QScience Connect - Issue 3- Medical Humanities in the Middle East Conference

On April 9 and 10, 2022, over 79 scholars and 230 attendees met online to share their research on the health and medical humanities in the Middle East and North Africa (MENA) region at the 2nd International Conference on the Medical Humanities in the Middle East (online). This meeting was the second convening of experts since the successful 2018 in-person conference in Doha, Qatar at the Sheraton Hotel. The 2022 conference was jointly sponsored by VCUArts Qatar and Weill Cornell Medicine – Qatar, and was convened by Drs. Alan Weber, Byrad Yyelland, and Mohamud Verjee. The diversity and increase in submissions from 2018 to 2022 testify to the growing importance of humanism in medicine in the region. The published abstracts in this special issue of QScience Connect provide a comprehensive overview of the medical and health humanities as they are currently practiced and researched in the Middle East region. For example, the first keynote speech, “Is the Beauty Industry a Virus Invading the Medical Profession?” by Iraqi surgeon and visual artist Dr. Ala Bashir, addressed a critical issue in the region, the growing popularity of cosmetic surgery and the unlicensed and unregulated nature of the industry.

The second keynote speech by health humanities professor Paul Crawford (University of Nottingham) entitled “Towards Creative Public Health: The Contribution of the Medical and Health Humanities,” provided an overview of recent international initiatives to harness the arts for health education, healing, and wellness. The other presentations from researchers in Kuwait, UK, Jordan, US, Turkey, Israel, Iran, Qatar, Iraq, UAE, India, and Egypt represented the full range of the medical and health humanities that are developing internationally, including the history of medicine, medical sociology and anthropology, narrative medicine, literature and medicine, graphic medicine, healthcare communications, art therapy, the visual arts, film and medicine, and medical ethics. In addition, a panel of premedical and medical students led by Maryam Arabi and Abdallah Tom provided their perspectives on the topic with respect to the educational needs of students. A group of gerontology experts composed of Mark Clarfield, Regina Roller-Wirnsberger, and Desmond O'Neill directed a workshop on publishing research on the health and medical humanities in scientific scholarly journals. Authors Shahd Alshammari and Robin Fetherston gave dramatic readings from their fiction and non-fiction works. Three posters published on the website added to the oral presentations (https://qatar-weill.cornell.edu/event/medical-humanities-in-the-middle-east/posters).

Three of the oral presentations spoke to ethics in medical humanities within the Middle East. Banu Buruk and Berna Arda shared the Turkish National Artificial Intelligence Strategy (TNAIS) report which describes methods for determining and initiating national priorities related to AI. This report identifies four ethical values and eight ethical principles worthy of examination since almost one in five AI strategies are applied in the health sciences. The authors discussed TNAIS and concomitant ethical issues, concluding with recommendations for dealing with conflicts as they arise. Alya Al Shakaki then presented on ethical questions related to use of the gene-editing tool, CRISPR-Cas9, which enables “designer babies”. CRISPR has been used in China to create babies that are immune to HIV and thereby able to create offspring with similar immunities; however, what happens to individual autonomy in such cases? Scholars of Islamic bioethics ask two questions: which cells will be edited and what is the aim of the editing? Editing confined to one individual without affecting the offspring is considered acceptable but human dignity must be protected. Fahad Ahmed, Yazgı Beriy Altun Güzelderen and Sefik Yurdakul shared their research on publications written by Turkish authors that have been retracted from scientific journals. In a study of PubMEd, Scopus and Web of Science databases, they identified 147 publications that had been removed due to duplication and irrelevant studies.

Six presentations were related to the history of medicine in the Middle East. Dmitry Balalykin tied the apodictic method (the method of rational and rigorous proof), typically accepted as the method of knowledge in the natural sciences, to the development of medicine as seen in anatomical dissections, clinical systematization and general pathology in Greek and medieval Islamic medicine. Balalykin cited Galen and Muhammad ibn Zakariya as pivotal influences. Katarzyna Gromek then discussed the history of perfumes as medical agents in early Islamic states; for example, scenting clothes, mostly undergarments, shirts, dresses, and bed linens, was also thought to increase therapeutic health effects, both in the sick and healthy. Fatima Saadatmand continued the historical discussion with a look at mystical applications of arithmetic, Ariṯmāṭῑqῑ in Arabic, in treating disease throughout the 9th to 13th centuries through an examination of ancient texts and modern writings.

Abdulnaser Kaadan’s historical research moves us into the writings of Avicenna (Ibn Sina) related to the diagnosis and treatment of breast lesions and the relevance of this historical work to current medicine. Amanda Caterina Leong then shared her work on the writings of Qajar Iranian Princess Taj al-Saltana in 19th century Iran, who discussed systemic challenges in reactions to Iran’s cholera epidemic and subsequent health care perils related to a corrupt patriarchy. Leong connected this work to current governmental handlings of COVID-19 issues. Finally, Forozan Falahatpishe examined the invisibility of autopsy within Islamic medicine. Of interest to mystics, theologians and philosophers as well as physicians, the autopsy has been historically avoided within the Avestan (ancient Iranian) approach to Islamic medicine because it has been perceived as a violation against the sanctity of the human body. Nevertheless, surgery has thrived within the Islamic world.

Art therapy in the Gulf was well represented by two full panels, one of which presented by Trish Bedford, Mowafa Househ, and Dr. Jens Schneider surveyed current art therapy practices including development of an art therapy app for making initial assessments powered by AI. In addition, Michelle Dixon, Natalia Gómez Carlier, Sara Powell, Mariam El-Halawani, and Alan Weber detailed in the paper, "Art Therapy Service Provision during the COVID-19 Pandemic in the Gulf Cooperation Council (GCC)" how services provision shifted abruptly to online telehealth. Natalia Gómez Carlier and Sara Powell additionally reported on their art therapy pilot dyadic (parent/caregiver and child) telemedicine program for children living with Autism Spectrum Disorder.

In a panel dedicated to healthcare communications, one paper described the best practices in communication skills with visually impaired patients (Dr. Nahla Khalaf Ali, Dr. Abdulsalam S. Sultan, Muna Hameed Faris, Muna Muneer Ahmed, Mohammed Modar Hameed, and Dr. Marab younis Abdullah Al-Fathy). A paper by Raji Anand and Dr. Sohaila Cheema included usage data that demonstrated that digital tools such as Mailchimp direct-mail campaigns can effectively promote positive public health behaviors. Another successful intervention for public health awareness was described in the panel "On Film and Medicine: Reflections on ‘Medfest Egypt’, an international ‘film for health’ forum," chaired by Khalid Ali, Mina El Naggar, and Robert Abrams.

Gatherings such as the 2nd International Conference on the Medical Humanities in the Middle East are designed to share the latest research findings among area experts, to help form new research collaborations, and to encourage translational medicine projects in which insights and pilot and full-scale studies of the medical and health humanities can be harnessed to revise medical education curricula, improve training for health sciences students, enhance clinical practice and ultimately improve patient outcomes to create more equitable, satisfying, and effective healthcare systems. Additionally, medical and health experiences can form the basis of artistic expression since health, disease, and illness represent key milestones in the universal life course.

The practice of medicine and the medical sciences have progressed tremendously in the past half century. This talk explores the background and causes of this transformation in medicine as seen through the lens of a surgeon who has practiced medicine for over 50 years.

If Medicine is the science and practice of diagnosis, treatment, prevention, alleviation, or cure of disease… If our role as Medical Professionals is to protect, promote, and restore good health… If our Hippocratic oath speaks to the notion of Primum Non Nocere. First, do no harm…

Then… Can the newly created branches of cosmetic and aesthetic surgery within the field of Reconstructive and Plastic Surgery be considered “Medicine”? Should Medicine be in the business of beauty services? Should beauty standards remain in the domain of art? Is the beauty industry a virus in the Medical Profession? How do we ensure our Profession stays true to its promise, its oath?

In this keynote address, Professor Paul Crawford introduces the distinctive fields of medical and health humanities, and the way that the arts and humanities can bring new capacities and possibilities for healthcare, health and wellbeing. He will discuss terminology and concepts of the medicalization of the illness experience and the rise of more critical, creative and democratising approaches. He will underline the substantial evidence for how the arts and humanities can improve medical outcomes and increase understanding of the public/patient experience of illness. In so doing, he addresses the potential for what he has called ‘creative public health’ that fully addresses the use of social and cultural assets to enhance the health of nations. In particular, he will provide insight into how this can be mobilised in practice through reference to major programs of research. First, he presents an overview of a major project to support and critically address the value of social and cultural assets for the public and a more medicalized initiative to provide patients with a social rather than pharmaceutical prescription. Second, he describes an innovative creative approach to ‘mutual recovery’ that seeks to enhance well-being within and between practitioners, family carers and patients as part of a whole community/ organisation approach to health. Third, he presents findings from his highly successful ‘What’s Up With Everyone’ research-embedded campaign to advance young people’s mental health literacy in association with Academy-award winning Aardman (Shaun the Sheep, Wallace & Gromit, etc). Finally, he discusses: a. the potential for creative industries to work more closely with governments and health organisations as part of a ‘shadow health service’, complementing centralised health services through the extensive resources of the creative arts; b. the importance of advancing creative clinical environments in a STEM-dominated healthcare culture.

The discovery of the genetic editing tool, CRISPR-Cas9, has enabled us to edit the human genome by removing or adding sections of the DNA. Scientists hope to eradicate some fatal diseases by using this technology. In short, CRISPR allows us to rewrite the code of life in contrast to discovery of the double helix where we can only read and understand our genome. Both somatic and germline editing can be done by this technology; however, they involve different ethical standpoints. The latter is controversial as it affects the reproductive cells, hence raising complex ethical dilemmas. Jennifer Doudna, a Noble prize winner in 2020, has contributed to the discovery of the CRISPR technology. She has never thought that this technology might be morally misused by others like the case of the Chinese scientist named He Jianki who produced the world's first CRISPR babies (Isaacson, 2021). Jianki's goal was to make the babies and their decedents immune to a deadly HIV virus; he knew that this announcement would be earth-shaking news that would ignite outrage among conservatives and religious scholars in the West and Islamic world alike.

Heated ethical deliberations have taken place following this incident by various groups, and each group believes that they have valid arguments for their reasoning. The opponents of the CRISPR germline editing argue that this technique violates one of the most important moral principles which is autonomy. Informed consent is an important element to ensure the subject's agreement to the treatment or procedure. The effect of germline editing will extend to future generations where autonomy would be neglected in this case (Hammerstein, 2019). This is concurrent with the moral view of Francis Collins, the former director of the National Institutes of Health (NIH). Collins argued that humans should not have the hubris to fiddle with nature (Skerrett, 2015). The CRISPR supporters, on the other side, argue that it would be immoral not to choose what are the best genes for you and your child (Savulescu, 2001), especially if germline editing can alleviate human suffering. The famous philosopher who advocated this approach is Julian Savulescu, a professor in practical ethics at Oxford University.

In Islamic bioethics, religious scholars make an ethical distinction between somatic and germline editing. They based their moral reasoning on two broad questions: what kind of cells will be edited, and what is the aim of editing? They legalized the use of somatic gene editing as it is confined to one person and does not affect the offspring; hence no ethical concerns arise. However, the majority of the scholars have condemned the use of germline editing and called for a temporary moratorium especially if mixing lineage is at stake (Ghaly, 2019). Following the news of the designer babies and its widespread media coverage, the International Islamic Fiqh Academy (IIFA), which represents Muslim countries and communities, convened a session in 2019 in the United Arab Emirates. They issued resolutions that corroborate the international calls to halt germline editing until further research proves its efficacy and safety. Moreover, they called to restrict the use of this technique for medical purposes and not for aesthetics or enhancement. Also, the committee stressed that human dignity should be preserved without exploitation. Therefore, more regulations are warranted (International Fiqh Academy, 2019).

Fragrances may appear to be a frivolous topic in the modern world, but well into the early modern period they were firmly located at the intersection of medicine and luxury products.

The fragrances created by physicians, pharmacists and perfumers in the early Islamic states influenced the olfactory traditions of Europe and Far East Asia. To study the fragrances of medieval China or the middle Byzantium, one needs first to understand how they were made at the source.

Many if not most of fragrance recipes are hidden in medical texts, cookbooks (as art of food preparation was considered a part of medicine), and independent treatises on perfumery. Besides being used for pleasure, as aphrodisiacs, or to satisfy the desire for luxury exotica, pleasant odours were associated with good health, and therefore were believed to have a therapeutic effect. In many cases, we have the direct statement of the author that a given incense or scented powder could cure body weakness, alleviate pain, or help with confusion after a stroke (Hamerneh, 1965). The beneficial effect may have been related more to the placebo effect though it is confirmed that odours can influence the human mind.

In my quest for accurate recreation of the beneficial fragrances, I study the processes used to prepare them by the original creators. This includes preparation of compound ingredients like ramik and sukk or distilled fragrant waters. I cross-reference different sources to identify ingredients although the ambiguity of identification cannot be fully eliminated. I attempt to source my ingredients, pending financial and legal limitations, from the same geographical locations referenced in the early medieval period. When the original ingredient is no longer available due to overharvesting or changes in plant biology, I look for a suitable replacement in contemporary sources, as many authors included chapters on substitutions (Levey, 1971).

As an independent scholar, my ability to study the effects of these recreated fragrances is limited to the assessment by olfactory approach (like in the experimental archaeology of food). I observe the stability and maturation of fragrances over time, as well as their longevity when applied to skin. A group of my volunteer testers helps with this task. They report if they liked the fragrance undergoing assessment, and how they felt about the odour. I am often surprised how the view of the same scent can range from ‘absolute stench’ to ‘good mood fragrance.’

I also organize presentations of the fragrances to introduce the public to the forgotten scents. I believe it is our duty to celebrate the traditions of all cultures, and this includes the amazing fragrances from the early caliphates, from Al-Andalus to the Near East and beyond.

Engaging in the arts has been demonstrated scientifically to enhance brain function. Creativity can modify a person’s perspective and experience of the world. Changes in cerebrum waves impact changes in the nervous system which can raise serotonin levels. This can affect emotions positively by regulating moods and improving brain function which influences both psychological and physiological wellbeing. Creativity is part of our natural development and should be a part of our healing as a community. Art Therapy (AT) is a mental health profession which carries out innovative adaptations as it is recognized as a stand-alone clinical intervention and through community engagement and social justice. Art Therapists are collaborating within diverse fields of clinical and non-clinical practice such as neuroscience and virtual reality. Three papers explore the development of Art Therapy as a profession in Qatar and how AT is an accessible and underutilised or often misjudged profession.

Paper one introduces ways that AT is practiced as a clinical, social action and community-based profession. AT might address the shame connected with psychological wellness by connecting with communities, sharing experiences of AT with the general public and by clinical professionals to support their careers, prompting less burnout. Dr. Hadi Mohamad Abu Rasheed shares the Qatar Cancer Society’s experience of using Art in psychosocial support for children living with cancer. The western trained Art Therapist's awareness of cultural competence when working in the context of non-western cultural approaches to mental health is imperative to complement the heritage, creativity and community values of the local culture. Intersectional frameworks will inform ethical professional values to be upheld.

Paper two develops how AT offers context to reduce the stigma of mental health in Qatar. The first Museum and Gallery AT visit in Qatar, with patients attending a substance misuse program, saw outcomes that included increased engagement in clinical sessions and an art exhibition that was held in the hospital and at conferences within Qatar and globally.

Paper three discusses the global alterations in the AT workplace following the Covid-19 epidemic; online AT; and how AT has adapted to employing technology before and after the pandemic. The technology employed in AT is not new. Art Therapists are now using Virtual Reality, where the client becomes part of the world they have created, interacting in it, with the art therapist present. The Emotion Sensing Recognition (ESRA) app is being developed by Dr. Mowafa and Dr. Jens with the consultation of an Art Therapist Trish, to ensure the ethics of working with images. This app can increase positive parent-child attachment and increase the ability to recognise and talk about feelings for parent and child.

AT is a cost-effective adaptive treatment and is being prescribed by General Practitioners in the UK and USA alongside visits to museums, choirs etc. How will Qatar embrace this adaptable, unique profession and will ensure it is ethically practiced by trained licensed Art Therapists? Collaborative research and training within different fields should be encouraged.

Based on five months of ethnographic fieldwork at an audiology department in Amman, Jordan, this paper anthropologically examines the provision of hearing technologies to deaf Jordanians as forms and practices of care (Livingston, 2012; McKay, 2018; Stevenson, 2014). Aside from hearing aids, the department also provides cochlear implants—medical devices implanted via surgery that aim to provide people with hearing loss with some electronic access to sound—to deaf Jordanians, in partnership with a state-affiliated initiative that has distributed more than 1,170 cochlear implants since its establishment in 2010. I ask: how do deaf Jordanians engage with the cochlear implant and other medical technologies, and the biomedical imaginaries in which they are embedded, within and outside the clinical encounter? The cochlear implant and, to a lesser degree, the hearing aid (Edwards, 2010), was controversial when it was first introduced in North America, where some deaf people saw cochlear implantation as a form of cultural “genocide” (Ladd, 2003; Lane et al., 1996; Padden & Humphries, 1988). The cochlear implant has not only become increasingly normalized in the U.S. (Mauldin, 2016) but has also spread transnationally as a medical technology for deaf people in Japan (Nakamura, 2006), India (Friedner, 2018), Mexico (Pfister, 2019), and elsewhere. As cochlear implants have become more prevalent in Jordan, they have become linked not only to debates about language—as I found during preliminary research in 2019 (Loh, 2022)—but also to broader questions about development (cf. Sargent, 2019b) and political economy in a materially under-resourced context where unemployment rates are high. Based on participant observation at the hospital and interviews with clinicians and patients, I argue that care is a useful analytic tool to understand the ambivalence with which many deaf Jordanians view these technologies, in its doublehanded recognition of how such technologies can be useful developmentally—in potentially providing access to speech and presumably better integration into society—but also problematic socio-politically—in diminishing their sense of belonging to broader deaf collectivities. I draw upon medical anthropology, science and technology studies, and “a disability-centered anthropology of the Middle East” (Sargent, 2019a) to ethnographically demonstrate the social life of these hearing technologies in Jordan.

Although the visual and expressive arts and music have been used in therapeutics and diagnosis for centuries, only in the past two decades has evidenced-based research on the role of arts in healing achieved a critical mass to warrant inclusion of the arts in health systems both inside and outside the clinic. Qualitative and quantitative studies have demonstrated that the arts can impact prevention, management, and treatment of disease in addition to health promotion. Specifically, the visual, performing and literary arts have been shown to positively affect the following dimensions of health: psychological (coping, emotional regulation); physiological (hormone response, immune function); social (isolation, social support); and behavioral (skills, lifestyle behaviors, exercise). This talk reviews the current medical evidence for the efficacy of Arts for Health programs based on recent reports from WHO, UK government white papers, and published scoping reviews, systematic reviews, and meta-analyses.

This presentation is a comparative study between two works of autobiographic fiction: Lauren Slater’s Lying (2000), which is about the author's epilepsy diagnosis, and Kuwaiti author Dr. Shahd Alshammari’s Notes on the Flesh (2017), about her diagnosis of, and how she lives with, multiple sclerosis. The two memoirs are studies of identity formation through disability and through the language surrounding disability: the languages both encompass disease as too medicalized and removed from personal experience to be able to describe disease. Both female authors choose to metaphorize their diagnoses in order to best understand (and explain) the pain they live in, the shock of receiving their diagnosis, and the confusion of living in a not-obviously disabled body. Their use of metaphor refers to hidden diseases: the title of Slater’s memoir is a reference to how her disease is hidden, unclear, and has made her feel like her diagnosis is false. Alshammari’s text is a reference to how the disease is written into the body, but not always outwardly shown on it. The authors use postmodern writing, weaving between ‘truth’ and, as Slater’s title blatantly puts it, ‘lying’, and what it means to vacillate between the two when talking about something as abstract as pain. Slater’s epilepsy makes her think that she is lying and that affects how she thinks of her disease. Slater invents a fictional medical procedure, relaying it in her memoir, which for a very long time, she believes happened. Alshammari writes about how her disease is etched onto, or right under, her flesh, and describes her medical procedures using similes and otherworldly language. Both authors show that even the language we use to describe medical procedures affect how we think of the medical practice. Using theorists who study memoir like Thomas Couser, I show that critics who place too much stock and importance in absolute truth in a disability memoir are limiting the disabled community’s chosen method of self-representation.

Paper 1: Introduction to Film and Medical Humanities

In recent years, medical humanities have become an important component of medical education. Student-selected modules, and special courses encourage medical students to reflect on the portrayal of illness and suffering as a means of nurturing empathy through watching film. Understanding the lived experience of sickness from a patient and family perspective is a requirement for all healthcare professionals. Role play and simulation focusing on doctor-patient encounters is commonly practised in undergraduate courses.

Academic institutions such as the Royal College of Psychiatry advocate the use of film as a platform for discussing mental health through their annual UK Medfest (https://www.medfest.co.uk/what-is-medfest). The WHO recently used film as an educational and cultural backdrop for exploring health (https://www.euro.who.int/en/media-centre/events/events/2019/10/the-health-for-all-film-festival-inviting-filmmakers-to-submit-health-for-all-short-videos). Hospitals, too, have embraced film as a learning and entertainment medium by building purpose-built cinemas within hospitals, as seen in Medicinema in the UK (https://www.medicinema.org.uk/).

Paper 2: Describing ‘Medfest Egypt’

Medfest-Egypt is an interactive program of films originally launched in Egypt in 2016 by Dr. Mina El-Naggar, and Dr. Khalid Ali. and intended for a diverse medical audience. The main objective of this forum was to assimilate wider social and artistic perspectives into clinical encounters, all via film. With the British Council as its principal funder, four editions have been delivered, “Under the Skin” (2017), exploring mental health; “About Her” (2018), reflecting on women’s health; “Tiny Marks” (2019), investigating children’s health, and ‘’Moments’’ (2022) portraying life-defining moments in family lives. In its 4 editions, Medfest-Egypt screened films from the MENA region, Europe, North and South America and Africa attracting around 7000 audience members involving 140 panellists in the Q and A sessions. Medfest screenings travelled within Egypt: Cairo, Alexandria, El Minya, Assiut, Sohag, and Luxor; and abroad in Tunisia, New York, and London.

Paper 3: Three Short films from ‘Medfest Egypt’

Over the course of ‘Medfest-Egypt’ editions, we have interspersed short films with full-length feature productions. Whether in conventional style or creative animations, short films can impact viewers in powerful, enduring ways. Furthermore, grouping evocative short films together affords an opportunity to explore the nuances of a subject within a single presentation providing a compelling, creative medium for clinical teaching. We will present three short films from different Medfest editions: Father and Daughter (Michaël Dudok de Wit, Netherlands, 2000), Mare Nostrum (Rana Kazkaz and Anas Khalaf, Syria, 2016), and Daughter (Daria Kashcheeva, Czech Republic, 2019). These films comprise three trenchant variations on father-daughter relationships, estrangement, and the dynamics of reconciliation and forgiveness at the end of life

Persianate cultures have been greatly influenced by the “mirror for princes” genre, which offers monarchs advice on how to treat their subjects justly and methods of being an ideal ruler. While scholars have chosen to study this genre from a male-centered perspective, how royal women shaped this genre has remained under-examined by current scholarship. This presentation argues that Crowning Anguish: Memoirs of a Persian Princess from the Harem to Modernity (1884-1936) by Iranian Qajar Princess Taj al-Saltana, offers new ways of seeing how women used memoir writing to challenge the dominance of their male counterparts during times of pandemics. As the daughter of Naser al-Din Shah, Princess Taj al-Saltana, was able to carefully document one of the many cholera epidemics that ravaged late 19^th century Iran from her unique perspective as a recognized intellectual and activist who advocated constitutionalism, freedom, and women’s rights in Iran. In addition to chronicling a cholera epidemic in Iran over one hundred years ago, Taj al-Saltana’s memoir holds interest for modern scholars interested in her handling of genre conventions, specifically how she indicts the ruling patriarchy of the Qajar government of Iran and its corruption which led to the failure to control cholera in the country, while simultaneously instructing female readers about the conduct of an ideal female ruler to build a healthier Iran. This presentation aims to show the way Crowning Anguish functions as a “mirror for princesses” and how we can come up with better strategies of resistance especially in the age of COVID-19 with the failures of patriarchal governments to stop pandemics.

The world is ageing, and this phenomenon is found in almost all countries: low-, middle-, and high-income. Scholarship providing perspectives on ageing deriving from the humanities, arts and cultural gerontology has augmented our understanding of ageing and the life course. Over the past decade one can observe an increased focus in relevant publications relating to ageing and its treatment in the disciplines within the Humanities. At this session we offer the perspective of two editors responsible for the humanities, arts and cultural gerontology columns in their respective journals (Journal of the American Geriatrics Society and European Geriatric Medicine). We outline the vision, philosophy, criteria and opportunities for publishing in these journals. The session will deal with how best to submit articles to such columns with practical advice offered. We hope that this session will interest members from various disciplines associated with gerontology and the humanities. We look forward to students, faculty and researchers interested in learning how to publish in the most appropriate journals in humanities and aging also to attend.

Introduction: Communication skills “CS” have no clear curriculum in most Iraqi medical colleges. This shortcoming of education is reflected in a doctor-centered approach in Iraq.

Aim: To identify challenges facing introduction of CS into medical education in Iraq.

Methods: Feedback form including the main challenges on introducing CS was distributed online to healthcare professionals who have participated in training of CS courses.

Results: Ninety-three healthcare professionals responded; 55 males and 38 females; 46 faculty members and 47 practitioners with part-time teaching. Doctors constituted 92 % of the respondents from different disciplines, and 75.2% had more than 15 years’ experience in practice. Frequency of educational and practical challenges were 40% and 44% respectively. Lack of appropriate curriculum constitutes 42% of educational challenges. Challenges include doctors' training in western models which are difficult to transform the interview into a dialogue that harmonizes Iraqi culture and social barriers (16% of respondents). A biomedical approach (22%) and lack of resources (22%) presented other challenges, while 14% of the participants mentioned high proportion of students to faculty members. Challenges related to practice includes a doctor-centered approach (47%) and neglect of patients' psychosocial needs (30%). Factors related to patients revealed that 46% of the challenges were related to health literacy and 26% to patients’ behavior for seeking medical advice. The presence of more than one person at interview was the most difficult factor for successful interview (14%), in addition to the passive role of the patient during interview (13%). There is no significance statistical difference in challenges in relation to specialty, workplace, sex and years of practice.

Conclusion: Multiple levels of challenges facing introduction of CS into medical education were revealed which need systematic review in the educational curricula and practice of medicine.

Avicenna (Ibn Sina) is Abu Ali al-Hussein, titled “Sheikh the President”. Avicenna was born in 370 Al-Hijra, (980 AD) in the village of Afshana, near Bukhara in Turkistan, or what is now the Republic of Uzbekistan. At the age of 21, he left Bukhara to spend the rest of his life travelling among various Persian cities. When he died in 1037 AD, he was considered one of the geniuses of philosophy in Islam, and in medicine he was placed in the rank of Galen, where he was called the Galen of Islam. Avicenna wrote 276 books, all written in Arabic, except for a few small books he wrote in his Persian native language. Unfortunately, most of these works have been lost, and have not reached us. There are currently 68 books scattered among east-west libraries. Avicenna’s most important book of medicine was al-Qanunn book, which is written in Arabic, and was described by William Osler, as the most famous medical textbook ever written.

Avicenna devoted a full article of the 12th art of the third book of al-Qanunn Book to talk about breast diseases; In this research, I followed a unified approach that included reviewing all the topics in which Avicenna talked about breast conditions and diseases, and then discussed these diseases according to the data of modern medicine.

Breast Injuries considered among celebrated illnesses that assault particularly females. For occasion, breast cancer assaults one among seven ladies. The point of this paper is to shed light on the accomplishments of Avicenna within the field of breast maladies which were known at that time, and to compare them with those known presently, to recognize the presence of a few components (dietary, natural, hormonal…) that take portion presently in actuating a few kinds of breast malady. Avicenna talked about Galactorrhoea, which could be a smooth emission from the breasts. The term presently ordinarily alludes to drain discharge not due to breast-feeding. It is reciprocal and from numerous conduits. Moreover, he depicted what is called presently fibrocystic breasts, which are characterized by unevenness, and as a rule distress in one or both breasts. The condition is exceptionally common presently, and kind, meaning that fibrocystic breasts are not dangerous (cancerous). Avicenna said what is called presently Incendiary Breast Cancer, which is considered nowadays as particularly forceful sort of breast cancer that can happen in ladies of any age (and, in spite of the fact that amazingly once in a while, in men). It gets its title from the ruddy, swollen, kindled appearance of the breast, as was portrayed by Avicenna.

Conclusion: Through this research we reviewed the various breast lesions, that Avicenna spoke of in his book al-Qanunn. Various chapters were reviewed, including all the breast lesions that were known at the time. These lesions have been interpreted according to our recent medical information. It is noteworthy that there is some convergence in Avicenna clinical description of some breast lesions with our current information, but Avicenna treatment methods for treating these conditions have largely differed from those currently in use.

With the aim of introducing medical humanities to medical colleges in Iraq, the researcher, who teaches English to medical students at Al-Nahrain University in Baghdad, initiated the idea of a performance of Shakespeare’s most popular play Romeo and Juliet. The main aim was to promote empathy and compassion for medical students after realizing that biomedical sciences have detached them from these feelings. Through activities in the English Language lectures, students, particularly 2nd and 3rd year, reflected on stories and passages in a way that lacked any connection or empathy. In one of the units of their English coursebook, there are two pages dedicated to Shakespeare’s play Romeo and Juliet. With the idea of the pair of star-crossed lovers, who suffer misfortunes brought upon them by causes quite independent of any flaw of character or immorality of conduct in both or either of them, the researcher found in the play a work of art that can create empathy and compassion in the readers as well as the audience, and hence came the idea of the performance. The researcher chose an abridged version of the play found on the Internet. To link the play with science to avoid objection from the scientific institution, the researcher added a scene taken from a speech by the scientist Fatima AlZahra’a Alatraktchi comparing the secret communication of bacteria with this Shakespearean play. The paper is about the reception of the idea of the play by the students at the medical college, who were overjoyed when they read the call for actors for the play and immediately a huge number of them showed interest in taking part in the performance. Though the performance was supposed to take place in mid-March, it was postponed because of the end-of-term exams. The paper deals with the manners of building empathy and compassion among the medical college community. Finally, the paper tries to show the importance of introducing literature and arts to medical students with the aim of giving more emphasis to the study of humanities disciplines in medical colleges in Iraq in the future.

Visual literacy is both an awareness of visual input and output, encoding and decoding, processing via the eyes and output through visual creation. When informed by the neuroscience of sight and memory, artists and educators can objectively understand their own visual work as well as nurture the visual language of their students (Kasdorf, 2020).

This arts-based and practice-based research was part of the author’s thesis during her master’s program in Museum and Gallery Practice at UCL Qatar (Kasdorf, 2020). The analysis further informs the author’s dialogue in creative workshops and classes in Qatar, with children and adults. In the case of workshops with illustration students, participants engage with the aesthetics of archival regional picture books to develop a personal voice. Their outcomes resist mainstream styles and embrace childlike exploration, a perspective that has been exercised in noteworthy Arab publishing history (Khan et al., 2009).

Observing Ephemeral Moments

An entry point into understanding visual neuroscience is pinpointing ephemeral moments; to acknowledge the “spark” of aesthetic preference. Masland (2017) describes that raw visual data is amalgamated for efficiency by the retina, thereby curated by the personal circuitry. Neurons are generally latent with consistent light and activated with changes in light and direction (Masland, 2017). More determinant of individuality is the heightened activity of neurons in the working memory in relation to a preferred visual; even when the visual is out of direct view, neuronic activity persists (Self & Roelfsema, 2017). By repeatedly recognizing these ephemeral moments, subconscious activity can be harnessed to build visual style and language.

Children and Visual Literacy

A child’s visual communication is noteworthy and telling of themselves (Khamis, 1962). With knowledge of the neuroscience of sight, an educator’s visual observation and objective language can nurture a child’s uninhibited and automated drawing and creating, as opposed to simply providing external validation. In turn, the child learns to value their own work objectively, without resorting to binary terms such as “good” or “bad”.

A Wider Spectrum of “Normal”

Visual literacy that incorporates knowledge of the neuroscience of sight supports more possibilities in drawing and creating, and thereby a broader sense of “normal”. Additionally, if drawing can allow for more diverse exploration, the same is enabled for people; visually literate people contribute to a broader normative knowledge system in society.

Drawing mirrors the relationships of people; if there is less of a “right” way to draw, there is less of a “right” way for people to be, and less of a “right” way for children (and adults) to understand themselves.

Philosophical interpretation of any scientific discipline is impossible without understanding the methods of cognition inherent in this discipline. The history of medicine is also formed by the understanding of the evolution of the methods of knowledge–clinical and experimental. Unfortunately, there is a tendency to describe the history of medicine as a set of individual events, but philosophy of medicine is understood as a system-forming phenomenon only from the moment of scientific revolutions (17th - 19th centuries). However, in relation to other natural science disciplines, for example, mathematics, the point of view regarding the apodictic method (i.e., the method of rigorous proof) is generally accepted as a method of knowledge that has determined the entire history of these disciplines. I argue that medicine was also strongly influenced by early Ionian physics (as well as astronomy or mathematics), and the apodictic method (methods of rigorous rational knowledge and proof) has existed in the history of medicine since antiquity. Even Sir Geoffrey Lloyd expressed this hypothesis, based on some treatises from the Hippocratic Corpus. In turn, I argue that the apodictic method in medicine had already been fully developed in the treatises of Galen. I propose to define the apodictic methodology in medicine as follows: the apodictic method of proof in medicine is anatomical dissections, clinical systematization and the rational doctrine of general pathology (the last one with certain limitations). The characteristics of the use of the method of rigorous proof in the work of ancient authors enables us to identify three stages in the development of the methodology of ancient medicine. The first stage ‒ the period of the inception of the apodictic method—defines the establishment of the foundations of Greek rational medicine, based on Hippocratic principles. The period of the establishment of the apodictic method is associated with the works of Aristotle devoted to the argumentation theory, the theory of motion and the practice of systematic dissection of animals based thereon. Most important was the establishment of comparative anatomy. The third stage—the period of the development of the apodictic method—is characterized by Galen’s work. Galen introduced the apodictic method in medical practice and substantiated its significance for further development of medicine as a science. The real keeper of Galenic-Hippocratic medicine during the 8th-11th centuries was the medicine of the Islamic world. In a certain sense, it was not only preserved, but also enriched. In this context the works of Muhammad ibn Zakariya al-Razi are of particular importance. He developed and critically rethought the teachings of Galen on the systematics of diseases. Most of al-Razi’s critical points were aimed at expanding and deepening clinical applications and general clinical logic reflected by this systematic approach. At the same time, we practically cannot speak about the development of anatomic dissections during the Islamic period of Galenic-Hippocratic medicine existence.

This paper will discuss the interdisciplinary approach of literature and medicine in light of the recent introduction of Narrative Medicine as a course at Fatima College of Health Sciences, Institute of Applied Technology, UAE. I proposed a Narrative Medicine course at Fatima College of Health Sciences (FCHS) which was accepted, and I currently teach and coordinate this course (which is also being taught at FCHS in Ajman and Al Ain). The course has been tailored to suit healthcare students in the field of nursing, psychology, radiography/imaging, paramedics, pharmacy and physiotherapy. This paper will examine the pedagogical approaches used to enhance the skills of creativity and close-reading and the application of these skills in medical contexts. More specifically, the paper will address the importance of using literature to teach the subjectivity of health-related experiences and the interconnectedness of literary frameworks to stories of illness—while taking into consideration the specific cultural context of the region. While the principles of Narrative Medicine of recognizing, absorbing, interpreting, and acting when hearing stories of illness may seem general and applicable to all contexts, it is essential to consider that the cultural context necessitates that these principles be applied with a sensitivity to both the cultural values of the region as well as its diversity and multiculturalism. The paper will focus on how these two sides are balanced while developing and teaching Narrative Medicine in the UAE. Drawing upon Susan Sontag’s Illness as Metaphor (1990), the paper will use the example of “military metaphors” in relation to a patient’s experience with cancer, to show how the linguistic underpinnings of these metaphors and their implications can vary depending upon the cultural and social context of a clinical setting. While Sontag’s attack on cancer’s military metaphors may seem applicable to some Western contexts, the application of Sontag’s work in an Arab context must take into consideration the difference in cultural perspective on the concepts of acceptance, surrender, and fight in relation to illness and death.

Background: Not all manuscripts that are accepted and published in scientific journals have retained their status as published articles, and some of them are retracted after publication. There are various reasons for retraction that are usually grouped into a scientific error, such as statistical flaws, and research misconduct such as plagiarism. Nowadays the number of scientific publications are a source of career advancement and respect in the scientific community. To attain these, the focus of researchers is towards increasing the number of publications per year which sometimes compromises the quality of publications.

Aim: The current study aimed to investigate the characteristics of retracted publications that were contributed by Turkish authors to scientific databases.

Methods: We searched PubMed, Scopus, and Web of Science databases. The search strategies were based on a combination of MeSH terms relevant to “retracted publication” and “Turkey.” The databases were searched on 23rd October 2021, without any restrictions on the search period. The inclusion criteria were: (i) retracted publication and, (ii) any authors of the study having affiliation with an institution in Turkey. The titles, authors' affiliations, and abstracts of the search results were screened and bibliographic information was extracted.

Results: After removing duplicates and irrelevant studies, our search retrieved a total of 147 publications. The oldest retracted article was published in 1996; thereafter an increasing trend of retracted publications was evident. Regarding access to full-text status, 106 (72.1%) of full-texts were available. Overall 127 scientific journals have published these articles. Biochemical Genetics was the most frequent publisher with five publications. From the institutional point of view, Hacettepe University was the main university, contributing seven papers. The most common reason for retractions was duplication = 50 (34%), and most retracted notices have been issued by the editor-in-chief = 63 (42.9% of papers). The majority of publications were from Medical Science = 93 (63.3% of papers). Among the Medical Science publications, the highest number, 44, were from surgery and allied fields. Turkish authors had international collaborations with 20 countries. Sixteen papers have international collaborations with researchers from Iran. Only 10 of the retracted publications have received funding. Five of the first authors have submitted more than one retracted publication. Citation analysis indicates that the median number of citations received by retracted publications was two (IQR 0-7). The minimum time lag between publication and retraction was less than one year and the maximum was 13 years.

Conclusion: The publish or perish pressure in academia sometimes leads to intentional and unintentional research misconduct. Although the number of retracted publications is fewer, their trend is increasing. To overcome the problem, it can be suggested that research methodology and research ethics training are essential in the under- and post-graduate curriculum.

Background: Disability is any restriction or lack of ability to perform an activity (WHO, 2022). The numbers of visually impaired persons globally was 285 million during 2020 and grows by up to 2 million yearly (Jabnoun et al., 2016). They receive the least benefits from health care services (Pratt et al, 2018). Realizing the principles of human rights regarding health care provision (Duffly, 2022), communication is an important human feature during the medical interview (Ben-noun, 2014) and it is very important to deliver a useful health service in any health system (Kaplonyi, 2017). It has been noted that unsighted persons suffer from communication problems with health care providers that affect their health care.

Aim: To identify needs of unsighted persons during the medical interview.

Materials and Methods: This study was done in Um Al-Rabean Development Foundation for Blinds and Purblinds in Mosul, Iraq, using a case series study design from January1 to February 1, 2022. Sixty-seven blind (unsighted) persons. Data were collected by using an electronic data collection Google form consisting of two axes, the 1st one included the demographic information of the study sample, and the 2nd one included the doctor- communication skills followed during the medical interview with the unsighted patients.

Results: This study revealed that the participants’ response rate was equal among both sexes. Most of them were aged 18 years and above and about one third were married. The percentage of celibacy was high, about 58.2%. Only (44.8%) of respondents had access to education, and the percentage of government employees was very low at 26.9%. The doctors’ communication skills followed during the medical interview with the participants were weak; more than half of doctors did not introduce their names, lower their voice, or give enough time for the patient to present their problem; adding to that, 74.6% did not shake hands with patients (before the COVID-19 pandemic). 20% of doctors did not assist during seating, only one third asked permission before giving help, and only 25.4% of doctors treat unsighted patients as normal persons. Roughly one fifth of doctors called the participants by their names more than once.

Conclusion: Training of doctors in communication skills techniques concerning this group is seriously needed. We recommend broader research work on a larger sample to study this topic from the point of view of doctors and patients.

Life narratives are rare in the Gulf region due to many issues. Khaleeji women writing about their lives, bodies, illnesses, and disabilities is almost unheard of. By writing about their illness and disability, authors re-claim their voice and agency, writing their silenced bodies as Helene Cixous urges women to write through Écriture feminine. This presentation considers the genre of illness narrative through using my memoir on Multiple Sclerosis (MS), teaching, and academia. I will read excerpts from the memoir to contextualize the work in order to stimulate discussion. Head Above Water: Reflections on Illness was published on 30 May 2022, the World MS Day. I will share excerpts from the work with the audience and point out relevant issues of the medicalization of the body. Head Above Water considers the intersections of sexism, racism, and ableism. It calls for a destigmatization of disability and illness in our personal lives and in the academy. It is my hope that the presentation is accessible, creative, and inspires discussion.

This project has the primary aim of investigating the hypothesis that ‘voluntary euthanasia should be legalised due to the importance of respecting patient autonomy and dignity’. A secondary aim is to suggest possible reasons for the apparently lower levels of support for legalisation among physicians compared to the general population. The possible consequences of including dignity as part of the justification for legalising voluntary euthanasia are evaluated, with a focus on the link between dignity and incontinence and the resultant implications on the disabled population. Factors influencing the degree of autonomy a patient can experience when making end-of-life decisions are also explored and applied to the initial hypothesis presented. It is suggested that there are significant safeguarding concerns associated with legalising voluntary euthanasia, with specific considerations of the risks presented to the disabled and terminally ill communities. It is argued that this may provide an explanation for the discrepancies between levels of support for legalising euthanasia between the public, who largely do not have a duty to consider these safeguards, and medical professionals, who largely do. The project makes a universally generalisable conclusion that legalising euthanasia on the grounds of autonomy and dignity presents too significant a risk of harm to vulnerable communities within society, and therefore legalisation should be rejected. This presents a bridge connecting Islamic medical ethics, which strictly prohibits suicide and euthanasia, with values it holds in common with the ‘four principles approach’ outlined by Beauchamp and Childress and develops a rich space for the exploration of how autonomy and dignity can be related to Islamic values of community and public interest, and the paralleled principle of Justice.

Arithmetic in the Arabic world was introduced with the loanword Ariṯmāṭῑqῑ which is derived from the Greek root αριθμός meaning "number", and depending on the context, it is used in two quite distinct senses. In the first sense, arithmetic as a technical term refers to a branch of mathematics that deals with the theory of numbers, numerical computations, and calculations, which is known as ‘Ilm al-ḥisāb from the Islamic era onwards; in the second sense, arithmetic deals with magical matters, talismans, or even some mystical traditions based on numbers and ABJAD letters which could be generally supposed to be used for superstitious purposes. The period from the 9th to the 13th century is well-known as “The Islamic Golden Age” in which works in science and medicine flourished. During this time, knowledge was synthesized from works originating in ancient Mesopotamia, ancient Greece, ancient Rome, ancient Egypt, North Africa, Persia, India, China, and Byzantine civilizations, and the most remarkable treatises on the subject of medicine, specifically in pharmacology and in the profession of apothecary, were published by Arabs and non-Arabs in Muslim-ruled areas enriched by both preserving earlier traditions and enhancing extra experiences and findings of their own. On the other hand, the natural and cultural resources, as well as trade relations, had contributed greatly to the spread of these scientific works. Now, it may be asked, how these two completely distinct disciplines, arithmetic (in both senses) and medicine converge?! The purpose of this study is to investigate the relations between these two fields by examining the significant sources, treatises, ancient texts as well as by introducing notable scientists, physicians, mathematicians in the guise of a physician and polymaths who have written a treatise, monograph or even who collected an encyclopedia and were accomplished in numerous fields of endeavor and inquiry that had writings on both medicine and mathematics besides other fields of study like physics and philosophy. The present research intends to provide a short review on textbooks written by physicians in math but with a remarkable medical approach, on topics, for example, including weights and quantities required in posology (the study of dosages) observed as an example in al-Kindῑ’s pharmaceutical work by the title “Risālah fī ma˓rifat qūwah al-adwīyah al-murakkabah”, where the efficacy (qūwah) of compound medicine is based on geometric progression; or what Avicenna described and formulated in dispensing of medical material in his far-famed medical work al-Qānūn fῑ al-Ṭibb (The Canon of Medicine). Pharmaceutical works are typically about materia medica (a Latin term for medical substances from the work of Dioscorides: De materia medica), singular medicine, their specifications, and some others are mainly about compound medicines (Greek term: γραϕίδιον) which are produced by ingredients in certain proportions. Ariṯmāṭῑqῑ in terms of occult (Arabic term: Xafῑya) is considered a sort of supernatural belief recommended and used widely by especially non-academic practitioners in disease cures outside the scope of science, which leads us to spot the use of magic squares and their applications in medicine as a way of assumed treatment.

Objective: The study reports on medical student learning outcomes from a cancer survivorship narrative medicine service-learning project in Doha, State of Qatar.

Methodology: From 2014-2017 students at Weill Cornell Medical College in Qatar in collaboration with persons living with cancer wrote stories of the patients’ cancer journeys published in a dual language Arabic / English book entitled قصة الامل (Story of Hope). The stories examined the socioeconomic, psychosocial, and familial impact of acute and chronic disease from the patients’ perspective. The Story of Hope is used throughout Qatar in peer-peer patient education groups. The research was approved for human subjects research by the Internal Review Boards of Weill Cornell Medicine-Qatar and Hamad Medical Corporation in 2014 and 2016. A convenience sample of 9 medical and premedical students participated in semi-structured taped audio interviews and filled out a questionnaire with free response and 5-point Likert Scale items (mixed methods research). Grounded Theory methods (Glaser & Strauss) were used to establish nine themes in the transcribed interview data, and themes were correlated with the questionnaire data.

Results: On average, the student participants in the study only had previous encounters with cancer patients of less than 1 hour. The project represented the first one-on-one meeting with a cancer patient for 80.0% of the students. Most students agreed (20.0%=strongly agreed, with 60.0%=agreed) that their encounters with patients changed their perspective on all aspects of cancer. The students unanimously agreed (80.0%=strongly agreed, and 20.0% =agreed) that service learning should be formally integrated into medical education. Some of the key themes from the interviews included: 1. Cancer Stigma: “M9: “as long as there is a strong stereotype against cancer, there is a big fear from the society about cancer. So, I don’t see how people would be willing to actually volunteer to go out of their daily routine and do a checkup for cancer.”  2. Delivering Diagnosis: “M3: I will spend a lot of time, I mean maybe an equivalent amount of time thinking about how to find a way to break this news down to people, as opposed to spending a lot of time discovering what treatment plans, I mean obviously that is very important…. on how to actually introduce this new change.” 3. Family Dynamics in Cancer: “M8: ...and family support is important and even when we deal with a patient as a physician, we should not deal with the patient himself, we should deal with the whole group, like the patient, the sister, the mother, brother….I have to orchestrate how everyone can help.”

Conclusions: The study provides proof of concept for the teaching of narrative medicine in a service-learning format in medical education in a high-income but developing Middle Eastern country. Positive effects in student learning were observed, as well as improvements in the psychosocial functioning of persons living with cancer. The research additionally provides evidence for the value of incorporating the patient perspective on disease into health training to teach human factors in disease and social determinants of health.

Background: Humanistic approaches to healthcare are required to facilitate positive patient-healthcare provider relationships and health outcomes. Researching these humanistic approaches can be challenging as social interactions are complex by nature. Recognition of complexity in social interactions requires a move away from simple, linear methodologies towards methodologies that can embrace and harness complexity to answer research questions.

Video Reflexive Ethnography: Video Reflexive Ethnography (VRE) is a novel and proactive research approach which recognises the complexity of everyday social situations. VRE aims to not only generate understanding but also improves practice. It does this by engaging participants and researchers in a collaborative process of reviewing video footage to gain new insights and interpretations about everyday practices. This process can empower participants to improve and change their practices. VRE has not been widely used as a research approach in the Middle East and the acceptability of these techniques for participants in the Middle Eastern context is unknown. At The Hashemite University in Jordan, we used VRE to explore medical students’ practices of receiving feedback about their clinical communication. We will detail the principles of VRE using the research from Jordan as an illustrative example.

Principles of Video Reflexive Ethnography:

VRE does not have a prescriptive set of procedures but allows for flexible application of four VRE principles to guide the research process:

•  Exnovation (a combination of the words excavation and innovation) – watching video-footage turned medical students’ and our attention to habits - purposeful or unconscious - that inform behaviours during feedback interactions about clinical communication simulations.

• Collaboration – working collaboratively with medical students allowed for different perspectives to be fully explored in the research. This resulted in co-construction of the research and knowledge generating process. This approach was empowering and gave meaningful results to the medical students themselves.

• Reflexivity – video footage enabled a complex activity, such as feedback, to be re-played and viewed by medical students and ourselves. Familiar routine activities could be seen as unfamiliar activities of interest. Multiple meanings and interpretations were found as medical students viewed themselves as others might and discussed what was shown and what they saw. Reflexivity has the potential to improve feedback practices and to give medical students increased agency to change behaviours of which they were not previously aware.

• Care – maintaining respect and considering emotions and power dynamics for medical students and ourselves throughout the research process, to facilitate honest discussions about video footage.

Conclusion: We found VRE to be a useful, acceptable research approach for healthcare education research in the Middle East context. Medical students engaged with the research process, consented to be video recorded and eagerly contributed to discussions when reviewing video footage. Notably, certain feedback practices were highlighted by reviewing video footage, that students mentioned that they would use in future feedback encounters. Using VRE in the Jordanian context generated new understanding and also facilitated learning, as students engaged with the process, and moved towards change in feedback practices.

Medical Humanities is an interdisciplinary field that has slowly been integrated into medical education. Despite developments in medical technologies, patients still experience feelings of grief, anger, and anxiety about their health and rely on their doctor for moral and emotional support. Thus, patients are inevitably finding doctors' empathy and understanding equally as important as their medical knowledge and clinical experience. The development and incorporation of medical humanities courses are vital for enhancing the delivery of treatment to the patient and optimizing their physical, mental, social, and emotional well-being. Nonetheless, some healthcare professionals and educators still argue that the medical field has advanced far beyond the theoretical approaches of medical humanities, especially since limited data is available to support their effectiveness. Another objection that is raised against the humanities is that the medical curriculum is already extremely rigorous, which makes it challenging to incorporate any new material into the standard coursework. Seven medical students from WCM-Q aim to uncover the potential values and limitations of medical humanities in current education and its efficacy in clinical settings. The discussion sheds light on the core skills that can be promoted by humanities including observation, listening, sensitivity, sensibility, and communication. Furthermore, the panelists engaged in a fruitful conversation exploring the narrative and scientific thinking of doctors and examining the cost-benefit analysis of modern medical practices with traditional therapeutic approaches.

Home visits on patients require checks for the request, the illness, the date last seen, current medications, and who the carer is. Globally, especially in the Middle East, cultural awareness and sensitivity are paramount, particularly in palliative care. Family physicians care for terminally ill patients. Often in the last stages, fatigued, dyspneic, anemic, cachectic, relatively anorexic, a patient’s mind may still be needle-sharp. Sincere empathy should never be standardized. Questions should be answered truthfully. No two caring moments are the same, making each interaction unique. In palliative care, the quality of physician conversations can assume wide empathetic dimensions.

Training in family medicine, while thorough, usually provides lighter exposure to cancer patients. The first serious cancer death experience can be stressful for the carer. However, responsibility for palliative care is a reality. There is no respite. In family practice, deaths from cancer are common. Some bête-noirs include multiple myeloma, ovarian, lung, and breast cancer. Intrinsic patient conversations occur after each diagnosis, at the beginning, in between, and in palliation. What vital information needs relaying by the physician? How much is shared with spouses or family relatives, with consent? What impact does that make on both the patient and physician?

Patient self-awareness being near death in terminal illness is common. It is still unsettling. A physician of care considers the choice of a dying patient choosing to stay home. The gain is avoiding moving to a hospital or a hospice in unfamiliar settings. More poignantly, it enables loving care from one’s lifetime partner and family at home.

After death, an exchange of warm words with facial expressions evokes everyone’s emotions. Personal feelings resonate in care, empathy, hope, truth, trust, and professional respect for one another. The end feels more like losing a friend. Such patients are not forgotten; physicians learn from them.

The dead do not suffer pain, only those left behind. Is healing ever complete when looking after sick patients for the practicing physician grappling with professional and personal emotions? How long does that take? Do multiple deaths cumulate the impact? Recovery is part of being resilient, critical in the profession, and feeling vocational compassion satisfaction in work. What if one does not always cope adequately? Is compassion fatigue a danger? Who tends for the wounded carer? When is physician resilience needed most? What keeps physicians motivated? How do they care for themselves and stay well-balanced? Reflections on practice experiences keep life in perspective. Dying patients, subconsciously, are often our best teachers.

Technoscientific pharmacology involved in finding remedies for diseases has always been concerned with the activity of relevant medical support at the cellular level, working on the principles of the Cartesian treatment of the body as a machine to be tinkered upon and moulded by the power of the pharmakon. As such, the project of determining a cure for any disease ends in creating what Michael Montagne calls pharmacomythology, that is, a single story of the drug (inevitably a remedy or a poison) that concerns itself with dominant patterns only and eliminates the rest as anomalies (13). In doing so, scientific drug narratives overlook the agency of the body that has ingested the drug, something that goes beyond the dose-response relationships and places the diseased body at the crossroads of automation and autonomy. These contradictory aspects reveal themselves in their respective ways; the former allowing the artificial power of the pharmakon to ‘write’, or rather ‘rewrite/overwrite’ the body, and the latter augmenting the ability of the body to exert its own power over the institutionally organised, extraneous control of the pharmakon and ‘write back’. Rabih Alameddine’s Koolaids: The Art of War is a novel that contests the largely Western medical paradigm of AIDS care and cure with the anomalous states of the body under the regulation of technomedical knowledge and support. The diseased bodies of the various characters not only narrate against the clinical nature of should-be’s and should-not-be’s in the Western healthcare system with alternative, unscientific dimensions of healing, but also against the sensational and oversentimental rhetoric tailing the former. Bodies that are forced to heal reject the institutionalised care, and those that have lost hope from such care find solace and amelioration (if only temporary) from the non-traditional practices rooted in the non-Western cultural identity of the characters. Bodies also reject the idea that AIDS has a single, unidirectional narrative of dying and death, or that the scientific paradigm of treatment that merely depends on the transparency of a therapeutic cause-effect relationship is the only key to everyday normalcy that HIV-positive patients should aspire to. Ensconced within the recurring motifs of war against a virus and between communities, the silent war of the body against the traditions of healthcare has, according to this researcher, proven a worthy theme of study. This paper, therefore, aims to examine how Alameddine’s novel destabilises the constructed relationship between the diseased and accepted modes of treatment at the intersections of race, faith, gender, sexuality, ability and beyond to establish a dimension of healing that does not cater for the escapism of a cure but for the transformation of care itself.

Globally, one-third of the world’s population has difficulty searching, comprehending, and using information needed to maintain health and well-being (Van den Broucke, 2020). Empowering people to learn and practice healthy behaviors and engage in self-care is at the core of health promotion (Van den Broucke, 2020). Appropriate health communication has been vital during the COVID-19 pandemic. The pandemic impact can be alleviated by promoting healthy behaviors while using appropriate tools to publicize information in easily understood language by the public. Most health information is accessed online so digital health communication and promotion is important. Numerous digital tools are available. Electronic mail (email) is a powerful tool to engage with various audiences using electronic devices. Worldwide 3.9 billion people use email, spending up to five hours daily to check work and personal emails (SlideShare, 2019) (Statista, 2021). Emails are cost effective and directly connect the intended audience with personalized content. MailChimp is a digital tool that the Institute for Population Health (IPH), Weill Cornell Medicine-Qatar uses to disseminate credible information via email to create awareness about health-related topics. MailChimp is convenient to use with in-built templates to create visually appealing content along with the option to add unique links as required. Embedding useful links and eye-catching visuals attracts consumers to read and learn from the content. MailChimp also hosts the audience database, manages audience preferences, and facilitates scheduling/sending the newsletters. For example, the IPH ‘Stay Safe, Stay Healthy’ newsletter created on MailChimp, focuses on topics relevant to COVID-19, health, and well-being. The newsletters guide the public to navigate, and access trusted/reputable sources to adopt lifestyles appropriate for optimum health and well-being. They provide information in simple language using appealing and culturally appropriate visuals and communicate new or updated evidence as necessary. The newsletter email campaigns have garnered 111,789 opens (total times the campaign was opened by recipients) and 28,507 clicks (total times any tracked link was clicked) from March 2020-2022 (MailChimp, 2022). Reliable, evidence-based, and well-crafted health communication can facilitate behavior change, dispel fear and uncertainty, promote compliance with positive health behaviors, and disseminate reliable and succinct information (Finset, 2020). It can also help alleviate stress and feelings of ‘overwhelm’ when confronted with information overload online (Van den Broucke, 2020). Most digital tools such as MailChimp are accessible via a paid subscription. Subscription fees could be a deterrent to their use. Nevertheless, digital tools like MailChimp are an effective means to optimize emails and can contribute to health promotion by facilitating the dissemination of health-related information via email, in a timely, efficient, and effective manner.

In this personal narrative, adapted from my memoir of my years in Doha, I present a digest of the educational philosophy that informed four years of my teaching at the Weill Cornell Medical College in Qatar, as WCM-Q was known when first established. As an author, artist, educator and practitioner of complementary alternative medicine who has worked with international students over many years, and in my therapeutic practice treated many clients from diverse backgrounds, I had much to bring to my teaching and to my position as Coordinator of the Writing Program in the college's Premedical Studies department. The years 2005 – 2009 were crucial in Qatar's development as an “education economy” and cosmopolitan crossroads, and I was eager to work with first and second year premed students on their way to our Medical Studies program—the first to grant American medical degrees anywhere overseas. It's not really so difficult for motivated, well instructed students to learn to write college level essays, but I also wanted these science-minded future doctors to learn what sorts of questions are asked in fields of the humanities. I wanted them to have a taste of what Socrates meant when he said, “The unexamined life is not worth living.” Such inquiry goes with learning the skills of close reading, literary analysis, and research methodology, which were the bases of my writing seminars. As well, in my course on literature and psychology, I introduced future doctors to the archetype of the shaman as wounded healer. I related this concept to my own undergraduate crisis that resulted in my choosing to become a poet rather than a doctor of veterinary medicine, and eventually to becoming certified as a hypnotherapist and establishing my private practice. Things might have changed somewhat since I left Qatar, but in this presentation I hope to inform my audience of what we started with at WCM-Q and how I succeeded with my students. I invite colleagues to consider how they approach the subjects of Narrative Medicine and Medical Humanities today to teach students in the Middle East.

The Turkish National Artificial Intelligence Strategy (TNAIS) has been prepared in line with the 11th Development Plan and the Presidential Annual Programs of the Republic of Turkey. The purpose of this strategy report is to describe the methods of determining national strategic AI priorities and set these priorities. In this report, according to the patent applications between 1980 and 2016, it is stated that the fields in which AI technologies are applied the most are: communication (24%), transportation (24%), and health sciences (19%). Therefore, it is seen that almost 1/5 of all AI technologies are applied in the field of health science. It can be concluded that AI technologies used in the field of health have a special place in the scope of the TNAIS report. The report covers four ethical values including: respect for human rights, democracy and the rule of law, improving the environment and biological ecosystem, ensuring diversity and inclusion, and living in peaceful, just and cohesive societies; and eight ethical principles including (1) proportionality, (2) safety and security, (3) fairness, (4) privacy, (5) transparency and explainability, (6) responsibility and accountability, (7) data sovereignty, and (8) multi-stakeholder governance. Consequently, in this study, the TNAIS report will be analyzed based on the ethical values and principles it contains within the scope of patients' access to healthcare. Then the current or prospective ethical issues emerging from the existence of AI technology used in healthcare will be addressed. Finally, the suggestions about the perspectives for approaching ethical issues when these values and principles are in conflict will be shared.

Objective: To report novel developments in standard art therapy practices in the United Arab Emirates (UAE) and Qatar that arose during the COVID-19 pandemic circa 2020-22.

Background: Art therapy services are a new phenomenon in the Middle East, with current practitioners having received their training primarily in the UK, US, and Australia. Religious therapies, such as prayers, rituals, talismans (against the evil eye) and Quranic recitation continue to be common approaches to mental illness in the Arabian Gulf. The visual arts have experienced a renaissance in the Gulf Cooperation Council (GCC) region, with billions of U.S. dollars of government funds invested in art education, galleries, exhibitions, and museums (Louvre Abu Dhabi, Museum of Islamic Art, etc.). Qatar has a national strategy to become an art and cultural hub in the Middle East.

Methodology: Self-reflective exercises, process art, and specialist discussions among 5 experts in the field currently practicing in the Gulf were conducted in 2020 to document and analyze new methodologies and perspectives implemented during COVID-19 lockdowns, primarily in the area of telehealth and telemedicine. A related study by the authors in 2020, “Best Practices in Art Therapy Telehealth Communication: Perspectives from the Middle East,” provided additional analytical data. Qualitative data was organized into themes using standard Grounded Theory techniques. The practitioners framed their therapeutic work within the model of Relational Cultural Theory (RCT).

Results and Discussion: The thematic findings were grouped under the headings: “Stigma,” “Empowerment,” “Confidentiality,” “Therapeutic Relations,” and “Art/Nonverbal Communication.” The pandemic allowed practitioners to expand services geographically outside of the Gulf beyond traditional face-face meetings through the Zoom.com videoconferencing platform. Online sessions provided unexpected benefits in the areas of increased privacy and reduction of social stigma. Since telehealth laws in the Gulf are almost non-existent, practitioners collaborated with international partners to develop best practices and ethical guidelines adapted to the local cultural context. Results of the analysis revealed shifts in previously established boundaries and power dynamics (clients and therapists can turn video and microphone off, see each other’s house, pets and other family members). The presence of family members at home sometimes impacted the privacy of the client, but in some situations allowed opportunities to meet extended family members, providing additional diagnostic clues into family dynamics. A reduced ability to communicate and understand nonverbal cues and body language (eye contact was different, lack of seeing the body) was cited as a drawback to virtual clinical encounters. The expert / novice skill level disparity of the therapist / client was diminished when co-creating digital artwork (ex. use of the Zoom whiteboard). The limitations on art materials that could be obtained during shop closures for some clients increased creativity and innovation in artmaking, but for others it decreased artmaking opportunities.

Conclusion: All aspects of art therapy in the Arabian Gulf, and especially online services provision, are under-researched. Areas for further inquiry include: cultural adaptation of western models of care, local perceptions of the origins and treatment of mental health disorders, and awareness and acceptance of expressive arts psychotherapeutic interventions.

Due to COVID-19 safety protocols, the vulnerable within our community had limited access to resources. Children of determination have encountered disruption to therapeutic services especially from March 2020 to November 2020. The pilot attempted to address question(s) of feasibility in maintaining services, preventing mental health and deterioration of symptoms and behaviour, and in increasing access to resources for children with Autism Spectrum Disorder (ASD). The research looked to question, if online services could substitute in-person services with this population, and to determine plausibility of online group art therapy services for children and their caregivers. The impact of COVID-19 on mental health is still unclear; early published reports indicate the onset of moderate to severe depressive symptoms, anxiety, and stress, potentially having a prolonged psychological impact on some individuals (Qiu et al., 2020). Overall, there is a lack of literature on art therapy in the region, and more so for online intervention, specifically in support of ASD during the pandemic. ASD is a neurodevelopmental disorder that impairs a person’s ability to communicate, socialize, and respond to certain stimuli within environments. Parents, pediatricians, and nurseries typically identify concerns that prompt diagnosis, ideally by age 3; prevalence is higher in males than females (Elsabbagh et al., 2012). ASD is recognized by delayed language development, repetitive and stereotyped patterns of behavior, impacting imagination, and difficulty with social interaction (Rapin & Dunn, 1997). Overall, the Middle East has had relatively little published research on ASD etiology, although statistics indicate that ASD affects 1 in 146 births in the United Arab Emirates (UAE) (Virolainen, 2020). Genetic linkage such as kinship and multiparity is culturally and regionally common. Epidemiological research into autism in the UAE is relatively new. The prevalence of autism likely remains underdetermined as many cases of autism potentially go undiagnosed within the community due to stigma and lack of awareness; mild cases can be unnoticed, and delayed diagnoses might result from a lack of focus or training in the area of early intervention (Salhia et al., 2014). It is, therefore, crucial that there is a continuation of support without disruption. Art Therapy is an integrative mental health profession that engages participants with the creative process, active art-making, and integrated psychological theory within the context of a therapeutic relationship (American Art Therapy Association, 2020). Art psychotherapists have a minimum of a master’s degree in art psychotherapy with clinical practice and supervised experience before gaining professional registration, a rigorous process. Children with autism are generally referred to art therapy specifically in the West (Martin, 2009; Teeuw, 2011) to support coping with communication challenges, behaviour, and low self-esteem (Schweizer et al., 2014; Schweizer et al., 2017). Research demonstrates that children with autism are expected to benefit from a non-verbal treatment such as art therapy, through sensory exploration, looking at, and shaping art materials to facilitate expression (Malchiodi, 2003; Rubin, 2001; Schweizer et al., 2009). This pilot study explores if conducting art therapy online would be beneficial and fill the gap when in-person services are not possible.

“Sidekick,” an original short fiction work, explores the concept of belonging through its two main characters, Birch and Aggie, who struggle to find social acceptance. The challenge for Birch is that he has paranoid schizophrenia. While he exhibits symptoms of delusions and experiences auditory complex perceptions, as do many with paranoid schizophrenia, unlike most, he also sees visual hallucinations. The general population might confuse his disability with dissociative identity disorder, or existing in multiple personality states. Instead, Birch seems cut off from reality, and while highly intelligent and educated, has been unable, especially in recent years, to maintain a successful life. The narrator, Aggie, is a retiree whose career was spent as an expatriate working with farming communities for a non-governmental organization (NGO) in Cambodia. She has recently returned to her home in Virginia. Her perceptions and experience are partially based on research and my observations while visiting Cambodia and my conversations with NGO employees there. The greater portion, however, is informed by my observations and experiences over the last eighteen years as a member of the expatriate community in Doha, Qatar, one of the Gulf states. Usually, expatriates are motivated by imagining a better life abroad in status, salary, and/or in opportunities to make a meaningful contribution. Aggie’s desires fit within the third category, but as is common in the lives of expats, her dreams met with obstacles, which require adjustment if the expat is to remain abroad. Aggie was unable to find a way to adjust. However, upon her return, she has realized that her home is no longer familiar to her, and while she has never quite fit into the fashionable society of Richmond’s West End, her outsider status has become even more pronounced. Her first-person account relays her chance encounter at a café with the much younger Birch and the tentative attempts these two lonely people make in pursuing a possible platonic friendship.

Aim: To determine the relationship between effective communication and the Quality of Life (QoL) of cancer patients through conducting a Meta-analysis (MA) to quantify and summarize the evidence and present the results of our local findings in the National Center for Cancer Care & Research (NCCCR) of HMC in Qatar.

Methods: MA was conducted via searching four online databases including PubMed, Medline, EMBASE and Psych info electronic and grey literature database, ProQuest dissertations. The MA encompassed published cross-sectional, longitudinal studies and a postgraduate PhD dissertation, that investigated the communication among cancer patients on one hand, and health care professionals (HCPs) and health caregivers (HCGs), and their impact in the QoL, on the other hand. Out of 20,796 hits, 204 full-text articles were assessed for eligibility. The final eligible studies were 19 articles that satisfied the inclusion criteria (18 published papers and one PhD dissertation). The quality of encompassed studies was calculated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Comprehensive (CMA) software version 2 was used to perform the MA. The pooled effect size was calculated using the random effect and ANOVAs were performed for moderation analyses for categorical moderators and meta regression analysis for continuous moderators. In addition, publications bias analysis was also performed. The Cochrane software “Review Manager v5.3” was employed to examine the quality of the included studies. Patient perception of physician’s communication skills was compared with the perception of physicians using the American Board of Internal Medicine (ABIM) communication assessment tool and QoL of cancer patients was assessed via FACTG questionnaire. Correlation coefficients of perception of patients were carried out using positive correlation analysis via SPSS V.26.

Results: Communication had a significant positive impact on the QoL of cancer patients and a significant association and moderation was observed for the mental component summary (MCS). Furthermore, a significant positive impact of involving Health Caregivers (HCGs) in communication on the QoL of cancer patients was also found. Covariate analysis indicated a true variation in effect sizes between studies and confirmed the existence of inconsistencies among different studies due to the diverse definitions and assessment tools used to measure the outcomes. The heterogeneity assessment offered explanation where possible to the consistencies and diversities between studies. Clinical and design heterogeneities were observed and reported. Our local pilot study in Qatar suggested a significant positive correlation between QoL and patients perception of physicians’ communication skills, r = 0.222, P=0.3. Moreover, our pilot study suggests a significant discrepancy between the patients perceptions & HCP perceptions, of the different communication skills set (Interpersonal, Content, Total Communication Skills). The patients reporting a lower perception 57% vs 86% total communication skills p=0.0028, 58% vs 88% for IP communication skills p=0.0003, and 55% vs 84% for content communication skills p=0.0042.

Conclusion: This MA covered a gap that existed in the literature among published systematic reviews and meta-analyses. It confirmed a significant correlation between communication and QoL of cancer patients irrespective of cancer type, age group, culture, gender, prognosis, or year of study. These results were global, transcontinental, and transcultural. It clearly highlighted the significant need to communicate with cancer patients and how much its benefits improve their QoL, as well as medical services. The results can be used to inform policy makers and health practitioners. Future Interventions should take into account these results to improve the communication between health practitioners and cancer patients and the involvement of families in the communication process. The health care system should consider communication as a vital component of providing a holistic patient and family centered care. The umbrella of QoL, provides a clear picture about patients and their families’ conditions and dictates that their communication needs are addressed as part of a standard of care. Furthermore, communication with its wide list of components should undergo a crucial level of studying, researching, critiquing and standardization, so that patients’ right to access a high standard of care is guaranteed across all health care systems. Our local results in Qatar resonate with this MA and raise the attention needed to clinical communication practice.

FGM, Female Genital Mutilation, is one of the most prevalent types of violence against girls and women in Egypt. Despite its horrific short- and long-term physical and psychological complications, according to UNICEF data reports, FGM remains widely practised against girls and women aged 15-49 in around 30 countries in Africa and Asia (UNICEF Egypt Data Snapshot, 2019). Non-medical, primarily, social and cultural beliefs that are associated with girls’ and women’s chastity, marriageability, hygiene and honour continue to control the lives of millions of them and, in some cases, lead to their death. November 25, 2021 marked the 30^th anniversary of the global 16 days campaign of activism which was launched by the Centre for Women’s Leadership to raise awareness about violence against women worldwide. In Egypt, this year, among several events that commemorate the anniversary, Care Egypt Foundation in collaboration with the United Nations Population Fund (UNFPA) and the National Committee for the Eradication of Female Genital Mutilation (NCEFGM), launched a social media campaign against FGM entitled “My Story with Genital Mutilation” (Care Egypt, 2021). The campaign’s team gathered eight real-life stories of Egyptian women survivors and collaborated with artist Noran Fikri who drew the graphic artwork. In this research project, I argue that the aim of choosing graphic drawings for that campaign is twofold: 1) drawing real-life stories of Egyptian FGM survivors empowers thousands of girls/women to break their silence, and report about similar practices which may prevent potential victims from undergoing such abuse; 2) this campaign aims to reach large numbers of social platform users, to make FGM everyone’s problem in Egypt, in the hope of shifting the narrative from chiefly raising awareness about performing such violent practices into inspiring mainly not Non-Government Organizations, lawmakers or national officials but individuals—whether directly harmed or not—to take an action against FGM. I also suggest that this eight-graphic-stories collection is a representation of a graphic medicine movement in Egypt. Coined in 2010 by Ian Williams, Graphic Medicine is “the intersection of the medium of comics and the discourse of healthcare… a community where many people have found their voice” (Czerwiec et al, 2015, p. 1). The graphic form lends a fresh perspective on FGM survivors’ personal physical, psychological and mental suffering. It softly invites other women survivors to share their stories. Since it is a social media campaign, each of these eight very short stories is illustrated in a one-page graphic artwork, in a short, quick yet shocking and horrifying emotion-packed post. The graphic visual delineation of the memory of pain and hurt of such abuse which those women are forced to live with, subtly connect them to their fellow survivors in a manner that words cannot attain.

Medical teachings such as medicines, treatment methods, special prayers to cure diseases, etc. in hadiths have formed traditional narrative medicine. Since experience and the use of scientific methods have a special place in modern medicine, the question arises about the position of experience in narrative medicine. The present study tries to examine the position of experience in this medicine at two levels, relying on hadith sources and in a descriptive-analytical manner: 1. The position of experience in the medical knowledge of the Infallibles (i.e. the Prophet and Ahlul-Bayt) and, 2. The position of experience in evaluating medical narrations. In the first part, considering the existence of the teachings of other medical schools in the many narrations, it was concluded that the Infallibles, in addition to divine knowledge, had authorized and employed others' experiences in medicine. Regarding the position of experience in the evaluation of medical narrations, firstly it is beneficial to divide these narrations into two categories: those which have been taken from other medical schools and those which are seemingly original from Infallibles. The medical teachings in the second group could be separated into natural teachings and supernatural teachings as well. Using experience and scientific methods for evaluating medical narrations are just as applicable to narrations taken from other schools and those with natural teachings apparently originated from Infallibles.

The Emotion Sensing Recognition App (ESRA) is a mobile app that uses AI to assess children’s drawings with respect to potential mental health issues. This can be an important tool for parents, since children have difficulties articulating many aspects of their mental well-being. In this context, art therapy can help: an art therapist observes children while they are drawing, either guided (i.e., by requesting certain objects in the image) or unguided. Relative size of objects in the image, their placement, type, color scheme etc. then provide valuable clues about the child’s well-being. Still, parents need to make an initial observation before contacting an art therapist.

In this work, we explore how technology, in particular AI, can be used as a tool to assist parents in starting a dialogue with the child and, potentially, an art therapist. ESRA is one such technology: parents take a picture of their child’s drawing using their mobile phone, and ESRA provides a binary assessment (“good”, “bad”). However, in addition to only providing binary results, ESRA’s decision process is a black box that cannot be inspected.

In contrast, our extended version uses joint-localization and classification to find and identify objects in a child’s drawing. The goal is to provide parents with a verifiable assessment in plain English, summarizing their child’s drawing. To do so, we generated a data set of drawings by conducting a web scrape. We then cleaned and annotated the data set. Under the guidance of the second author of this work, an experienced art therapist, we selected objects in the image and assigned a numerical score ranging from “good” to “bad”. We then used this data to train a “You Only Look Once” (YOLO) artificial neural network (Redmon & Fahadi, 2018). The resulting model predicts the location and score of the objects in an image. We use this information to highlight the objects (i.e., with a bounding box and the label) and summarize the model’s findings in plain English. We pay particular attention to capability awareness by converting numerical scores to quantitative categories such as “We are quite certain that object #7 is a tree without leaves (90%), which could be mildly concerning”. Our tool considers YOLO’s confidence as well the relative size and type of the object. We believe that this approach addresses an important aspect in the ethical use of AI. Deep neural networks are black box oracles. Their decision-making process is not well understood, even by AI experts, let alone lay persons. Our approach therefore allows parents to make an informed decision by attempting to make the recommendation of the AI verifiable. While more studies are needed before using our tool at scale, we think that it can play an important role in initiating a dialogue between children, parents, and art therapists.

Several reports over the last two decades have indicated the importance and success of incorporating medical humanities courses and modules in medical schools. While this inclusion is well established in the Euro-American contexts, it is still underrepresented and understudied in Eastern contexts. In this presentation we aim to describe building an elective course titled “Medicine and the Arts” for second and third-year medical students of different nationalities at the College of Medicine in Qatar University. In offering this elective we aimed to establish an understanding of the linkages between humanities, medicine and art, and to strengthen concepts and practices of culture competence among the students.

Little has been written on designing medical humanities courses in non-Western contexts. In structuring and building the content of the course in a Middle Eastern context, we faced several challenges. The discipline privileges the Western scene and discourse in art and humanities, means that resources tend to be mainly Euro-American in their framing of medical concepts such as doctor-patient relationship, patient-centred approach, illness narratives. Whereas the students enrolled in the college come from non-Western contexts, which are largely ignored in the majority of the available current reports.

To equivocate these challenges, we used the Cultural Competence Model of Purnell; adopted an interdisciplinary approach and employed the concept of intersectionality to structure and deliver a culturally competent course that explores the nexus of medicine, humanities and art. Students were encouraged to link topics discussed in the course to their own experiences and cultures as a way to create relevance and meaning. Lastly, we made a concerted effort to curate art work reflecting the students’ rich cultural heritage.

The course comprises five themes, taught in two-week blocks:

– Medicine, history and painting

– Medicine, anthropology and photography/documentary

– Medicine, sociology and music

– Medicine, literature and philosophy

– Medicine, psychology and cinema

The remaining sessions include physician-artists guest speakers and visits to relevant art exhibitions to explore art in medical contexts.

Adopting a culturally competent approach to medical humanities helps to broaden the scope and make the course relevant to a culturally diverse student population. This approach harnesses the students’ own cultural backgrounds and works of art to explore the nexus between humanities, social sciences and medical care from around the world.

In her Memoirs of a Woman Doctor, Dr. Nawal El-Saadawi, an Egyptian physician, writer and feminist, describes the development of her existential questions as a human being and a doctor throughout her life changes and the interaction with her socio-cultural patriarchal context. Following a crisis in her professional identity, Dr. El-Saadawi questions the meaning of doctoring, the doctor-patient relationship, and life as well as the absurdity of death and alienation. A young woman died while giving birth to her first child, and Dr. El-Saadawi's failure to save the woman's life changed her self-positioning in relation to medicine and the sanctity of science. This experience caused her to sanctify human beings and the humanity of doctors, rather than sanctifying their knowledge only, and created an acute awareness of the link between her body, mind and soul. She writes “The focus of the struggle inside me widened out from masculinity and femininity to embrace humankind as a whole. Human beings appeared to be insignificant creatures in spite of their muscles, their brain cells and the complexity of their arterial and nervous systems. A small microbe, invisible to the naked eye, could be breathed in through the nose and eat away at the cells of the lungs. An unidentifiable virus could strike at random and make the cells of the liver or spleen or any other part of the body multiply at a crazy rate and devour everything around them […] I found my feet taking me in a completely new direction.” (p. 21). In the end, she finds relief for her soul in her love for a musician and attributes music to rescuing her from darkness. Drawing on content-thematic analysis of the memoirs, in this presentation I make an analogy between the crisis that Dr. El-Saadawi experienced, and the potential crises that health care providers (HCPs) faced during their work in the first stages of the COVID-19 pandemic. Through the existential and philosophical questions suggested by Dr. El-Saadawi, in this presentation, I suggest that we look behind the scenes of the ICU and think in-depth about healthcare providers' existential experiences during the COVID-19 outbreak - a global crisis that can be very personal for the HCPs. We will discuss how the crisis and facing death on daily basis could influence healthcare providers' existential and philosophical perceptions, when they are unable to control a virus and save lives.

Data sets were plentifully used in the wake of the COVID-19 pandemic. Although they were utilized for documentation, policy formulation, course correction, and research among others, data sets relentlessly reduced human beings to mere numbers and glossed over the affective and emotional experiences which characterize our lived experience of the COVID-19 pandemic. Quarrelling with such decontextualized, depersonalized, and hegemonic impacts of data, graphic medicine while not entirely dismissive of the performative authority of data, criticizes and supplements data only to arrive at a complex model of data. Using close reading of comic panels created by Andy Warner, Sarah Firth, and Randall Munroe, the present article demonstrates how graphic medicine imagines different ways of engaging data through enfolding the social/individual and structures of feeling to convey the embodied nature of our existence. Put differently, graphic medicine rematerializes and reclaims the individuals from datasets through a process which we call “redrawing.” Redrawing is a textual practice and strategic engagement with the authority of visual/verbal discourses and its attendant technologies through rhetorical operations of irony, satire and genre blending among others. The article concludes by emphasizing the need to humanize, contextualize, and sensitively present data so as to convey the collective, entangled and affective nature of our existence.