Teaching medicine with art: a show and tell

Chris Ellis is a specialist family physician in Pietermaritzburg, KwaZulu-Natal. He was previously associate professor of family medicine at the University of the United Arab Emirates and Honorary Senior Lecturer at the Nelson Mandela Medical School, University of KwaZulu-Natal.

“The primary purpose of art is to help us see, not just with our eyes, but with our hearts and minds,” asserts Leo Tolstoy.¹

In recent years there has been a move to integrate medical humanities such as literature, film, theatre, art and poetry into the teaching of many aspects of biomedicine in medical schools. Art-based strategies and programs are being used in various clinical disciplines of medicine to improve observational skills and ‘sharpen the clinical eye.’^2,3

I have, at times and where appropriate, introduced different aspects of the humanities but find that art and poems provide, for the students, a short and often stimulating awareness of everyday life and illness. There is a wide variety of art available which is easily accessible and useful in the teaching of these observational and non-verbal reasoning skills.

For teaching some of the dysfunctional dynamics in a family one of the pictures I use is The Bellilli Family by the artist Edgar Degas, which hangs in the Musée d’Orsay in Paris.⁴ It depicts a father and mother with their two children in a drawing room. It is unlikely that my cohort of students have seen this before. Degas has used contrasting light and shadow, a chiaroscuro, to show the distance between the family members. The picture can lead to a discussion on similar dynamics in most families. Why is the father sitting far to the right in the shade and the mother dressed in black? What is the relationship between the two daughters and their parents? What is the mother suffering from? We then work inferentially and imaginatively from this non-verbal visual information.

From many of these artistic pieces one can follow clinical reasoning patterns whereby we can build up hypotheses from a swelling in the neck, the posture of the spine and body or the position of the hands and then discuss the diagnostic possibilities.

I find that one of the most useful artistic works for teaching clinical medicine is ‘Benefits Supervisor Sleeping‘ by the 20th century figurative painter Lucian Freud, who was the grandson of Sigmund Freud.⁶ This painting portrays an obese woman who is asleep naked on a couch.
The work was painted with a coarse hog-hair brush in impasto which is the application of thick layers of paint. It was last sold in 2008 for around thirty three million American dollars.

I set up a scenario of her coming in for a check-up. I estimate from the painting that she would be classed as morbidly obese (BMI above 40). This leads on to an interactive session where we build up, usually via a flip chart, her main risk factors for illness. What are her cardiovascular and peripheral vascular risks? How about dermatological illnesses? What cancers is she liable to develop? What musculoskeletal, gastrointestinal, metabolic and endocrine disease might she inherit?

I then allow the students only three blood tests that they can order. This is another exercise in clinical reasoning and we usually end up with five or six on the board that we can justify.

Some patients express themselves through art, especially artists themselves or  those in similar occupations such as graphic designers. I have pictures of this kind that I have been given by patients, who wanted to show via art how their lives were being experienced. These paintings and drawings give a real life authenticity to the illnesses and contexts of the patients. I use them, prima facie, as visual representations of illness or dysfunction without initially giving the background knowledge or histories of the actors or patients that are involved. Through the artist’s eye, and especially the cartoonist, there is often an emphasis or focused perspective that illuminates the subject in a way that we would not ordinarily be aware of.

‘Works of art,’ wrote the philosopher Alain de Botton, ‘…can function as vehicles to explain our condition to us. They may act as guides to a truer, more judicious, more intelligent understanding of the world.”⁶

In a lecture one can stop the world rotating for a minute or two with a work of art or photography and slow down the haste and complexity of modern life. Two minutes in silence is nowadays a long time for the students to observe an image as they are now accustomed to transient images that flash by as they scroll down on the screens of their phones.

It only takes this minute or two of ‘Eye-opening art’ to start revealing the underlying condition and the artist’s visual representations of human experience and existence. This is most evident in psychiatric art and images of schizophrenia, anxiety states and depression.

There is now an extensive choice of art to use in teaching medicine. They are mostly used as ways of emphasizing human nature and illness experiences. They can be used on the first powerpoint or as a “breaker” in a presentation. A short background of the artist or other psychosocial information can then be given that helps integrate the art into the illness and disease management.

References

1. Tolstoy L. What is Art? London; Brotherhood Publishing Co. 1898.
2. Wikström BM. Works of art as a pedagogical tool: an alternative approach to education. Creat Nurs. 2011;17(4):187-94.
3. Musri MC, Nehvi AI, Chacko SR, Eiger G, Moghbeli N. The Impact of Art in Medicine Training and Its Effectiveness on Professionalism and Interpersonal Skills: A Prospective Study. Adv Med Educ Pract. 2025 Mar 31;16:493-500.
4. Degas, E. (1858–1867). The Bellelli Family [Painting]. Musée d’Orsay, Paris, France. https://www.musee-orsay.fr/en/artworks/portrait-de-famille-9998 [accessed 9/9/26]
5. Freud, L. (1995). Benefits Supervisor Sleeping [Painting]. Private Collection. https://www.christies.com/en/lot/lot-5074074 [accessed 9/9/26]
6. De Botton A. p.135, Status Anxiety. London: Penguin books, 2005

Featured Photo by Zalfa Imani on Unsplash