The JEFFLINE Forum is pleased to present a new series on medical humanities, by Emilie S. Passow, Ph.D., Visiting Faculty of Medical Humanities, Thomas Jefferson University.
Part 1: A Very Short History of Medical Humanities
With the creation of a Department of Humanities in the newly established Pennsylvania State University’s College of Medicine (1967), the interdisciplinary field of medical humanities was launched. The goal: to incorporate perspectives from the study of humanities within medical education in order to nurture a humanistic practice of medicine, one which moves beyond disease and treatment as isolated bio-chemical phenomena, and instead focuses on the patient as a whole person and on illness and healing as experiences with deep social, emotional, spiritual, and ethical dimensions.
Since then, more than half of the 125 medical schools in the USA include some aspect of the study of humanities in their undergraduate and graduate training, ranging in format from full fledged institutes/centers and departments, elective and required courses or seminars, to lecture series, reading groups, and writing workshops.
Evident in the very topic as well as content of the October 2003 issue of Academic Medicine, "The Humanities and Medicine: Reports of 41 US, Canadian and International Programs," the value of medical humanities is becoming widely recognized and promoted. The field has become so rich that New York University Medical School maintains a very extensive, evolving website for medical humanities resources and programs (see below).
The relationship between medicine and the humanities is hardly new. Our empirical knowledge of anatomy, for example, is rooted in the work of the Renaissance painters, most notably Leonardo Da Vinci, who dissected cadavers in order to capture the form and movement of the human body as accurately as possible.
The Hippocratic oath is one of the oldest professional codes grounded in ethical, as distinct from exclusively technical /procedural guidelines, addressing as it does, personal and social motives as well as consequences of medical practice; and the subjects of illness and healing, suffering, death, and love have been dominant themes of literature, art, and music since the beginning of human creativity.
Note, for example The Book of Ruth and the Book of Job in Hebrew Scriptures, the important role of Jesus as healer in Christian Scriptures, the depictions of suffering, death and dying among the earliest artifacts, and the cross-cultural prevalence of music to accompany burials as well as other life-cycle events.
As Western notions of progress and efficiency increasingly have affected every aspect of modern life, this intimate connection between medicine and humanism, medicine and spirituality has been diminished.
To be sure, the 20th century shift away from an understanding of medicine as a humanistic endeavor is the product of many historical influences; to identify just a few with very broad strokes: the rise of the hospital as a primary site for care of the sick and dying; scientific explanations and validations of the etiology of disease; the general separation of scientific disciplines from the liberal arts, culminating in what C.P. Snow famously, or infamously, described as “two cultures”; and all the complex socio-economic, cultural, and philosophical factors embedded in these trends.
Most recent influences on this split have been the expansion of pharmacological efficacy in controlling mental as well as physical illness and far reaching technological inventions. With their help, we are now able both to diagnosis and treat previously fatal diseases, to detect incipient death, and to forestall its arrival. New reproductive technologies allow us not only to sustain life, but even to generate it.
Paradoxically, such increasingly sophisticated technologies and medications have made a deeper, more probing understanding of illness and healing all the more urgent. While helpful in so many ways, these radical innovations have seduced us into reductive, flattened perceptions of suffering as pain, of medicine as a primarily impersonal, scientific enterprise, and of well being as synonymous with physical fitness.
Technology and the sciences, after all, have proven insufficient to address the profound issues of identity and meaning-perhaps the broadest definition of spirituality- which illness and healing inevitably raise, especially given the increasing range and duration of chronic and terminal illness. Moreover, the power of the mind/body/spirit connection and the physician’s engagement in the process of healing remains a mysterious one.
Future installments in this series will explore general implications for the training of physicians, examine the history and current status of medical humanities at Jefferson, and discuss goals for further development.
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