As a U of R student, Philip Gruppuso found a way to merge medical school with music. Now, he says, liberal arts are even more critical to preparing the next generation of doctors.
When Philip Gruppuso, (MD ’77) applied to become a medical student at the U of R he was granted an interview with Samuel Adler. Adler was a university department head, but he knew very little about medical instruments. He had no use for scalpels, stethoscopes, or syringes. That’s because his appointment was not within the School of Medicine & Dentistry. Adler was professor of Composition at the Eastman School of Music.
“Professor Adler interviewed me for medical school, which was a remarkable thing. That’s why I went to Rochester,” says Gruppuso.
Gruppuso, the son of a housepainter and a secretary, was following his parents’ upwardly mobile advice to become a doctor. But he arrived in Rochester with an undergraduate degree in music, and no intention of giving up his piano. For the next four years, he could be found entertaining the Saturday dinner crowds at the former East Avenue Hotel or Hojack Yards, a once popular spot in Webster. He spent summers directing and composing music for a community theater program, and frequent wedding gigs helped pay his tuition. Nearly four decades later, Gruppuso is a steadfast proponent of blending med school with music — or any other liberal arts pursuit.
“I appreciate the central role of science in medicine. Good physicians, however, also have an understanding of the human condition and are empathetic. The humanities are essential to developing that and communicating it to patients,” says Gruppuso.
Gruppuso spends a lot of time thinking about the best way to turn students into doctors. He only recently stepped down as associate dean for Medical Education at Brown University, a post he held for eight years. Prior to that, he was director of Brown’s M.D.-Ph.D program. He remains a professor in Pediatrics, giving lectures on biochemistry, nutrition science, and endocrinology. Gruppuso is well aware of the need for medical schools to revamp their repertoires in response to dramatic changes in health care and technology.
“This is a challenging time in medical education,” he says. “We’re at a time of peculiar contradictions.”
For starters, he notes, the knowledge base has drastically increased since his time in Rochester. Yet today’s students don’t need to memorize as much information. Using their smartphones and tablets, they can find instant answers on the Internet. Another paradox: Students are more accomplished, have more demanding curricula, and spend more time in school than previous generations. Yet Gruppuso believes they are far more stressed about their futures than he was. Residency placement is a bigger concern, and many worry their professional salaries won’t justify their medical school debt.
“It’s hard to watch. Pre-medical and medical education need to change. There are brilliant people working on this daunting task. All medical schools are innovating and redesigning curriculum. To me, that’s a pretty clear indication we haven’t figured it out yet.”
Gruppuso is certain, however, that a "liberal medical education” needs to be part of any solution. While giving a TEDx talk on this subject last year at Brown, he pulled up an image from the manuscript of Beethoven’s Grosse Fuge. It appears furiously scribbled. Notes and symbols bounce haphazardly across the page, and full lines are heavily scratched out. This, Gruppuso told the audience, is what a patient chart looks like when someone has a complicated disease. It is indeterminate, with complex layers — yet everyone hopes the end result is masterful.
“Doctors don’t work in a linear fashion. When we practice evidence-based medicine, the evidence changes all of the time. That can be pretty unsettling, but I’ve been comfortable with it throughout my whole career,” explains Gruppuso, a pediatric endocrinologist. “I think that is because I did something other than just study physics, biology, and chemistry. I also studied music composition.”
As associate dean, Gruppuso inherited Brown’s program in liberal medical education and then quickly orchestrated an overhaul of the medical school curriculum. The liberal medical education program exposes undergraduates to the university’s liberal arts programs before automatically opening the door for them to study medicine. No MCAT required. At the medical school, all students enjoy a flexible curriculum that leaves room for them to follow their passions. Students are encouraged to engage in scholarly pursuits well beyond the traditional scope of a medical school.
The students don’t need to look far for a role model who embodies this blend of science and humanities. Yes, Gruppuso is a teacher and a researcher, who has kept an RO1 grant going for more than two decades. True, he’s been a practicing physician and a medical school administrator. However, he’s also a well-known fixture in Providence, Rhode Island’s jazz and blues scene. He’s trying to master a Domenico Scarlatti sonata on his living room piano. He has his own woodworking shop, and he relishes the ongoing task of restoring his family’s 200-year-old home. His wife publishes poetry, and their twin daughters are art school graduates living and working in New York City.
His diverse interests seem to effortlessly intertwine, even in very abstract works of art.
“I think about a painting by Mark Rothko, and somehow feel connected to the way I feel and what I learn when I interact with patients,” he said during his TEDx talk.
The universal threads of human experience have been woven into art and music and language since the beginning of civilization. So while most patients lack medical degrees — or even a comprehensive grasp of their own anatomies — there is a place where physicians and patients can intimately understand one another. For Gruppuso, teaching medical students how to get to that place is key to their ability to heal.
“The primary constituency of a medical school is not the students. It is the students’ patients,” Gruppuso reminds us.
To watch the video of Gruppuso’s TEDx talk, called Life, Learning and a Liberal Medical Education, click here