A Medical Student's Perspective...
This is a guest post written by Wan Ting Yew, a first year in pre-clinical medicine at University College Dublin. Wan Ting recently undertook a summer project to work on the data collected at Mind Reading: Mental Health and the Written Word, a one day conference at the DLR LexIcon Library in collaboration with Dr Elizabeth Barrett and UCD Child & Adolescent Psychiatry, and the Diseases of Modern Life project.
Hello everyone, this is my very first time writing a blog and it’s a pleasure to write about my take on a medical humanities event as a medical student.
In late June, I had the opportunity to attend a medical humanities event because of a summer project on the role of literature in medicine that I have been undertaking at University College Dublin. So here I’ll be talking about how I’ve learned new perspectives about medicine and doctors after this taster session of the medical humanities. Mind you, the field (despite it being called medical humanities) was very alien to me: I did not even know the difference between theology and philosophy, so you can imagine how awkward I felt during group conversations and how much of the talks simply washed over me. ’ If you’re still reading thus far, you have my heartfelt gratitude. Now, on to the real stuff.
On Tuesday, 27th June, the TORCH Medical Humanities programme at Oxford hosted an event called Accounts of Illness in Historical and Modern Texts: Exploring Methods in Medical Humanities Research across Disciplines. The organiser of the event, Professor Katherine Southwood (Theology, University of Oxford), gave the welcome address, during which she provided a summarized framework of the event in three simple words: Illness, Methods, Texts.
The talks started with a physician speaker, Dr Jeff Aronson from the Nuffield Department of Primary Care Health, University of Oxford. His talk was about autopathography: written works about the author’s own experiences of illness. He outlined the different forms that illness narratives have taken over the course of time: from paper to the web. He also talked about the underlying themes embedded in these written narratives, which include denial, misattribution of causes and somatisation; I found these important to keep in mind when listening to patient complaints. Then he explained why people write autopathographies, why we should read them and the limitations of such pathographies. Next, Catherine Kelsey who is a nurse lecturer from University of Bradford, further explored potential applications of illness narratives, not only to gain insight into patient life but also to use that insight to develop meaningful skills and treatment approaches. These talks reminded me of the sociology lectures I’ve attended in the past, in which the lecturer has repeatedly mentioned the need to shift the focus of healthcare from the biomedical model to a more humanistic one, in other words, to see the patient beyond the accumulation of bodily symptoms and consider their illness within the context of everyday life. The reasons and causes behind this loss of compassion in clinicians are for another conversation albeit an interesting one. Reading patient memoirs though, does seem like a nice solution. Knowing the patient’s story itself is certainly more powerful than simply being aware that there is a story. Although patient memoirs cannot replace the objective list of a patient history, they are a way to prevent the hustle of clinical work from corroding our sense of compassion. I understand if this sounds very superficial, heck I’ve only finished my first year in pre-clinical medicine so what would I know about compassion fatigue. But what I do know as a medical student is how tempting it is to start cutting corners when the workload is piling up and you start feeling tired from the stress.
Three of the talks were close readings of specific literature. All three speakers were from the University of Oxford: Professor Elizabeth Hsu, an anthropologist walked us through China’s medical case records from 2nd century BC; Professor Olivia Vázquez-Medina, a fellow and tutor in Spanish, explained the inner workings of the Sylvia Molloy’s book Desarticulaciones (2010), a carer’s auto-fictional account of Alzheimer’s disease; Dr Lisa Mullen from the Department of English Language and Literature guided us in unravelling key passages of a patient memoir titled In Gratitude by Jenny Diski. The methodologies of the speakers’ research were too unfamiliar for me to comprehend, but the general idea I appreciated was the importance of considering the culture where the author lived as well as the author’s life story, as this knowledge allows us to accurately understand the narratives they present and what matters to sick people the most. For example, the ‘heart’ can have entirely different meanings and functions in Chinese and English medical texts. Next, it was interesting to learn about the process of recovery from the patients’ point of view. Dr Hannah Newton, a historian from the University of Reading, spoke about her research on this topic. She taught us that the joy of recovering from illness is largely associated with the bodily senses and this is intertwined with abatement of emotional distress. Her talk focuses on what bothers people suffering from illness the most: sleep, appetite, and nausea. I found this a very meaningful way to reframe my mind set when considering a person’s recovery from illness. Having healed from a sprained ankle doesn’t just mean someone can walk again, it also means that they don’t have to constantly jolt awake from sleep when they turn the wrong way in bed.
Furthermore, there were also speakers who contemplated the role of medicine in society; that concepts of “compassion” and “professionalism” are more malleable than we think and how this malleability impedes moral healthcare. The introduction of the talk was very arresting so I started off feeling very enthusiastic. Sadly however, I could not keep up with the pace and unfamiliarity of the content so by the time the talk ended I can’t help but feel exasperated for missing out on an experience of a lifetime!
Furthermore, Dr Anna McFarlane from Glasgow University used science fiction as a way to critically evaluate what medicine can and cannot do. Her case study of Mary Shelley’s-“Frankenstein” allowed us to explore the controversial topic of medical ethics in terms of human reproduction within the safe confines of ‘fiction’. Delving deeper, Anna showed how Shelley’s personal experience of family deaths and miscarriages lead to such themes in her written works. As a student who used to think that hobbies and studies should be completely separate, it is certainly enlightening to appreciate how much benefit fiction can offer us other than a simple escape from reality: to contemplate the seemingly unthinkable and as windows into people’s lives.
During the day, there was a very provocative discussion among the speakers and attendees about the nature of interdisciplinarity and its use in medicine. Given that there were people from a variety of disciplines: theology, anthropology, medicine, IT, language literature etc., it should be less likely that no such conversation arose. It was interesting to see the conversation unveil how much overlap there is between the research in different disciplines. Medical humanities is notoriously difficult to define as a field or a practice but at the end of the day it doesn’t really matter. Someone also pointed out that subject hierarchy has to be abolished to improve the development of knowledge and for interdisciplinary conversation to be real. Despite my inexpertise in the humanities, I can definitely relate to this as a student; ever since I started school the academic culture is that students who do well in their studies naturally progress to specialize in the sciences, whereas the ‘underperformers’ can only end up in the arts stream. This gives a false and dangerous image of the arts as being impractical and of little value. I could never manage a business course with the amount of accounting and languages they do, and I am definitely not athletic or artistic enough to pursue a career in the arts (both performance and visual) so why the heck should I have the higher stature in people’s views? In my opinion, this stigma prevents us from being open-minded as it makes us blind to the unique values of others and apprehensive to venture outside of our own specialized field. As we reached the end of the conversation, Professor Southwood pointed out something that I think is inherently important for every student and scholar: breaking the borders of each discipline to welcome interdisciplinary conversation would also require us to admit that we are not entirely unique in our academic endeavours, which might be very difficult to accept.
Overall, I found that the humanities subjects are about exploring different layers of a story. I found this very refreshing as I’ve always felt that scientific medicine tends to get too caught up in mechanical efficiency. Yes, both have their merits; though when it comes to providing healthcare, the humanities still have a lot to offer since we are, obviously, human. Of course this experience wouldn’t do anything for my end-of-semester exam grades (at least for the programme I am enrolled in), but it’s one of the rare experiences that make me see a deeper layer of meaning in the bits and pieces of everyday life.
Post-script on the less medical realizations:
Even though I’ve been told by many people that every profession has an irreplaceable value, I’ve only meaningfully appreciated importance of the humanities and its contributions from the bottom of my heart after hearing about the actual work behind the published articles. What I realized as I let these thoughts stew is: we can only genuinely respect something when we know about it, not of it, because that would be too superficial and the more accurate word for it would be ‘politeness’ instead of respect.
--Wan Ting Yew