it. Not knowing the severity of my situation took my mind to dark places. “What if this is it for me?”

“Am I happy with what I’ve accomplished?”

Even though I was in a rough state, I found a sense of contentment with what I had achieved, the people

You can probably guess that because I have written this article, everything turned out okay, and I am still alive. The possibility of death gave me a new perspective on living, and taught me that we have no control of our time here. I started changing my priorities and made choices that ultimately led to embracing more music in my life.

I started going out to more open mics, playing shows with artists I loved, and started to look seriously about a life in music.

During my very minor brush with cancer, I noticed I had a lot of difficulty communicating with others about it. It wasn’t that there was a lack of support from the people in my life. It just felt like something you don’t talk about. Death is sad.

Death is uncomfortable. Death is a kind of a secret we don’t like to talk about.

In 2010, my father became terminally ill with a rare form of cancer, and it propelled me to make a big change.

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Songs of Old, Lives of New 5 In April of 2011, I left my personal training job with the goal of pursuing a career in music, and spending more time with family. My dad wasn’t given a long timeline, and I wanted to see him as much as I could.

Just before my last day at work, I had a conversation with a friend at the gym. It ended with an offer to be a part of a team of mixed artists traveling to remote mountain villages in Nepal. The trip was slated for April 2012. It seemed like an amazing opportunity, and for me, felt like a sign that I’d made the right choice.

A couple of months after I made the decision to commit to the trip, my Dad took a turn for the worse. He was moved to a hospice to receive the round the clock care he needed.

One thing to know about my Dad is that until the last year of his life, I had never heard him use the word “love.” I came home to visit more often, and every time I left, I felt that I had missed an opportunity to say…something. What it was, I wasn’t sure, and I couldn’t figure it out. Every time I left, I felt regret and worry that something had remained unsaid.

I processed a lot of what was going on through writing music, and being around other performers and artists. I had never been skilled with communicating my feelings, and writing songs became the best outlet for this.

It took me roughly 3-4 times of visiting to realize what I needed to say to him. I realized I had never really voiced the words in a meaningful way. It was actually quite simple – an honest deep down “Thank you.”

Seeing my Dad’s face when I said this to him was a sight I will always remember. Something shift-

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ed within him. His reply, for the first time verbally in my life, was “I love you.” This exchange came with a massive unloading of what felt like a slow squeezing pressure on my heart, and left me with a sense of both relief and acceptance for his impending death. I had a feeling that what needed to be said was said, and just like what I learned from my mole, any future time we had together would be bonus.

From that point on, I started seeing past the fact that he was dying. In conversations with friends, family, and visitors, I noticed that there was too much discomfort and worry about what to say and what not to say during times like these. We’re afraid to say the wrong thing.

“The possibility of death gave me a new perspective on living, and taught me that we have no control of our time here.”

Music became more integral with my Dad in the hospice. Sometimes he would play, but most of the time he just appreciated listening. The last stretch of time with my Dad felt like some of the most connected time I ever had with him. I felt that any self-imposed conversation barrier I had created before was now gone, and our conversations became more open and authentic.

He would ask me to play my songs, some of which seemed to have a therapeutic effect in helping him relax and sleep. This was another pivotal time in which I witnessed the power of music. It seemed to break the ice for deeper conversation to take place.

By this point in time, my Dad had expressed to my Mom that he was

growing weary of sitting around waiting to die. The decline of his health over the year had worn him down.

The day I had to return to Vancouver, I was reading him quotes out of a book my friend had given me called “Illusions,” by Richard Bach.

There was a line in there that read, “If you ever wondered if your life’s purpose is complete…if you’re still alive, it isn’t.” I felt the second I finished reading this out loud that maybe I had said something wrong.

I looked at him for his reaction, and he just chuckled, looked at me, and we laughed together.

I took the Greyhound west, and the very next morning, received a phone call from my Mom that my Dad passed away. After our call, I sat down and looked out the window towards the ocean. I sat for a while, ruminating on how precious the time we have with each other really is. It is so important to say the things that need to be said: to clear the air, to express our feelings, gratitude, frustrations, and love. I was thankful that the events played out the way they did, and that I had numerous chances to say what I did. If I hadn’t, I know I would have regretted it the rest of my life. The whole experience made me think, “Why did I wait till the near end to say that?”

A wild chain of events followed. I released my first album, went to Nepal, China, and Europe, and learned from many people along the way that death is the only guaranteed thing we have. It’s going to happen, so why be afraid of it. Live as much as you can, while you can.

In North America, or at least in my experience with this region of the world, death seems to be something to fear. We live in a culture that promotes hiding from death, or

6 Songs of Old, Lives of New any signs of aging for that matter.

I started asking more questions as to why.

In 2013, I started a walking tour of Canada in honour of my Dad. When he was alive, he walked everywhere, loved it, and greeted everyone along the way. It is with this friendly walking spirit that I set out to learn more about my home country, and further understand how others dealt with loss, I wanted to create safe spaces for people to be able to freely converse about death and for them to potentially experience a healing effect through music.

I have now walked over 2700 miles across Canada, and had the most beautiful conversations with people of almost every region of the country on the topic. In one instance, an old classmate of mine reached out and asked if I could run a grief and loss workshop with the seniors at the center she worked at. She spoke of how many of them had friends passing away, and wasn’t sure how to best address it. I was intrigued by the opportunity, but also intimidated. Who was I to talk to people aged 70 to 90 about death and loss?

Despite my own doubts, I accepted.

This was a perfect opportunity to bring forward what I had learned, and I was quite curious to see how it would play out. I decided to call it “Songs of Old, Lives of New.” A week before the workshop, I went

in to play some music during their lunch session. It gave me a chance to chat and listen to some of their stories. For them, seeing and listening to music brought up a great deal to converse about, and it gave me insight into the kind of people I’d be doing the workshop with.

When the workshop day came, I was the most nervous I have been for anything in my life. It felt really emotionally loaded. These people didn’t know me, and here we were going to have a talk about one of the most sensitive subject matters you can have.

“We live in a culture that promotes hiding from death, or any signs of aging for that matter.

I started asking more questions as to why.”

I shared a unique story about my discovery of my Dad’s music in the Yukon. I played some of his songs, and some of mine. From there, I decided to ask if anyone had any thoughts, questions, or feelings about what I presented. A few people requested that I play some more songs, such as “This Little Light of Mine”, “You Are My Sunshine”, “Four Strong Winds”.

At first, it didn’t seem like my story was of any relevance. However, after sharing some laughs through the joy of singing together, one by one, they opened up. All of a sudden, it was okay to share their deepest kept emotions, pain, thoughts, and burdens. Once that was cleared, it seemed to pave the way for fond memories of lost loved ones to be shared. It was one of the most beautiful moments I have ever had the privilege of witnessing.

That day, music floored me. I felt that a few people underwent deep healing there, but it wasn’t from me trying to solve their problems or telling them what they needed to do. The simple act of singing and sharing stories together made something quite magical happen.

If they had been feeling stuck or standing at any kind of crossroad, it appeared that music, in that moment, enticed them down a positive path of grieving.

I left, sat down on a bench in a park close by, and cried. I can’t tell you exactly why, other than that the rawness of emotion I saw at my workshop deeply touched me. Like with my Dad, I experienced the sensation that a weight was lifted. Feeling lighter, I was inspired to carry on and make the most of the day.

Maybe that’s the secret: live life like it’s a bonus, share honest feelings with loved ones, and if it seems hard to do either of those things, music will help it along.

ABOUT THE AUTHOR - Michael Averill is an adventurous Canadian troubadour who delivers stories and songs of serendipity around the country by foot. He has covered 2700 miles of Canada with a project called “I’d Rather Walk,” and captivates his audiences through heartfelt Roots, Folk, and Blues. His work speaks to the importance of health, community, grief, and the importance of human connection.

“Michael has a pied piper quality to him. He is a community builder, scene creator, and movement organizer. He is a teacher and inspirational leader that has the ability to gather the arts community around him, and take them in directions they might not achieve on their own.” – Chris Brandt, Executive Director of Music Heals Onstage, Michael’s performance versatility ranges from southern lap steel slide blues, to intricate finger-style folk, to driving Celtic. He combines buttery guitar licks and philosophical wordplay into an intriguing musical experience.

Inevitably, show-goers leave with joy filled hearts, new friends, and positively charged minds.

THE MUSE • SPRING 2018

Social Determinants of Atrocity

By Edward W. Li Art by Kelly Dong

The closest I came to understanding what it feels like to be a victim of wartime atrocity was when I contracted the common cold during the spread of the severe acute respiratory syndrome (SARS) virus—or, at least, when I first emerged from not knowing and awoke into my mother’s nightmarish recollection of what it must have been like taking care of a sick five-year-old in foreign Canada.

As someone who grew up in a time and place privileged with relative societal peace, it is difficult for me to imagine the lasting trauma suffered by victims of war. Yet, whether it be related to a physical insult to the body or the knock-on burden of mental worry imposed on a caregiver, a disease of any sort often invokes the very familiar notion of loss. Upon immediate inspection, this notion of loss may be the taking-away of a physical ability once had.

For me, it was a momentary confinement to my bed, pending my probable return to full strength.

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Social Determinants of Atrocity For my mother, it must have been a longer and more arduous sort of confinement as she wondered what would have happened if that recovery failed to come.

The idea of speaking to white-coated figures in an unfamiliar language, and being thrown into quarantine, separated from her child, all equated to the slim chance, but real fear, of losing her identity, freedom, innocence, and family—a fear that my mother and I had escaped, but was a reality for victims of SARS and war alike. Are the characteristics and consequences of historical atrocity then any different from that of a disease which metastasizes from the body into one’s personhood and humanity?

To the 200,000 girls and young women forced into military sexual slavery by the Japanese Imperial Army during World War II, disease encompassed not only physical assault unto the body, but also a redaction of language and identity. These women were confined to unlivable “comfort stations” and isolated from society; they experienced innocence-undoing atrocity and even, at times, were forced to commit an unwilling sacrifice of a newly borne innocence of their own (1). It was a fear of losing identity, freedom, innocence, and family.

Perhaps one fundamental difference between these 200,000 young women and the victims of SARS is that the disease of historical atrocity has not received sufficient treatment as a matter of human health.

During my visit to the family doctor, and amidst the Canadian outbreak of SARS, my mother recounts being asked every thing I had been up to, every where I had been, and every when I had gone, but exactly who I had been in contact with was besides the question; the person who had passed on their symptoms to me was as much a victim as a perpetrator and, above all, the mark of a society that did not yet have the necessary safeguards in place.

For survivors of the Nanjing massacre and of military sexual slavery, the healing process stopped once it was identified that a member of the Japanese Imperial Army introduced the disease (2).

From my recent interview with Diana Tso, theatre artist and author of “Comfort”, I learned that the antagonist of the Asia Pacific War is not a singular group of soldiers but the prevail of authoritarian, patriarchal society at large and its quick willingness to treat human beings as a means to an end (3). In fact, as I’ve learned from Dr. Sarah Lynn Kleeb of ALPHA Education, soldiers who raped and killed may have been “victims-as-perpetrators” in their own respects as they were subjected to the harsh conditions of militarization and made to undergo “a substantial reprogramming of human psychology” (4). However, it’s difficult for me to come to terms with hearing that at least one of these soldiers, as unknowing as I was at five, had brought their watercolour brushes with them to war (3). I can’t imagine being stripped

of my teddy bear at the dentist’s office. Neither can I bear the thought that any survivor forever needs to live with this pain.

In the words of my close friend, “nobody grows up wanting to be the bad guy”, though in hindsight, disease isn’t always forgiving towards the young. With persisting social oppression being a key determinant of recurring atrocity and humanity being its collective target, the onus is on the patient, perpetrator, and provider within every one of us to pursue a path towards peace and reconciliation. More than knowing the root cause of disease, we need an opportunity to heal.

REFERENCES (1) Radhika Coomaraswam. Addendum: Report on the mission to the Democratic People’s Republic of Korea, the Republic of Korea and Japan on the issue of military sexual slavery in wartime. UN CHR, 52th sess, Agenda Item 9, UN Doc E/CN.4/1996/53/ Add.1. 1996.

(2) Seo J. Politics of memory in Korea and China: Remembering the comfort women and the Nanjing massacre. New Political Science.

2008;30(3):369-92. Available from doi:10.1080/07393140802269021.

(3) Diana Tso. Interview by Edward Li. Personal interview. Toronto, December 30, 2017.

(4) Sarah Lynn Kleeb. E-mail communications. December 12, 2017.

ABOUT THE AUTHOR - Edward is an undergraduate Health Sciences student at McMaster University who first learned about the story of sexual slaves from World War II at a high school conference organized by ALPHA Education, a Toronto-based non-profit organization. Weeks later, when a documentary depicting the individual experiences of sexual slavery survivors aired in his home town, Edward and a group of classmates witnessed first-hand how important and powerful it was to humanize survivors of wartime atrocity. Currently, Edward volunteers as co-president of the McMaster Chapter of ALPHA Education, where he aims to foster an inclusive and compassionate understanding of often overlooked aspects of history, in the interest of furthering the values of peace, justice, and collective healing.

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Lost in Translation

By Afreen Ahmad Art by Alice Lu

“Yo no hablo español.” It was probably the 15th time I had spoken these words that day, abruptly stopping the patients from giving me their life details filled with their pains and hardships. I looked up from the patient sheet and scanned the room once more. People of all ages, many different backgrounds, and walks of life were lined up to access free healthcare in the medical camp set up by Humanity First.

A 28-year-old man eagerly came to my table. “¿Como está?” I asked, and the man followed with a detailed report of the symptoms he was experiencing. “Yo no hablo español,” I said once more as I nodded politely. I took his blood pressure and then

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tried to assure him that he had presión normal. Assured his vitals were intact, he rejoined the line while I continued to ponder over what he had said. Could I really help these patients if I didn’t understand their language? This was an internal conflict I had wrestled with countless of times. Nonetheless, I had always wanted to experience healthcare in a global setting, especially as an immigrant. It never made sense to me why people in developed countries would withhold healthcare from the less fortunate.

On what basis would it be just to deprive nations of basic necessities?

My thought process may have been immature, but my intentions were not. This is why I jumped at the chance to volunteer in Guatemala - a country whose culture and language in which I had never thought to immerse myself. Only closer to my departure did I begin to doubt my decision. I skimmed through forums and tried to understand why volunteering

abroad had such a negative connotation and why it was so controversial. The results seemed to show that the person volunteering would be benefiting the most from their trip. Any help provided would be temporary and rarely would these sorts of trips be sustainable. The volunteers and international doctors would potentially be taking jobs away from local doctors, resulting in the mission harming the country’s economy. In the end, the trip would make the situation worse by making the locals dependent on the volunteers. It made sense to me logically but my heart would not agree, and so I just focused on my intentions and ignored this inner dilemma.

However, while sitting in the medical camp checking patients’ blood pressures, these questions circled around in my head. Was I of any real help if I could not even communicate with these patients? Was healthcare as global as my past self thought it was? At what point would boundaries and language barri-

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Lost in Translation ers not matter? Could a healthcare volunteer contribute ethically? At that point I must have had a troubled expression on my face since a 70-year-old woman came and patted me on the back while expressing her gratitude. I didn’t know what she was saying but I knew she was glad to see me. From then on, I noticed similar expressions of grief and worry on the patients’ faces. They were anxious people just wanting to share their burden with someone who was willing to listen.

I finally understood them, despite my lack of Spanish skills. Everyone had their own personal reasons for being there - perhaps they couldn’t afford to see their local doctor or purchase medication for chronic illnesses such as diabetes or Parkinson’s. Maybe they could not find reliable healthcare. Whatever the reason, it was not my place to judge them.

would not forget the care and empathy. This form of empathy could change their lifestyle factors and delay onset of disease, or even prevent it from occurring altogether.

This empathy could validate the patient’s problems, so much so that they would continue to seek medical help rather than ignoring this basic necessity as they had done the rest of their life. That empathy given by a healthcare provider was what formed these crossroads between healthcare and different cultures.

The next time a patient approached me, I said, “ Yo hablo poquito español.” I gave them an encouraging smile and diligently listened to what they had to say.

I knew the medication we gave the patients would inevitably run out, and the temporary psychological reassurance provided by the doctors would be forgotten. The model was temporary and not sustainable, but it provided relief. The patients

ABOUT THE AUTHOR - Afreen is in her second year in the BHSc program and is specializing in child health. She loves travelling and embracing new cultures although, she sometimes lacks the necessary language skills.

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Arts-Based Storytelling: Engaging Clients in Meaningful Recovery

By Natalie Brunswick and Sezgi Ozel Art by Gracia Chen

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Arts-Based Storytelling As newly graduated occupational therapists, from the University of Toronto’s MScOT program, we wanted to reflect on the fieldwork placement we created this past summer with joint participation from Sheena’s Place, a community based not-for-profit that supports individuals who identify as having an eating disorder (ED), and the Toronto International Film Festival’s (TIFF) Reel Comfort program. Reel Comfort connects clients in mental health programs across Toronto to TIFF’s year-round programming, both at the TIFF Bell Lightbox, and off-site in hospitals and community spaces. Events include screenings and facilitated discussions featuring guest speakers, hands-on workshops in which participants learn about different aspects of filmmaking, and organized group outings to the TIFF Bell Lightbox. We reached out to Sheena’s Place for this partnership, after our contact at TIFF disclosed interest in getting more involved in community-based programming, as we felt that the values and mission of Sheena’s Place aligned well with TIFF’s programming goals.

In occupational therapy practice, we see our clinical interactions through an occupational lens. Occupation, by definition, is anything and everything that individuals can do to occupy their time and is considered to be a basic human need. They help to organize our behaviours, enable the development and expression of our identities, and impact the way we interact with the world around us. Research shows that when individuals are faced with illness, their engagement in occupations tend to diminish; as such, a great deal of our interventions as occupational therapists are focused on re-engaging clients in meaningful activities, whether new or old. Creativity and arts-based programming are valuable tools in the healing pro-

cess and our experience in running these types of programs at Sheena’s Place has made evident to us how well they fit within the role of an occupational therapist.

We created this placement because we both had an interest in mental health and the arts, as well as a desire to explore innovative occupational therapy practice. As a result, this placement opportunity allowed us the chance to develop a project management role that saw us collaborating with staff from Sheena’s Place and TIFF to develop artsbased programming, with a focus on storytelling and film. The final product of this collaborative effort was the successful implementation of five different workshops at Sheena’s Place during August, 2017.

The first workshop was a reflective criticism workshop that focused on the film To The Bone. This session was developed in light of the critical discourse and client response to the Netflix drama released this past summer. While the film positions itself as having been made “by and with individuals who have struggled with eating disorders,” many clients indicated a discrepancy between the representation of EDs it offers and their own diverse experiences.

Our facilitator, a film critic, shared her experiences in film criticism and provided clients with some tools for articulating their complex responses to the film, drawing upon aspects of film form, production, and a broader consideration of EDs in popular culture.

The second workshop was an improvisation workshop and was facilitated by a professional actor.

The goal of this session was to introduce participants to the principles of improv theatre as it relates to storytelling, as well as to give our clients an opportunity to engage in the concepts behind improv, such

as a de-emphasis on failure and the importance of play. One of the goals behind introducing these concepts was to help build self-confidence and combat common negative thought patterns that might make a client afraid to engage with others, for fear of saying the wrong thing.

The third workshop was a stop-motion animation session. Stop-motion is an animation technique used to bring static objects to life on screen. Objects, puppets, or clay figures are moved in small increments and filmed frame by frame to create the illusion of motion. In this workshop participants learned the basic technical and creative steps involved in stop-motion animation.

They developed characters, brainstormed a plot, and created a short film using familiar objects, 2D puppets, and paper backdrops. This was a fantastic collaborative exercise for our clients and one that pushed many of them beyond the limits of what they thought they were capable of artistically producing.

The fourth workshop was a film screening, where clients watched selected clips from the feature film Maison du Bonheur, created by filmmaker Sofia Bohdanowicz.

This gave clients the opportunity to learn about the filmmaking process and how film can be used as both a storytelling medium and a tool to connect with and understand others. The film’s themes allowed discussion surrounding common representations of aging and older women in film/TV, and cultural norms relating to beauty and youth.

The final workshop was a visual storytelling session, which involved communicating narrative information, ideas, and emotions using visual means, rather than conversation. In this workshop, clients looked at photographs and selected 3-5 that they felt told a story to-

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Arts-Based Storytelling gether. As they told the story, another group member scribed short words or phrases, which were later rearranged by the group to create a poem. This workshop gave clients an opportunity to work collaboratively in a way that emphasized the sharing of opinions, and compromising on artistic ideas.

Working with Elysse Leonard, Senior Coordinator of Youth and Community Initiatives at TIFF, and the individual film arts facilitators involved in TIFF’s community programming was a seamless experience and one that has greatly expanded our understanding of what an interdisciplinary partnership can look like. We learn a lot about interprofessional practice as healthcare providers, but it is always discussed within the context of working alongside healthcare providers from different professions. It is never, however, discussed within the context of working alongside other professionals who have training in fields outside of healthcare. It has been an incredible experience for us to be able to collaborate with TIFF facilitators, who have extensive training and experience in film and storytelling mediums. We feel that the combination of our clinical lens with their expertise in film has led to richer arts-based programming than we’ve seen in contexts that are either solely clinically or arts focused. We feel that the success of our programming, as well as our positive experience thus far,

is evidence that there is a role for more collaborations of this kind in both mental health and healthcare contexts in general.

We found it to be particularly exciting to see how this programming appeared to meet a wide variety of client needs, at least within the population of clients seeking support at Sheena’s Place. The TIFF workshops supported an environment that provided the best of both worlds; for clients who came with the sole intention of having fun and participating in a recreational group, they had the ability to do so, while these workshops also allowed the space for those with desires to dive deeper and explore more challenging themes and ideas. This coming together of individuals, with different motivations for participating, allowed for a diverse group that appeared to have a positive effect on one another. For example, some clients, who may have come solely to have fun, found themselves getting involved in conversations and new ways of thinking than they may otherwise have been inclined to.

Another interesting observation in the programming process was the ability to use the arts as a starting point for conversations with marginalized groups. This was first highlighted for us when we decided to hold a screening of the new Netflix film, To The Bone. The film had been referred to in a number of Sheena’s Place groups leading

up to its release date, and appeared to be causing some distress for our clients. In response, we arranged a viewing of To The Bone and a second workshop led by a film critic to discuss how one can begin to talk about films in a more objective and critical way. By screening the film in a safe and supportive environment, introducing film terminology, and exploring how to perform a close reading of a film, clients were able to express both positive and negative opinions of the film, and contribute to the larger discourse surrounding eating disorders and societal perspectives. It was here that we saw the value of the arts as an entry point into advocacy, challenging stigma, and empowering individuals to have a voice.

This fieldwork placement is the first time either of us have worked clinically outside of a traditional healthcare setting. We attribute a great deal of our success in implementing our program to the openness with which Sheena’s Place greeted our project proposal and the freedom TIFF granted us in modifying their programming for the population at Sheena’s Place. We are very grateful for all the people involved in making this happen.

To learn more about TIFF’s education and outreach initiatives, please visit: https://www.tiff.net/education-and-outreach/

ABOUT THE AUTHOR - Natalie Brunswick is a recent graduate of the University of Toronto’s MScOT program in occupational therapy. She is passionate about delivering effective and innovative mental health care and believes that the arts provide a rich and exciting forum through which to engage clients in their recovery. She is looking forward to further exploring their intersectionality through exciting new programs in the future.

Sezgi Ozel is a Toronto-based Occupational Therapist who supports child development within school settings. After graduating from McMaster’s Honours Bachelor of Health Sciences program with a specialization in Child Health, she completed her Master of Science in Occupational Therapy at the University of Toronto. Her previous work in the Cerebral Palsy lab at Holland Bloorview Kids Rehabilitation Hospital was published in the Developmental Medicine and Child Neurology journal. Sezgi has also designed self-care and arts-based workshops for Toronto International Film Festival (TIFF) and Sheena’s Place, aimed at providing support for individuals living with eating disorders. Her interests lie in child development, mental health, and program development.

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An Interview with Dr. Catherine Morley Catherine holds a PhD in Community Rehabilitation and Disability Studies (Calgary), an MA in Adult Education (UBC), a BASc in Human Nutrition (Guelph), and completed a dietetic internship at Vancouver General Hospital. After 25 years working in dietetics, she completed a Documentary Film certificate and a Textile Arts diploma at Capilano University to explore use of the arts to expand the reach of research findings. She is active in the international Critical Dietetics movement (criticaldieteticsblog.com), and incorporates critical social theory and arts-based approaches into teaching and research. Her research interests are how eating changes with illness, malnutrition and foodborne illness risk reduction in older adults (to support aging in place), and trans-friendly nutrition assessment and dietetic practice.

Why were you interested in becoming a dietitian?

I was very good at science and math in high school and I always wanted to do work that would help people. I wanted to apply what I had learned.

But I didn’t come from a family that did that kind of work. So when I said I wanted to help others, my parents didn’t quite know what I meant. This was 1978 and I was trying to figure out what I wanted to do, but there were not many choices for women. The choices given to me in high school were to become a nurse, teacher, secretary, or flight attendant. The rationale was that since a young woman was going to get married and have babies, what was the point of going to university?

In our high school guidance office, there was a rolling file folder of pink and blue files. When I looked

in the blue files, the guidance counsellor told me that blue was for boys! Garrgh! That was distressing. Obediently, I looked at the folder about dietitian as a career. I liked the application of science to work in health and human services. It was fascinating to me that what a person eats affects their health. In the beginning, it was all about biology to me, but now, years later, I know that it’s so much bigger than that, with influences socially, psychologically, spiritually, and in all kinds of ways.

Did you face any struggles along the way?

The process of being a dietitian is this: a four year degree in nutrition, then apply for and be accepted into a one-year dietetic practicum or combined practicum/Masters program. Since I was an undergraduate in the 1970s, there has been/is a 50% chance of getting a practicum placement. I was one of the 50% who didn’t get an internship. Back

then, decisions were made only on grades. Mine weren’t good enough, even though I had ample experience working with people. So I just kept applying. Nine times. One day, I got a call to somewhere I had applied; someone had been accepted into dentistry school so I got the practicum spot!

My Dad worked in steel in Hamilton and many of our relatives worked in factories. No one worked in health care. Eventually, they accepted that I wanted to go to university and become a dietitian but at the beginning the idea of a young woman getting a degree was commonly thought to be a waste of time. It was the way it was for working class people in the 1970s.

Things have changed where more parents have the mindset that they want better for their children than what they had. I think our parents wanted that for us too, but [in different] times ‘better’ meant different things. I always try to remember that our parents grew up during the Great Depression and World War

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An Interview with Dr. Catherine Morley Two so ‘better’ often meant a stable job and a place to live. We think of this differently now.

To complete university, I persevered, and yes, I was stubborn and had an ‘I’ll show you!’ attitude. I figured there was no way an education could be a waste. At 17, I didn’t really know what that meant but I still believe it today. Getting over the ‘I’m going to university anyway’ hurdle meant I needed to work during the school year and every summer to pay for it (just as students do now). I learned about working hard to achieve my goals no matter the obstacles which is a good thing for people who work in health care.

What made you choose to work someplace so far away from your hometown (Burlington, ON)?

I live in Nova Scotia now and work as a professor at Acadia University.

Before that, I lived in the west (Vancouver/Calgary/Vancouver) for 32 years. I went west in 1979 because that’s what young people did. We had the idea that there were unparalleled opportunities in the west so hundreds of thousands of young people from Central and Eastern Canada ‘went west’. So, I didn’t really ‘choose’ to work somewhere, I just went west with my friend.

In 2011, I applied for a position as a professor in the School of Nutrition and Dietetics. I had completed a PhD in Community Rehabilitation and Disability Studies (UCalgary; the topic was ‘Meanings of Eating: Changes with Illness), and was working as a self-employed consultant conducting needs, assessments, and evaluations for nutrition programs, and articulating policy and service needs related to food and nutrition issues. Clients were mainly federal, provincial, and

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local government agencies, NGOs, health authorities, the College of Dietitians of BC, and Dietitians of Canada. I produced useful work as a consultant; however, I wanted to teach. I always thought that I had a lot to offer to students who wanted to be dietitians or nutritionists, and I had a lot of experience nurturing learners. When I heard about the job at Acadia, even though I had never taught before, I applied.

At that time, I thought to myself, “Am I nuts? It’s across the country!” I also thought, “When I go for the interview, I’ll know whether it is the right move for me and my family.” I was candid at the interview.

I said I wanted to better prepare students than how I was (not) prepared to work with people (to avoid unleashing the unprepared on the unsuspecting), and I wanted to work in research partnerships with dietitian colleagues and with people living in the local area. The interview team liked what I had to say so off I went to the east coast.

“You can try really hard to create the thing you have in mind, and yet, when it comes to the final product, you don’t really have control.”

I am devoted to community engagement and partnerships with all kinds of people and groups in the community. Most often this involves people who work in all levels of government, older adults’ groups, and caregivers. Basically, I am keen to work with anyone who or any group that wants to work in collaboration to reduce malnutrition risk in community-living older adults and to support caregivers. I

think it is critically important for us to seek out, hear, respect, and include the voices of people in decision-making about the policies and services that will affect them. The way to accomplish that is to do consultations and the research in partnerships. I always think I’m asking the people in the community for a lot, to make tough decisions about certain matters. Turns out, everyone I have worked with was gratified to be (and relieved to finally be) included, even when what we were working on were difficult topics to talk about such as malnutrition and nurturing (not nourishing) people at the end of life.

How did the idea of incorporating art into your work as a dietitian come about?

I have been involved in the arts and creating in some way my whole life.

As a teenager, I stopped dancing because I felt I had to choose between it and science/math. Over time (30 or so years), I got so tired of and frustrated with my work as a dietitian, and in BC, there was no opportunity to teach at the university.

Looking for something that would feed the creative cravings that I had abandoned as a teenager, I took a two year diploma program in Textile Arts and a one year certificate in Documentary Film at Capilano University. It was risky as a single parent to not make money for three years to go to school; I didn’t know how I could afford it. However, the Vancouver real estate market was an advantage for me as my house gained in value while I was at school.

In Textile Arts, our assignments involved combining the various techniques we had learned to make a piece that had a meaning or message. Turns out, every piece I made

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An Interview with Dr. Catherine Morley had to do with families, eating, and illness or end of life. Same in documentary film. What I loved was that when creating in whatever medium, you can try really hard to create the thing you have in mind, and yet, when it comes to the final product, you don’t really have control. This applies to any art form, but especially to textiles - humidity, temperature, time of year, and timing of each process will affect the final result. This encourages letting go of the notion of control, and to work with what you get. This is how I approach research and teaching.

So, how do this apply to the arts in dietetics? We know that when people are diagnosed with a serious medical condition, they look on the Internet. What is there on nutrition and diet is, for the most part, not very helpful. It’s often a talking Remember Biology

head talking about nutrition concepts in a prescriptive manner or trying to sell their products, which is not what people need. People need to see what it is you’re talking about, instead of just listening to someone talk. When I was a textile art and film student, I thought of how I could engage people who were looking for nutrition information, advice, and support. I thought of making edutainment videos, having a website where the videos and other resources were available, how I could write plays, make scripts available online for others to use in teaching or community engagement, and have shows of art pieces.

All of this would engage learners and share thoughts on the challenges involved in eating with changed health status and nourishing loved ones who can no longer eat as they once did. This was how I thought I would combine my doctoral research and art. When I got the job at Acadia, I was able to incorporate these concepts into teaching.

For example, the majority of the group projects in my classes require students to present their findings “using anything but a PowerPoint presentation”. At first, students didn’t like it; “We’re science students; we can’t do art.” I say, “I know you all have some connection to art somewhere, even when the last time you held a paint brush was in grade six. Most of you played (or play) an instrument, or sang, danced, were in a play at least once in your life. You can do this.” At first, they struggle with how to convey their ideas and findings into some kind of performance or art piece. Once they do, the work they produce is incredible. They are so surprised with themselves and love how good it feels to produce something

that people can readily engage with.

The class showcases are wonderful!

Is there a specific piece of art that is special to you? What is the story behind it?

I have two. One is a woven tapestry I made of the human gastrointestinal tract entitled, “Remember Biology.” On the back I sewed a worn out dishcloth, as this represents the work we have to do to feed ourselves. I mounted it in a Financial Post binder with photos of people with the weaving, going about their days and eating on the run. I like the juxtaposition of what the binder represents, capitalism and finances, with what we do everyday to be well nourished. It is a reminder that the day-to-day work we have to do to feed ourselves requires that we pay attention to our biology, something that is often taken for granted.

The story behind it is that, as a student, I was at my loom. The person beside me kept making mistakes; she was frustrated that she had to go to the bathroom and she was hungry but she didn’t want to stop weaving because she so loved it.

Eventually, she went to take care of her biological needs. After she got back she noticed that she found weaving so easy compared to before her break. Duh!!! No surprise that she’s a human who needed to take a break. We spend our days responding to the functions of our bodies – we need to sleep, pee, eat, breathe – yet we usually don’t think about it until something goes wrong. We are all biological entities that need to be taken care of, not as machines, as complex social and spiritual creatures. That’s why I wove this piece.

It doesn’t matter what you’re doing, whether you are at work, school, hiking, or on an airplane, you have to eat and take care of yourself.

The other piece I like is entitled

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An Interview with Dr. Catherine Morley

Dietary Cacophony “Dietary Cacophony”, the noise that people hear and think about on what they should eat. We hear messages about this everyday, all day, but don’t see or hear them or recognize them for their effects on us. The self policing of “I’m a bad person if I eat this, and I’m a good person if I eat this,” or “I don’t deserve to take care of myself and eat”, or “I would be morally superior if I ate tofu and beans (that I don’t like)” is fairly constant, especially for women.

These choices don’t actually make a person a better person. The piece is a wallhanging. It is presented rolled up so the viewer sees a simple cotton print (that is actually made

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from my children’s old bassinet lining). Sewn on to this are the words, “It seems like a simple question.”

When the piece is unrolled, there are all photo-transfers of about 20 magazine covers with messages about weight loss, decadent dessert recipes, dinner ideas to treat one’s family, and the ‘perfect dinner’ for a festive family meal.

This is to show the many competing and often conflicting messages about eating that people encounter everyday.

Connecting the magazine covers are strips of black and white striped fabrics to represent how people want/ need straightforward, clear answers about what to eat, especially when they or a loved one has a serious medical condition affecting what/how they can eat. People feel lost and overwhelmed about what they should do. This is dietary cacophony. I’m fascinated about what people think about what they eat, and how we can use that understanding in developing ways to support eating decisions and behaviours.

Our theme for this issue is “Crossroads.” How might you interpret this theme in relation to the work that you do?

I interpret this theme mainly in two

ways. First, there is the intersection between art-making and the expression of complex ideas that we generate in science, and in the very complex environments we work in for health and human services that try to help people. Art-making provides a way for students and those who have been working for some time in these complex environments, or have been conducting research in these environments, to express how they feel about their work and their coworkers, the barriers and facilitators to getting their work done. Clients of these services can use art-making to share their experiences and thoughts. By working at the crossroads of sharing lived experiences and conveying these through art (in whatever form that takes), there is potential for everyone involved to have a better understanding of themselves and others, then to work collaboratively to enhance the experiences for everyone involved.

Secondly, I think about the crossroads between what I think I am doing as a teacher and researcher, and the experiences and points of view of the people with whom I’ve been working (students, those who are the focus of my research, and those who are end users of the research). Bringing together people, inviting their perspectives, and thinking through the challenges and successes they have experienced, create conditions for a much richer outcome than one can come to by sitting alone and trying to decide your course of action.

Thank you for this opportunity to share my story.

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An Interview with Dr. Yvette Lu

Yvette Lu is an actor, filmmaker, and family physician in Vancouver, BC, Canada. As an actor, she has appeared on various television shows including FOX’s Gracepoint and BBC America’s Intruders.

As well, her short films have screened on television and in film festivals across North America, including at the Vancouver Asian Film Festival, the Route 66 Film Festival, and on Shaw Multicultural Channel. On the other side of the camera, Yvette has worked as a producer, director, and composer for numerous projects. She produced “Alive and Kicking”, a documentary that won Best in Show at the

Near Enemy Film Festival in New Jersey. Her most recent project is “House Call with Dr. Yvette Lu”, in which she interviews caregivers and helps them seek practical solutions to improve their lives. Dr. Lu is passionate about projects that improve health and well-being, and has written a research-based play about chronic illness. She speaks about medical issues on CityTV’s Breakfast Television, and has also appeared on CBC, CBC News Now, and The Weather Network as a medical expert.

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An Interview with Dr. Yvette Lu Can you tell us a bit about yourself and describe your journey leading up to today, as a family physician, filmmaker and actor?

From a young age, I have always enjoyed stories. I read a lot as a child and I always imagined myself as characters in books. I loved singing and musical theatre in high school, but when it came to choosing a major in university, I chose science, as it seemed like the best choice at the time. In the summers, however, I would continue to pursue my artistic interests and after my 3rd year of university, I auditioned and was offered a wonderful part in the musical “Joseph and the Amazing Technicolour Dreamcoat”. During the run, a fellow cast member recommended that I take Peter Loeffler’s first year theatre course at my university, the University of British Columbia, and that’s when I fell in love with theatre. Taking the course gave me the courage and inspiration to pursue acting. As I continued studying science and medicine, I made sure to continue nurturing my artistic interests. I pursued creative projects in the summer, when I had time off from my university courses. After I became a doctor, I decided to work part time so that I would be able to be an actor and filmmaker in addition to being a doctor. My professions complement each other. Listening, compassion, empathy, clarity in communication, and the understanding of the human spirit are key to acting, filmmaking, and medicine.

What inspired you to incorporate being a doctor with your other professions?

Studying medicine was incredibly intense and time-consuming, and there were times that I needed all my energy and focus to go towards learning to become a skilled doc-

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tor. However, while I loved studying medicine, I felt like a part of my brain, my creative side, had gone missing. Medicine is creative in the sense that you can seek solutions and creative ways to help your patient, but this is different from being artistically creative. I knew that it was important to me to have artistic pursuits in my life, so when I graduated from medical school, I made it a priority.

Being artistic helps me be a better doctor and vice versa. They use different parts of my brain, and each helps me cope with the challenges of the other profession. It is well-known that the emotional burden of being a doctor can be significant, and filmmaking and acting help me release that tension and cope with the emotions associated with medicine.

“I felt like a part of my brain, my creative side, had gone missing.”

Did you face any challenges or setbacks when you decided to take on more than just one professional occupation?

Yes, of course, there are challenges and setbacks when you’re forging an unexpected path. I had some

people tell me that I couldn’t “do both,” and that I had to pick one. I had to figure out how to balance my time. You have to make choices, because there is only a limited number of hours in a day. When you’re doing something that is not the norm you have to have the courage to find your own way, but it’s worth it!

Has being of Asian-Canadian heritage impacted your role as a family physician, filmmaker, and actor in any way, whether it be positively or negatively?

Being an actor who is of visible mi-

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An Interview with Dr. Yvette Lu nority is challenging in that there are not as many opportunities to be cast in roles. In the last year or two, there has been increased awareness about casting roles with people from a diversity of cultural backgrounds. However, if you look at the majority of people on film and television, very few people are from visible minorities and even fewer stories are about families from cultural backgrounds that are non-caucasian. I’m hoping that in coming years, we will see more and more shows like “Jane the Virgin”, “Master of None,” and “Fresh off the Boat” that feature families from diverse cultural backgrounds.

What is your favourite piece that you’ve filmed or acted in?

Are you working on any other projects at the moment?

There are so many projects that I have worked on that I have loved, it is difficult to pick a favourite.

One of the projects that is really important to me is a play I wrote about chronic illness. This was a research-based play, meaning that I interviewed three young women about their experiences with chronic illness, analyzed their interviews using research techniques, and then incorporated some of their words and thoughts into the play.

I have done staged readings of the play several times and performed excerpts of the play, and every time I receive such amazing and inspiring feedback. Chronic illness is poorly understood in people who don’t have it and, as a result, people who do have it can feel isolated. The play allows people with chronic illness to feel validation of their experiences, and allows for their family and friends to have a better understanding of what their loved one is going through. That is why it is so powerful. Theatre and film have the power to improve relationships and to improve our lives.

“Storytelling – reading stories, telling stories, talking about stories – gives us an outlet to process and deal with our emotions in a healthy way.”

Currently, I just finished working on a web series called House Call with Dr. Yvette Lu. I am the host of this series and I also helped to produce it. In House Call, we meet caregivers, people who care for family and friends with chronic illness, disabilities, and aging needs, and we learn about some of the challenges they are facing. Then we identify one or two challenges and help them find

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An Interview with Dr. Yvette Lu practical solutions. We travelled across Canada to meet caregivers and we hope that people will share our show with their loved ones to raise awareness about caregiving.

Caregiving is a global issue and in Canada there are 8 million caregivers, with the number expected to increase significantly in the next ten years. Most of these caregivers are unpaid, and it’s important to raise awareness about the issue and support them. You can check out the show at www.storiesforcaregivers. com.

How do you think storytelling in medicine heals us?

In medicine, we are inundated by stories from our patients and we need to find a way to cope with the emotional burden that comes with these stories. We can’t hear about trauma and loss, give bad news, and see people get sick and die, and not be affected. We need to be able to process these events, and storytelling – reading stories, telling stories, talking about stories – gives us an outlet to process and deal with our emotions in a healthy way. Understanding stories also helps us be better doctors in that we can better understand patient histories, and pull them together to form a diagnosis. Storytelling also helps us explain things in a clear way to patients. There is ample evidence that narrative medicine can improve health outcomes. For example, in a study on blood pressure treatment, patients were given videos of other patients telling stories about their experiences of how they dealt with high blood pressure (1).

The storytelling intervention produced greater reductions in blood pressure than many behavioural interventions and performed similarly to non-pharmaceutical and pharmaceutical interventions (1).

Storytelling gives us an emotional touchstone through which to con-

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nect to patients and help them heal.

Oftentimes it feels like medicine and the arts are two completely separate fields. What advice can you give to aspiring doctors or current science students, who also place importance in the arts?

It’s important to remember that being an artist will help you be a better doctor and to prioritize it in your life. Many students go into medical school with artistic interests but, because of being too busy, it is often the first thing to go. Students have to remember that being artistic will make you a more balanced person and will give you a better understanding of people, their behaviour, and yourself, which will in turn make you a better doctor. It can be helpful to schedule in artistic time, by taking a course or studying with a teacher, so that you have accountability. Even if you are very busy, scheduling a small amount of time each week can be helpful and inspiring.

Our theme for this issue is “Crossroads.” How might you interpret this theme in relation to the work that you do?

Sometimes people interpret the word crossroads to be a single choice, you must choose one or the other. Robert Frost’s famous poem, The Road Not Taken, has a traveller wondering what might have happened had s/he taken the other road in the woods. With my work in art and medicine, I see the crossroads not as a choice, but as an opportunity. There are so many interesting discoveries and opportunities that can be found where different disciplines intersect. I work as a health educator on television and in media. My acting studies help me be a better communicator and my medical background provides me with

the expertise and knowledge. When I play roles or write stories, my experience with patients helps me to better understand the characters in the scripts. Choice is about choosing where to direct your energy at what time. Sometimes more of my energy goes into medicine and sometimes more of it goes into art, but I don’t have to choose one and ignore the other permanently. My choice is to travel both roads, and the journey is bright and beautiful.

REFERENCES (1) Thomas K. Houston, et al., Culturally Appropriate Storytelling to Improve Blood Pressure: A Randomized Trial. Annals of Internal Medicine. 2011;154(2):77-84.

Available from: http://annals.org/article. aspx?articleid=746718

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Art and Healing

Traditional healing and leading edge medicine practices understand health as embodying more than the physical state. From this holistic perspective, health is considerably more than the absence of symptoms or disease. It is an integrated state of balance and harmony involving body, mind, emotions and spirit.

The mission of the Healing Arts Program is to enhance and support the holistic nature of the care offered at St. Paul’s Hospital by creating opportunities for patients and families to bridge their imagination and everyday reality by freely expressing themselves while create meaning through the arts. Participation in the arts has helped patients and family members to uplift their mood, ease stress, and improve health outcomes. Many have said that engaging in the healing power of creativity helps take their mind off their problems and makes them feel better.

The Healing Arts Program is delivered by a multidisciplinary team of skilled experts comprised of an Artist-in-Residence, a Music Therapist, a Writer-in-Residence, and volunteer artists in the community. Through culturally sensitive and inclusive programming, the visual arts, music therapy and literary arts are offered to patients, family and community by the bedside, common areas of the hospital, and in the Healing Arts studio. Through creative expression, patients are more inclined to cultivate a positive approach to life that enhances the immune system, takes their focus off of pain and illness, widens their social networks, reduces feelings of isolation, and supports a feeling of connection and community.

The Healing Arts Program also benefits the community through community engaged art programming. Outreach activities extend the program beyond the walls of St. Paul’s Hospital through positive, collaborative relationships with community organizations. These relationships contribute positively to maintaining or enhancing individual and community health and wellness. With a special focus on youth-with-potential and vulnerable populations, these partnerships encourage the community to feel empowered and develop skills while engaging them with the hospital.

We would like to thank Ken Brevik for sharing his story.

For more information contact: Marlessa Wesolowski, Artist in Residence: Phone: 306-655-0514 E-mail: Marlessa.Wesolowski@saskatoonhealthauthority.ca

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Art and Healing Could you tell us a bit about yourself?

ature, etc.) that you prefer working with and why?

My name is Ken Brevik and I am a 44 year old First Nations man that has gone from farming to being an artist.

Visual art. I love painting and pencil portrait. I have also started to play guitar. But I do love painting and drawing the most as it seems to relieve my stress levels.

How did you come to get involved with the Healing Arts program?

I became involved with the Healing Arts Program when I was admitted to St. Paul’s Hospital in Saskatoon SK for surgery from a work-related accident. I also have Post-Traumatic Stress Disorder, anxiety, and difficulty sleeping so I was quite worried about going to the hospital.

One day the Artist-in-Residence, Marlessa Wesolowski, came to my room and introduced herself. She gave me some paints and canvas. At first I was a Nervous Nelly, thinking that I was not an artist. But with her encouragement and kindness I began to explore, and much to my surprise I found myself expressing and creating through paint. Once I was mobile and could leave my room, I would go to the art studio where I found creativity, community and connection.

What was the most memorable experience at the Healing Arts program?

My most memorable experience with the Healing Arts program was that prior to meeting Marlessa, I never considered myself an artist – art was not in my life the way it is today, and today I am an artist.

Connecting with my own creativity has allowed me to positively manage my physical limitations and my Post-Traumatic Stress Disorder while discovering new things about myself and others.

Is there a specific form of art (e.g. visual art, music, liter-

How did art supplement your overall healing process?

The Healing Arts program gave me my life back. If it weren’t for this program, I wouldn’t be where I am today. During my time in the hospital I painted 60 pieces either in bed or in the studio. I was nervous about painting, but once I started, I stopped watching the clock to see when it was time to take my medications because I forgot about my pain. The program also helped me deal with my mental state. I’m more comfortable with myself, and I find it easier to talk to people I don’t know, and I even sleep better now. I feel like I have control of my life again. I am also very grateful to Natalie Ewen, Unit Assistant at St. Paul’s Hospital, who, on one particular day, helped me hang my paintings in my room. This made my space so bright and colourful that people walking by would come in to look.

How do you think you have changed after you joined the

program as opposed to before?

The art I create comes from my soul, and it was my soul that needed to be healed. Mental health programs and professionals provided me with the ‘mind things’ I needed to do, but it wasn’t helping. It was after I started creating and painting with the program that my soul began to heal.

Do you continue to apply the arts to your life, even outside the program?

When Marlessa gave me the first canvas, I was nervous, second guessing myself, not wanting to.

Now I paint and create something new every day. I have become a fulltime artist selling my work. I also share and teach others how to paint and draw. It is about how we can connect to our inner artist.

Our theme for this issue is “Crossroads.” How might you interpret this theme in relation to your experience in the Healing Arts program?

I was at a crossroads in my life, not knowing if I’d be able to work again, or for that matter laugh again. Today I am working as an artist and I feel like my life has meaning.

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Uncertainty and Altruism: From the Perspective of a Stem Cell Donor and Recipient

By Judy Chen, Shannon Gui, Farnia Khoshsorour, Edward W. Li, Gar-Way Ma, and Tina Mahmoudi

Crossroads: “a point at which a crucial decision must be made that will have far-reaching consequences”.

We encounter countless crossroads on our journey through life, but not everything is under the control of our own decisions. Illness and death, for example, are often beyond human control. On the other hand, the power and choice to save the life of another is something we each possess.

Many patients suffering from leukemia, autoimmune diseases, and other blood disorders are desperately seeking stem cell transplants as their hope for survival. These patients may be strangers in a foreign land, or they may be people closest to our hearts. As healthy individuals, we have the choice to register as potential stem cell donors, and the choice to proceed with the donation if found to be a match with a patient.

Here are the stories of two extraordinary women – one a stem cell donor and the other a stem cell recipient – providing first-hand perspectives on a common crossroad that has had an enormous impact on their lives.

Stem cell donor Nikki Reklitis is a first year medical student at McMaster. Originally from Ottawa, Nikki worked as a social worker at the Ottawa Hospital, the same hospital where her bone marrow harvest procedure was completed. Although Nikki was unable to contact her recipient, she did discover that her recipient’s transplant was successful, and that they were able to live for three more months before passing away.

Stem cell recipient Erin Morrison is a first year nursing student at McMaster. As a recipient of a stem cell transplant via bone marrow to treat aplastic anemia, she was inspired by her experience to pursue nursing.

Aplastic anemia is a rare but serious condition whereby the bone marrow and stem cells of the patient are damaged, resulting in the inability to generate red blood cells, white blood cells, and platelets. Fortunately, Erin’s brother was found to be her perfect match, and became her donor.

A Match Nikki If you had to chance to meet the person to whom you donated your stem cells right now, what would you say to them?

I just feel so grateful for having the opportunity to donate [and] to be a part of something that could possibly have given them a little bit more time with their family. I would’ve wished to have known a little bit more about them, and I’m just so sorry that they passed away. I also always wondered about how they

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Uncertainty and Altruism

were feeling. He or she – I still don’t know – how he or she was feeling throughout. I thought about him or her the entire way. I thought about them. Where they were, what they were doing, what it was like for them to go through the workup?

I just thought about them all the time. I would’ve wanted to know that.

Read more about Nikki’s thoughts here: https://macmedplacebo.com /2017/11/30/a-match/ Erin Did this donation change your relationship with your brother in any way?

We are much closer; it brought the whole family together. It’s really weird how in these situations, in times of trouble and difficulty, it can bring people together – although I wouldn’t wish this on anybody. I’m 25 and he is 28, and at the time that I got diagnosed, his wedding was [in] 5 days so I thought I wasn’t able to go to the wedding. They didn’t know what to do; they had to have the wedding because it was too late to cancel. I was able to go to the wedding [by being] pumped with blood. Two very different things were happening at the same time in our family. My brother was getting married and starting a new family while I thought that I was going to die.

We were always close, [...] but I learned a lot about him so I guess that did change our relationship.

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When he was a 10/10 match for the HLA testing he immediately, without a thought in his mind, said that he would do it. He was super positive about it. What he had to go through was harder than what I would have to do in my opinion.

The night of my transplant when I went into quarantine, my immune system was completely gone and I was waiting for the marrow. My brother was in another room in the hospital at the same time, having 1.2 L of marrow taken out. It was so weird. We were in seperate places but also in the same place at the same time.

“I think that everything that is meaningful is hard.”

A Decision Nikki Were you ever hesitant about donating your stem cells?

What would you want to say to someone who is unsure of whether or not they want to register as a potential donor?

No, not at all. There was so much going on in my life at the time. It was so uncertain – there was so much I just didn’t have control over. And then this call came in. And it was the one thing I felt like “yeah, of course, yeah I can do this.” It was the one thing I felt really sure about. It also gave me really important perspective because there was all this chaos whirling around me. When stuff happens in life, you can start to feel down. And I thought – well, look, there’s this person somewhere in the world who is fighting for their life right now, and here I am worrying about x, y, and z. So it gave me perspective. It actually ended up giving me a lot of strength.

I think that everything that is meaningful is hard. Donating bone marrow is one example. I think we do things that are hard to do all the time. If a person feels drawn to donating bone marrow or blood, and that’s meaningful for them, and they see it as an opportunity to contribute to society and to humanity, I don’t think that they should be deterred by a little bit of pain, or a little bit of a pause in everyday functioning. To me that’s a small price to pay for everything that comes with donation – you can’t even compare it.

Erin There is certainly a lot of stigma surrounding the invasiveness of stem cell donation – how do you think we can battle this stigma? What would you want to say to someone who is unsure of whether or not they want to register as a potential donor?

Maybe if they know that the success rates of transplantations are relatively high – that is, if a person gets [a donor] quick enough and assuming that if they have cancer, they stay in remission. Aplastic anemia doesn’t have a remission; I’m cured forever. If someone knew that’s what they could do, that they could keep someone alive... They’re not only a hero for that person, but also for that person’s family and everyone around them. Dying sucks for the people around you. When you’re dead, you’re dead, but then everyone else has to deal with it. So you’re not saving one life, you’re saving a small group of people, and impacting a few people’s lives.

When you persuade people to join the registry, you usually focus on saving one life. Maybe now you should tell people, “You could save a family”.

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Embracing the Arts

Transformation and Inclusion

By Kathleen Purdy

David shuffles into the room, all smiles. People are milling around.

He sees fabric draped on the walls, a couple of young women standing around a keyboard, and many familiar faces.

“Hi,” he shouts to no one in particular and everyone in general. Several people say hi back.

David moves through the room giving a few select people great bear hugs.

Amy sits in a chair with her head down, not ready to look at anyone.

Her buddy comes and sits beside her and they talk. Brendon walks around with a big smile on his face, looking everyone in the eye for the acknowledgement he seeks. Jessica comes and talks to me, saying she will help out if I need it. Tony comes in pushing his walker and says in his strong voice, “Hi, Kathaleen!”

He loves to sing, and is known for his great rendition of a lion’s roar.

companied by Dad, his caregiver.

All smiles. Legs kicking in excitement. Katie is somewhat subdued as she arrives with her two caregivers. A few more people come in.

Luke arrives in his wheelchair, ac-

Then we play a ‘Name game’. I sing

We are ready to start.

A music therapy student plays the piano as we form a circle and start to sing a Welcome Song. We walk around in the circle, singing and clapping our hands.

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Embracing the Arts my name and perform an action.

Everyone responds with “Hello, Kathleen,” and repeats my action.

And so, we go around the circle, everyone singing their name (or having their buddy introduce them), everyone being acknowledged.

All our participants are different, but they share at least one thing in common. They all LOVE this Creative Arts program for adults with special needs. They all have a chance to participate in the storytelling, drama, music, movement, and visual arts and crafts that will unfold over the evening.

We are in the midst of a 10-week program for which we have chosen the story of “The Castle of Kerglas” also known as “The Adventures of Peronnik” to enable everyone involved to experience a wide variety of sensory activities that are tied together by the storyline. By the end of the evening (1.5 hours), participants will have taken on character roles, perhaps built a house out of fabric and chairs, made masks for the Enchanted Forest, sung songs, and played games, all of which relate to and enhance the understanding of the story.

This is one of many stories that the Alexander Society for Inclusive Arts

has developed over the past eighteen years.

“If a child can’t learn the way we teach him, then we should teach him the way he learns.”

After my son Brendon was born, this quote inspired my husband and me all those years ago to find out more about learning through the arts. Our son had been diagnosed with a severe global developmental delay and the education system was unsatisfactory at best. We worried about what social opportunities would be there for him as he grew up.

After researching alternative ways of teaching children who were atypical, talking to a lot of parents who were in the same boat, and observing a special education teacher whose experience spanned over 30 years working within the Waldorf schools and communities, I decided to create a multi-sensory program we called Creative Arts Play Group for children with special needs in the Annapolis Valley of Nova Scotia.

The first one began in March 2000 with three facilitators: a storyteller/ drama animateur, a music teacher, and a movement & art teacher.

As the initial group of children grew, the programs also grew… and evolved. They became teens.

We added a teen program. They became adults. We adapted. Many of the original participants are still with us. And we have continued to offer younger children’s programs.

With the first program, the parents accompanied the children, but we soon had volunteers knocking on the door, very curious to come and see what we were doing. It evolved into inviting volunteers to provide one-on-one support for the participants (parents enjoyed having the break). Many of the volunteers came from Acadia University and some from the local Community College.

All along, we wanted to make these programs inclusive, knowing that the arts provide the perfect venue in which people of diverse abilities can work and play together.

One of the interesting outcomes was that the volunteers were getting as much out of the program as the people who were intellectually challenged.

From volunteers, in their own words: I learned not only about people with special needs, but also about myself. I learned that there are new ways to communicate with people who have special needs.

This program is providing me with experience for all of the many things I hope to pursue such as education, children’s literature, and assisting special needs people. … I was able to see how much of an impact the arts could have on children with special needs. … it has opened my eyes to the abilities of children with special needs.

As an education student this has

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Embracing the Arts greatly influenced my future professional interests. I am now much more interested in exploring special education. … it has strengthened my commitment to a truly inclusive classroom; every student has special strengths and gifts to offer. The Alexander Society is a wonderful embodiment of this!

I think the arts is an excellent way to learn. Especially I thought it helped with cognitive function/ memory. The kids always remembered the stories perfectly, better than we did! As an aspiring speech therapist this program has made me realize the kinds of challenges I will have to face .…

Our approach is teaching through the arts. We expose the participants to a wide variety of sensory stimuli.

Just about everyone can do something. Several years ago, when we hosted a guest teacher from England, there was a small boy who was usually in a wheelchair, but liked to be on the floor and pull himself around. He had good use of his arms, so the teacher, when assigning roles for the drama, asked if he would like to be the gate-keeper, a very important role! She gave him a branch, and whenever anyone needed to go in and out of the castle, he swung the “door” open.

He was delighted! That day he took the branch back to school with him.

Months later I ran into his assistant and she said he still has the branch.

The arts provide an opportunity for all of us to find our strengths.

Every art form has its specific value for learning. Here are just a few indications. Storytelling and drama

foster the development of imagination, memory, listening skills, empathy, and both expressive and receptive language. And they can inspire one to greater heights. Recently, a young man who understands a lot, but speaks little, was inspired to read. In the story, the Princess leaves a letter for the Traveller with instructions on what he must do to save her. After hearing the letter several times, our young man insisted on reading it to the group during the drama. We all patiently waited while he held the letter and valiantly emitted sounds that approximated some of the words he remembered. After about two minutes of having his time in the spotlight, he was finished. He deftly folded the letter, returned it to the envelope and passed it back to the storyteller. He had achieved his goal.

“If a child can’t learn the way we teach him, then we should teach him the way he learns.”

There are many more stories I could tell about heroic endeavors, breakthroughs and successes. Fairy tales and myths have provided the stepping stone for these transformations.

The other art forms add more depth. Movement and dance allow the participants to experience the story elements kinesthetically and rhythmically. “The more the body becomes rhythmically organized and paced the more the entire functionality of the system becomes organized and manageable, because

the brain can at last relax and do its other work” (From Music Therapy, Sensory Integration and the Autistic Child, by Dorita S. Berger).

The visual arts help develop fine motor skills, increasing the ability to create conscious forms. Painting a stormy ocean or making a felted golden ball deepen the understanding of the drama.

Music is key to the unfolding of each session. Participants sing, play rhythm instruments, and get an opportunity to be leaders and to be part of group activities. Music forms a major part of our daily ritual.

Our ten-week program has come to an end. The hero has reached the Castle of Kerglas, fulfilling his quest for the diamond spear and golden bowl of plenty. Peronnik has been proclaimed Duke of Brittany. At the celebration banquet, each participant is presented with a certificate that makes him/her an honorary member of the Court of Peronnik. When I present this to Tony, he bursts out crying! He says, “Oh Kathaleen! Thank you!” We share a big hug. Then it is time to sing our last goodbye song, bidding goodbye to each participant and to the characters in the drama.

The ritual has ended, we all go back to our daily lives, a little bit richer.

To find out more about our programs and view the videos, please visit the website at www.alexandersociety.org.

ABOUT THE AUTHOR - Kathleen Purdy is co-founder of the Alexander Society for Inclusive Arts. She is a teacher, mother, former dancer and coordinator and facilitator of Creative Arts programs. She is also a certified Educational Support teacher through the Association for a Healing Education (based on the pedagogy of the Waldorf Schools).

Kathleen is available to do workshops on setting up Creative Arts programs in other communities.

THE MUSE • SPRING 2018

The Conversation Canada

By Dr. Christine Wekerle Art by Alice Lu

#MeToo has launched a public space for disclosures of sexual violence victimization and a community of solidarity, but not so much so for males. The #MeToo hashtag advocacy has triggered a Twitter account. The #MenTooCampaign.

The Global Partnership to End Violence against children puts the estimate of female victimization as much higher than that of males. In numbers, this is 120 million females to 70 million males. That statistic tells us that there are huge number of males who confront sexual abuse. Most male victims of childhood sexual abuse must confront the pairing of a very toxic display of

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masculinity alongside experiencing very high levels of toxic stress from the trauma, as male assaults tend to happen to young males (under age 6) as well as adolescents, and to be more physically injurious, in part because of the greater likelihood of weapons and restraints. Positively, there is a growing recognition of the need to engage with male youth in high schools and universities to have discussion and creating definition of what masculinity is and how stereotyped norms and expectations translate into sexual violence behaviours (see the new documentary, Liberated: The New Sexual Revolution to get an eye-full

(and eye-sore) on power dynamics and gender-as-weapon approaches to the US Spring Break. Male victims have entered the #MeToo space sometimes with little other times. We have to ask ourselves, are we ready to really see and really listen to what is going on? The Global Early Adolescent Study surveyed youth attitudes about their expectations for boys and girls and found a strong message about the influence of peers (1). Boys were expected to have the traits of toughness, physical strength, competitiveness, ‘not act like girls’ (homophobic), and need to demonstrate manhood by having sex with many girls. These

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The Conversation Canada same themes are very evident in the Liberated documentary. A meta-analytic study on sexting among adolescents by lead author, Jeff Temple, found that about a third of youth were engaged in sexting and 12% were engaged in non-consent sexting (e.g., forward a sext).

These issues resonate with a team of Canadian researchers in boys’ and men’s health, led by child abuse and dating violence expert, Dr. Christine Wekerle, of McMaster University’s Department of Pediatrics and the Offord Centre for Child Studies (2). CIHRTeamSV researchers from Montreal looked to population health data to compare males who experienced CSA to those who did not, following them up 5 years later, in their mid-adolescence.

Compared to non-CSA males, they were more likely to consult a physician for mental health problems and to be hospitalized for physical health issues (3). Compared to CSA females, CSA males were 2.2 times more likely to consult a physician for physical health problems, but 2.3 times less likely to consult one for mental health problems (4).

This leads to the question, are we more likely to respond to physical health for males, funneling them towards less and less connection to their emotional life? If we cannot accept male emotional distress (and maybe the victims’ themselves cannot either), then what are we ready to listen to – acting out violence?

Are we further stigmatizing these youth towards troubles with the law and juvenile detention when they are experiencing trauma symptoms of distress, fear, and anxiety? Prior

work from this team showed that, for maltreated males, their trauma symptoms explained in part the relationship between having experienced childhood psychological abuse and adolescent dating violence perpetration (5). Part of the opportunity for positive change may exist in how we support youth in their romantic relationships.

When it comes to responding as to why they have sex, males who experienced CSA were more likely to report having sex to cope with negative affect than did teens who did not experience CSA (but had experienced maltreatment). The motive of having sex to cope with negative emotions explained in part the relationship between CSA and adolescent sexual health risk behaviours, like multiple partners or unsafe sex practices, for both male and female victims (6).

With the current conversation in colleges about the need for a culture of consent, do we validate the male survivor? Adolescence and young adulthood are windows of opportunity. The first step is to prevent. To prevent is to intervene. But to intervene we have to be ready to listen.

As our research-based understandings of gender and sexuality develop and expand, we have to be open to the male victim of CSA to support their participation in the ongoing, important conversation of #MeToo. As this transforms more towards the practical strategies of #HowIwillChange, we can take this moment to pull the cloak of invisibility from perpetrators and support victims coming forward with their stories, where most victims hold

the motivation to prevent others’ victimizations. It is a sea-change in the current of toxic masculinity towards defining the alternative – a compassionate masculinity. All victims deserve to be heard – are we #ReadytoListen to male victims?

REFERENCES (1) Kågesten A, Gibbs S, Blum RW, Moreau C, Chandra-Mouli V, Herbert A, et. al., Understanding factors that shape gender attitudes in early adolescence globally: A mixed-methods systematic review. PloS one. 2016;11(6):e0157805. Available from doi: 10.1371/journal.pone.0157805.

(2) Research summary available at: https:// youtu.be/k1qvzGhOWU4 (3) Daigneault I, Bourgeois C, Vézina-Gagnon P, Alie-Poirier A, Dargan S, Hébert M, et. al., Physical and mental health of sexually abused boys: a 5 year matched-control and cohort study. Journal of Child & Adolescent Trauma. 2017;10(1):9-17. Available from doi: 10.1007/s40653-016-0120-1.

(4) Daigneault I, Vézina-Gagnon P, Bourgeois C, Esposito T, Hébert M. Physical and mental health of children with substantiated sexual abuse: gender comparisons from a matched-control cohort study. Child Abuse & Neglect. 2017;66:155-65. Available from doi: 10.1016/j.chiabu.2017.02.038.

(5) Wekerle C, Leung E, Wall AM, MacMillan H, Boyle M, Trocme N, et. al,. The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth. Child Abuse & Neglect. 2009;33(1):45-58. Available from doi: 10.1016/j.chiabu.2008.12.006.

(6) Wekerle C, Goldstein AL, Tanaka M, Tonmyr L. Childhood sexual abuse, sexual motives, and adolescent sexual risk-taking among males and females receiving child welfare services. Child Abuse & Neglect. 2017;66:101-11. Available from doi: 10.1016/j.chiabu.2017.01.013

ABOUT THE AUTHOR - Dr. Christine Wekerle obtained her Ph.D. in Clinical Psychology from Western University and is currently Associate Professor, Pediatrics, and an affiliate of the Offord Centre for Child Studies at McMaster University. She is Editor-in-Chief of the Elsevier journal Child Abuse & Neglect, and leads a forthcoming second edition of the book, Child Maltreatment (Hogrefe/Huber). She leads a team of researchers and stakeholder in examining boys’ and men’s health as it relates to the under-attended area of sexual violence victimization.

This CIHRTeamSV has information on the INCAR website www.in-car.ca, and people can follow the research on its project site: https://www.researchgate.net/project/Understanding-health-risks-and-promoting-resilience-in-maleyouth-with-sexual-violence-experience-CIHR-Team-Grant-TE3-138302

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The Voices Inside Your Head The Success of a Novel Therapeutic Software for Auditory Verbal Hallucinations

By Talha Tahir Art by Amy Ajay

Advancements in information technology have changed the healthcare field in remarkable ways. The use of novel diagnostic techniques and imaging procedures alone has saved countless lives. Despite the numerous crossroads between information technology (IT) and healthcare, IT advancements have been slow to drastically change the field of mental illness. However, with the growing role of technology in our world it was inevitable that computerization would eventually turn its gaze towards mental illness.

In particular this article will be discussing a novel software-based treatment method for schizophrenia and other mental illnesses involving auditory verbal hallucinations. The causes of certain mental disorders, such as schizophrenia, are still unknown and there are currently no foolproof methods of treatment (1). Currently, second generation antipsychotics along with psychotherapeutic approaches such as meta-cognitive training are used in conjunction to treat the illness (1). The novel treatment being discussed here has been given the name of AVATAR therapy, or Audio Visual Assisted Therapy Aid for Refractory auditory hallucinations.

The treatment is highly customizable, has no adverse effects, and has been proven to be more effective

than supportive counselling (3).

AVATAR therapy involves creating an avatar of the voice a schizophrenic hears in their head. The patient then converses with that avatar over multiple sessions, standing up to its taunts and derisions.

Over time, the avatar starts to soften its tone and become less malevolent. This software based approach to psychotherapeutics has proven to not only be original but extremely effective (3). Perhaps a key to the success of the treatment is the customizability of the avatar’s voice and physical appearance. Patients are able to choose with great specificity the voice they hear in their heads, as well as the face of the avatar. Patients that do not visualize a face are asked to choose a face to which they would not have a problem speaking (2). The speech of the avatar is controlled by the therapist, starting out aggressive but yielding control to the patient over time.

During the patient’s conversation with the avatar, the therapist gives advice to the patient through a separate audio channel. The aim of the software is to allow the patient to take their experience of bringing the voice of the avatar under their control and apply it to the voice(s) they hear in their heads (3).

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The Voices Inside Your Head The effectiveness of this therapy makes it an exciting potential addition to existing psychotherapeutic treatments. The pilot study, a single blind randomised partial cross over trial, compared AVATAR therapy to treatment as usual. The study found a mean reduction of 8.75 in the PYSRATS-AH (Psychotic Symptom Rating Scales, auditory hallucinations subscale) scale (p < 0.003), while the control groups experienced no changes (2). However, it is important to note that AVATAR therapy is not intended to replace pharmacological treatments, it is meant to be used in conjunction with them. As a result, the larger single blind randomised control trial conducted on AVATAR therapy did not test it against pharmacological treatments such as Clozapine or second generation antipsychotics, instead choosing supportive counselling as the control (3). The trial was conducted on 150 individuals, 75 of which were assigned to AVATAR therapy and 75 being assigned to supportive counselling. Out of 150 patients, 123 achieved the primary outcome which was defined as a reduction in auditory hallucinations as assessed by the PSYRATS-AH total score at 12 weeks (3). The group assigned to AVATAR training experienced a mean 3.82pts (P < 0.0093) greater reduction in PYSRATS-AH scores than the group assigned to supportive counselling. AVATAR therapy resulted in a marked and sustained reduction in auditory verbal hallucinations as compared to supportive counselling (3). However, while there was a reduction in the frequency and omnipotence of auditory verbal hallucinations, there was no reduction in the malevolence of the voices observed. Nevertheless, the study revealed appealing benefits; one of the most favourable

aspects of AVATAR therapy was that there was not a single adverse patient reaction observed from its use (3). The safety of the treatment is going to be vital in its widespread implementation going forward.

Despite the national and international interest in the results achieved by AVATAR therapy, a multicenter study will likely be required before it can be recommended as a treatment in clinics (3). The success of the therapy however, especially in the larger follow-up case control study, has been highly impressive. While it may not be a complete treatment by itself, it can be a powerful addition to an existing treatment package. AVATAR therapy will perhaps one day be available online for anyone to access.

AVATAR therapy’s success thus far, can be seen as an incentive for researchers to further investigate IT-based treatments for mental illness. This is due to the fact that, despite AVATAR’s success, none of the technology used to create the software is cutting edge. In fact, the software uses an existing commercial software for face construction called ‘facegen modeller’ (2). The only novel aspect of the software was the customizability of the voice of the avatar. However, even this component of AVATAR is no impossible feat. AVATAR’s success therefore, is not the result of technological advancement; rather it is the product of the creative integration of existing technology within existing therapeutic frameworks.

AVATAR therapy is a testament to the potential of existing technology to change the healthcare. While advancements in technology will undoubtedly make their impact felt on the healthcare field, the creative use of existing options may yield equal-

ly impressive results.

In a future where computerization and information technology are going to dominate, it is high time that mental illness gets its due share of attention from the IT world.

REFERENCES (1) Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options. Pharmacy and Therapeutics.

2014;39(9):638. Available from: https:// www-ncbi-nlm-nih-gov.libaccess.lib.mcmaster.ca/pmc/articles/PMC4159061/ (2) Craig TK, Rus-Calafell M, Ward T, Leff JP, Huckvale M, Howarth E, et. al., AVATAR therapy for auditory verbal hallucinations in people with psychosis: a single-blind, randomised controlled trial. The Lancet Psychiatry. 2018;5(1):31-40. Available from doi: 10.1016/S2215-0366(17)30427-3.

(3) Leff J, Williams G, Huckvale MA, Arbuthnot M, Leff AP. Computer-assisted therapy for medication-resistant auditory hallucinations: Proof-of-concept study. Br J Psychiatry. 2013;202(6):428–33. Available from doi: 10.1192/bjp.bp.112.124883.

ABOUT THE AUTHOR - Talha Tahir is a second year student in McMaster’s Health Sciences Program. He has an interest in modernizing healthcare through the implementation of information technology based solutions to current healthcare problems. Talha is also passionate about human rights, powerlifting and animal welfare.

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One Drag at a Time THE MUSE â&#x20AC;¢ SPRING 2018

By Aahil Dayani Art by Grace Huang

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One Drag at a Time September of 2017 was a really important month because it was the year I turned 19. It meant I could buy cigarettes at any convenience store without having to convince the clerk that I was a drunk 19 year old who just so happened to have forgotten his ID at home. I could indulge in my vice legally, but beyond that, I wouldn’t have to ration off my cigarettes. With legality, I could smoke as many as I wanted, without having to constantly pester my friends who were 19 to buy them for me.

Unfortunately, my period of celebration came to an unceremonious end when it was announced that McMaster would be the first campus in Ontario to be completely “smoke free”. This meant that no one on campus could enjoy a cigarette outside of Mills, the unofficial designated smoking area.

The privileged thinker I am, I believed this was simply a bullshit marketing ruse created by the dean to promote how healthy and forward-thinking our campus was.

While I understood that smoking was detrimental to our campus and our shared breathing space, it felt more like a vendetta – a personal attack that fully displayed that smokers were not welcome, that they were a nuisance to society that would now slowly be locked away.

Realizing that come January 2018, I couldn’t smoke on campus, I felt scared. Smoking was just as big a part of my life as breathing air – I couldn’t live without it. Despite my adherence to the almighty cigarette, I was aware that change was coming and I couldn’t be left behind.

I know cigarettes are bad – everybody does. It yellows the teeth, makes it harder to breathe, and increases your chance of dying via cancer and heart attack. It’s liter-

al physical degradation. For every pack of cigarette I bought, a sterile black and white picture of a slowly dying old man laid just below the brand name. He was supposed to deter us from continuing to smoke, but to other young smokers like myself, those pictures felt like a challenge that insulted us.

Most people often ask me why I started smoking and I always reply by saying “it was out of circumstance”. My dad’s a smoker – the ‘pack a day’ guy who most of us should stay away from. My home was always engulfed with the sickening stench of tobacco, but it was just normal to me. As a kid, I thought everybody smoked – even my elementary school teacher, who I once caught smoking a slim cigarette at the edge of our playground during recess.

“I coughed. A lot... The taste in my mouth was ungodly and I felt sick to my stomach.”

I went to a very small elementary school, maybe 15 kids per grade.

This meant that everybody knew each others parents, including Julia from the third grade. She told me one day that she saw my dad smoking in the parking lot, and she asked her dad what my father was doing.

Now, my memory’s a bit foggy, but I remember her dad saying that he was doing something bad. As kids, we lacked a filter, so as expected, Julia came up to me and told me that my dad was a bad man for smoking. I didn’t really understand what she meant, and since Julia wasn’t the kindest person, I didn’t take her words to heart.

That night, I asked my mom if dad

was a bad man, and she said he wasn’t, but he was bad for smoking. I assume my mom scolded my dad for smoking in the parking lot, because he later told me that night that smoking was bad and I should never do it. Naively, I asked him why he smoked and he responded by saying “out of circumstance” in Gujarati. I later promised him that I would never smoke.

I was seventeen when I smoked my first cigarette. Working at a dingy, fast-paced breakfast restaurant where I didn’t receive breaks, I noticed that some of the older staff would get smoke breaks. I didn’t really connect with the younger workers there, mostly because they weren’t interested in making friends. I’ve always felt like an old soul, and apparently the older workers (we’re talking 30 and older) thought the same, because soon I’d end up joining them on their smoke breaks, talking about what I was doing in school, or how annoying table 7 was.

Curious to know why people gravitated towards this “death stick”, I bummed one off my co-worker during a routine smoke break.

I coughed. A lot. I tossed it out within three drags. The taste in my mouth was ungodly and I felt sick to my stomach. And then the headrush prevailed and was ingrained into my life. I felt wavey and slightly high, feeling more “forward thinking”. For the last few weeks of summer, I’d occasionally smoke a cigarette just to get a break and feel that oh so heavenly headrush. I would get right back into work, taking orders with a smile that had no right to be there.

Like all good things, summer came to an end, and I was entering my first year of university. I wasn’t terribly excited because I was scared I

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One Drag at a Time would completely fail at everything: living on my own, making friends, and getting good grades.

I would later get diagnosed with depression at the Student Wellness Center that October after multiple meetings with counselors and therapists. The happiest parts of those days? Smoking a cigarette. Smoking was a stress reliever when I had no stress and a distraction when I wasn’t ready to deal with my daily duties like going to class. It also give me a chance to just be by myself, listening to music, alone with my thoughts.

Smoking a cigarette was perfect. I was bored, I’d smoke. I was having a boring conversation with somebody, I’d excuse myself and light one up. I was studying and needed a break, I’d ask a nearby student in Mills to watch my stuff while I went out for a few drags.

The best part of smoking was meeting a fellow smoker and enjoying a few smokes with them. Smokers have a special connection, really.

We all know it’s bad for us, and half of the conversation is usually talking about how we want to quit, but there’s just something so intoxicating about sharing a smoke with someone. And if the conversation was good, we’d smoke as many as we needed to keep the conversation going.

Smoking was like living life in definitive intervals… nothing existed before and nothing existed after; it was a self-contained moment of tranquility, and a hell of a stress reliever.

I’m in university, and everything felt like it was the biggest deal in the world. I didn’t get a good mark on

this test, I’d smoke. The girl I liked just started a new relationship, I’d smoke. Each passive or active action in my life felt like it deserved a smoke. It was a crutch.

I started smoking a pack a day. I became the guy you should stay away from. Beyond the obvious financial burden, I felt sicker and sicker every day. I’m not the healthiest person out there, so it didn’t help that I could barely walk up stairs without panting heavily. I missed breathing, because frankly, I couldn’t.

me to deal with that issue, as I enjoyed a drag that morning.

I had my last cigarette on December 31st in the same back alley where I had my first: the restaurant. It felt poetically sound. By the time you’re reading this, it will have been almost three months.

So why did I quit if I was I so romantically involved with cigarettes? Out of circumstance.

“We all know it’s bad for us... but there’s just something so intoxicating about sharing a smoke with someone.”

My friends didn’t like that I smoked because of the stench I carried around with me. My mom found out I was a smoker and was heartbroken. I’m glossing over this because even though I’m in a much more healthier, stable place, it’s painful to remember how I felt like a burden to my friends and my mother.

So, what does one do when they’re addicted to the thing they love the most? They deny it. They live on.

And then one day, they’re at rock bottom, ready to make a change.

On September 18, I hit rock bottom when it was announced that McMaster was going to become a “smoke free” campus. So, that day, I told myself I’d somehow quit before New Year’s. It was wishful thinking, and I was going to allow the future

ABOUT THE AUTHOR - Aahil Dayani is a second-year Theatre & Film Studies student who hopes to one day become a screenwriter and the inventor of time travel.

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A Pivotal Question Can Lead to a Change in Outlook

By Dr. Lalit Chawla Art by Gracia Chen

Before becoming a physician, I was a professional magician. For me, magic and illusions have been and always will be great forms of entertainment and amusement, especially in a large theatrical setting,

bringing excitement and laughter whenever it’s performed. When I finally became a doctor, it seemed like a natural segue to performing magic for children, even in the clinical setting. It transformed a

serious, cold, and sterile clinical environment into a more hospitable and less threatening one. Let’s face it, most people do not prefer to visit a doctor’s office or a hospital.

As I progressed in my journey from medical student to full-fledged physician, I experienced something very unexpected, inspiring, and life-altering.

But to understand where I ended up, I need to take you back to the early stages of my medical training. Here is part of my story.

When I was an apprehensive thirdyear medical student, I was following a pediatrician in my clinical rotation. We were about to see a patient together when he stopped and said to me, “You’d better not come in with me to see this little girl.

She’s seven years old and extremely shy. It’s taken me three years to develop some level of trust with her. She’s finally not afraid of me, and she has finally allowed me to examine her without screaming and crying.”

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A Pivotal Question Can Lead to a Change in Outlook Like an obedient student, I merely sighed and replied, “Okay, I’ll wait outside the exam room.” He took a pitying look at me and said, “Okay, come in, but be quiet. Stand in the corner on the opposite side of the room and try to be invisible.” He didn’t realize I was a magician, or that being invisible (or vanishing) had an entirely different connotation for me.

While we were in the exam room, the pediatrician realized he’d forgotten something and excused himself for a brief moment. I stood there, the little girl looking at me, her parents looking at me, while I looked back at them. All the while I was trying to be invisible—not an easy task.

The uncomfortable silence became more uncomfortable with each passing second. So I did what any magician would do in moments like these. I asked the little girl, “Do you want to see some magic?” And with those words I made a coin appear, disappear, and reappear. The girl laughed and walked over to me. She touched the coin in my hand and said, “Do that again.” So I did. This was followed by laughter and questions; “How did you do that? Can you make that pen disappear?”

The pediatrician walked back in and saw the little girl talking to me, and it was his turn to be amazed.

He stood there, eyes bulging, jaw wide open, like a person hypnotized. He absolutely couldn’t believe his patient was talking to me, let alone laughing with me. He finally snapped from his hypnotic trance, regained his composure and completed his clinical assessment.

When the little girl left, she waved to me and said, “Bye, magic doctor.”

Now the tables had turned, and the pediatrician came to me for tutelage. “It took me years to build a rapport with that little girl, and you did it in seconds! Will you teach me a couple of magic tricks?” So I

THE MUSE • SPRING 2018

did. Needless to say, I received an outstanding evaluation at the end of the rotation. Who knew being a magician could inflate your grades?

Years passed, and more doctors and nurses asked if I would teach them magic. They too wanted to make children feel more comfortable and less intimidated in a clinical setting.

After all, as health care providers, we want to help patients have a positive experience. We want to restore our patients to their normal lives so they can flourish.

Children feel happy when they see a magic trick and so do adults. It brings them to a state of wonder, a place of excitement. That’s why stories, music, movies, and sports exist. These things give life added vitality. Medicine keeps us alive while magic and the arts allow us to thrive.

In the end, doctors, nurses and other healthcare professionals can use this skill of magic to make children feel comfortable as they poke, prod, and stitch them up or give an immunization. Instead of being traumatized, children can leave with a positive experience and a happy memory.

What Changed for Me One day, a few years ago, I received a call from Children’s Aid Services asking me to examine two brothers, aged three and six. There was a strong suspicion of sexual abuse perpetrated by their male teen babysitter (which was later confirmed). The boys refused to see any healthcare worker, whether it be a doctor, nurse, or social worker. I told Children’s Aid I would see them immediately.

While it was my first time seeing the boys, I’d met the mother twice. She was a single parent and a sincere individual. She’d come from a fractured childhood and an abusive en-

vironment. She was working hard to create a new, positive life for her two boys. She’d moved hundreds of miles away from her “so-called family,” as she often called them. The next day, anxious and distraught, she brought in her three-year-old son. She told me her eldest refused to see me or anyone at all. He just wasn’t ready to talk to anyone, not even her. He had become quiet and was keeping to himself.

Normally, I do one or two tricks for the children, but for this encounter, I did a few. As usual, the threeyear-old smiled and laughed, and we began developing a connection.

He allowed me to examine him and fortunately there appeared to be nothing physically wrong with him.

However, assessing psychological damage is difficult through a medical exam. I suggested to the mother that I would show her eldest son some magic and asked her to bring him in; I would make room in my schedule to see him anytime. She called me back after two days, apologizing that she hadn’t called earlier, and told me her son did not want to see me at all. However, after listening to his younger brother talk about the magic tricks he’d seen, the older boy changed his mind. His mother prefaced this by saying, “He just wants to see the magic tricks, and that’s it. He doesn’t want to talk to you or do anything else.” I replied, “That’s a start; I’d be happy to show him some magic,” and asked her to bring him in.

She did so, and I did several tricks for him. I could see the smile on his face and noticed his delight as he spoke to me. I saw trust beginning to form. I asked him if he would let me examine him since his mother wanted to make sure he was healthy. He happily agreed and, fortunately, he showed no physical signs of abuse. He came several times after the initial visit.

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A Pivotal Question Can Lead to a Change in Outlook He would only see me and no other healthcare provider. I realized that I was making an impact on both his life and his brother’s life. I was not just a doctor to them. The older boy started to trust other people again.

Eventually, I was able to connect him to other services and other professionals who have since aided in his healing process. Now both boys are leading healthy lives.

After having first seen them, and after every subsequent visit from them, I sat back in my chair and wondered, “How would I have ever connected with those little boys to help them if I hadn’t known magic?” I had no answer. Magic was the tool that helped build a rapport with them. Those children had their most basic trust violated. They may have even lost faith in their mother, who was supposed to be their protector. Through no fault of her own, her children had ended up in the hands of someone who’d seemed trustworthy but had turned out not to be.

Children grow up to be adults who may have children of their own.

Consciously or unconsciously, they will impart their attitudes toward seeking medical attention and seeing healthcare professionals onto their children. Healthcare professionals are people who everyone, sooner or later, will need to encounter, whether the encounter is welcomed or not.

Asking the pivotal question, “How could I have helped those boys if I didn’t know magic?” opened my eyes to how valuable magic is in helping healthcare professionals connect with their patients. Prior to this experience, I’d never truly appreciated or understood why people found my lessons on magic so valuable. I was too close to the situation to see what others were seeing. But more than ever, after helping those boys, I understood the value of using magic. I realized I could help more people by teaching healthcare professionals how to bridge the gap between them and their patients by using magic. Illusions can truly make the clinical encounter magical. It can help in the healing process. In that sense, the magic is the medicine.

My focus and energy changed when I asked that pivotal question. My illusion of humility was a disservice.

By not sharing what I’d learned as a “magic doctor,” I was not empowering other clinicians to create better connections. I now share this skill with others by giving workshops and lectures locally, nationally, and internationally on “How to Use Magic in a Clinical Setting.”

I see the positive impact it makes in creating greater joy not only with patients but also among physicians.

The physician becomes a magician, who becomes a healer.

Through this experiential awakening, I learned that we all have gifts

that we can share with others. Yet only through the act of asking questions could I gain greater clarity and meaning about what I was doing. As much as this story is rooted in a clinical setting, it is my story of personal transformation. Great key questions lead to key decisions, which dictate daily actions and behaviors, ultimately affecting your life’s trajectory.

Too often, we’re blind to our own influences and oblivious to our inherent gifts. We all share our gifts in many ways, whether by encouraging others, like the pediatrician did by wanting to learn from me, or by appreciating someone for an act of kindness, no matter how big or small.

I believe we all offer some sort of value, something to say, an inherent gift we aren’t always using to its full potential. Don’t be fooled by illusions of humility, fear, or the thinking that your contributions aren’t significant or necessary. Don’t be fooled by the illusion of not seeing your inherent gifts and your ability to bring out those gifts in others. When we don’t share our gifts, it is a loss for ourselves and everyone else. Sharing our gifts in all the ways we know how, even in the little ways, is the greatest gift we can give to ourselves and the greater world. These are the gifts that transform everyone’s lives forever and leave a footprint long after we’re gone.

ABOUT THE AUTHOR - Dr. Chawla is an author, international speaker, and TEDx speaker. He was a professional Illusionist and had a successful career but returned to his original pursuit to be a physician. He has a breadth of experience as he’s worked in addiction medicine and palliative care, with incarcerated individuals, and as an ER physician. He was awarded the “2014 University of Alberta Augustana Distinguished Alumni Award” for his contributions in the field of Medicine. His lectures are entertaining, educational, and empowering as he’s able to bring his experience as a performer into the teaching arena.

He’s currently developing a podcast to share tools, tips, and strategies for professionals to enhance their life at work, home, and play.

For more information you can go to www.magicandmedicine.ca THE MUSE • SPRING 2018

THEY TELL ME THINGS Like how he didn’t tell his wife about his suicide attempt.

Like how she didn’t tell her daughter about not wanting to go home.

People are heavy with stories Untold Unspoken Until moments that they think may be their last, moments alone with me and my unfamiliarity, together comforting days spent thinking about days spent.

ABOUT THE AUTHOR - Michal Coret is in her fourth year in the Bachelor of Health Sciences program at McMaster. She has a passion for narrative medicine, used books, reading and writing poetry, playing music, overthinking, swing dancing, and travelling.

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By Michal Coret Art by Peri Ren

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Tobacco Child

By Tenzin Gyaltsen Art by Katherine Tang

the perfect nuclear family, normality bordering insanity, reciprocating affection tenfold, memories betray an imperfect rapport, on a quest for amusement, disregard for prudence, an inquisitive mind seeks out, no direction; an ambiguous route, cramped hidden spaces ransacked, beckoned by household artifacts, sundry gadgets and old photos, a packet of darkness; he froze, knowing what the substance entailed, he strove to understand; he failed, cancerous substance of innate evil, dreadful and toxic, though not illegal, these details had been instilled within, by friends, school and advertisings, nervously fixed at a dog-legged crossroads, vigilante justice under his fatherâ&#x20AC;&#x2122;s nose. *** on a quest for comfort, like all, he had suffered, an aged mind seeks out, unilateral; an explicit route, seeking his stash; the man was dismayed, all ten packets had been tossed away.

ABOUT THE AUTHOR - Tenzin Gyaltsen is a first year in the Life Sciences program at McMaster University. In addition to writing and reading, he enjoys gardening and playing soccer. Currently, he volunteers at the McMaster Biology Greenhouse.

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Shared World, Divergent Reality

By Owen Dan Luo Art by Adhora Mir

A shoal of rising bubbles disturbs, Clear water – a safe-house from the raging storm, With heart pounding against chest, My eyes drift above at the sky beyond the waves, Clouds wrinkled in fury – erupting in a rainy deluge – Thundering like the kids who fail to fathom my depths, Soaring above me on their ice-capped summits.

From above, their silhouettes beckon, Yet – past the wall of water – I can’t make them out, I heave my chest to shout in response – But no sound manifests, Only more bubbles.

Another sign from the deep; Another disturbance of the pristine world above.

They respond without consideration, Ridiculing me – excluding me – Laying waste to my waters; Dumping plastic and chemical debris Fish no longer flash their brilliant colors Amidst the chilling clutches of bleached coral, Leaving me without any choice, But to lash out like a tsunami, Or disappear into the depths.

Living on a spectrum, Which wrests me from my peers To a perpetual dive, My condition transforms my perceptions Like water refracting the light – Yes, I behave differently, But appreciate me – all the same.

ABOUT THE AUTHOR - Owen Dan Luo is a third year student in the BHSc Child Health specialization.

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STAFF

Editors-in-chief Katherine Kim

Nikki Wong

Editorial board Managing Editors

Irina Sverdlichenko Jim Xie

Editors

Afreen Ahmad Darwin Chan Kevin Chen Michal Coret Susan Dong Isabella Fany Sarah Fu

Paige Guyatt Sawmmiya Kirupaharan Samuel Lee Isabel Ng Bhagyashree Sharma

advertising & social media Coordinators Sophie Zhang

Members

Aline-Claire Huynh Matilda Kim Maya Kshatriya Joon Mun

FINANCE Coordinators Lucy Luo

Heather Zhao

Saara Punjani Irina Sverdlichenko

Graphics & Layout Creative Directors Hana Brath

Graphic Designers Amy Ajay Gracia Chen Kelly Dong Yih-Chyuan Hsiao Grace Huang Alice Lu

THE MUSE â&#x20AC;˘ SPRING 2018

Cathy Lu Adhora Mir Peri Ren Katherine Tang Michelle Yao

Event PLANNING Coordinators Angus Lee

Members

Aline-Clare Huynh Jacqueline Lim Dorothy Qian Yina Shan

Sarib Malik Sukhmandeep Sidhu Annie Wu

Blog & Development Coordinators Judy Chen

Members Maaz Muhammad

Michael Sun

Julie Cho Aahil Dayani Parnika Godkhindi

Joon Mun Victor Khoung Hannah Swayze Hadi Tehfe