Why Not Medical Humanities?

My decision to study medical humanities evolved from an academic background in biology and religious studies as well as a few volunteer experiences in healthcare advocacy. After exploring several programs, I chose to attend the University of Texas Medical Branch at Galveston (UTMB), which offers a doctoral program in medical humanities through its Institute for the Medical Humanities (IMH). The IMH is an academic research center within the Graduate School of Biomedical Sciences, comprising ten full-time faculty. I was primarily attracted by the breadth of disciplines represented by the faculty; however, the generous stipend provided by the Institute was not insignificant.

In my day the medical humanities program encompassed studies in history, literature, philosophy, religion, law, ethics, and visual arts. Students were expected to take courses in all of these areas and complete a number of clinical practica. The classes were small. Some provided a solid introduction to a humanistic discipline in the context of medicine; others allowed for a focused exploration of particular topics. Independent studies were also an option. Of particular value to me was the medical environment. UTMB is a large, tertiary care center with seven hospitals, a large research agenda, and schools of medicine, nursing, and allied health, in addition to the Graduate School of Biomedical Sciences and the IMH. The Institute is centrally located on the medical campus, making it easy to attend rounds or ethics consults or to shadow individual clinicians. Total immersion in the culture of medicine was inescapable and a very important part of my education.

Upon receiving my Ph.D. in 1995 and then accepted a position teaching ethics and medical humanities at Wright State University School of Medicine in Dayton, Ohio. As in most medical schools, I found medical students pragmatically oriented, little interested in mastering concepts that were not immediately applicable. Philosophy holds minimal (if any) interest for them, history and literature only slightly more. Were I to satisfy their demands for clarity and applicability, I would probably spend most of my time teaching jurisprudence. But to the extent that our job is to teach students skills of empathy, insight, and discernment, the medical humanities provides a highly useful and flexible range of tools and approaches. I toss a little history into most of my teaching for purposes of context; urge students to explore the existential questions—why do we live, suffer, and die—as circumstances warrant; use patients, literature, and films to elicit empathy and analyze communication; and keep discussions of ethical theory as user-friendly as possible. I have found that putting a human face on any issue makes it memorable and meaningful to students. It is for this reason, if no other, that the medical humanities have a rightful place in medical education.

In terms of research and scholarship, UTMB's graduate program in medical humanities provided a breadth of perspectives that have each proved valuable. Although a graduate of such a program at times wonders what kind of hat to call his or her own, my research and publications are not limited to any particular discipline or approach. In this way the medical humanities can promote a kind of intellectual freedom that is not available to those schooled in a single discipline.

When I began teaching medical students, I felt the primary weakness of my graduate training was that I had not spent enough time with the kinds of practical clinical information my students demanded. A gap like this is bound to be part of any learning curve in a new position and was not a serious problem, but I am told the current curriculum at the IMH includes more attention to clinical ethics. Nonetheless, I would caution students against this program if they do not come to it with a sense of direction and identity—either by having already completed some kind of graduate work or by having had significant clinical experience. Absent either of these, the medical humanities might appear to lack a disciplinary core...