The Humanities in Medicine

It is no doubt that we are all unique in the experiences that we have had and in the outlooks that we hold about life. We each are on different pages of our personal stories. The page that we are currently on is only a small part of the myriad of situations, places, relationships, and memories that influence who we are. At the core of the Humanities, lies understanding this intricate nature of the human being and making sense of its seemingly unmanageable complexity. Thus, the very essence of this field focuses on becoming aware of the many factors that affect how a human thinks, acts, and feels. These factors are ones that intermix and are conditioned by the world that surrounds us. For this reason, “storying and restorying ourselves, and contributing to social stories around us, is as natural to being a person as breathing” (Bolton, 2008). Since medicine and health concern the health and conditions of the human being, there is a great need for addressing these same factors that the Humanities emphasizes. In fact, its integration with medicine offers a way in which we can grapple with health issues while truly fostering an understanding as well as an effective evaluation of the page we are allowed to read of an individual’s narrative.

The integration of medicine and the humanities, now termed Medical Humanities, did not develop without controversy and hesitation. The Medical Humanities took on its contemporary form in a religious setting in the United States during the 1960s (Martignoni et al., 2012). It was introduced as a way of humanizing medicine at a time when there was a dramatic increase of machines at patient bedsides and a techno-revolution that emphasized rigid categories and traditional methods of thinking. Over time, the Medical Humanities has strived to push past the idea of simply challenging this narrow view of healthcare. By highlighting the fact that “illness occurs in the context of an individual life filled with imagination, belief, feelings: subjectivities shape meaning for that patient,” advocates of Medical Humanities have been able to highlight the importance of the Humanities within medicine (Macnaughton, 2011). Central to this belief, is the importance of realizing that not every person is the same and that we cannot understand variety from subjective experiences. What the Humanities brings to this difficult task is a way of thinking that accepts individuality and allows us to empathetically approach the depth and range of the integral parts of the human experience. A productive engagement between the humanities and medicine requires understanding what each field can contribute and how the two rely on one another rather than simply fine tune each other. It also presents a model where both scientists and humanists can form a “community of interpreters, across disciplines, willing to learn from each other” (Davis & Morris, 2007). This community cultivates an environment for meaningful dialogue and progress in multiple fields.

So, what can the humanities truly and practically contribute to the field of medicine? This can be best illustrated using an example. All researchers are required to use racial categories when forming their experiments. The typical way in which they would determined race was by having individuals report their race according to the United States census categories. This method, according to humanists, is not only extremely simplistic but also very misrepresentative. They believe that their expertise in the area of race, which they have studied for more than fifty years, could have enriched the experiment that the researchers were conducting (Clayton, Davis, Metzl, Wald, & Hausman, 2009). Their contribution could have improved research protocols and eventually the outcomes of the entire experiment. Taking into consideration the humanistic approach could have introduced an even bigger question of what race even means and how it contributes to the idea of identity. From this example, we can see how the Humanities and its knowledge of subjects such as race, gender, social conditions that affect health, and history of the body in society can contribute and even improve aspects of medical research and practice. The contribution that the Humanities provides is one that moves past simply breathing a finer spirit into medicine, but rather one that creates a respectful and progressive form of interdisciplinary communication. Within this relationship, there is mutual influence that occurs between the disciplines, rather than one field commenting on the other’s practices and studies.

Another way that the Humanities contributes to medicine is in the compelling vision of human nature that it provides. This vision is one that goes beyond observations and findings that can be documented as testable facts. It is one that is “informed by philosophy, illustrated and explored in literature and other creative arts, and assumed by the empirical ethnographic and qualitative methods of social science” (Macnaughton, 2011). Medicine has tried to measure subjective elements such as emotion and imagination, but it has failed to do so in a manner that is objective and useful. On the other hand, the Humanities has collected a vast amount of knowledge on a variety of subjects and can provide a framework for which these elements can be addressed. Artists, poets, and thinkers seem so far from the medical field, yet they are far closer than one may imagine. Themes such as sickness, treatment, life, and death reoccur in many humanistic works, and they may provide the missing link for difficult subjects in the world of medicine and patient care. For this reason, the Humanities can introduce a new way of thinking about different subjects. This new method of thinking can eventually provide the immunity that doctors need from a mindset that is restrictive and relies on sameness.

Skills that humanists have such as “awareness of difference, recognition of forms of symbolic representation, and ability to analyze unfamiliar speech” can be useful to adopt and infuse in the medical field (Clayton et al., 2009). Additionally, the methods of the humanities can help scientists better comprehend the way science circulates in the realms of culture and society and even the language that is needed to produce successful publications and policy statements. Such cooperation favors a way of thinking that is open-minded and interdisciplinary in nature that strives to prevent a reductiveness stemming from an ignorance of the knowledge that another discipline possesses. Even within the process of writing, there are abundant elements that can produce doctors who possess the ability to critically evaluate and effectively understand a patient’s unique narrative. Reflective writing, for example, can allow a doctor to “focus on meaning as well as emotion, explore ambiguity, uncertainty and complexity as well as strive for theoretical lucidity” (Bolton, 2008). This creates professionals that can look further into the meaning of different beliefs, values, thoughts, and identity in a variety of contexts such as the political and cultural spheres.

Writing, although usually seen as a subject strictly within the Humanities, has values in the medical field that are abundant. For the art of medicine itself is an art that is literary; a physician must be able to empathize in a particular way and listen in a special way that allows him to understand what it is like for the patient to be lying their and telling their story. The physician must understand and connect with not only the story but the storyteller himself. For this reason, writing and similar subjects within the Humanities can provide ways for those in the medical field to explore beyond their perceived boundaries of perception and understanding. It can also allow for students to study, in depth, questions like, ‘what is medicine truly for?’ ‘how should it truly be practiced?’ or ‘who are my patients as individuals?’. Within the exploration of these questions, students are able to harness the ability to listen more carefully and engage more critically with habitual matters that are sometimes overlooked. Integrating the Humanities into the rhetoric of medicine while “tackling the joyous but utterly messy and uncertain complexity of these professions can help us avoid hearing the story but missing the plot” (Bolton, 2008).

As we have seen, understanding medical narratives through a humanistic lens can provide many benefits and solutions. Writing, as a reflective exercise, is only one element of Medical Humanities that can empower physicians with more tools for better care. Of the most important influences in medicine that the Humanities encompasses are culture as well as psychology. These two elements infused within the field of Medical Humanities, allow for a new interdisciplinary approach to patient care through reintegration of the mind, body, and spirit. In this way, Medical Humanities strives to focus on a view that sees the patient as well as the clinician as whole persons rather two characters in completely different plots. Understanding the influences of culture and psychology can open up new opportunities for understanding the social determinants of health and the intricate relationship between the mind and the body. In analyzing the influences of culture and psychology on patient care, students as well as practicing physicians can begin to think differently about how medicine is practiced and what the human side of treatment truly looks like.

Syrian Refugee engaging in reflective writing (Turkey, 2014)