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Medics face the music

2006; BMJ; Volume: 332; Issue: 7549 Linguagem: Inglês

10.1136/bmj.332.7549.1099

0959-8138

Tiago Villanueva,

Empathy and Medical Education

One of the first things I was told when I entered medical school was to see the 1933 film A Cancao de Lisboa (The Lisbon Song). I didn't have to wait too long, for, just like The Sound of Music, it is regularly shown on national television in Portugal at Christmas. Now a stage musical adaptation of the film is running at Lisbon's Teatro Politeama and is pulling in crowds from all over the country. So what is its special appeal to doctors and medical students? The Lisbon Song is a story about Vasco, a medical student in Lisbon, who is about to graduate but fails his final examination, a viva. Vasco is supported by a couple of rich aunts living in the remote countryside and is unable to tell them about his failure. He instead says that he graduated, whereupon his aunts assume that Vasco will have started his own successful practice and decide to visit him in Lisbon.​Lisbon. Figure 1 Traditional: a still from the film And thus a single event unfolds into several parallel stories. Vasco tries all sorts of diversions, lies, and schemes to avoid having to show his practice to his aunts—for example, by taking them to the zoo. He is also a party animal, a lover of the good life and its pleasures rather than of his medical studies, and he vies with a classmate for the love of Alice, a tailor whose father cannot stand Vasco. Brought to the stage by Filipe La Feria, a well known Portuguese producer, director, and writer, the current production is spectacular, with magnificent scenery, and delightful singing and dancing. In the viva scene, a panel of three intimidating professors towers some 10 metres above the ground in their huge chairs to question Vasco, their height symbolising their superior and almost untouchable status in an era when there was more formality and ceremony attached to this never easy student ritual than there is today, with relatives, friends, and colleagues often present to watch the exam. Traditional Portuguese culture provides a constant backdrop, with scenes set in the old neighbourhoods of Lisbon, with their traditional stores, street parties, and Fado, the unique Portuguese melancholic music sung to a guitar accompaniment. For medical students and doctors alike, the show's portrayal of Portuguese academic traditions—such as medical students wearing typical ornate black overcoats still used today in all sorts of university related events—is likely to create a feeling of deja vu. In the end, Vasco's lie is uncovered, despite all his efforts, and his aunts turn their backs on him. However, he overcomes that setback, by resitting his exam before the same panel that had previously failed him and passing it impressively (and so becoming a doctor). The final question of his exam, “What is the name of the neck's main muscle involved in lateral flexion?” has become the stuff of legend in Portugal, and suprisingly most people in the country today know what the sternocleidomastoid is.​is. Figure 2 Bringing anatomy to the masses: a poster for the show Vasco also regains his love (for Alice, meanwhile, had fallen into his classmate's arms). He also wins back his aunts' respect. Perhaps the take-home message for the medic is that you can, with both commitment and luck playing their parts, have time for everything during medical school. Vasco might not, however, seem an appropriate role model today. The glitter, cheerfulness, and genuine Portuguese soul and spirit reflected in this show (and which wins out over the melancholy of Fado) brings an acclaimed work back to life. Were it performed in English, A Cancao de Lisboa might well deserve a slot on Broadway. As it is, anyone not familiar with the Lusophone pitch can follow the plot with the help of the small screen above the stage, which supplies a written summary of each act in English.