Literature and Medicine

4fc Literature and Medicine Lawrence J. Schneiderman And glutted now with learning's golden gifts, He surfeits upon cursed necromancy. Nothing so sweet as magic is to him, Which he prefers before his chief est bliss. —Christopher Marlowe, The Tragical History of Doctor Faustus The very word startled me when I first heard it in medical school. Literature. The professors were referring to those tedious journal articles they made us scurry after as literature. For one who had sipped sherry in Gothic rooms whilst pondering Homer, Tolstoy, Proust, Joyce, et al., such barbarity was tantamount to child abuse. I am afraid my standards have slipped since those precious days. I use the word myself now when I want to send medical students scurrying, although I like to think I would as happily see them scamper back with the Kansas Quarterly, say, as with the New England Journal of Medicine. Isn't this, after all, how we once regarded the ideal physician— nurtured by both the Humanities and the Sciences? We hardly remember, now that technology and specialization have overwhelmed the humanistic tradition of medicine—and philosophy, music, and history, for that matter. But perhaps we are beginning to experience a kind of microrenaissance . Not only a few perceptive individuals, but national commissions, are urging us to revive the humanities. Once again, it is up-to-date to be old-fashioned. (When I want to tease my "young Turk" colleagues, I accuse them of being back in the Age of Molecular Biology.) As with any renaissance, the process involves rediscovery. We are discovering things we never should have forgotten—that the practice of medicine is not limited to the repair of mechanical flaws. Physicians deal with that larger, more elusive subject, the human condition. By training, if not by instinct, scientists follow Occam's Law, seeking the simplest explanation to a scientific mystery. As anyone who has Literature and Medicine 1 (Rev. ed., 1992) 40^1 © 1992 by The Johns Hopkins University Press Lawrence J. Schneiderman 41 grown up on the great writers will tell you, simple answers to human mysteries are likely to be wrong. It is a commonplace that literature teaches the meaning of life. I believe it does more. Like science, literature is a way of perceiving. Great literature re-creates our world with the intense imagery of metaphor. Literature leaps where the scientific method treads circumspectly. Literature constructs the most profound truths out of selected data and delirious imaginings. I know scientists who are appalled to think that people actually believe that stuff. And yet, great writers do make us believe, using the marvelous powers of language to construct towers and flying machines from which we view earthbound knowledge. They provide unexpected contexts, wild perspectives, allowing us to see better, yet paradoxically to look at such obvious contrasts as health and illness and wonder which is which. Great literature reveals the voluptuousness of disease, the illumination of pain, the generative force of death—the obverse sides of medicine's nemeses. I'm convinced that human beings have a need—perhaps a biologic need—to believe in magic. Even blatant falsehood. At its most grandiose, this leads to religion and tragedy; at its most pathetic, to fad diets and quack cancer cures. But the need is unquenchable; the truths of science will never slake it. It is in this chasm of paradox that some of the greatest literature takes root. And it is here—as well as into the well-lit laboratory —that physicians must peer. ...