Warrior Monk Conversations 011: Art, Medicine, and Humanizing Healthcare with Dr. Iva Fattorini
Updated: Jul 2, 2020
In this episode, I talk to Dr. Iva Fattorini about the therapeutic power of the arts and using it to address emotional needs of patients and their families. She also shares about her experience growing up during the Balkans War in Croatia, how her parents influenced her and how she is doing the same to her daughters by teaching them about human values.
Dr. Iva Fattorini, completed her dermatology residency and masters in Croatia, and undertook an international training program at Harvard University. From 2004-2015 she worked in executive roles at the Cleveland Clinic, in the USA and in Abu Dhabi, UAE.
She founded Artocene in 2014 and Artocene Digital in 2018 with a vision to activate the latent therapeutic power of the arts on a global level with the highest professional standards.
To know more about Artocene, redirect here: www.artocene.com
Intro and Outro Music: Hearts on Fire by Immersive Music
Read more about the Warrior Monk mission here: www.thewarriormonk.com
The repository of Warrior Monk Conversations podcast episodes are found here: www.thewarriormonk.me
Warrior Monk Conversations 011: Art, Medicine, and Humanizing Healthcare with Dr. Iva Fattorini
Welcome to Warrior Monk Conversations, a treasure trove of inspirational discussions in personal and professional development.
I am Poonacha Machaiah. Join me on this journey where I have immersive conversations with the most thought-provoking leaders and everyday heroes from our communities to inspire, educate, and empower you to build resilience and reach your highest potential. Join me on this mission to create a positive societal shift to the compassionate transformation of humankind.
Dr. Iva Fattorini completed her Dermatology Residency and Masters in Croatia and undertook an International Training program at Harvard University.
From 2004 to 2015, she worked in executive roles at Cleveland Clinic, in USA and in Abu Dhabi. Strongly driven by her vision to enrich the care and hospital experience, she founded the Arts and Medicine Institute at Cleveland Clinic in 2008. Under her leadership, first as Executive Director and then as a Chair, the Institute has grown and has become the integral part of the culture of one of the best and largest hospitals in the U.S. The Institute has set up a new paradigm and standards in the area of arts and medicine. She founded Artocene in 2014 and Artocene Digital in 2018, with a vision to activate the latent therapeutic power of the arts on a global level with the highest professional standards.
Poonacha: Hey, Iva! Good to connect with you, and it's been a while. I guess our journey started in India, Cleveland Clinic. I'm here in San Diego, and you're in Oxford. And, so it's good to connect. Good to have you on my podcast.
Iva: Thank you for having me on the podcast, and it's wonderful to reconnect. Thank you, Poonacha.
Poonacha: So jumping right in, I think I wanted to---I guess we were talking about your passion, and I guess ever since I've known you, it's about art and healthcare, and your personal journey, how you got into art and healthcare, and then where you see it going in the world and your vision for the world.
Iva: Wonderful. Simple questions, Poonacha. Thank you! (both laugh) Thank you for actually asking me that. Because to me, having arts was always a form of expression. It was very intrinsic for me. As a child, I was trying to express my emotions through images. I love visual arts. I was playing guitar as a child. So it was always speaking some other language, and it's allowing us to say the unsayable. So fast forward, when I turned 18, I wanted to do either art school or medical school. Where I grew up, in communism, there were not as many options as people have today. You have, like a very, like basic fundamental things that you have to decide which direction in life you're going to take. I was too afraid to do arts. I didn't know that it can be a job that will allow you to pay the bills, you know. It was not encouraged. Any form of creativity and imagination, I say, was not so encouraged. But I think, that being said, every environment that suppresses people actually creates rebellion.
Iva: And then, through the suffering and kind of rebellious behavior, you develop this desire to express it even more creatively, and, you know, very often, we have fantastic artists in the areas where it was suppressed. So, anyway, I ended up being a doctor. I spent my life in medicine. I've been in medicine, healthcare for 27 years, and on that journey, being a doctor, being a patient myself, on three different continents, and then also, being administrator, health administrator for the last 15 years, there was one thing in common. And that was that addressing human emotions was not professionalized in healthcare, not in a way that we should approach it. There are multiple people who are trying to help people in their emotional journey, but it's not about whether we want to do it or not wanting to do it, it's about do we have time to see, to tell people how much we actually care for them.
And as a doctor, you realized, I was booked probably every 20 minutes for like six months in a row, and in that time, you don't have even---you don't have time to ask people how you were doing. Nevertheless, allowing them to express themselves through some different modality. So, when I was working at the Cleveland Clinic, I was working a lot with international patients and out-of-town patients, and then, I realized I was trying to help them to cope with what they were going through. And then, that particular institution is surrounded with other arts institutions, and I realized, while we are addressing their issues, you know, related to their body, we don't have really a system in place to help them to express themselves and, you know, try to redirect their thoughts and give them something else to do. And then I was exploring what can be done, and I didn't know. I was very determined to do something about it because, you know,
Poonacha: I think ‘determined’ is your middle name.
Iva: Oh, thank you. (both chuckle)
Poonacha: Ever since I've known you, I think determination is something you are the poster child for. So, yeah, keep, sorry, keep going.
Iva: Yeah, I'm sorry. I'm just kind of expanding now too much in the---but it was, into,
Iva: It's such an important question. I just think, Poonacha, at one point, I realized how much our emotional---our state of mind impacts our outcomes, whether it is clinical outcomes, or anything we measure in healthcare can be super, like, very profoundly impacted by how we actually feel about it.
Poonacha: I remember you telling me that, you know, it's not just the patient, it's people who came to take care of the patients, the---who really got tired getting sick, and that became one of your, I would say, core focus areas, right? People who were taking care, what do they do in the hospital? And it was fascinating for me because I never had ever looked at it in that way. Right? Somebody's going through cancer therapy, and people are spending three to six months in the hospital.
Iva: Yeah, a lot of people are going, whether you're talking about transplant patients, lung transplant, heart transplant, kidney transplant. Sometimes, they really, they spend months in the hospitals. There are a lot of chronic diseases, cancer patients, and dialysis patients. Dialysis can be 9-12 hours a week, you know, and it's a very long term condition. So, we forget the fact that there are, currently, as you and I speak, there are millions of people around the world who are in the hospital, and the hospital is home to them. And in addition to them, very often, their families are with them, and they’re spending a lot of time in the hospital.
Again, we need to come up with some service, with some solution, to this humongous amount of time that people are not doing anything meaningful. You know, in the hospital, you kind of realize that the time stops, for when you're a patient, people reset their priorities. Very quickly, what was important yesterday, all of a sudden, it doesn't have any importance today. It allows us to turn back to what is really, really, really important in life. And it boils down to, sometimes, ‘look at the---I wish I can see one more time a beautiful sunset,’ or ‘I wish I had gone to see this,’ I don't know, ‘exhibition,’ or ‘I wish I had a lunch with my son or daughter,’ or ‘I wish I had done this or that.’
And all of a sudden, these simple things that are actually related to beauty become very important. It’s as if we are ignoring the notion of beauty, no matter how we define it right now, when we rush through life, and we don't stop enough. So I saw this as an opportunity, Poonacha, to---the realizing that we are on halt, we are stopped by the disease, and we are facing this new shift of paradigms, and in that moment in between, if we infuse those moments with some beauty, through arts, we can actually change who we were before when we entered the hospital. We can become something else when we leave the hospital.
Poonacha: Beautiful. I want to break it down. There's a lot to unpack over here, right? So it's like, so you said beauty. I love what you said, addressing human emotions. That is so simple, yet so profound, so complex. How do you do it? Like, how does---what is the role of technology? How do you kind of capture the essence of human emotion? Because I think, in the world you live in today, especially in the medical world, it is really structured, a lot of it are metrics, and measurements, and hard proof, and science. How are you kind of dealing with addressing this human emotion, and quantifying it, and convincing the healthcare providers that this is truly moving the needle?
Iva: I think that healthcare providers are very aware that it's important. I don't think they need to be convinced of that. It's about creating the tool that will help them actually implement it. I think the health care providers all around the world are burning out to be able to provide basic care for patients. I think giving additional burden to them to, in addition to that, to, on the psychologist, you know, to address this emotional needs of the patients is too much. So, again, that's kind of answering your question. That's where we come in with professionals, such as art therapists, music therapists, and different forms of art programming, arts and health programming for the hospital. And this is now where technology comes in in a 21st century.
Poonacha: Right. Are there any examples of art programs? You can really give real use cases, and you can also use, obviously, the one in Cleveland Clinic, which I've seen personally. I'm like, ‘wow! Amazing!’ I thought I was going into a museum, not a hospital. But, are there any examples? You've done stuff even in Kochi, right? In Kerala. You had, like, an example.
Poonacha: So you have, it's not like the elite and the most, richest hospitals in the world can afford this, but you have examples across all strata of society. Can you walk me through some use cases and examples from your experience, you know, and deployments you want to showcase?
Iva: Art in health is a very broad definition, and that's to be clarified first. It encompasses all different forms of art. It's not just visual arts. It’s music, performing arts, creative writing, literature, poetry. And also, arts in health, per se, has education and research as a component, different lectures, etc. Induced in a large hospital system, what usually works is a combination of everything that I just said. The closer you get to the bedside, the more educated people need to be. So for example, art therapy or music therapy, those are board certified professionals in the United States. Those are trained professionals, who allow people to express their emotions through creativity. So it's a form of creative expression. It's almost like a psychotherapy process.
But instead of just using the words, people can use images. They can use collage. They can draw something guided by the professional. The deepest emotions we have are usually hard to reach with words only, and the therapist has this ability to use creative processes to reach fast the deep. So imagine a child waiting for the heart transplant for several weeks, eight-year old boy, being on a bedside, can't move, attached to the machines, being in a hospital, has very limited mobility, very limited creativity, so our therapists would come in, talk to the child, and through the process of talking first, guiding the child to express how they feel in that moment, what the fears are, you know, giving them a project to do, creation, the creation of enabling people to cope with the current situation, giving them empowerment to deal with suffering, is something in that moment that art therapist can do. Imagine patients who are terminal, and the cancer patients, for example, and they're, usually, they have nothing to do, and in this waiting time, we all we all have experience in that, but those patients usually know, you know, that it's coming sooner. Every morning when they wake up, they don't really know what to do. It's kind of a very hard place. The family comes to the room; they don't know what to talk about.
So what you do if you have this program, you can connect the person and the family to the art therapist. They can start working on a project together, going through the memories from the past, remembering nice things, putting this into the story, creating images, and at the end of the day, family gathers around the patient. They have legacy. They can create legacy together through the process of creation. And when the patient is no longer with the family, they have something to remember fondly, some beauty to remember.
Poonacha: Beautiful. You know, I was just watching a documentary last week. It was called Tuning the Brain with Music. And there’s an amazing---there's an art therapist, a music therapist, was basically working with a premature baby, and was basically going through a lot of pain, and it was amazing to watch when she started singing songs and playing on the guitar. Just the expressions of the baby, like, it was constantly changing. But more importantly, the mother was bei---actually said, “I need this more because this is the only time I really look forward to.” Because everybody comes in, they were like, ‘oh, my God, what happened?’ And an art therapist comes in, there's actually an uplifting thing which happens, right? And it's beautiful to see that.
So I want to go back, little bit switching gears over here. I was just reading that you were, you trained or attended classical gymnasium. (Iva laughs) So, tell me, walk me through, you know, with, what is Eva like? When Eva was, you know, a teenager, what were you thinking?
Iva: (laughingly) What kind of a question is that? (Poonacha laughs, too)
Poonacha: Classical gymnasium to MD, a dermatologist, and obviously, entrepreneur, but what is it like when you were in those days? What is it like growing up? You know. Walk me through those, and if you walk back in memory lane.
Iva: Yeah, the memory lane goes very---you know, it was a long time ago. Once upon a time, (both laugh) there lived a rebellious girl called Iva. I think I had a wonderful childhood. At the classical gymnasium where I grew up meant that we had old Greek and Latin. So I had Greek and Latin, and I think we had around maybe 48 different subjects. I had sociology, psychology, logic, philosophy. It was a very broad education. I loved it.
I was spending a lot of time in nature. To me, it was another way to kind of find a respite. So I was doing a lot of horseback riding. I loved animals and horses. And I don't know, I just tried to, instead of as a teenager, I remember, yes, I would go out, but instead of, very often, there was no clubbing at that time, but, you know, we would go to disco or, I don't know what the name was, dancing. That was nice.
But, you know, there were not many drugs, not that I was meeting with those problems. I don't know. It was more social. No, definitely, no digital platforms, no social media, so we were actually communicating and talking to each other. It's probably---what I remember fondly, improvising, creating toys from objects, not being able to buy a lot of toys, and talking, like, human-to-human connection was more profound.
Poonacha: Wonderful. So if you fast forward now, and, now, you have two beautiful daughters, who I know. What is that---when you look at them through the lens of Iva back in Croatia and now at Oxford, are there lessons that you say, ‘you know what? I really want to pass this on to them or I want them to know there's like horseback riding, nature’? What is it like being a mom? And when you look at the lens and they’re becoming teenagers soon, I guess.
Iva: But I think everything you learned, you want to give them the best you learned, right? It's another great question, Poonacha. You know, I can ask you back the same question. (Poonacha chuckles)
Poonacha: You know, I'm actually a mirror reflection because, you know, like I said, I have two boys. I'm going through the same thing, you know. Like, how, what do I do? I’ve done everything and
Iva: I think that the real learning in life is to extract the essence that different times and different circumstances are teaching us the same thing. So as long as we are able to extract the true meaning of certain events and dislocate it from particular time, that's the message we want to give to our kids. So we don't want to tell them, probably, ‘oh, you know what? We did not have phones.’ They don't care. Now, they have phones. Trying to create a timeless message and trying to give them something that whether they will be born in hundred years from now or, you know, or if it was happening 200 years ago, the message should be the same. It's about the values. It's about human values, something that transcends any time limitations or generations.
Iva: So I'm trying to avoid the language of, ‘you know, when I was your age? Then, we played on the street.’ You know, forget about it.
Poonacha: I know. That's like, that's not happening. That’s not connecting. They're like, they’re already forgotten about that. No, I want to kind of---yeah, thank you.
Iva: What do you mean? I mean, what are your thoughts? I have to ask you.
Poonacha: You know, we grew up in different times, you know. My dad was a retired---is a police officer, you know. I was as stringent, as strict, very different times. And I said a couple of things, you know. I really wanted to be a friend to my boys; also, knowing that I'm the dad, right? And there's a boundary, and it's kind of this very delicate dance between being a friend and being a father, being able to impart values yet not being, you know, dictatorial; but also, what I love, what you said is, the essence of human values about being human. My kids asked me, “Dad, what religion do you practice?”
And I keep telling them, there's only one sentence actually, is “do all the good you can, in all the ways you can, as long as you ever can, and if that becomes your compass, then I think you cannot go astray.” So I think for them, I’m really trying to impart this thing about being really a good human being, being kind. As boys, I tell them to be tender. Right?
Poonacha: I said, the world that they need to go in, it's not about ‘grown men don't cry.’ It's about, ‘how tender can you be?’ ‘How can you be tender in relationships?’ And I said, something I want them to take in, it's, you know, kind of really going against kind of the typical stereotypes of, you know, what a man is or what a boy is or what---I don't know. So I think these are lessons I've learned, and I hope to share; but once again, being, and aligned with what you're saying: human values, timeless. You know. Being kind is a timeless virtue.
Iva: There's one more thing, Poonacha, that also, that I think I hope I realized soon enough. You know, that love is---you know, how love is spelled.
Iva: T-I-M-E (Poonacha chuckles)
Iva: Love is time. It's really how much time we spend with our children. I don't think parents realize that, you know, at the beginning of their journey, and I think every parent should understand it. That's the language the kids speak; how much time you actually spend with them.
Poonacha: You know, it's actually, it’s also a very difficult thing, you know. Obviously, you know that I'm kind of, I'm living across two continents. You know, my wife and my younger son live in India, for practical reasons, because he loves India, and my oldest son lives in California with me because he loves golf. And this is something I think about every day. Like, you know, I feel like, ‘oh, my God, am I being a good father? I'm still over here,’ and like, ‘what can I do better?’ And like, I guess both of us, we do connect, and I said, "man, this is a frickin experiment." (both laugh) And I'm hoping for the best possible outcome.
Iva: No, absolutely. But I had to then clarify; I don't think you can do it all alike. I think, you know, I'm talking about the first few years of life, and, no, at least, I think that parent, the kids have to have at least one parent who is present. Usually, that's the mother, but, you know, they feel it. They feel it, and we can't. I was always a working mother, you know. You can't be with them all the time, and---but that time that you have with them, you want it to be high quality time.
Poonacha: So going, you know, I talked about you as determination, but I also know you as resilience. I know your father was a physician, had a hospital, right? Children's Hospital, if I'm not mistaken.
Iva: Yes. My father is a retired pediatric surgeon, and he was the CEO of the Children's Hospital in Zagreb, Croatia.
Poonacha: And I remember sitting down with you in Abu Dhabi, talking about the times of the Balkan Wars, and you said, one of the few places which were not bombed was the Children's Hospital. What was it like growing up in that period? And can you just walk me through, you know, were there moments which shaped who you are today? Were there moments which---what was your father like? Was he a big role model in you taking up medicine?
Iva: So the war thing was very impactful. I think I was very lucky because I survived. I think there were areas of former Croatia that were really severely affected. A lot of people died. In the city where the hospital is, I remember I was a student, and it's kind of several hills in that city. And then, I was in a hospital on one Hill, and when a grenade hits the city, it's very loud. You hear it all over, and because I was high on this hospital window, I could see the smoke coming from the region where---so it was grenaded. The city, the center of the capital of Croatia, which is full of civilians was grenaded, and several people were killed. And on the radio, because there were no mobile phones there, on radio, we heard that the Children's Hospital was actually hit.
Iva: In the first few hours, you really don't know. You can't leave the environment where you're at, and I just was waiting for them to call to see whether my father was still okay or not, and I think my---I tried to call, and there were only landlines, so I managed to reach my mom, and she said, "He’s okay. He just has a lot of dust." You know, there were just----because something near his office, something fell apart. It was a miracle that none of the kids were injured. And the weapons they were using was like bells. I don't even know the name of this, but when the grenade explodes, there are little kind of
Iva: It was not---it was just horrible. It was something that every single institution or organization should forbid to be used. But anyway, it was---every day we lived like that. You know, we would have lessons in the shelters. You would have a lesson, and all of a sudden, the air raid would go on; you go down to the shelter and continue the lesson. Very often, the hallways were full of wounded soldiers and wounded people. A lot of the doctors would go to the first line, to the front line. It was just like a parallel time. It was---and you realize in that moment that most of the world---it sounds harsh, but I'm going to say it. You realize that most of the world just doesn't care, and I think we are in the same situation now. We, you and I talked about hundreds and thousands of people being injured somewhere and---it's not that we don't care, it's just that you're not tuned to it. Because we read it---
Poonacha: We’re desensitized.
Iva: We read it as news from the newspaper. We don't understand. This is real, and it can happen to everyone, you know. Look what's happening now with coronavirus, you know. These things can happen anytime to anyone.
Poonacha: And this is going to bring out the best in humans or the worst in humans, right? We are actually going to see it today, and I see it already happening. All the people getting isolated, people almost thinking that, you know, you have leprosy or some kind of---and people literally saying hello with their elbows and, you know. That's like, that's crazy! You know, it's interesting how I just watch how society is even addressing and reacting to this. Anyway, sorry. Go ahead.
Iva: But you know why, Poonacha, because that's why we, you and I discussed, because the real human values were not instilled in them when they were children. If those values were there, then people would probably not see each other as enemies. They would see us as a big union. So that---the answer for my father, I don't know if I inherited interest in medicine from him. I was always, as a child, reading his medical encyclopedias. I was very interested in that. So maybe there was this kind of inspiration. I think I was---I have both my mom and father, thank God, still alive, and they're both my models.
Iva: I think, hard work, ethics, very, extremely modest and honest people, very hard working. So I'm very grateful that I have had parents like them.
Poonacha: Beautiful. So fast forward and going into Artocene, can you just walk me through your latest passion project, transcending now from, you know, an MD, being in a very executive in the largest hospital groups, you know, being an entrepreneur, and starting Artocene?
Poonacha: What is it like?
Iva: Artocene. So I'm building a digital platform that will allow people to express themselves through creativity. So it's a form of a telehealth augmented by creative art tools. And the first thing we're going to start is working with art therapists. I think it's very exciting because, you know, current technology is allowing people to do telehealth through articulating their problems. I think that we are going to tackle the mental health epidemic. And there are amazing tools existing right now, but we want to add our unique value which's going to be actually adding everything I learned, that we learned, in area of arts and health, to use art as a form of expression, to allow people to say the unsayable, and to give voice to the voiceless.
Poonacha: Absolutely. I'm going to add the link to your website on the page. So I want to kind of, I guess we have a few minutes, I want to kind of maybe, kind of circle back to a couple of questions for you. As a woman entrepreneur, you know, being a doctor, being a mother, what advice do you have to women entrepreneurs who are getting into or doing startups and things like that? What's your---any thoughts you want to share?
Iva: I think that they need to be ready for thorough planning before they jump on any executive decision. I think that a lot of information is online now. They need to get as much advice as possible. And if they want to do the work-life balance, there is no such thing. There is just work-life integration.
Poonacha: Absolutely. And who came up with that particular concept needs to be, you know, readjusted was
Iva: It's a work-life integration, and I think we need to be grateful that we have the ability to connect remotely now, to give---to have flexibility. Trying to work in regular hours, it's impossible. So I think, take care of yourself, you know, of your own health and give yourself time. I think for women entrepreneurs, just give yourself time. Don't try to compete with those who don't have obligations towards children and logistics, you know, and all that. It's always fine. Have in mind, you're doing probably three or four jobs at the same time. And be gentle to yourself.
Poonacha: So in closing, when you look at the future of AR, VR, mixed reality technology, what is---if you were a fortune-teller, and you're looking into this world, what do you see the future world with, for art and healthcare, look like?
Iva: I think that people in the future will communicate more through images and sound vibration than through words. I think that there is something, if you take art as a form of energy, it will boil down to energy, frequency, vibration. And I think art is trying to tell us that there is other way how we can communicate and upgrade our levels of consciousness.
Poonacha: Beautiful. I think Artocene will probably usher in a new era of energy medicine. And I believe, I think when I listen to an artist play, I'm transformed. There's no time---there's timelessness. Right? There's richness of experience, time for literally what we call the flow moment. So, Iva, once again, I'm really grateful and love talking to you.
We can go on for hours catching up, but I want to just conclude by saying that, you know, what you said today really struck a chord which is, you know, being human, right? It's about really sharing values and bringing your core of your being and sharing it with your amazing work, with art. And I'm wishing you the very best. And obviously, I'll be working very closely, watching your journey, as you unfold Artocene as a digital platform. I think the world needs it. And I think we are, at this time, I think we are going to hit an all-time high and an all-time low when it comes to social beings. And I think, I believe that platforms like Artocene and art therapy, music therapy, all the different visual arts or performing arts have to come together to heal. So thank you for everything you do.
Iva: Thank you, Poonacha, and I hope you'll become Artocenenian very soon. (Poonacha chuckles)
Poonacha: I already am. Thank you. Talk to you soon. Have a wonderful afternoon, evening. Good bye.
Iva: Thank you, Poonacha. Good bye.
Imagine a world where no one ever feels helpless or hopeless. Join me on the Warrior Monk mission to create a positive shift through the compassionate transformation of humankind.
Warrior Monk Conversations 011: Art, Medicine, and Humanizing Healthcare with Dr. Iva Fattorini