Silver or Gold?

“Silver or Gold?” I ask, showing two paint palates.

“Silver,” she replies. I place the palate on the table. The artist takes a crumpled ball of foil and dips it into the silver paint. She then presses the foil ball against her canvas creating texture, contrast, and depth. At times, the foil ball goes off the page, as if she loses sight of the edge of the canvas. I guide her back to center. When she completes her painting, I ask her, “What would you like to call it?”

“I don’t know,” she says, “What do you think I should call it?” I tell her that it is her artwork. It could be any name. It is abstract art after all.

“How about ‘A Starry Night’?”

“That’s perfect! It reflects the silver texture with the foil paint, the contrast against the darker water-colored background, and the glitter dashed across the page.”

“Well, I meant to do that…that…was what I was thinking.” She takes the pencil in her hand but as she presses pencil to paper, she pauses.

“What was I supposed to do?”

“You are naming your piece and signing your name,” I reply. “Oh, that’s right,” but she pauses again and hesitates. “Can you write it for me?” She asks, “I am not very good at writing this.”

“Sure,” I reply, “I can write the name of your painting, but it’s important to sign your work yourself.” She nods in agreement, and with an unsteady hand, signs her name.

Last fall, I did this every Friday morning. My painting partner was an adult artist at a local retirement community. Every Friday morning, since our first session together, I would ask her to sign and name her piece. Every time, she would hesitate, and sometimes, forget what she was doing.

My artist partner has early-onset Alzheimer’s dementia. For ten Fridays every fall and spring, Art for the Journey, a not-for-profit organization located in Richmond, Virginia, offers an abstract art program for adults with Alzheimer’s and dementia called Opening Minds through Art (OMA). An evidence-based program founded by Dr. Elizabeth Lokon at the Scripps Gerontology Center, Miami University, OH, OMA aims to restore and maintain quality of life and function for adults experiencing neurocognitive decline. OMA trains young adult volunteers to assist adult artists to help facilitate an inter-generational abstract art-making session. As a volunteer, I do not make any decisions for the artist—I simply provide them the space, time, and opportunity to be creative. In taking charge of their self-expression, the artists regain their autonomy, demonstrate their inner creativity, and gain a sense of emotional well-being and achievement.

At first, I found the sessions challenging. Her artwork often deviated from the assigned project and I worried that she would be unhappy with her work. At times, she was frustrated that the watercolors had turned muddy or that the masking tape failed to create the negative space that she intended. By far, what was most challenging was discussing her abstract artwork. As a person who struggles to see and analyze intangible patterns or grasp abstract concepts, commenting and giving feedback about abstract art placed me outside of my comfort zone. But she did not give up on me. Every week she challenged me in interpreting her abstract paintings. She challenged me to see critically, the pigments, shapes, and shadows that I would easily overlook. And out from those colors, shapes, and shadows, I began to see her feelings of achievement, well-being, and peace. I came to embrace that it wasn’t about how close or realistic the final product was, but rather, how the unstructured and intangible interpretation of each art-making task healed and preserved her identity.

A few months later, while I was shadowing clinic, a middle age woman sought help for excruciating chronic pain, numbness, and tingling in her right leg. Each time she described her pain she would become overwhelmed and cry. At the conclusion of her interview, her doctor discussed his assessment, presented the advantages and disadvantages of her options and gave her time to make a decision. What  struck me the most about this encounter was how her pain affected her. Where previously, I would have honed in on the science, the clinical dilemma, and its associated decision-making—I saw instead, a person’s frustration, their struggle with a chronic condition. I heard how distressing and debilitating the pain was. I heard, but, even more, saw, how that pain stole her autonomy, function, and above all, quality of life.

I never expected an artist to show me how the world of shapes, lines, and colors could transfer to an improved ability to understand and appreciate how people interpret and see themselves—how each individual person perceives their health and disease. As a clinician-in-training, it is all too easy to only hear what relevant symptoms indicate what disease, rather than listening to how the symptoms are interpreted by patients. Painting with another person reminded me how important this is for future clinicians. It reminded me to take a step back, tune out the white noise of a bustling, fast-paced ambulatory clinic, and dial in to the frame of the patient.

From the sessions, I made a friend who paints and illuminates her world like no other. Through the unique opportunity that I have had in working with Art for the Journey, I gained a better understanding of individuals struggling with dementia not as patients, but as people. On one hand, painting with another person showed how opportunities for artistic expression can rebuild confidence where broken, heal what was shattered, and return to others, their autonomy through decision making in their own art. On the other hand, painting with another person has provided a new appreciation and awareness of the often overlooked, unseen, unheard part of a narrative. Who ever thought that a series of simple abstract art-making sessions could so profoundly influence and alter the fundamental way in which I approach interpersonal interactions and serve my future patients?

So pick up a brush and make a choice—silver or gold?