The undergraduates weren't sure what to expect. They filled a classroom at The Dartmouth Institute for Health Policy and Clinical Practice, a space normally reserved for graduate students and healthcare professionals, where they met professors from not only the Geisel School of Medicine but also Dartmouth's Faculty of Arts and Sciences. They saw a class schedule that included lectures about rugby, religion, music, and vampires. How would those topics relate to healthcare?
Answering that question is what attracted these students to the first annual Dartmouth Health Care Foundations in July—a groundbreaking summer intensive program sponsored by The Dartmouth Institute that bridges science and the humanities to introduce undergraduates to the complexities of current issues in healthcare.
Manish Mishra MED '05, MPH '09, program director for Dartmouth Health Care Foundations and a clinical assistant professor of community and family medicine and of The Dartmouth Institute, says, "A multidisciplinary approach to medicine can put the heart back in healthcare—and it should begin before medical school."
The launch of this annual week-long summer intensive was made possible by a visionary gift from Eric Eichler D '57. The son of a physician, Eichler has paid close attention to the evolution of medicine and healthcare. He describes his father as "a dedicated, old-time doctor who made house calls" but who also grew increasingly disturbed with the bureaucratic changes to healthcare that robbed him of time with his patients. "I'm concerned about what's happening to medicine in America," Eichler says. "I hope this gift will start the ball rolling to address questions about healthcare and medicine and how they are taught."
With assistance from Elizabeth Carpenter-Song, PhD (D '01), a research associate professor of anthropology who also holds adjunct appointments in the Department of Psychiatry and with The Dartmouth Institute, Mishra developed a curriculum that focused on the opioid crisis as a lens through which to explore current issues in healthcare from a variety of angles.
After Mishra provided background on physiological processes of addiction, a patient in recovery recounted his personal experience of struggling with a substance use disorder; Matthew Babineau D '00, MED '05, an emergency medicine physician at Dartmouth-Hitchcock, spoke about managing addiction in the emergency room; and Mary Flanagan, PhD, the Sherman Fairchild Distinguished Professor in Digital Humanities at Dartmouth College, discussed vampire narratives as metaphors for addiction and how learning about the history of the vampire provides a perspective for engaging compassionately with marginalized individuals.
A multidisciplinary approach to medicine can put the heart back in healthcare—and it should begin before medical school.
Professional rugby player and Olympic coach Alexander Magleby D '00, offered students a unique slant on teamwork, as did Glyn Elwyn, MD, PhD, a professor of The Dartmouth Institute, who talked about the importance of engaging patients in shared decision making. Dartmouth faculty members Vaughn Booker, PhD (D '07), assistant professor of religion and African American studies, and Will Cheng, PhD, associate professor of music, drew connections between medicine, community, and morality. Carpenter-Song shared an ethnographic account of rural families shattered by addiction and poverty.
And the former Minister of Health of Rwanda, Agnes Binagwaho, MD, PhD, and the physician known as the Father of Palliative Care in India, M.R. Rajagopal, MD, brought viewpoints from their respective disciplines in two special global health sessions held through video conference.
"Learning how to see is the invitation of the week," Mishra had told the students. "Understand a character in a novel and it helps you understand yourself and others. Rwanda seems so different from the U.S., so find similarities to apply the lessons learned there. When a rugby player falls down, how does the rest of the team react to help? If you go into healthcare thinking about the invisible," Mishra further explains, "you'll be primed to face the challenges that are not reflective of your thinking."
Answering the Call to Humanize Healthcare
Though open to students from any institution, this inaugural class of 37 consisted mostly of Dartmouth undergraduates majoring in everything from biology, physics, statistics, and bioengineering to sociology, anthropology, economics, and romance languages—all of whom are considering careers in medicine or public health. These future healthcare leaders latched on to the themes that linked the interdisciplinary talks.
"Medicine is a human-based science," says Ben Pundyk D '18, "and patient experience is where rubber meets the road. How can we, as members of a system, change the culture to include a multidisciplinary approach that puts patient experience first?"
Minda Liu, a 2018 graduate of Carleton College, says, "At the end of the day, it's not about what kind of doctor I want to be, but what kind of person I want to be as a doctor."
Students noted the privilege of learning with world-class scholars—especially as undergraduates. "I came away from each day feeling star-struck and inspired," says Kennedy Ella Jensen D '18. Reflecting on the opportunity to keep in touch with the teachers she met through Health Care Foundations, Hansa Sharma D '19, says, "The process of learning doesn't end in the classroom. Like a tree, it keeps growing."
Eichler's generous gift will also support a year-long fellowship for 10 Dartmouth College undergraduates who will receive one-on-one mentorship with faculty from The Dartmouth Institute, Geisel, and Arts and Sciences, as well as key leaders from the community. Fellows will participate in monthly seminars designed to strengthen students' abilities to draw meaningful interdisciplinary connections, and will engage in community-based learning projects in partnership with local organizations to deepen their experiential knowledge of patient- and system-level challenges in healthcare.
"We've received over 100 applications for the fellowship in this inaugural cycle," says Mishra. "Students want to connect humanities and arts into medical science. We discovered an intense need bursting from the seams, which we have to continue curating."
Carpenter-Song agrees. "We have critical mass here at Dartmouth thinking about the issue of humanizing healthcare, and students are eager to accompany us on this journey."