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Cover Art Artists’ Statement: Inner Light Inner Light is a mixed media interpretive project from the Family Centered Experience (FCE) program at the University of Michigan Medical School. The FCE is an immersive course for preclinical medical students in partnership with patient volunteers managing chronic illnesses and is intended to explore the personal, human side of medicine. Through a series of home visits and conversations, these volunteers provide narratives of their illness experience and navigation of the health care system. Midway through first year, students are challenged to represent an understanding of their volunteer’s perspective through an artistic medium, an undertaking known as the Interpretive Project. Student projects range from poetry to pottery, from drawing to dance, and can be mixed media visual art, such as the piece on the cover of this issue: Inner Light.1 Although we each have a different patient volunteer, one a man with type 2 diabetes and the other a woman with breast cancer who underwent a double mastectomy, we regarded the striking similarity between our volunteers’ strength and positivity in the face of illness as an empowering concept worthy of visual depiction. In the face of life-changing diagnoses, invasive treatments, and uncertain futures, our volunteers found fortitude and peace from family, faith, and a strong sense of self-empowerment. Inner Light represents this triumph over the negativity of illness. An array of positive words related to wellness, health, and recovery are brightly colored to convey the feeling of glowing vitality associated with overcoming illness. These words form a half-dome beneath an array of negative

Academic Medicine, Vol. 90, No. 6 / June 2015

experienced illness or stood by in solidarity with a loved one who was ill.

Inner Light

words related to sickness and disease, which are accordingly darkly colored. The bright, positive words evoke a hopeful sunrise, a sheltering umbrella, or an inextinguishable light burning from within. The dark, negative words evoke a storm cloud, a frightening dream, or a starless night. The melted crayon adds a swirling, dreamlike, abstract quality to the concreteness of the words, conveying the blended reality of subjectivity and objectivity in which we live while simultaneously reminding us of the precarious division between positivity and negativity, between illness and health. In addition, a silhouetted figure stands within the dome of positive words, shielded from the oppressive, overhanging negativity by an enveloping blend of positivity. This silhouette represents anyone who has ever

We chose to incorporate word clouds to highlight the power of words themselves. We latch onto words that provide us strength or peace; in contrast, a single word of discouragement or judgment—especially from a health care provider—may seem to hover over us relentlessly when we suffer. Our identities, both fleeting and lifelong, are defined with words, and their connotations can either build us up or tear us down. One patient volunteer expressed that, although he was diagnosed with diabetes, he does not refer to himself as “diabetic,” or perhaps more condemningly, “a diabetic,” to avoid permitting mere words to define and dishearten him. During the FCE program, we have observed the power that the choice of words can provide in the face of adversity, and we hope to convey this concept with this piece. Acknowledgment: The authors would like to thank Aki Yao for expert photography of the original work. Cristina Sarmiento, Kevin Schmidt, and Arno K. Kumagai, MD C. Sarmiento is a third-year student, University of Michigan Medical School, Ann Arbor, Michigan. K. Schmidt is a third-year student, University of Michigan Medical School, Ann Arbor, Michigan. A.K. Kumagai is professor of internal medicine and medical education and director, Family Centered Experience and Longitudinal Case Studies Programs, University of Michigan Medical School, Ann Arbor, Michigan; [email protected].

Reference 1 Kumagai AK. A conceptual framework for the use of illness narratives in medical education. Acad Med. 2008;83:653–658.

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Artists' statement: inner light.

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