Practicing Medicine, Practicing Art

By Jeffrey Donahoe

For as long as medicine has been practiced, physicians have turned to the arts for inspiration. Georgetown Medicine spoke with three alumni who find a new sense of self, improved clinical skills, and the joy of discovery through the art they create.

Rupa and the April Fishes.
Rupa and the April Fishes.

Border Crossing

If anyone was born to embody the worlds of medicine and art, it is Rupa Marya (M’02), an associate professor of internal medicine and hospitalist at UC San Francisco, and composer and lead singer of her global roots band Rupa and the April Fishes.

Marya’s mother comes from a long line of artists and was set to be a concert pianist before her arranged marriage. And the lineage of Marya’s father? “More doctors,” she says.

Rupa Marya (M’02)Rupa Marya (M’02)

Marya grew up in the San Francisco area with extended time in France and India. Her parents encouraged her interests in music and theater. But as she reached adulthood, they didn’t understand when she announced that she wanted to pursue music professionally as well as becoming a doctor. (Her two undergraduate degrees from UC San Diego are in theater, and in biochemistry and cell biology.)

“They didn’t see music and medicine as complementary,” Marya says. “But, historically, music has been a healing experience, so being a doctor and an artist makes total sense to me.”

After a post-undergraduate gap year of odd jobs and writing and performing music in San Francisco, she started medical school at Georgetown. Washington gave her opportunities to perform, but when the time came for the medical board exams, “I had to put my guitar under my bed for a while,” she says. The demands on a third- and fourth-year medical education left no room for music.

But Marya knew that, after singing since she was 5, she didn’t want music to become solely an after-hours hobby.

“I was kind of tortured about music and medicine,” she says. “I knew I was both. My friends gave me lots of advice. It was conflicting, of course.”

Watch music videos from Rupa and the April Fishes.

Marya took a year off between her internship and residency to attend a program on making audio documentaries. “That experience helped me be a better clinician and diagnostician,” she says. “It taught me the art of interviewing, to listen, to hear how people talk.”

Returning to UCSF for her residency, she pushed for a longer program that was two months practicing medicine and two months off. This gave her the time to be serious about performing and writing. In 2008, she joined the faculty of UCSF’s division of hospital medicine, negotiating the time commitment she has today— working 60 percent of full time, so that she can continue to write and perform professionally.

She formed Rupa and the April Fishes as a street band in 2006. Like Marya’s life in music and medicine, her compositions and the band’s sound defy traditional boundaries. They mix musical vocabularies, evoking jazz and gypsy music, French chansons, and flavors of Marya’s Punjabi heritage, among other influences. The lyrics’ languages—English, French, Hindi, and Spanish—reflect the band’s respect and appreciation for the world’s rich cultural diversity and encourages audiences to deepen their own understanding of other cultures.

Some of her song ideas draw from her patients. “Medicine is an unusual opportunity to be close to people’s fears, dreams, and hopes,” at a particularly vulnerable moment in their lives, she notes. “It’s impossible not to be affected by that.”

Today, Marya is working on a new album, Growing Upward. The title subtly references the natural elements which spark Marya’s activism around the interrelation of the environment and health equity. Her medical research focuses on the health outcomes of racism and law enforcement violence.

Marya says that one of the best kernels of wisdom she received came from infectious disease specialist Harry Hollander, also at UCSF, who counseled her on her unusual career path. “Bind to your fear,” he told her.

“It means, be okay with not knowing,” she says.

“In medicine, there is so much attempt to know. But the mysteries of human life and the body are unknown and unknowable,” she says. “In art, you’re also sitting in the unknown.”

Stephen Madigan with cast members in Shakespeare’s Richard III at Stage Company in 2015.
Stephen Madigan, who has been in a wheelchair most of his life, rehearsed with cast members in Shakespeare’s Richard III at Portland Stage Company in 2015.

Radiologist Drawn to New Role

This winter, after his long work days end, radiologist Stephen Madigan (M’80) is still reading— carefully, thoughtfully, searching for all that exists beneath the surface of what the eye can see.

Sometimes it’s a late night reading radiology images, but more often Madigan has been poring over a dramatic script, learning lines and inhabiting Robert Louis Stevenson’s iconic characters Dr. Jekyll and Mr. Hyde. Madigan played both roles in April in a new theatrical production of the novel at Footlights Theatre in Falmouth, Maine, where he lives and has his practice.

Dr. Jekyll and Mr. Hyde is only the second play in which Madigan has performed. The first was in downtown Portland, Maine, in 2015, when he played the title role in Shakespeare’s Richard III at Studio Theater at Portland Stage. Madigan came to the production with no theatrical background or training— an amateur alongside professionals, a doctor among artists. And playing one of Shakespeare’s most debated and difficult roles, no less.

Madigan says that Richard III director Sally Wood took a huge chance on him.

Before she cast him, Wood talked with Madigan for 90 minutes without hearing him recite a single line. “What struck me first was his passion for the project,” she recalls. “The main thing a good actor needs is enthusiasm for the project and Stephen had that in spades.”

His fellow actors might have been a little nervous when he joined the production, Madigan admits, but he turned the challenge into an opportunity. “I explained why I was drawn to the role and that I wanted their input and help.” Over rehearsals, they grew and learned together.

“I love actors,” Madigan happily says. “Theater people only care about who you are as a person, what you are working at, what you are doing.”

Dr. Jekyll and Mr. Hyde director Michael Tobin remembered Madigan from the three-week run of Richard III and encouraged him to audition.

Asked if he enjoys acting, Madigan points to the intensity of the craft. “‘Fun’ isn’t a word that I would use for acting. I’m really into the moments on stage, so I can’t later remember more than little wisps. A friend who saw me as Richard said ‘He’s coming right out of you.’”

Madigan’s two turns as an actor are perhaps even more noteworthy because he has been in a wheelchair since 1975, when an auto accident left him paralyzed from the waist down. Madigan recalls waking up in intensive care the morning after the accident: “They told me straight that I’d be paralyzed.” He spent nearly seven months hospitalized. Family, music, and films got him through it.

Before the accident, he spent a few years floundering as an operating room assistant while trying unsuccessfully to get into medical school. The applications weren’t going anywhere, and neither was he. From his hospital bed, Madigan recommitted to applying to medical schools.

In all aspects his life, Madigan refuses to let his disability get in the way of what he wants to achieve. “I don’t think of myself as a man in a wheelchair. It’s just the way it is.”

His list of his achievements is long and inspiring. He’s drag raced at one of New England’s most challenging speedways, studied with a horse whisperer, can pilot a training plane using top-gun maneuvers, and has sung in an opera. “I am fascinated by everything,” he says. “There’s so much to learn, so many things to know.”

On ordinary days, Madigan practices radiology from a specially built addition on his home that fully accommodates his wheelchair and the technical demands of digital radiology. While Madigan refuses to see barriers in his life, older buildings present challenges. The newer Footlights Theatre needed only to build a ramp over one step to be wheel chair-accessible for Madigan, vastly less work than was needed in the older theater where Richard III was performed.

In addition to his home radiology suite, Madigan has a hospital-based practice at Down East Community Hospital in Machias, Maine, but admits that the late nights there can make him less inclined to practice his lines once he gets home.

Madigan says that radiology and theater are separate worlds for him, which might make the evenings as an actor easier. “Radiology is demanding but you start and leave,” he says. “The advantage is that I can shift gears at night.”

“I’m fortunate. I’ve had a pretty rich life,” he says. “There are days when it is not easy, but you just push through. You keep going,” he says. “Keep pushing. Something good will come of it.”

Plastic surgeon and artist Saeed Marefat (M’85) at his home studio
Plastic surgeon and artist Saeed Marefat (M’85) at his home studio

Acts of Discovery

The light-red brick, streamlined home of plastic surgeon and artist Saeed Marefat (M’85) sits modestly on a quiet street in upper northwest D.C. But the house is also Marefat’s art studio, and wonders await behind the front door.

Inside, hallways have become galleries. Windowsills hold original sculptures. The basement is a large painting studio. A photo darkroom was once a small bathroom. There is no car in the garage; instead Marefat has turned the space into a sculpture studio. He’s cutting and welding metal, making a large multi-piece installation that will be part of a larger meditation on war and September 11.

Some paintings mix highly detailed realism with fantasy to interpret myths from Marefat’s native Iran. Nearby, he is completing a large canvas, building soft strokes of paint to capture the sorrow of an Afghani family devastated by war. A small sculpture of St. Ignatius waits for a final coat of paint before it can be given as an award from the Georgetown Clinical Society.

Marefat works on his art as much as he can on the weekends and sometimes after a day of work in his Falls Church, Virginia practice. It’s about priorities, he says. “I make time for art, no matter how busy I am. If I am not doing art, I don’t feel good.”

Marefat says that art and medicine are completely interrelated. “I’m a better painter and sculptor because I know more about anatomy. And I can apply techniques from sculpting to surgery,” he says, putting his thumbs and forefingers together to form a view finder. He holds them over a clay sculpture he made of the face of a young woman. “To build up the face, for it to be realistic, you must know the volume of the face, the fat and the muscles, the materials.”

His finger traces the outlines of the sculpture, then stops. “Art schools are paying less attention to anatomy,” he says with disapproval. “You have to know anatomy, no matter how you present the body.”

Marefat, now a U.S. citizen, grew up in Iran, and came to the U.S. at 18 for undergraduate studies at George Washington University. At GW, he continued his boyhood interests in drawing and painting as well as preparing for a medical career.

Entering medical school, he wanted to become a psychiatrist. But once at Georgetown, he fell in love with the human body. “When we started doing dissection, I knew I wanted to be a surgeon,” he says. “I already liked to draw, and somehow drawing and surgery melded into each other.”

Dr. John Little, a longtime Georgetown faculty member and plastic surgeon, had students sketch from live models to sharpen the eye for detail. “I just ate it up,” Marefat says. He now dedicates time to work with Georgetown students in the anatomy lab.

His current project is large: the metal sculpture of the New York skyline on September 11 and the large painting showing both sides of current strife. Together, they are his War Series. The works are products of his imagination, but also made of research into preliminary sources and materials. Anything can inform his art—whether a photo or a statistic.

Unfinished paintings, vying for attention at the easel, start to give the artist’s perspective. One is a cityscape of chaotic motion, American camouflage, and smoke. The next, a quiet open courtyard of mourners.

He’s not political, he insists. He’s an artist.

“I have a curiosity to discover, to learn,” he says. “That act of discovery is what makes art and science so alike.”