Toward the Cultural Interpretation of Medicine

^Toward the Cultural Interpretation of Medicine Kathryn Montgomery Hunter The first volume of Literature and Medicine is frankly introductory. It bears the subtitle Toward a New Discipline and is packed with speculative and explanatory pieces about the conjunction of two apparently disparate kinds of knowledge.1 Was literature and medicine to be a scholarly discipline ? A movement to reform medical practice? A service teaching enterprise or a more imperial intellectual one? Were the two halves, the fields of literature and medicine, to be equally balanced? If not, which was to predominate and what would be the proportions of the imbalance? Could there be an intellectual synergy, a genuinely new discipline? Although in 1982 there were only three full-time professors of literature in American medical schools (and two of them had held their positions for less than five years), literature had not been entirely absent from the medical curriculum. Theologians and professors of religious studies, who played a major role as members of Ministers in Medical Education in founding the Society for Health and Human Values, often used literature in their medical-school lectures and électives, and a few physicians incorporated literature, particularly short fiction, in their assignments and talks to students and residents. This demographic state of affairs is reflected in a census of the authors in volume 1. There are twenty essays and an introduction: five by authors in religious studies, seven by physicians, nine by literature professors (including a poet who had held academic positions). Literature and medicine was not yet a discipline by prevailing academic standards. It was too friendly, too ill defined, too shapeless. It was energetic, hopeful, avocational, unprofessional . Nevertheless, the first volume oÃ- Literature and Medicine, as its subtitle suggests, is something of an outline of the directions that the enterprise, still in search of definition and legitimacy, might take. Half the essays are about the uses of literature in medicine, primarily the contribution that literature can make to medical education. A number of other essays concern medicine in literature, principally the clinical aspects of characLiterature and Medicine 10 (1991) 1-17 © 1991 by The Johns Hopkins University Press CULTURAL INTERPRETATION OF MEDICINE ters, themes, and plots. A final few essays look toward an interactive, unified discourse, a separable field of literature and medicine. These last essays concern literature or literary methods that are useful in clinical practice or contribute to a philosophy of medicine or, conversely, take up aspects of the theory and practice of medicine that enrich literary studies. Literature in Medicine Ten years ago, the field of literature and medicine was almost entirely occupied by the uses of literature in medical education—a more or less traditional liberal-arts undertaking, but in a strange, new place. Literature was seen as an effective way of enlarging medical students' experience, of sensitizing them to the human predicament of their patients and fellow practitioners. Not surprisingly, many of the opening essays in volume 1 enumerate the benefits that justify literature's presence in medical education —both formally in the curricula of medical schools and informally in the continuing education and the intellectual, perhaps spiritual, resuscitation of physicians. There are ten of these essays in all, some as brief as a page, all committed to an Enlightenment model of literature and literary study and to a materialist view of literature as a mirror of social reality. In her introduction to the volume, its editor, Kathryn Allen Rabuzzi, characterizes these essays as "theoretical," but they are not exactly that—not, at least, in the current sense of the word. She means that they do not address literature or literary issues but focus on the difficulties of medical education and practice; they point out the harmonies and affinities of literature and medicine and present a rationale for including literature in the physician's armamentarium. The authors of these ten essays on the uses of literature in medicine are more or less evenly distributed among three disciplines—four in religious studies, four in medicine, and two in literature. Essays by the religious-studies scholars are clustered in this category and reflect their pedagogical rather than their scholarly interests; they allude to poems and stories, but they are...