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)

Purification of the Soul

I’ll never forget the first day of Tazkiyeh class. Our teacher brother Imran Salha said something that stuck with me throughout all the classes to come. He said, “Don’t make your goal of this class to simply share what you learn or to impress others—focus on yourself”. Focus on yourself. These three words I believe, are the core of Tazkiyeh which rely on self-awareness, self-observation, and self-criticism. In this way, tazkiyeh is purification of the soul for the sake of Allah (swt) alone. There is beauty that is felt when things are done for Allah (swt) alone, for what better audience is there for a good deed than the Master of the Universe, the Creator of all creation? When the action is done for Allah (swt) alone, it’s benefits can be infinite. Not only will you be rewarded from the Most High, but you will take off the shackles that chain you to the dunya. When you make Allah your main concern and you chase His pleasure, you will find the dunya chasing YOU. You will become rich, not in money, not in praise, but rich in the tranquility of your soul. For this is the true richness. And when you are rich, you are the one that gives because your supply is the infinite blessing of Allah (swt).

One of these blessings given to us is the gift of prayer: where our hearts are higher than our minds in elevation and our intentions are to please the One who’s in control of all our affairs. The way brother Iman taught this portion of the class on prayer really touched me and inspired me to look at prayer in a different way. He explained to us that salah removes the external and shows us our true relationship with Allah. Prayer was instructed to our Prophet in the heavens and for this reason it is divine and its essence is so lofty that it could not merely be given in this world. It’s establishment breaks arrogance, breaks rebellion, and when perfectly executed, it will break loving of the self and replace it with loving the Creator of the self. A practical application to our concentration in prayer is like that of a litmus test. The amount of concentration you put into prayer is a testament and an indicator for your love of Allah (swt). Do you rush to prayer? Do you pray during the most favored times? Do you imagine it to be your last prayer, with the Angel of Death behind your back? These are things I learned to ask myself. Remembrance of Allah is the polish for the heart. It is no doubt that our hearts may get rusty and our trials may make us forgetful, but the answer to all our worries lies in remembrance of our true purpose here on Earth: to know Allah. To know Allah during ease and to know Allah during hardship. Indeed knowing Him is the guidance from darkness into light—a paradise in this world and the next.

Finding the Courage

I’m not a poet

or a spoken word artist

Sometimes my voice shakes

and my words fall out of place

But sometimes I find the courage,

to look injustice in the face

When the silence is so loud 

and all that’s said is to please the crowds

When the news that’s presented “BREAKING”

is only breaking the hearts of those who's story its faking

When everything is painted black and white and anything in-between isn’t given its right

You find yourself searching

Searching for a way to give the voiceless a voice

The choice-less a choice

and the oppressed…a moment of peace in which to rejoice  

I’m not a poet 

or a spoken word artist

Sometimes my voice shakes

and my words fall out of place

But sometimes I find the courage, 

to look injustice in the face

When you see images of children drawing tanks and towers 

instead of houses and flowers

Childhoods scarred in a world that bombards, 

With nothing but sheer dis-regard 

Left as orphans to live alone, not knowing again the meaning of “home”

You wonder what you can do from countries away 

For such children living in eternal dismay

Fighting for dignity and liberty

Palestine and Syria, alone face an enemy

An enemy called ignorance and inequality 

An enemy with no regard for innocent souls 

Who's only goals were freedom with no controls

No limitation and segregation 

No checkpoints and humiliations

No violence…just peace throughout their nations 

I’m not a poet 

or a spoken word artist

Sometimes my voice shakes

and my words fall out of place

But sometimes I find the courage, 

to look injustice in the face

I find the courage to pick up my pen

Write until the ink runs out 

Till I’ve shattered all my doubts

I find the courage to put it on paper

To put it in words, to present “maybe later”

And in that scrambled paper and wrinkled page

I realized that the world is our stage

A place of liberation from our cage

Into a world where we are united and represented

Not disconnected and reinvented 

I used to say Somebody should do something about that

Then I realized I am somebody…

I may not be a poet or a spoken word artist

My voice may shake and my words may fall out of place

But sometimes I find the courage, 

to look injustice in the face

My Touch

From a distance, you may have made out this art piece to be a simple image of a fingerprint, but as you look closer you will notice that the fingerprint is created from sentences, phrases, quotes and words. This piece that I created over the course of two weeks is entitled “My Touch” for many reasons. While searching for things to paint or draw, we often look around the room or outside at nature for inspiration. For this art piece, I realized that art can also be seen within. We are walking and talking pieces of art. And although we are all different, we are all the same in that we are all human. Your hand looks like mine, your fingers look like mine, but your fingerprint and “your touch” are what make you unique. There is beauty in realizing that just because we are different, does not mean we are not the same. Our differences unite us rather than separate us, and our uniqueness only strengthens us.

Many of the quotes you will find in the fingerprint are ones that have touched me either intellectually or spiritually. Together, my art piece is like a mirror. It not only mirrors my physical fingerprint, as I actually used my real fingerprint as the blueprint, but it also mirrors the things I identify with. We are all comprised of many things that make us whole. In this sense, the many words on the page come together to represent and reflect pieces of myself. Like an onion, you can travel through the image in different levels. First you can see the fingerprint image, then the distinct lines, and then the many phrases that make it up. Being a representational image painted with media ink, I was really able to experiment and finally get the perfect interplay of words and overall image. My fingerprint is my story and so is yours. It tells of your experiences, where you've been, what you've touched, and who you are. So take a second and look at your fingerprint, no one else in the world is like you. So leave your touch.

Real Tears of Joy

Tears streamed down his face as he slipped on the new pair of shoes he was handed. One foot in his old, torn shoe and one foot now in a new, black and shiny dress shoe. I had never seen tears of joy so real before. I looked at his old tattered shoe he was still wearing on his left foot—ripped at the edges with mud on the sides. I could tell they had been through so much. I could tell he had been through so much. How I wished I could be in his shoes instead of only being able to hand him new ones. How I wished I could fill the emptiness in his soul as he placed the soles of his feet into their new home. His home, though, he can’t call it a home anymore. He is a Syrian refugee now living in Turkey. I had the honor of teaching children like him during the summer this year. I noticed though that his tears were not filled with the woes of past misfortunes. They were filled with hope for a new journey. And he did not need more than one pair for that. I learned a lot from this boy. True blessings are not the materialistic things we adorn, but the feelings of gratitude that touch our hearts when we remember how much we have been given. Walk a mile in someone else’s shoes. Count your blessings. Clichés that become so real when you see real tears of joy.

In Nizip, Turkey Summer Camp for Syrian Refugees

Light upon Light

No corner of the cosmos existing except with His light that illuminates

Closer to man than his jugular vein

Guiding him to a path away from the darkness and away from the pain

Light Upon Light

Our Creator exists eternally

His illumination, from the Infinite, perpetually flowing

His Essence infuses the universe with guidance

Showing man the correct path, living a life of true balance

Light Upon Light

Like nothing in all the universe

Allah’s guidance reaches the hearts of true believers

His eternal radiance polishing the mind and the soul

promising mankind a Paradise of bliss and much much more

To guide us along the way

He gave us the Quran here to stay

Purifying our souls and cleansing them

like a plant that grows from seed to stem

Blossoming out of the soil, widening the heart

Splitting darkness and light, far apart.

A gift from the Creator, up above

Showing Mercy, forgiveness, and beautiful love

A healer of pain, a book to cheer hearts

The book that feels the tears in your eyes

and testifies of your readings to the Most High

Food for the mind

its words so intelligent and so wise

A jewel and a treasure brought down from the skies

Revealed to our Prophet, peace and blessings be upon him

A sacred treasure, a luminating jem.

Our source of guidance to the only source of Light

Our friend until the end, when no one else is in sight.

Except our Beloved Creator, may we be worthy of this sight.

Nuroun 3ala Nour.

Light Upon Light.

“O Allah we ask You from You of Your most illuminating Light, to grant us this most beautiful delight”

Ameen.

Illuminating Potential

Based off "The Allegory of the Cave" in Plato's Republic

As we grow and mature in the world we live in, we begin to learn more about our personal fears, hopes, and beliefs. We begin to mold a self-concept of who we think we are. This self-concept is a composite of ideas and attitudes that a person has about his or her own identity. Factors such as the values and opinions of others, however, can play a significant role in the shaping of this self-concept. Although this compound of ideas that we believe is true about ourselves can be one that is admirable, it can also be one that diminishes the light of true self-actualization. Instead of a person becoming more of who they already are, a self-concept can be a chain that merely traps a person in a state of longing to become something they hope they are, while at the same time fearing they are not truly that person they are striving to be. Concepts like these that are conceived in the mind usually represent abstract ideas generalized from mental perceptions about life. Who you truly are does not stem from these abstract and general ideas; however, it stems from something not conceived in your mind. Who you truly are rather stems from something deeper and more real and that is from the depth of your being, your soul.

Recognizing and being in tune with the true essence of our being is what can lead us to self-actualization and the true illumination of our potential. If we live our lives based off a false or generalized concept of who we wish we were, we will never truly realize the things we are capable of overcoming and becoming; we will be shackled in a mindset of false illusions and desires. We will find ourselves in a cave of false hopes, beliefs, and perceptions. Like the cumulative image of the Cave that Plato illustrates in The Republic, we will be trapped in our own misconceptions of reality. The Allegory of the Cave presented in Book VII helps us understand this concept further as it illustrates what is truly preventing us from being enlightened and from attaining true knowledge of ourselves and the world around us.

Through Socrates, we are able to visualize and understand the multi-faceted meanings from the Cave metaphor. These can be seen in the beginning with the presence of prisoners that are chained within the cave; they are bound to the floor and are unable to turn their heads to see what goes on behind them (514a-15a; 516a-c). Behind the prisoners, under the protection of the parapet, lie the puppeteers that create the shadows on the walls that the prisoners perceive as being reality. Since the prisoners are incapable of turning around, they are thus incapable of realizing that the realities they are witnessing are merely shadows created from wooden and iron objects. And so, through the allegory at this point, we can conclude that the prisoners have “names” for only things they can fathom with their minds and not things they are actually able to see.

This inability to see things for what they truly are is one of the major shackles that causes the prisoners to remain in their dwelling of darkness. The shadows cast by the puppets are those that keep the prisoners preoccupied with cultural myths and assumptions. In an unjust society these things can be prejudices, stereotypes, and other false conceptions that hinder members of society from seeing the truth about themselves or those around them. These false concepts are what hold back individuals from realizing their full potential; they conversely influence individuals into forming self-concepts that are not based on reality but rather on ideals and standards unjustly made. If these cultural shackles are not questioned or removed, they will continue to blind the prisoners from the truth of self-fulfillment that can only be achieved when the shackles are removed and one can witness the reality that is not a mere shadow of cultural presuppositions.

This ascent towards understanding the truth about one’s self and reality is not an easy task. Plato describes the vision of the real truth to be "aching" to the eyes of the prisoners, and that after seeing that which is truly real, a previous dweller of the cave would need some time to adjust to his new world above (516a-b). What allows the prisoner to free himself from his shackles and foolishness is the process of acquiring a certain type of education. This education is not obtained through simply putting knowledge into empty minds, but rather through making people realize that which they already know. Thus, the process of reaching enlightenment and self-actualization is not a process of creating one’s self but a process of discovering one’s self. Here we can again see the distinction between a self-concept and reality. If one is blinded about the reality of himself due to cultural assumptions or the opinions of others, he will never truly match his reality with his self-concept. This will ultimately shackle him in the cave and prevent him from illuminating his true potential.

Just like sight cannot be put into blind eyes, knowledge cannot simply be placed into souls that lack it; it requires awareness of one’s own self and understanding. Learning can only occur then when an individual frees himself from the chains that bind him, turns around towards the light, and learns to accept things as they are rather than as one perceives them to be. This learning can be marked and seen when those that achieve enlightenment can see their former chains. They no longer view these chains as being transparent, and the things that previously shackled them become noticeable. This is because the soul has become illuminated and the enlightened person has achieved true self-actualization where he understands the true essence of his being. When we realize that who we are is not the collection of abstract ideas that we have conjured in our minds and we comprehend that "the capacity to learn and the organ with which to do so are present in every person's soul" (518c), we can then begin to ascend from the shadows of our perceptions into the true awareness of our existence.

An allegory, like the Allegory of the Cave, is a representation of abstract meanings through symbolism to illustrate a truth or a moral. Being like an incomplete simile, it requires that the reader supply what is similar to the events described. For this reason, when one reads the Allegory of the Cave, he can make connections to his own life that may be different than the connections others make. These many connections that readers can establish do not take away from the elements of the allegory, but rather enforce them. Everyone must find his or her own path to self-actualization, and although the road may be tedious and difficult, it will always provide illumination to those who reach their full potential and understand reality as it truly is. No matter how strong one’s shackles were or how difficult it was to ascend into that understanding that is based on truth, the destination will yield similar results. Some may take longer than others and some may reach different answers, but no matter how shadowed their previous beliefs were, it is still possible for them to conquer the path to enlightenment.

Those who have been liberated from the cave have achieved the highest level of knowledge that comes with understanding. The contrasts formulated between the shadows, the reflections, and the actual objects are clues to discerning the different levels of enlightenment that can be attained. For example, the shadows reflected in the cave can be a wide variety of disagreements and opinions that individuals have about a certain truth. This can be how others view you or interpret your behavior. In order to “see” the real version of yourself, you must attain reliable knowledge that guides you towards a truth that is not blurred and a truth that is not changing. This truth is not always something that can be seen in your outward behavior and conduct because it stems from an intelligible source rather than a visible source—the soul. True understanding of your soul and the essence of your being is what can de-mystify the shackles that you may be blinded from; with this realization you can enter the world of thought and leave the world of only senses and wavering shadows.

The Allegory of the Cave represents a complex model of how we journey in our lives towards understanding ourselves and reality. The progress of thought, introspection, and human development is what can guide our souls to true self-actualization. Our path to complete awareness will require that we drop created self-concepts that are shadowed and adopt truths about ourselves that are based on reality. In many instances in our lives we may find ourselves placed in situations where we are challenged to stand in the integrity of our soul and who we truly are. But as we accept the reality of our essence, we may find that the opinions of others will affect us less and less. We may discover that through accepting who we are, we are able to relieve ourselves of shackles imposed on us by others; we may find our finally unveiled truths ultimately guiding us from the Cave to illuminated potential.