IJCS | Volume 31, Nº4, July / August 2018

DOI: 10.5935/2359-4802.20180029 451 VIEWPOINT International Journal of Cardiovascular Sciences. 2018;31(4)451-453 Mailing Address: Ana Luisa Rocha Mallet Rua Almirante Alexandrino, 1808/SS-302. Postal Code: 20241-263, Santa Teresa, RJ - Brazil. E-mail: alr.mallet@gmail.com Cardiology and Films: An Important Teaching Tool Ana Luisa Rocha Mallet, 1,2 Fatima Geovanini, 2 Luciana Andrade, 2 David Kestenberg 2 Hospital Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ); 1 Rio de Janeiro, RJ - Brazil Universidade Estácio de Sá, 2 Rio de Janeiro, RJ - Brazil Manuscript received 11/12/2017, reviewed 12/18/2017, accepted 02/16/2018. Communication; Humans; Cardiovascular Diseases; Neoplasms; Physician Patient Relations; Prognosis; Truth Disclosure. Keywords The use of films and literary texts as didactic material in medical school has increased based on the perception that it might benefit the discussion of certain technical aspects of clinical conditions and enable students to experience the illness process. An article on literature and cardiology 1 has shown that the description of the death process in Tolstoy’s novel “The death of Ivan Ilyich” could be more powerful to provide medical students and physicians with the perception of the finitude process than reading theoretical texts about the end of life. Similarly, Marguerite Yourcenar’s “Memoirs of Hadrian” could help to understand the suffering of a patient with heart failure. Similarly to literature, films have been used for medical education to discuss questions relatedmainly to ethics and medical practice. Some films, such as “Patch Adams”, “Cry Danger”, “The Sea Inside”, “Black Swan”, “As Good as it Gets”, “Wit”, are classically presented to medical students for medical education. If on the one hand, by telling a story and showing an image, films can reduce our ability to imagine how the story’s characters and places would be, on the other, they provide us with a different aesthetic experience, usually shorter than book reading, by offering images and sounds that affect our sensitivity in a different way than book reading does. Both literature and films allow us access to a level of internalization difficult to achieve when reading a medical book or text about a certain disease. Medical books provide the description of cells, organs and diseases, how to establish a diagnosis, in addition to the drugs and other treatments to be used, while literature and films provide us with the experience of patients with their illnesses. Regarding cardiology, the year 2016 was particularly interesting, because two awarded films, “Manchester by the Sea” and “I, Daniel Blake”, approached under different aspects one of the most prevalent heart conditions worldwide: heart failure. Kenneth Lonergan’s “Manchester by the Sea” was awarded with the 2017 Oscar for best actor in a leading role (Casey Affleck) and best original screenplay. Its central plot is the return of a man to his hometown after the death of his brother to take care of his 16-year-old nephew, re-opening an unspeakable tragedy. The film scene that interests us, due to its potential to foster a cardiology class discussion, lasts less than three minutes and approaches the disclosure of his brother’s heart failure diagnosis to the patient and his family (wife, brother and father) by a female doctor during one of his hospitalizations. The doctor talks with the patient about his diagnosis and prognosis, explaining that the data presented were statistics and not definitive numbers about a particular patient. The scene raises ethical and technical questions, such as possible heart failure etiologies, its treatment, its mechanisms of death, its prognosis. In addition, that scene provides us with the different ways to react to such talk, always difficult, especially the patient’s and his wife’s reactions. Talks involving the disclosure of the diagnosis and prognosis of life-threatening diseases, also known as bad news, are one of the most difficult attributions of a doctor. Bad news in the healthcare field are any information that will drastically affect the future perspective of patients and families. Difficulties in communicating bad news usually postpone discussions with the patients and families about terminal diseases,