Humanities and Medicine
Humanities and Medicine
By Steven C. Schlozman, M.D., and Nathalie Feldman, M.D.
The world of medicine is increasingly recognizing the importance of explicit attention to the humanities. After all, if medicine is devoted to making sense of what it means to be sick, then it is the job of the physician to tease out the nuanced spaces between wellness and disease. The study of the humanities is distinctively suited to this challenging task. Each person’s illness is unique because each individual is unique, and this means that accurate diagnosis is only part of the doctor’s job. A 78-year-old woman with pneumonia is not the same as an eighth-grader with the same condition. In fact, the 78-year-woman with pneumonia isn’t the same as the 78-year-old woman with the same infection in the next bed. People are wonderfully individualized, and the art of medicine rests in the doctor’s ability to keep in mind the science of common symptoms and at the same time to toggle from one person’s experience to another’s. As the famous physician Sir William Osler said to his students more than a hundred years ago, “To know the patient that has the disease is more important than to know the disease that the patient has.”
Each person has a story, and the critical skills inherent in the appraisal of the humanities is especially applicable to the appreciation of the individual. This is what makes the practice of medicine so daunting and rewarding. In “Ode on a Grecian Urn,” the romantic poet John Keats wrote that “Beauty is truth, truth beauty.” Each person’s story is central and beautiful, and these stories therefore retain their own, unique truth. It is only through attention to this beauty that the physician can best understand how to help a patient to heal. And Keats would know a thing or two about healing—he was also a physician.
These lofty ideas call for some more honed definitions. What do we mean when we refer to the humanities, especially with regard to the practice of medicine? Put simply, medical humanities focus on what it means, literally, to be human. To this end, physicians benefit from skilled attention to literature, poetry, philosophy, history, ethics, art, artistic performance, and even the social sciences. All of this begs an important and ironic question: If humanities are so important to the work of the physician, why is emphasis on the humanities a relatively new phenomenon in United States medical education?
To some extent, the answer is that emphasis on humanities has always been part of medicine. We already mentioned the physician-poet Keats, and the list of physician-writers and artists is much longer than most people realize. The playwright Chekov was a physician. So was the sculptor Francois Emile Camu. The enlightenment philosopher John Locke was a physician, and the award-winning writer Daniel Mason continues to practice medicine. Even George Miller, the wonderfully versatile Australian director and writer who brought us both Mad Max and Babe: Pig in the City, was trained and practiced as a physician. Doctors have long been drawn to the humanities, and for every famous physician-humanities figure, there are literally thousands of doctors who are focused, daily, on the humanities. The difference in medical education over the past few decades has been the explicit integration of the humanities into medical curricula and post-graduate training. This is for some very good reasons.
Studies continue to show that attention to the humanities helps physicians in all fields of medicine to increase their clinical skills and to decrease the increasingly present threat of burnout.
The Larner College of Medicine has multiple extra- and intra-curricular programs that emphasize the humanities. These include the annual StorySlam Rx, an engaging evening during which faculty, staff, and students share personal narratives related to health, wellness, and patient care. The Performing Arts Night showcases the talents of students and faculty, demonstrating the healing power of performance in expressing complex emotions and experiences. The Teaching Academy hosts faculty development conferences and Grand Rounds on humanities based on pedagogic principles, for example on the use of improv in medical education. Narrative medicine plays a crucial role within the longitudinal Professionalism, Communication, and Reflection course. This includes a “First Patient” experience on day one of medical school, focused on building active listening and reflective writing skills. Narrative Medicine is also featured in a fourth year global health elective, encouraging students to challenge their thinking and assumptions, and to appreciate and be curious about different cultures and perspectives. Art of Observation events, utilizing visits to the nearby Fleming Museum or local artist exhibits within the medical school itself, invite participants to sharpen their observational skills through art through visual cognitive strategies that cultivate critical thinking skills. In addition, the visual arts provide sociological and historical context to health and wellness that might otherwise be unexplored.
An elective on Graphic Medicine is also offered providing fourth year medical students with the opportunity to read a range of graphic novels to learn about psychiatric conditions and reflect on lived experiences through comics. There are activities where students are encouraged to draw their own comics, reflect on content, and consider the role of humanities in their overall learning. Larner even boasts its own literary journal, fittingly titled The Red Wheelbarrow in honor of a poem by William Carlos Williams, a pediatrician and one of the most famous poets of the 20th century. This journal provides a platform for students, staff, and faculty to express their reflections and experiences through poetry and visual art, further emphasizing the intersection of creativity and medicine.
Given the invaluable ways in which the arts and humanities contribute to the training and development of compassionate physicians and health care providers, our next step is to expand our current programming to include the entire university in the establishment of a Health Humanities Consortium.
We read and hear a lot these days of the increasing use and promise of technologies, such as artificial intelligence (AI), in medicine. The paradox remains, however, that the implementation of technology in medicine can only succeed if the technology itself is fueled by the kinds of inquiries that characterize the study of the humanities. By the same token, the humanities themselves will reflect the growth of technology in the art of healing. This is because technology in medicine and humanities in medicine are most useful when they focus on the experience of individual patients. This emphasis, after all, is at the very heart of what it means to be a doctor.
- Associate professor of psychiatry Steven C. Schlozman, M.D., is chief of the Division of Child and Adolescent Psychiatry and medical director of the Vermont Center for Children, Youth, and Families.
- Associate professor of obstetrics, gynecology, and reproductive medicine Nathalie Feldman, M.D., is director of the Learning Environment at the Larner College of Medicine.