Coffee with a Colleague

Executive Director of Medicine & the Muse and Memoirist Jacqueline Genovese

Jacqueline Genovese, MFA, MA, combined personal, professional, and academic experience and expertise to change career course. After 20 years in higher education communications, faculty, and alumni relations, she forged a new path in the medical humanities and arts. She is the Executive Director of the Medicine & the Muse Program and an educator at Stanford University School of Medicine.

Sarah Berry //

This interview series features educators, scholars, artists, and healthcare providers whose work is vital to the growth of the health humanities. On Tuesday, January 19, I interviewed Ms. Jacqueline Genovese, MFA, MA, about her work as Executive Director of the Medical Humanities and Arts program at Stanford, physician and veteran educator, and author of a memoir in progress about family and cancer.

Sarah Berry: What is the Medicine and the Muse program at Stanford University School of Medicine, and what are the various hats you wear?

Jacqueline Genovese: I am the Executive Director of the Medicine and the Muse program, and our founder and faculty director is Dr. Audrey Shafer [MD], an anesthesiologist and a poet. Dr. Shafer and I work together on the strategic vision for the program, and then my role is to work with my program coordinator and our director of writing and storytelling to make it all happen, which includes communications and social media, programming, logistics, budget, operations, and working with university-wide arts programming and other relevant groups.

The fact that we’re on the same campus as the undergraduate and the other professional schools is very unusual [because other universities have separate locations for their medical schools]. So we try to take advantage of that as much as possible. We can bring doctors into our art museum on the main campus because it’s an eight-minute walk from the hospital. We create collaborations across campus not only to bring Medical Humanities to the medical students and physicians, but also to bring the physician perspective to the non-physician community, such as with our Pegasus Physician Writers group that we hold four times a year; the physicians read their creative writing, and, before COVID, it was standing room only. [A lot of the stories were] personal. Some wrote about what they were taught in medical school [about interacting with patients] or challenges like, “I’m afraid I have bad news,” how to talk about death and dying, and facilitating two-way communication.

The beauty of those events is they’re open to everybody, so we have community members and medical students. We have undergrad and graduate students. We have visiting faculty and community physicians. Alumni show up. It’s just wonderful. Pre-COVID we had a space issue, as anyone who does event planning on a college campus knows, but one silver lining of the pandemic has been pivoting to Zoom programming, which makes our programs more accessible. For example, with our new series, the Stuck@Home concerts. We had 1,000 people for the first couple of concerts, and there’s only one space, Bing Hall, that would have seated that many people.

SB: Well, maybe that’s one upshot of the pandemic; virtual events can bring more people together. I attended the first Stuck@Home concert that you put on back in March. I was so touched by how intimate and community-focused it was. Everybody was so plugged in, and we were seeing folks performing in their living rooms or in their home offices. It reminded me that I wasn’t alone in quarantine by myself. And then on top of that, I was so impressed by the incredible generosity of spirit of all the performers. The music was beautiful, but it was their generosity of spirit that really came through. I’ve attended several more, and each time, I was reminded of that all over again. Something changes you with music, something changes your affect and your attitude, in my experience; it’s a very restorative event.

Would you like to talk more about the Stuck@Home concerts, how they came about and what your favorite part is?

JG: It literally started out as a way as a substitute for an in-person symphony concert that we had planned. Our Stanford Medicine Music Network has over 270 physicians and other healthcare professionals who have an interest in music. A current Fellow in cardiology who had conducted a symphony before came to us and said, “I would love to conduct a symphony.”  We had to cancel due to COVID, and then a wonderful colleague I have worked with in the past on arts programming for physicians, Dr. Bryant Lin, called me, and said, “Do you think we can do something virtually?” So with his Zoom and music expertise and my connections with our musicians on campus and experience with running events, we created the series.

By having the audience tune in and add their comments in the Q&A, that was just this added bonus of connectedness and community. People were seeing their colleagues for the first time as performers, like, “I knew she was a great surgeon, but I didn’t know she could play the piano.” People even wanted to perform with their children. It just really just organically grew into, as you said, this sense of community and belonging.

And one of my favorite moments was Amelia Ligons, who works at the hospital, who mentioned that her Mom was watching and that her birthday was coming up.  And so Bryant asked, “Do you want to sing her ‘Happy Birthday’?”, and man, she just belted out a beautiful gospel-like version of “Happy Birthday.” It was beautiful. It was amazing. And then we have Dr. Matias Bruzoni and Raji Koppolu. He is a pediatric surgeon, and she’s a nurse practitioner. For one concert, they lost power at the last minute. They ended up singing a capella by candlelight. They just went with it in the moment, and it was magical.

Those kinds of things aren’t scripted.

We typically have a question that we ask each performer to address before they begin. And that’s been another beauty of the concerts: being able to address things that are happening around us, not only with COVID, but also when George Floyd was killed. We did a moment of silence around that. Later on, during Women in Medicine Month, we had special speakers. For the Jan. 21 concert, the theme was “The America We All Love and Strive For,” for inauguration week and in recognition of what happened [at the Capitol] last week. Music doesn’t need a translation, and there’s a more immediate effect and response that I believe only music can have.

SB: Healthcare workers are so stressed and overworked right now. Have you gotten any comments or feedback from clinicians about any benefits to performing for their colleagues or with their colleagues?

JG: Yes, Dr. Tamara Dunn told us she loves to sing, but with three small children and working as a hematology oncologist, she is short on time. The concerts gave her a reason to practice and to get back into it and to keep that part of herself. And so she started singing more on her own on Twitter @TamaraDunnMD for #songbirdsunday. Another colleague, Margarita Gallardo, created a ukulele team with her young daughters. So the concerts gave them a deadline for practicing. Then there were all the physicians and medical professionals tuning in. I’ve heard from people saying, “This is the highlight of my week. I’ve had the worst week in the world. And this is just so healing and restorative.” And just this week one of my colleagues said her grandmother has been quite ill and tuning into the concerts has been a highlight for her. That really touched me.

SB: It’s so important to be part of a community centered around art and performance. In “The Slow Medicine of Literature,” you describe the Literature and Medicine Dinner and Discussion program for Stanford physicians as “a safe space for physicians to talk about their own challenging experiences, fears, and joys.” Why is a safe space important for physicians, and how does literature play a role?

JG: With the LitMed series, whatever we are reading serves as the launch pad to talk about challenges through a more neutral thing. If it’s a poem or a short story, it’s not personal, but it provides a platform for discussions of bigger topics like what happens if you don’t like your patient, or when a physician becomes a patient and being on that side of the stethoscope. In the clinic or hospital, there’s no time or space for physicians to process, to decompress, or to talk about the bigger issues that might come up because of [shortcomings in] our healthcare system.

My framework for the sessions starts with the Four Cs: Collegiality, Confidentiality, Compassion, and Cussing Is Allowed! I always say, “This is Vegas: what happens here, stays here,” so that way, people feel comfortable sharing experiences or frustrations. There’s just not a space for that [in daily clinical work]. One of the physicians said, “I forgot how beautiful language can be, when you’re around medical language all day.” Medical language focuses on classification, and the language of poetry is obviously evocative and beautiful. Doctors hold themselves to such high standards personally, and we as a community also hold them to high standards. What I like to say is, “It’s a white coat, not a cape. You’re not Superman or Wonder Woman.” I like to talk about their favorite books from childhood and just explore the part of themselves that they sometimes have to put on a shelf.

I like to introduce poetry with the Billy Collins poem “Introduction to Poetry,” which is about folks who make the poetry experience torture, and so you don’t want to read it. One of my goals with the class is to have people fall in love with poetry again because it’s economical. You get a lot of bang for your buck with a poem, and physicians are busy, so poems can be useful.

SB: In addition to Collins, what are some other pieces that you have read together?

JG: “Cathedral” by Raymond Carver, also his poem “Grief”; “Laundry” by Susan Onthank Mates; “Let America Be America Again” by Langston Hughes. There have been so many. I guess it might be easier to talk about authors: Mary Oliver, Jesmyn Ward, Rafael Campo, Oliver Sacks, Emily Dickinson, Zora Neale Hurston, Brian Doyle, Eudora Welty, David Whyte, Anne Lamott, Tobias Wolff, Anton Chekov, and Abraham Verghese, to name a few.  The syllabus changes each session, so physicians are introduced to new authors and writing each time.

Whenever I can, I include pertinent readings that have a Stanford connection, which is another way to build community. We’ve read excerpts from Paul Kalanithi’s When Breath Becomes Air and “Interesting Facts” by Adam Johnson, a Stanford faculty member in Creative Writing who won the National Book Award. And Eavan Boland, our former chair of the Creative Writing program, who sadly died this spring, wrote a poem called “Quarantine” about the potato famine, which eerily relates to our current moment.  

SB: I do teach that story in a summer course for pre health-students in Kentucky and Tennessee. We read “Laundry” every summer, and it’s beautifully written. It always strikes me [in] fresh and new ways, all the layers that she’s packed into the identity of being a woman and a mother and a doctor all at once, and the social pressures.

That’s a great list of and diverse array of voices and perspectives on health and living and dying. And I love that the syllabus changes regularly so that physicians can take it more than once.

JG: Yes, it is the same with my military-affiliated students because we only have about 90 total throughout the whole [campus], and there are not many opportunities for them to come together.

We arranged with the registrar’s office for military-affiliated students to take it up to eight times. In both the physician and military groups, the community that’s created among the class, through literature, is what’s most important.

SB: You have given a TEDx Talk about your work at the intersection of medicine, the military, and the humanities. Can you tell us how this interest area for your research and work came about?

JG: Sure, yes. My Medical Humanities Master’s thesis was “Post-Traumatic Story Disorder: Using the Power of Narrative to Heal the Invisible Wounds of War.” My whole thesis was driven, sadly, by both professional and personal experiences with [trauma]. While I was getting my Medical Humanities Master’s degree, I was working full time at the University of Texas Medical Branch as an assistant vice president for faculty communications, and a male medical student and a male physician both died by suicide.  And so I was working with those families in the aftermath of their horrific loss. Then in my personal life, my friend’s son had served three tours in Iraq, and he came home and died by suicide. In my coursework I was reading Renaissance humanists like Petrarch and Machiavelli who were going through their own trauma and looking back to Cicero and other writers from previous centuries to gain consolation about what they were experiencing. At the same time, I was hearing very similar things from the families of the medical student and physician and veteran. And these are all men. So there’s the cult of masculinity in the military and medicine, and a lot of similar themes came up. This intersection of military and medicine is a little bit unusual to study [at this level] although the idea of the military physician is very much a part of Medical Humanities in terms of the ethical conflict that military physicians have.

Because of those experiences, I had a profound interest in veterans and what they were experiencing coming back from Iraq and Afghanistan, not to mention the fact that these young men were close to my sons’ ages. For one thing, these veterans have no transition time. If I could wave a wand and become president, I would create a reboot camp for people coming back from [deployment and] getting out of military service. Because they go to boot camp initially to shed their [civilian] identity and become this military person, but they’re not given anything to transition back into their community. The class can be helpful for students as they are making that transition.

SB: Why do you think that writing in particular is so helpful for returning service people to transition to civilian life?

JG: Something I’ve learned in my thesis work and also as the mom of two boys is that men tend to process and deal with things a little bit differently than women. With my daughter, I could sit down, and we’d have a really heavy-duty conversation over a cup of coffee, but with my sons, that occurred through much more indirect communication. And that’s what I found in my research in terms of males. Folks with post-traumatic stress disorder in particular were more comfortable writing about their experiences or keeping a journal or processing it that way. One student veteran said, “I feel like writing it gives me some kind of control over it. Once it’s out of my head and written down on paper.” I think for anybody that’s a benefit of writing. It’s a safe way to figure out what it is that you think you know and then what you do know, through the writing process. They also are able to see themselves in these classic works of literature like the novel All Quiet on the Western Front [by Erich Maria Remarque], about a German World War I soldier who had very similar experiences to them. There’s this timelessness of war trauma and the experience of war, and seeing themselves in that and not feeling so alone is helpful. Then, of course, they’re hearing from their classmates in different services, like Army, Marines, and Air Force, who had very similar experiences, both good and bad.

SB: And I can only imagine that you create a safe space for those for those students as well?

JG: Yes. I apply the four Cs to that class, too. I actually added “Cussing Allowed” for the military students! And then brought it into the doctors’ classes because it happens, right?  

So those classes are closed, and I invite special faculty, such as [Former U.S. Secretary of State] General [James] Mattis, who spoke in my spring class. And we have offered a class that was actually half non-military and half military students, and that is part of my goal of bridging the civilian-military divide. We’ve done that twice now. And I took my students up on their dare to complete the Alcatraz Swim Challenge with them, which was humbling and great fun.

SB: Can you share a prompt?

JG: Yes, based on the essay “Names” by Paul Crenshaw. The military is notorious for giving people nicknames, but the piece is also about hiding behind the nickname, and the fear that the soldiers might have of combat, and the unknown. And so the prompt for that particular piece was to tell us about your nickname and how you got it, in the military, which is hilarious. [And that helps to open a conversation about] what scares you the most, which is not something people typically like to talk about. That’s a way of using the piece of writing [as a way to get talking]. These guys are doing this because they’re scared, but it builds a connecting point: “Did you have a similar experience of your unit?”

SB: That’s absolutely brilliant. What a great illustration of how a piece of literature can provide the springboard for something that is very applied in terms of healing and finding community. Like the virtual concerts, realizing that you’re not alone is so meaningful.

JG: Right. Yes.

Typically my military-affiliated students are fantastic writers, and they think that they’re not. They are so humble about their abilities, but that’s something that the military and medicine have in common: you become a very succinct, accurate writer because you have to. I love editing military and medical writers because usually there’s not a lot of extra that they’re saying because they’re very specific.

Jacqueline Genovese with her sister Maria, children Sean and Kristen, and niece Petra. Photo by permission of Jacqueline Genovese.

SB: Right. And what are you working on in your creative writing project right now?

JG: It’s a memoir about becoming a new kind of family after my sister died at 33 and my then-husband and I raising her kids, who were three and four at the time. They are now wonderful, amazing young adults.  

I actually have my students to thank for being the catalyst for me to write about this experience.

In one of the first classes, I had them write a six-word war story about their war or military experience, which they did. And then they asked me to write my six-word story. I wrote, “Cancer made this aunt a mother.” And they said, “Teach, you need to write about that!”

The way I describe my story is this: we have a family oncologist who took care of my sister, who died at 33 of breast cancer, then my mom, who died at 62 of ovarian cancer, and then my sister Natalie, who died at 52 of lung cancer. I was the responsible person for both of my sisters in those situations. So I got to know their oncologist, Dr. Haggerty, very well. It just gave me a window into his world and into the world of oncologists in general, and how difficult that calling has to be.

And I had written a few stories about my family when I was in Texas that ran in the newspaper. It was really interesting to me to see people’s response to that writing and their connection. People I didn’t even know would just approach me on the street to talk about it or to tell me their stories. It was so powerful.  When I decided to enroll in the MFA program, it was really for both professional and personal reasons. It was sort of like a continuation of the work I had done in my Medical Humanities thesis, but also by that time, my oldest son had a son, Declan. And I was thinking, I need to get this information down about my sister, Declan’s grandmother, who he’ll never meet. I just wanted to get all the stories about Maria down, and I know myself well enough to know that if I tried to do it on my own, I wouldn’t. Having the structure of the MFA program was fantastic for that.

So if I were a better person, I probably would have been able to do a lot of writing during COVID, but I have not, unfortunately. I’m old enough to realize that it’s going to take a little bit more time for me post-vaccine. First, I would like to see my kids whom I’ve not seen in person in over a year because of COVID!

SB: Yes. I think we have to cut ourselves a lot of slack. I think we cut our students a lot of slack and compassion because everything has gotten more difficult with COVID, and it’s not necessarily true that, since we’re all at home, now we all have all this extra time. I’ve had way less extra time and headspace since March, when I had to figure out how to do my entire job online.

I think that’s true of many educators and writers. We need to encourage each other to be realistic about our capabilities and give ourselves the extra time and consideration we give our students to get work done or to be creative. I really look forward to reading your work as it develops on whatever schedule that takes!

You have also worked with other Medical Humanities programs internationally. Your article “Medicine and the Muse teams up with Sorbonne University in Paris” describes a decade-long collaboration. What was the result of that collaboration?

JG: Yes. Hats off to the Sorbonne. They’ve created their Master’s program in Medical Humanities, and their first cohort, I believe, is coming in the fall. The continuation of the collaboration is trying to figure out how some of our faculty can be part of the program. In fall of 2019, we talked about a physical exchange of faculty because we also have an undergraduate Stanford in Paris office.

For us, it was a really interesting experience. They hosted us there in Paris, and we each presented on our area of medical humanities. The Sorbonne School of Medicine and their undergrad campus merged. Because of our interdisciplinary [focus], I think that’s really what they took from us, but also they were poised to really take advantage of their new academic structure. At that conference, the PhD English literature folks were talking to the physicians from the Sorbonne for the first time because they just hadn’t been together in that way. So I would say we were a great model for that type of interdisciplinary work because that’s what we’ve been doing at Stanford for two decades now by virtue of physically being together.

Medicine & the Muse team members, left to right: Dr. Alyssa Burgart, Dr. Audrey Shafer, Aleta Hayes (Stanford Theater Department), Jacqueline Genovese, and Laura Wittman, PhD, in the courtyard at Sorbonne University, featuring statues of Victor Hugo and Louis Pasteur in the background.  Photo provided by permission of Jacqueline Genovese.

SB: If you could recommend one book, performance, artwork, or film for everyone in light of our current moment, what would it be?

JG: Obviously, racism is at the base of so many disparities in COVID and healthcare, so I recommend The Men We Reaped [a memoir] by Jesmyn Ward and Medical Apartheid [a medical history] by Harriet Washington. Also, the Netflix documentary Thirteenth about the 13th amendment.  [These three sources provide] a foundation for understanding racism and how people of color were misused by the medical profession for research.

SB: They are all fantastic sources on race and medicine, I agree. Do you have other titles on your own reading list?

JG: Plague and Music in the Renaissance by Remi Chiu (Cambridge UP, 2017). In the Renaissance, the doctor prescribed music. And they talked meeting friends and staying five feet apart. So I would recommend it for Medical Humanities folks in particular.

And then there’s The Man in the Red Coat by Julian Barnes. This is about Samuel Pozzi, a progressive obstetrician who pioneered hysterectomy for fibroid [masses]; he also served as a physician-surgeon in World War I. He had his portrait painted by John Singer Sargent, and he was Italian Protestant, which was a bit unusual for the time. He also had a love affair with Sarah Bernhardt, but that’s off the record.

SB: Do you have a secret reading list?

JG: A fun but also sad book my daughter sent me is Shade by Pres. Obama’s photographer, Pete Souza, who took all these beautiful pictures of President Obama and then contrasted them with similar times or events in the Trump administration. Also on my list is a book about Tuscany during World War II called The Tuscan Secret [by Angela Petch].

SB: You’ve said in a prior conversation that you’re always looking for ways to operationalize the Medical Humanities, to make it something like “emotional PPE” and to have it do good work in the world. And I am always looking for ways to get resources into colleagues’ hands and to have a reading list to pick up, or a new book, or new ways to think about the arts and medicine. And everyone in this field has such a distinctive set of talents and interests. Who else besides you would have all this diverse experience with military students and music and the Sorbonne and physicians and then also have the personal background that informs all you do at Medicine and the Muse?

JG: I was in a meeting last week, talking about ABC News wanting to cover the Stuck@Home concerts and describing [Dr.] Audrey [Shafer]’s KevinMD piece on democracy and also our Memorial project. And one of my bioengineering colleagues said, “Thank you for being the heart and soul of Stanford Medicine.” I think that’s what our program strives to be—really the heart and soul of Stanford Medicine. We strive to be the place where people can come for community projects like creating a memorial [for coronavirus deceased]. People can say, “We want to have a physician writing group; we want to have a medical student Talk Rx,” and we can make it happen. But I just so appreciated her words. If that’s how we’re viewed, there’s no higher praise, in terms of what we’re here for.

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