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Reading Patients— Cautions and Concerns Anne Hudson Jones Inaugural Address of the Harriet W. Sheridan Literature and Medicine Lectureship and Forum Brown University 6 April 1994 It's a great pleasure to be here today for this special occasion: the endowment of the Harriet W Sheridan Literature and Medicine Lectureship and Forum. I wish that I had known Harriet Sheridan. From all I have heard about her, she sounds like a wonderful teacher, scholar, colleague, and friend. It is an honor to give this year's lecture in her name and to help continue the work she started here. Dean Epstein has told me that the physician-writer John Stone spoke here last year and that plans are for this newly endowed lectureship to alternate between someone from medicine and someone from literature. Because I know how eloquent a writer and presenter John Stone is, I am sure that he got things off to a splendid start. No one likes to take the podium after John Stone—not even a year later. But a major theme of my lecture today is the importance of listening to different voices, of making our conversations about medicine and literature dialogic, and of honoring the patient's perspective and story. In the dialogic spirit, then, I add my voice to the literature-andmedicine conversation that John Stone initiated here last year and that—thanks to the endowment we celebrate today—others will carry on in the future. In the early years of the effort to secure a place for literature among the humanities disciplines in medical education, several of its advocates—Joanne Trautmann Banks, Stephen L. Daniel, James S. Terry and Edward L. Gogel, Rita Charon, Kathryn Montgomery Hunter, and myself, among others—tried to explain why it is important for medical students and physicians to read literature. One of the most persuasive claims we made is that learning to read and interpret literary texts Literature and Medicine 13, no. 2 (Fall 1994) 190-200 © 1994 by The Johns Hopkins University Press Anne Hudson Jones 191 develops skills analogous to those physicians use in their clinical work, especially in making diagnoses. Joanne Trautmann argued, in 1979, that "to teach a student to read, in the fullest sense, is to help train him or her medically." She maintained that reading in the fullest sense would help students "to develop a tolerance for ambiguity and to learn how to come to conclusions when the data are incomplete or capable of being interpreted variously."1 In 1986, Stephen L. Daniel published an article titled "The Patient as Text," in which he proposed a hermeneutical model of the patient as text that may require four levels of interpretation, in accord with medieval schema: literal; diagnostic (allegorical); prognostic and therapeutic (moral); and change in life-world (analogical).2 That same year, in an article subtitled "The Physician as Textual Critic," Kathryn Montgomery Hunter argued that medicine is an interpretive activity in which doctors function as literary critics and theorists of patients, who are their texts.3 Thus, both in their titles and their arguments, these two articles made the analogy explicit: the patient as text; the physician as reader, interpreter, and critic. The next year, 1987, James S. Terry and Edward L. Gogel published a pair of articles—one in Literature and Medicine, the other in the Journal of Philosophy and Medicine—about physicians' interpreting patients as texts.4 In their article for Literature and Medicine, they discussed "skills development" as a justification for studying literature and medicine and then went on to compare in some detail the process of explicating poetry to the process of diagnosing patients. Also in 1987, I published the first article in which I characterized these claims as "the aesthetic approach" and contrasted them with what I call "the ethical approach" to the use of literature in medical education.5 In 1989, using ideas from reader-response theory, Rita Charon wrote about the doctor as reader, the patient as writer, and argued that the patient, not the illness, is the text.6 Perhaps the culmination of this line of development was Kathryn Montgomery Hunter's 1991 book, Doctors' Stories: The Narrative Structure of Medical...

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