(Renoir’s Luncheon of the Boating Party, 1881)
Just the other day, I attended a conference on evaluating disease in patients with rheumatoid arthritis at Emory University Hospital in Atlanta. The lecturer was a rheumatologist from the Hospital for Special Surgery in NY. The main points that ‘stuck’ with me were the following:
- the importance of a multi-dimensional health assessment completed by the patient identifying level of physical functioning and pain levels
- the need to gather evidence-based outcomes of medical treatment
- treating the whole patient, not just the disease
Also, there is a link between premature death of patients with rheumatoid artritis (RA) and social deprivation (1). This may be related to a number reasons such as delay in seeking medical attention; vulnerability for the disease to get worse due to other medical problems; different medical treatment and mangement by physicians; not following the medical treatment plan by the patient. Social deprivation has been also linked to ongoing depression which affects 13-20% of RA patients (2). Depression in RA patients is associated with pain, disability from work, poor adherence to treatment and sometimes suicide (3).
To focus on patient-centered outcomes, clinicans are encouraging patients to attend self-care programs and local support groups. Self-care management programs’ goal is to control the disease (RA) from getting worse by managing the pain, damage and disability of RA, but also to provide psychological, educational and employment opportunities (4). (1st time painter)
Patients with rheumatic conditions that participate in support groups seem to experience a decrease in feelings of loneliness, achieve new relationships, improve skills in eliciting and accepting social support, have better daily functioning, and may have an increase in life satisfaction outcomes (5). There are other avenues of support that can accomplish similar goals. The process of creating art has been proposed to enhance cognitive abilities, increase self awareness, help cope with symptoms of a physical disorder, and gain relief from emotional distress such as anger, loss, depression, worry and anxiety in certain chronic conditions (5,6).
I want to re-emphasize that creative interventions are not only benefical for patients diagnosed with rheumatoid arthritis, but cancer and chronic disease management, disease prevention – art, dance and musical interventions can be helpful when treating brain injury, dementia, cardiovascular accidents, depression, beareavement, pain management, peds, sexual abuse, and AIDS (7).
Note: I did not do the periodic research on rheumatoid arthritis above; a rheumatologist (Dr. Ines Colmegna) working at Emory did. However, if you want the bibliography, email me at firstname.lastname@example.org.
Pierre Auguste Renoir
The famous French painter Renoir, whose works adorn many museums, suffered from debilitating rheumatoid arthritis during the last three decades of his life. He suffered his first attack in 1898, and his joints became severely deformed later.
In 1904, Renoir weighed only 105 pounds and was barely able to sit. By 1910 he could not even walk using crutches and he became a prisoner in his own wheelchair. His hands were completely deformed, like the claws of a bird. A gauze bandage was used to prevent his fingernails from growing into the flesh. Renoir was unable to pick up a paintbrush at this point and it had to be wedged between his fingers. Still, he continued to paint everyday and produced some of his greatest masterpieces.
Painting was almost a physical need and sometimes a cure, as if Renoir wanted to create on the canvas those things which he had to miss in real life because of his disability. Even when he woke at night crying in pain, he asked for some painting material and started to make small paintings on wood – see below.