Position: Associate Professor, Department of Internal Medicine, Yale University School of Medicine
Clinical Scholar: 1999–2001, University of California at Los Angeles School of Medicine
Research Project: English and Spanish Health Information on the Internet; Capturing Patients' Perspectives through Video
Clinical Specialty: Internal Medicine
When Gretchen Kimberly Berland entered medical school in 1992, she assumed she would leave behind her first career as a television documentary producer.
"I didn't go to medical school to be a 'TV doctor,'" she says. But all of that changed during a psychiatry rotation in her third year of medical school at Oregon Health Sciences University in Portland. At a juvenile justice center, she and colleagues were assigned to interview incarcerated teens. "Where do you picture yourself in five years?" Berland asked one of them. "Dead" was the sobering answer.
"This led me to think that if you gave them a camera, you could see aspects of their world that you don't know and don't understand," she recalls. Berland got a small grant to give cameras to five teenagers outside the jail. They made a film that was broadcast on public access TV.
When Berland enrolled in her residency program at Washington University School of Medicine in St. Louis in 1996, she decided to try the same method. She gave cameras to a dozen of her colleagues who filmed a "video diary" of what happened while on call. The resulting half-hour film, called Cross-Cover, was later distributed to 150 residency programs nationwide for use as a teaching tool.
In 1999, Berland was accepted into the Robert Wood Johnson Foundation Clinical Scholars program. "It has allowed me to pursue an area of work that I would not do otherwise," she says, "presenting the patient's perspective using the visual medium. There is no other fellowship that allowed me to do that."
Berland's first research project under the Clinical Scholars program was a traditional one—studying the accuracy of medical information on the Internet. Her second project came to her serendipitously, and would mark her as "nontraditional."
She was attending a medical conference when she noticed a participant using an electronic scooter. "I watched her for a few days, and wondered, 'what is her life like?'" Berland recalls. "Could I conduct a qualitative study and use a camera to explore the life of a person who had to use a wheelchair?"
Berland gave small video cameras to three people who navigate the world in wheelchairs. The footage they produced was so powerful that it became clear that it should be more than an accompaniment to a research paper. The film, Rolling, may soon air on PBS.
Berland continues to use film in her research, and she has plans for films about women wounded in Iraq and about the lives of poor people in Waterbury, Conn.
"Understanding the patient's perspective, particularly in the context outside of the clinical arena, is an essential, though often overlooked, component of the doctor-patient relationship," she says. "I'm not sure a picture is worth a thousand words, but there are times when the visual medium can have a power and inform us in ways that other methods of inquiry don't."