Broken Heart Syndrome Unravelled
I naively expected to have a conversation with a patient just about their medical conditions, treatments and so on. Instead, this patient told a very moving, heartfelt story, which I tried to represent in my creative piece.
The patient, I shall call Imelda* related her story through an online call, but even ‘remotely’, the content and telling of the story made it feel very personal. This made me realise the obvious fact that medicine has profound, personal impacts, there is so much more to treating a patient than fixing a medical problem. The points I focused on in my creative piece were the depression felt by the patient, worsened by the death of their family members, and a heart condition they experienced called ‘takotsubo’.
Takotsubo is a type of cardiomyopathy, severe emotional stress causes the heart to balloon and become weakened, leading to severe chest pain. It is colloquially known as ‘broken heart syndrome’, as it is often felt after the death of a loved one, due to the emotional stress of that situation. During the acute phase of the disease, the left ventricle swells, and takes the shape of a ’tako-tsubo’ (an octopus trap in Japanese). However, the patient recovers quickly, and there is no specific treatment for this syndrome. Therefore, instead of displaying the physiological changes of the heart in a takotsubo state in my creative piece, I wanted to represent the emotional impact.
I chose to create a drawing (of the heart) as part of a three-dimensional model to reflect how the patient’s story was so impactful. They were just outlining their story, like the outline of the heart, but the emotion and unexpectedness made it feel vivid and shocking – as if their words became three-dimensional.
The choice of a book represents Imelda’s life, her ‘life story’. This starting point was inspired by a different clinical encounter when someone in my group asked a patient ‘if this was a story, where would it all begin?’ There is writing on one of the pages to show their life story so far, which is then interrupted by an emotional and physical stress on their heart which dominates their life at this current page. The next page hasn’t been ‘written’ yet as the heart problem must first be dealt with before it can be reached.
The Heartstrings represent how the patient felt like their ‘heart was broken’, but also how the story pulled on my ‘heartstrings’, as I empathised with Imelda. The string is positioned to show the destruction to the patient’s life-story caused by intense emotions leading up to this event. The strings come forward and off the canvas to again reflect how I responded to the Imelda’s story, the meeting was online, but, it felt as though the story had reached me in person. The string is only on the left side of the heart for two reasons: to show the sudden onset of the cardiomyopathy, and how takotsubo mainly effects the left ventricle.
As previously mentioned, the hand-writing reflects the patient’s story so far. It gets darker at the bottom of the page to reflect the worsening depression felt by the patient. This numb feeling of depression contrasts with the intense emotional and physical pain of this heart condition represented by the heartstrings. The writing is illegible to show how the doctor/ myself as a medical student can’t interpret the patient’s story independently, we must rely on the patient to choose to tell us the story. It also reflects doctor’s infamously bad handwriting.
The black book cover – I painted the book cover black to again symbolise how, as medical professionals, we cannot interpret, or be fully aware of a patient’s situation without them telling us their story. We cannot judge a book by its cover. This also represents how I assumed the conversation with this patient would be quite direct and unemotional, as I was completely unaware of their situation and story when first introduced to them.
The book is open to show how the patient is choosing to share their story with us, which I felt quite privileged by. I think it also shows vulnerability, when alongside the heart. It shows how the patient is being vulnerable and talking to strangers about matters that are close to their heart, which is admirable and brave.
I think this story stood out to me especially as I believe many people view the heart as a ‘life force’: the heart and it’s beat symbolise life. Therefore, I found it quite shocking that the patient had gone through emotions so strongly that physical change occurred within this vital organ. I learnt about the power of listening to the patient’s story and the emotional, personal impacts to the patient when in this clinical encounter, and then reflecting on it to make this piece. If we had just looked at hospital notes, for example, we would’ve just seen a brief hospital stay to treat cardiomyopathy, and not their surrounding situation, and just how much the event affected the Imelda’s life and wellbeing. I also realised how important it is to reflect on previous clinical encounters. This patient’s story shocked me and I empathised with them when I first heard it, but it was only during reflecting when designing this creative piece that I realised just how admirable Imelda was, and how important it is to not assume, but to take the time to listen.
*Name changed to preserve confidentiality
Winner of the Effective Consulting Creative Prize, Year One, 2021
I like this art piece as it really encapsulated how Takatsubo cardiomyopathy affects people’s life through emotional or physical stress. In the case of Imelda, she had a story to tell, which was interrupted by depression and the death of her family members. The heart sits at the centre of the piece, which strings coming out of it, both depicting the amount of stress Imelda probably feels because of this incident and the octopus-like feature of Takatsubo. I can also appreciate how the next page is left blank, suggesting that there is more to Imelda’s story after Takatsubo, and there is hope that Imelda can complete the next page of her story.
This piece is so effective at communicating so much with deliberately illegible text which is symbolic of so much in a clinical setting. The image of the heart starting on the page but then leaving the pages of the book into the 3D display to me speaks about how medicine transcends what can be learned in a book. The piece moves from an image that makes me think of a classic anatomy textbook to a web of blood vessels that are deliberately not accurate to actual anatomy, showing how complex patients are and how this can only be explored through real life interactions.
I also love the unassuming nature of the book until opened. It is too easy to make snap judgments of patients or only treat what can be physically observed when with a little exploration the complex web of intertwined physical and emotional symptoms can be discovered.
The chaotic nature of the vessels also shows how individual each patient is and how the only way to truly understand each person is to truly listen to them as there is no universal model that can describe every patient
The art piece is so precise as in every aspect of the art pice has a meaning behind it and some parts have multiple meaning such as the bad hand writing or the strings on the left side allowing us as viewers to interpret it how we want. The art piece really shows both side of the story as Imelda but also as the doctor and the student doctor for example how the heart strings come forward to show how even though it was an online consultation it felt like it was in person. The art form also allows the viewer to understand what the heart condition is as it affects the left ventricle and is caused by distress and it allows the viewer to see the art piece as a story. The art piece also shows the true reality of a consultation and how its not just a quick diagnosis and the consultation is over but is soo much more personal, sometimes the patient just needs someone to listen to them. Most of the information about what they are actually feeling and what is that they are really here for can just come from giving time to the patient and letting them speak.
This piece highlights the importance of caring for a patient beyond immediate medical needs, taking the time to communicate thoroughly with them and ask them their story.
I love the way it encapsulates the patient and doctors and medical students perspective, as this gives a sense of collaboration and support between healthcare workers and patients.
The choice of this student to artistically present the story and emotional distress of the patient, over an anatomically accurate representation of this disease, is powerful and moving, as we can observe the erupting pain from the heart and empathise with the patient as a complex human being rather than a case of an illness.
The use of illegible writing and the black book cover is important as the student describes how the doctor and herself can’t make assumptions about or judge a patient, and can not treat a patient as effectively without hearing their full story.
This piece not only caught my eye but the story and process behind it was very meaningful. I love the way every single detail was thought out from the black book cover to show how we cannot judge a book by its cover, to the ‘heartstrings’ which seem to be reaching off the page towards you. I think it is a great representation of the patient encounter and conveys the story and underlying meaning exceptionally well. I think it was very clever to link the patient’s heart condition to the ‘broken-heart’ narrative as it provides a well-rounded piece that tells a story. I love the use of thread and the use of colour in the thread alone is very clever as I got the impression that everything else is depressive and colourless to the patient, but the pain is very vivid. I also think that this highlights we empathy we feel as doctors which is a key part of the profession. I think this piece captures many different aspects of the patient’s story as well as being something that we can all relate to in terms of empathy.
Firstly, the art piece instantly stood out to me as the heartstrings spiraling across the book made me want to understand the deeper meaning. The incomplete book is very powerful as it depicts how Imelda’s story has been abruptly put on hold due to the ‘broken heart syndrome’ caused by her severe depression. The writing could also connote how Imelda is sharing her personal story with the doctor while the illegible handwriting could be that the doctors can never truly feel the patient’s raw emotions no matter how empathetic you are. I was particularly touched by how the heart which is one of the most vital organs can undergo physical change due to emotional stress. This just shows the importance of your mental state which is often overshadowed by physical health problems.
Wow. This piece is incredible, what initially drew me to it was not only the talent behind the artwork but the actual heart itself, as so much to do with this organ is what initially drove me to study medicine myself. After reading the summary I am in awe, not only have I been educated about an interesting condition of the more commonly known “broken heart syndrome” but i can appreciate the artwork so much more. The way the strings are only attached to the left side of the heart, the illegible writing that reflects how we can never really walk in someone else’s shoes, all the way down to the choice of colour of the book cover. The artist(s) have really thought about every single detail and how the story of this patient can be reflected in the piece. I can feel the passion and emotion that went into making the piece and even the writing of the summary, which really expresses that medicine is so much more than clinical knowledge and as the writer says “there is so much more to treating a patient than fixing a medical problem”.
This art piece caught my interest initially due to how much detail and thought has gone into the presentation of it. After reading the explanation I firstly feel like it really shows how medicine is an art and not just a science due to their being so much more to treating a patient than just the problem and the importance of getting to know them deeper to be able to really understand why the symptoms present. I also really like how the writing is illegible as this shows how you have to work with the patient and not just interpret it yourself as you can’t get an accurate reading working alone. Another part I like is how they used the heartstrings to represent her condition and how she felt but also with the dual meaning of the empathy the student felt towards the patient and connected to them.
The detail in the book of this piece is incredible. The subtlety of the meaning behind the illegible writing and the darkening of the page is an amazing detail and such an interesting way to portray the persepctives of both the patient and medical student. I love the emotion that runs through this whole piece. Incorporating a deeper meaning to every section of it ,from drawing to colour, to always link an emotional aspect of the patient’s experience with tako-tsubo is so clever and makes for such a layered piece. Not only is the artwork incredible, but the story behind it is so touching and it is amazing to create artwork this beautful from such a sad situation. Looking at the piece and reading the story, the passion and respect you feel for the project and patient is so evident and elevates this from art to an experience it is really beautiful.
I am deeply moved by this piece and it’s profoundly contrasting themes. The blank page in particular creates an intriguing triality of possible meaning. It simultaneously holds the promise of life beyond depression and takotsubo, the potential bleakness and void of any real emotion following on from takotsubo, or – perhaps – even life’s end. The empty canvas of the right half of the art piece signifies ultimate meaning in life or death, whilst being the simplest form of art imaginable – just a blank page. As such we as medical professionals must endeavour not to imprint ourselves on a patient’s “blank page”, but rather provide a platform for them to express themselves wholly, helped hopefully by healing of some kind, to then fill the rest of their pages with as much vivacity as one could possibly hope for.
This piece of art is 3 dimensional, which makes it eye-catching and interesting to look at. What is particularly effective is how the heartstrings visually depict the feeling of a ‘broken heart’. I like how multi-layered the artwork is, with particular small details like the string spilling out of the left ventricle; the darkening handwriting to symbolise depression; and the illegibility in the handwriting to show how it isn’t possible to understand a patient’s story without the patient choosing to tell it, to name just a few. You don’t notice all of these details initially, as they are quite subtle, but once they are pointed out you notice them and they are very effective.
I love how every aspect of this art piece has been chosen to represent something, from the black cover to the illegible writing. Every little detail is thought through, and the piece encompasses how much comes into a single doctor-patient encounter, how causes and treatments are only surface level. I especially love that the book is representing the patient’s story. This is such an amazing art piece and I found myself wanting to learn more about Takatsubo cardiomyopathy and the affect it can have.
I think that this art piece reached out to me the way Imelda’s story did to the artist ; it’s a feeling I’ve felt many times, but I’ve understood the true psychological and physiological as a result of their perception. The carefully crafted and chosen aspects both somehow encapsulate Imelda’s story and emotions perfectly and contradict the unpredictable nature of broken heart syndrome. I especially love the unravelling ‘heartstrings’ and gradually messy handwriting, as they both exemplify the uncontrollable nature of the strength of one’s feelings, which in this case can lead to Takatsubo cardiomyopathy.
This piece of artwork deeply touched me, which is what I think a good piece of artwork should do. The student incorporates mixed media which I really liked as they use threads of string to show the heartbreak, I also really enjoyed the 3D aspect of the piece. A broken heart is usually never considered physical but more emotional, however this piece teaches the observer that there is a real physical component of heartbreak and its effect on a person over prolonged periods of time. This piece also reflects the students empathy and their understanding of Imelda’s situation. Takatsubo cardiomyopathy was not something I had ever heard of before I saw this piece and I love how this piece has taught me something whilst observing a beautiful piece of art.
I felt immediately drawn to this piece. The bundles of blood-red string crawling out of the heart conveys a sense of pain and gave me the feeling that this is an emotive piece. By having the heartstrings running towards the viewer, it bridges the physical gap between them and the artwork, it invites us to engage and feel more connected with what the artwork is trying to express. I enjoy how well this emotional feeling was communicated in a physical manner.
I also believe that what Rose said is so important- it is so important to take the time to listen to patients. From my own experience of interacting with patients, the doctor-patient relationship flourished most when the doctor made an attempt to get to know the patient on more than just a medical level. This is an important reminder that there is so much more to a patient than just their patient notes, they are complex human beings who each have a different story to tell, if only they are given the chance to.
The creativity of this piece is what inspires me. The use of the heart in the centre of the patient’s life-story is incredibly poignant as she is dealing with takatsubo – it has a resounding impact to the very core of the patient, represented by its placement in the middle of the book. I like how the artist has incorporated both intimate details from the patient’s life but also, has managed to portray an accurate level of medical knowledge, with the strings only on the left side of the heart to represent the left ventricle’s role in takatsubo. Although an all-round incredible piece of work, the final thing which has stuck to me is the fact that this patient has described their experiences completely remotely. This highlights just how important it was to the patient just to be able to convey their story, whether it be in-person or online.
As I was scrolling through all the artwork, this one really stood out to me. I love how you look at it and possibly think that its quite simple whilst also being meaningful. But actually, every part is complex and carefully thought through to link the different parts of the patient’s journey together. I like how one page is blank, symbolising ‘after takotsubo’, as we should recognise that when patients are ill and as a doctor you no longer see them, they still go on to live with that. Even if they get better, that was part of their life and affected every day from that point on. I love how different mediums are involved, again symbolising how some parts maybe have a greater effect. Or how the disease is that the left ventricle swells, yet the main effect you see in the artwork is the emotional hurt of the page being half blank and the heartstrings overwhelming so much of the book.