Hero Next Door: DO paints a humanistic picture of medical education

This article is part of a series, The Hero Next Door, on osteopathic physicians who are quietly transforming health care in their communities and beyond.

One evening last February, Audra L. Lloyd, OMS II, drove to her apartment after a long day of school at the Des Moines (Iowa) University College of Osteopathic Medicine (DMU-COM). After a few hours’ rest she headed back to class, but not to campus. She drove about 5 miles west of DMU-COM, and felt her anxiety and stress about medical school lifting as the wheels of her Jeep put more distance between her and campus. She pulled up outside a large hospice administration building and got out of her car, ready for something different.

Lloyd was a student in The Healer’s Art, an in-depth discussion-based course for medical students that emphasizes professionalism, compassionate care and self-care. More than 70 U.S. medical schools offer the course, which a California medical educator created in the early ’90s. Gary L. Hoff, DO, brought the course to DMU-COM. Dr. Hoff, an associate professor of medicine, and his co-teacher, Norma Hirsch, MD, went out West to train for the course and now teach it off campus, giving students a break from the conventional academic scene. In the class, they lead talks about healing, death, empathy and the demands of modern medicine, often citing examples from their own lives and careers. They also facilitate small group huddles, during which students share their personal stories with one another.

“The curriculum and concept of the class is unlike anything we’re being taught in our basic science classes,” Lloyd says. “It’s really about the connection between humanity and being a physician. We talk about the awe of medicine, the wonder of medicine, grief and loss—a lot of the intangible aspects of medicine.”

In class that February day, Lloyd sat in a half-circle with about 40 other students. Dr. Hoff sat in the center and engaged the students in an hour-long conversation about work-life balance. Then, everyone broke into small groups of five or six students, each moderated by a guest physician. Lloyd and her group sat on the floor in a small office and talked more about work-life balance: the hobbies and passions they had given up to pursue medicine, and how they might reincorporate them into their lives.

“In the small groups, you really get to be vulnerable, and you get to talk about a lot of your hopes, your desires, and your fears about going into medicine,” she says. “It was really good to see that a lot of other students had these similar feelings.”

The course is a welcome contrast to the students’ other classes, Dr. Hoff says.

“It’s a wonderful course for the students because they get an opportunity to explore feelings and ideas that they suppress when they’re in strictly down-the-road scientific coursework,” he says.

Medical humanities

In addition to bringing The Healer’s Art to DMU-COM, Dr. Hoff has taken several other steps to encourage outside-the-box learning opportunities. The most significant is his championing of humanities in the medical curriculum and at the school, says Dr. Hirsch, who is an assistant professor of behavioral medicine, medical humanities and bioethics at DMU-COM. Dr. Hoff also helped establish Abaton, DMU’s student literary publication, as well as a medical humanities student interest group.

“At this point in time in our history, when there’s so much burnout in physicians and so much dissatisfaction from patients with physicians’ care, the humanities are going to help renew, restore and transform medicine,” Dr. Hirsch says. “We’re helping students understand how important it is for patients and physicians to connect on a human level. Gary’s understanding of the patient-physician relationship is so profound. And he wants to teach the physicians coming behind him to value it as well.”

When Dr. Hoff led the work-life balance discussion in The Healer’s Art, he shared stories from his own life: He’s a professional artist, and has managed to forge dual careers in art and medicine.

Dr. Hoff began painting at age 12 after his grandmother gave him oil paints and showed him how to mix them. For the past 20 years, he has been selling his oil portraits, still lifes and landscapes.

“I’ve been very fortunate,” he says. “I’ve had a whole lifetime to hone my painting skills in parallel to practicing cardiology and teaching, so I consider myself a really lucky guy.”

After a stint as a pilot with the Air Force during the Vietnam War, Dr. Hoff became a cardiologist and part-time professor at DMU-COM. He transitioned to full-time academia in 1997. He’s found several ways to incorporate his painting career into his work as an educator and community volunteer.

“Being an artist of any kind, whether you’re a painter or a sculptor, requires intense concentration and focus on detail,” he says. “And that intense concentrating state also can bleed over into examining and diagnosing an ailment in a patient. I teach several electives wherein we talk about the intersection of the arts and medicine, and I tell students that painting can help with focus and attention.”

Dr. Hoff has sold portraits to DMU, including one of Iowa Gov. Terry Branstad, a former president of DMU. And in 2011, Dr. Hoff donated a painting of Andrew Taylor Still, MD, DO, to DMU-COM’s student leadership, who sold it for $1,000 during a Council of Osteopathic Student Government Presidents fundraiser.

Giving back

Dr. Hoff often donates 10% of the proceeds he earns from selling his art to Rotary International. Community service is another of his passions—he joined his local Rotary Club about 15 years ago, and has been teaching reading to elementary school students for five years.

For the past four years, he’s been working with a class of 9- and 10-year-old students at The Downtown School in Des Moines, where he has taught units on art and anatomy in addition to reading.

“I taught the students about landscape drawings and still lifes, but like everybody else, they are most interested in people,” he says. “So learning to draw faces is what they like the best. They love the idea that they could draw one of their classmates and draw their own face. And it’s great when they come out with a pretty good resemblance. These are 10-year-olds. It’s a lot of fun. They’re sponges at that age.”

Dr. Hoff’s work with these students won him the club’s Rotarian of the Year award in July. He brings unprecedented enthusiasm and commitment to his role, says Amanda Clark, a teacher who works with Dr. Hoff.

“He’s kind of the grandpa of the class,” she says. “He tells us, ‘I’ll do whatever you need, and I’ll come whenever you need me.’ He always writes us thoughtful notes about what the kids did. I’ve worked with other people in volunteer capacities and none of them are like that. He goes above and beyond in everything he does.”

Dr. Hoff’s passion for art has inspired a greater interest in the subject from students, Clark says.

“‘Is he coming today? Is Dr. Hoff coming today?’ They ask all the time,” she says. “Typically that’s what 5-year-olds do, not fifth-graders. But he is just so warm and loving. They love working with him.”

And at DMU-COM, Dr. Hoff is showing students that they can become physicians without sacrificing their free time and other interests.

“Dr. Hoff wants us to realize that medicine is not just a hard and dirty profession—that you can be a whole person and you can nurture yourself,” Lloyd says. “And he encourages us to pursue interests that we identify with throughout our medical careers so we can maintain our personalities and be whole people.”