The six students stared at the huge painting in its gold frame at the Portland Museum of Art.

The label on the wall identified this work as a circa-1873 portrait of “Miss Florence Leyland” by James Abbott McNeill Whistler. The subject is cloaked in darkness and rendered in shades of gray, a ghostly figure emerging from the black background. The students talked about her hands, her skirt.

“The longer you sit with it, the more of it comes forth,” Charlotte Collins, 24, said.

These are not art students. They are medical students in their second year of the Maine Track program at Tufts University School of Medicine. Nearby is Dr. Sam Woodworth, an internal medicine physician at Maine Medical Center. He developed and teaches the optional course that brought these students to the art museum on a Friday afternoon in October. Woodworth considered the shadowy woman in Whistler’s painting.

“It’s a good point,” Woodworth said. “Because the painting is not changing, right? You are changing. You have a decision about how much time you want to spend looking at something and where you want to put your focus. And in time, it will change. You’re changing. Your thoughts become more built up and more nuanced and academic, right? So I encourage you, in medicine and in the museum, to spend more time.”

Woodworth launched the class as a pilot program in the spring and taught it this fall for the second time. It is an example of the way medical schools are increasingly using the humanities to help students develop clinical observation skills, empathy and resilience.

“We didn’t know this for a long time, but now there’s fairly good literature that exposing medical students to the humanities – that would include visual art like the museum, but also literature, music, theater, any of the humanities – actually improves their personal qualities, their ability to tolerate ambiguity, their empathy, their ability to appraise their own and people’s emotional state at any given time,” said Dr. Jennifer Hayman, a pediatric doctor at Barbara Bush Children’s Hospital in Portland and the assistant dean of educational affairs for the Maine-based students in the Tufts University medical school. “The humanities also have been shown to decrease certain risk factors or aspects of burnout, including physical fatigue, feeling emotionally exhausted, feeling cognitively overtaxed.”

Other examples exist in Maine and across the country. At the University of New England College of Osteopathic Medicine, an alum teaches a recurring workshop on “medical improv,” a popular practice that uses theater techniques to build communication skills. The college also puts out an annual call for art by students and faculty and hosts an exhibition of the submissions.

“So much of medicine is so data and science heavy, and you lose the humanistic piece,” Vincent Buonocore, associate dean of recruitment student and alumni services at UNE’s medical school, said about ArtCOM, the annual exhibition. “This is collectively a creative outlet for our community, and it allows us to pause and reflect on our humanity in general.”

THE ACT OF BEING CURIOUS

On that afternoon in October, Woodworth waited patiently in the lobby for the students. This was to be their fourth and final session. Scheduling around their required courses and exams had been somewhat of a challenge, but Woodworth wanted to offer the course here because he remembered his own experience in a similar one.

Woodworth, 36, grew up in West Bath and studied classics as an undergraduate at McGill University in Montreal. His parents are both artists, and he grew up going to museums, painting wooden animals and drawing. Today, he and his wife live in Portland and maintain their own studio space at Fort Andross in Brunswick, where he sketches and does collage. When he decided to become a doctor, he did additional coursework at the University of Vermont before he started Cornell University’s medical school in New York City.

He and a handful of classmates would walk from their campus to the Metropolitan Museum of Art for the class. He recalled one day when they did an exercise centered on Swiss artist Alberto Giacometti’s sculpture “The Cat.”

“You had a notebook, and you would sketch it for a bit,” Woodworth said. “Then you would move to someone else’s. Not only is your drawing different, but their paper is turned a different way, the other way around. You realize that everybody has a different take on the same thing that you’re looking at.”

At Maine Health, he is able to divide his time between clinical and academic work. He decided to use that time away from the hospital to pitch a course similar to the one he took during his own training. These medical students are enrolled at Tufts University but spend the majority of their time in Maine.

“I just noticed in myself and colleagues and time spent practicing medicine that there is a push to become less curious,” he said. “Curiosity is essential to having the endurance to get up and do your work again tomorrow. The act of being curious I find very important to the work of the physician.”

‘A LOT GOING ON’

Woodworth built his curriculum around five dimensions of curiosity developed by psychologists at George Mason University. During his recent course, he led the students up the elevator to the top floor of the museum to Matt Blackwell’s “Moose.” In the painting, the titular animal is a Godzilla of sorts towering over a busy cityscape. Woodworth instructed the students to pick one feature of the chaotic scene and draw it on a piece of paper.

They were quiet as they studied and sketched. When they finished, each student explained what she chose to draw and why. One chose a figure that had the body of a man and a head she compared to an alien. (“It was funny to me,” she said.) Another chose a woman whose figure was hard to discern in the paint. (“She was blurry, so I thought it was a fun challenge to figure out what she was doing in the fuzz.”) A third chose a bright pink car. (“It was spiraling out of control,” she said.)

Woodworth listened, nodded, encouraged.

“There’s a lot going on,” he said.

One of the five dimensions of curiosity, he said, is stress tolerance.

“What this means is being able to tolerate a lot of unknown information so you can act on your curiosity and discover new things,” Woodworth continued. “You have to be able to tolerate stress as a curious person.”

The students talked about the stresses they feel in their medical training – not just in their intense coursework, but also in the impending decisions about specialties and residencies. They talked about managing complex problems by breaking them down into smaller pieces.

“I remember what it’s like to be a medical student,” Woodworth said. “It’s very, very jarring. Your focus can be so intently on one thing, but there’s so much going on that you can be pulled around. And I hate to tell you, but being an intern, a resident, an attending – that doesn’t go away.

“The decisions never go away, the noise never goes away, and all of your cases are going to be like this too,” he gestured to the painting. “You have to be able to see it for what it is, which is a lot, and have that tolerance of stress to go after individual parts.”

DEVELOPING A PRACTICE

Meghan Quigley Graham is the learning and teaching manager at the Portland Museum of Art, and she works with students of all ages and disciplines. This course is something new, but the museum has previously organized programs for other medical professionals and trainees, including psychiatrists from Maine Medical Center and nursing students from the University of Southern Maine.

Experts and educators say that one way this practice can build empathy is by reminding clinicians what it feels like to not understand the topic at hand.

“It’s really incredible for me to see these folks who are in this world of medicine that I think for me and a lot of people feels really foreign,” Quigley Graham said. “Oftentimes we talk with these groups about how patients coming into their settings can feel really unsettled. The language they’re using, they don’t understand it. Medicine has a specific vocabulary, and it’s the same with art.”

Medicine is also constantly evolving. Hayman said she feels this practice helps future doctors be more comfortable asking for help or seeking opinions from other people on their team.

“Medicine is practice so much within a healthcare team these days,” she said. “Being able to integrate in a team is really important. I see that vulnerability already coming through and giving them strength in that field when they’re back in the hospital.”

During the last course of the series, Woodworth split the students into two groups and sent each to study a separate painting. One considered the Whistler. The second was a more modern work – a 2021 painting by Reggie Burrows Hodges titled “Bathers and the Cleansed: Pearl.” There, too, the central figure is hard to discern; the artist also obscured the woman’s features in the dark tones of the image. She is in a moment of transition, wrapped in a towel, getting either in or out of a bathtub.

Woodworth prompted their small group to think about how the painting might relate to the patient experience. The featureless face made them think about how patients can feel dehumanized in the medical system.

“There’s more attention given to a disease, the thing that is happening to the person, than the actual person,” Laurel Swanson, 26, said.

Olivia Berger nodded. Growing up in Oxford County, she developed an interest in photography and even sold images she made with her camera. When she started college and then medical school, she had less time for artistic pursuits. She signed up for Woodworth’s course in hopes of reconnecting with that creative side of herself. She said she liked the way Woodworth talked about curiosity as an ongoing skill that must be cultivated.

“That is a practice,” she said after the class. “It is something you have to work on and improve on and realize what works well for you and what doesn’t, and that’s different for every person.”

During the first class, Berger spoke little. By the final session, she shared her opinions more freely and and with less inhibition.

“I’ve gone to art museums as an adult many a time,” she said. “But having the structure to slow down and really think about a piece and let it sit with you for more than a quick glance was something I hadn’t really appreciated prior to this class. I think that experience was super powerful.”