Medical Humanities and Contemporary Literary Practices

Dr. Prasenjit Das

Dept. of English, K.K.Handique State Open University
[email protected]

Introduction:

Medical Humanities, as defined by Medical Humanities Community of the New York University School of Medicine, refers to an interdisciplinary field of humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theatre, film, and visual arts) and their application to medical education and practice. It needs no mentioning that courses on Medical Humanities are becoming very popular in the American universities like Harvard, Yale, New York; and also in South East Asian universities like Peking University of China, and University of Hong Kong. One of the most important objectives of introducing Humanities courses to medical curricula is to improve the relationship between the doctors and the patients. Besides, these world ranking institutions perhaps made this point clear that awareness on creative discourses on health and treatment can only be generated through a kind of interdisciplinary literature which justifies the idea that a certain kind of literature is actually written for the world and is relevant to the world in which we live. This is because, unlike the other disciplines, Humanities and Arts provide important insights into the human experience, condition, suffering, personality, responsibility to each other, besides offering a historico-cultural perspective on medical practices. Attention to literature and the arts became an important aspect in Medical Humanities as it started developing and nurturingthe skills of observation, analysis, empathy and self-reflection—qualities which are most essential in providing a humane medical care.

So, the emergence of the discourse of Medical Humanities as a particular mode of scholarship in the developed countries has inaugurated much discussion on health and diseases. It is because, literature notonly generates awareness about health care and treatment but also exposespersonal biases which may directly affect medical practices. Besides, some also believe that literature can enable the doctors or the frontline workers to think critically and empathically about the issues involved in their practices with the patients. In the United States as well as in Europe, the emergence of Reading Groups in various universities to discuss the growing interdisciplinary field of Medical Humanities and the inclusion of compulsory courses on literature and medicine among all types of health care practitioners in all stages of their career, make this point clear. Introduction of literary texts to medical curriculum and training has further enabled the learners to listen warmly to their patients, as the multiple perspectives in the texts selected for their studies have the potential to help them deal with the different types of responses coming out of the patients during treatment. But serious discussions of Medical Humanities arestill not evenly distributed across the globe although the term has gained much significance in critical debates of recent times. In the Non Western countries awareness on Medical Humanities seems to be only occasionaland it is only recently that Medical Humanities has been introduced into the undergraduate Medical Curriculum in India. Whereas the fact is that an interdisciplinary understanding of health and illness, role of medicine, the body and narrative, material culture and the arts, disability andhealthcare, ethics and pedagogy and the emergent global challenges can positively impact the ways of living in the days to come.

Placing Medical Humanities in Literary Studies:

What exactly is Medical Humanities and what trajectories and contours would be the most appropriate to build connection between Humanities in general and Medical Humanities in particular. Humanities, since the medieval times, has already been used to enhance our understanding on illness and healing, besides foregrounding the meaning and possibilities of human existence/experience, and has mostly been concerned with describing experiences from the individual to the global on multiple scales. But in its most recent developments, Medical Humanities engages itself with constructive criticism of the experiences of illness as well as transformation of the individual through treatment. The recent developments help to discuss how madness, anxiety, psychological disorders, trauma and sufferings of different types have informed literary works in an unprecedented way. Appreciating and interpreting the experiences of medical and health care practitioners in the study of films, literatures, music, visual arts and also philosophy as well as other cultural discourses and productions, Medical Humanities has been increasingly visible in the recent decades.

In addition to analysing the varied assumptions, the methods and models of medical education, research and practice, Medical Humanitiesalso aims at explaining the complexities and nuances of clinical experiences across the world. The literary practices of patients; health care providers including the physicians, doctors, nurses, social workers etc; and also the non-professional care givers like family members, friends, relatives and neighbours, who assume primary and secondary care giving responsibilities, have been instrumental in popularising the ideas of this trend. So, improving human health andproviding better health care more effectively depends on appreciating the very experiences of illness and suffering as opposed to focussing exclusively on the symptoms, treatment and taste results of disease etc. Thus, Medical Humanities has much to offer in this regard by extending our views, making us better thinkers and more sensitive individuals.One of the most important additions to Medical Humanities is the emergence of narrative medicine which talks about recognising, interpreting and being moved by the stories that both doctors and patients tell about their experiences.In this regard, Rita Charon’s Narrative Medicine: Honoring the Stories of Illness is an important reference where the author opines that narrative medicine emerged as a response to a ‘commodified’ health care system that places corporate and bureaucratic concerns over the actual needs of the patient.

Different literary practices have in fact exposed the health care professionals as well as the common readers to the varieties of the available approaches towards illness. It is important to note that in many places and contexts, specific scholarship on literature and medicine, and training in narrative medicine continue to draw entirely from specific previous literary works like Ken Kesey’s One Flew Over the Cucko’s Nest (1962) that serves as a study of institutional processes, a critique of behaviourism and a tribute to individualistic principles. However, recent publications like Kamran Nazeer’s Send in the Idiots(2007)which deals with autism, or Antonio Lobo Antunes’ The Land at the End of the World(2012) that describes the experiences of the suffering people by an army doctor sent to Angola during the Portuguese Colonial War.Such narratives promote understanding of how different societies grapple with diseases and illness, trauma and suffering. Even in a third world country like India, where many people are forced to face the atrocities of life due to illness, suffering and ethnic violence in many impoverished places, Medical Humanities, besides health care, can explain the ways to deal with them in a more appealing way. Thus, new researches in the Humanities, or Medical Humanities to be more specific,should pose additional questions about the varied and multifaceted experiences of modern humans, uncovering new meaning of illness and suffering in artistic works, the very constructedness of being ill or being a ‘patient’, finding new ways to understand cultural interactionsbetween the care givers and the ill in the society we live in and so on.

The Problems in Contemporary Literary Studies: 

Allan Beveridge in his “The Benefits of Reading Literature” provides an interesting discussion on if literature has anything to offer the physicians. He argues that until recently exposure to the humanities was believed to have only deepenedone’s understanding of suffering and illness. For instance, many clinicians wrote essays, novels and poetry, and so many writersembraced medical themes. In the 18thcentury, the ScottishdoctorTobias Smollettearned fame through The Adventuresof Roderick Random (1748) and The Expedition of Humphry Clinker (1771).The Romantic poet John Keatstoo was a qualified doctor andLaurence Sterne made frequent references to medicine, health and sicknessin The Life and Opinions of Tristram Shandy, Gentleman (1759–69). Even in the 19thand early-20thcentury, authors like GeorgBuchner, Anton Chekhov, Arthur Conan Doyle, Mikhail Bulgakov, ArthurSchnitzler and William Carlos Williams among others also produced literary works with some medical themes. In the second half of the 20thcentury, the Scottish psychiatrist R. D.Laing drew inspiration from writers like William Blake, Dostoyevsky, Kafka, Beckettand Jean-Paul Sartre to construct his existential model of madness, and inthe latter part of his career, he also wrote poetry. Such examples show that instances of Medical Humanities can’t be seen as something very new to the contemporary world.

However, at some point, there did occur a rift between the Arts and medicine causing a loosening of the link between the ‘scientific’ and the ‘artistic.’Beveridge opines that the origins of the rift can be traced to the Enlightenment, which held that reason wouldalone solve the problems of humanity. Subsequently, the relationship began to falter again following World War I which caused the closure of liberal arts education to which doctors had previously been meaningfully exposed. The point that can be made here is that Literary Studies doesn’t seem to have recovered from this problem even today. However, an interdisciplinary literary practice can open up new areas of research and prepare us for the some real world issues. Besides, it may also encourage collaboration of writers and researchers on relevant medical issues for creating a more integrated experience of the affairs of the world. For example, meaningful communications between the doctors and patients is essential to effective care and relationships of trust—an area still not gaining much relevance in contemporary literary practices.

Jonathan Miller, way back in 1978 provided an interesting definition of illness which helps us to comprehend the very idea of falling ill from a narrative point of view. He stated, “Falling ill is not something that happens to us, it is a choice we make asa result of things happening to us. It is an action we take when we feelunacceptably odd. Obviously, there are times when this choice is taken out of the victim’s hands: he may be so overwhelmed by events that heplays no active part in what happens next and is brought to the doctor by friends or relatives, stricken and helpless. But this is rare. Most peoplewho fall ill have chosen to cast themselves in the role of patient. Viewing their unfortunate situation, they see themselves as sick people and beginto act differently.” (p 49) Therefore, much of the experiences of the ill persons need to be mediated by language, culture, expectation and the conventions of the clinical consultation. And this is very important because it reminds us that health, illness, well-being and suffering are aspects of experience which need to be narrativised.

From the reader’s/receiver’s view point then, Medical Humanities helps in addressing the human aspects of medicine from within disciplines like history, philosophy, sociology and literature. It also calls for the intersection of medicine and the arts; and the schooling of more insightful and compassionate care givers. The affairs of the 21st century have rendered an important impact on the phenomenon of World Literature following which many areas hitherto been excluded or left un-explored are sought to be discussed within the ambit of literature. However, as Hooker and Noonan have also stated, Medical Humanities is culturally limited by a pedagogical and scholarly emphasis on Western cultural artefacts, as well as on an unquestioned reliance upon concepts like ‘patient’, ‘illness’ and ‘experience.’ But no systematic attempt can be seen even within Contemporary World Literature which has neither addressed cultural difference as a central concern of Medical Humanities nor has it tried to felicitate the expansion of the Medical Humanities in the non-Western and/or non-Anglophone locations. Perhaps, this is one of the biggest challenges to be met by the literature scholars researching the discourse of Medical Humanities in a non western country like India.

Conclusion:

The Federation of Royal Colleges of Physicians of the UK also mentions that ‘Good communication’ can be the solution to many of the problems that might crop up during the actual treatment of illness and it involves listening to patients and respecting their views and beliefs, giving them the proper information they need, ensuring treatment and prognosis in a way they can understand, sharing information with patients’ partners, close relatives or care taker among others. Though all these are part of medical ethics so to say, it is language what distinguishes a doctor from a veterinary surgeon. The fact is that literature can actually shape important discussions on health care and medical treatment as is evident from certain international practices. However, in the local and regional contexts, world literary practices must try to further explore human’s abilities to listen, interpret and communicate, and contribute to sensitive appreciation of medical practices. But contemporary literature does not seem to have purposefully addressed the problems like trauma, suffering, slavery, environmental degradation, health, disease and disabilities which are the most difficult challenges of contemporary times. Moreover, despite all developments in medical sciences, diseases like HIV/AIDS, Malaria, TB or sudden outbreaks of Pandemics like the Covid 19, still continue to kill millions of people annually in the entire world. And here comes the relevance of analysing the ‘narratives’ under Medical Humanities for ensuring a better health care system.