The medical humanities emerged in the late 1960s in response to shared concerns among a group of hospital chaplains, academic clinicians, and moral theologians and philosophers about the growing power of a technological imperative and a perceived trend toward depersonalization in medicine. Gathering themselves originally under the rubric of "health and human values," these reformers launched a new field of intellectual work and practice reminiscent of the revival of liberal learning spawned by the Renaissance humanists, who endeavored to link humanistic ideals to professional practice in the workaday world of their time. The task of appropriating and adapting the studia humanitatis to our time and circumstances is crucial to defining the evolving identity of the medical humanities field.
Through a comparison of two graphic novels concerned with the experience of cancer diagnosis and treatment, Brian Fies's Mom's Cancer (2006) and Harvey Pekar and Joyce Brabner's Our Cancer Year (1994), this essay suggests some of the strengths and limitations of the medical humanities in responding to the experience of illness. It demonstrates how the graphic medium enables us to generate a new set of reading strategies and thus to articulate a more complex and powerful analysis of illness, disability, medicine, and health. Finally, the essay considers the question raised by the comparison of the graphic novels: whether the term "health humanities" might not be preferable to its predecessor, "medical humanities."
In this essay we link the rationale for the medical humanities with radical hermeneutics, a move that infuses the medical humanities with incredulity and suspicion. This orientation is particularly important at this historical moment, when the evidence-based and competency blanket is threatening to overpower all aspects of medical education, including the medical humanities discourse itself. Radical her-meneutics works relentlessly against the final word on anything, and as such, it provides a critically provocative way of thinking about doctors, patients, illness, health, families, death—in short, the experience of being human. We use three literary examples to illustrate the complex, contradictory, perplexing, and disturbing questions related to a life in medicine: Rafael Campo's "Like a Prayer," Irvin Yalom's "Fat Lady," and Richard Selzer's "Brute."
Medicine is driven by much more than science and reason (ethics); it is also driven by the circuits of culture within which it operates. This article examines how postmodern theory deconstructs standard ideals of science and reason and allows medical humanities scholars to better contextualize the world of medicine. As such, postmodern theory provides an invaluable tool for understanding the circuits of popular culture and medicine's place within these circuits. Using a recent issue of Newsweek magazine devoted to health and technology to illustrate the main points, this essay argues that contemporary popular influences on medicine are deeply problematic, and that through an appreciation of the dynamics of culture, medical humanities scholars can join the struggle over medical culture. This perspective allows medical humanities to make important contributions toward alternative circuits of medical representation, consumption, and identification.
First-person narratives of illness experience are dramatic: the narrator, who is also the sufferer, is caught in conflicts of forces that permit understanding more than control. Among the dramas of illness, five occur frequently in autobiographical accounts of illness. These dramas overlap and have varying emphases in different people's stories. They are the drama of genesis (what instigated the illness); the drama of emotion work (what emotional displays are required or prohibited); the drama of fear and loss; the drama of meaning; and finally, the drama of self. This five-drama framework can focus critical and clinical attention on which conflicting forces the ill person is working to reconcile, what makes that work difficult, and how conceiving of one's illness as a drama can be a source of meaning and value.
Margaret Edson's play W;t (1999) serves both as a guide to apprehending the dangers of a perspective that privileges the technological over the aesthetic and as a model for appreciating the magic of yielding to a performance. Inspired by William F. Pinar's (1995) examination of the place and value of the aesthetic in contemporary American education, this article considers Edson's play in relation to theory, teaching, learning, and art, in order to resituate the humanities—with their emphasis on imagination, transformation, and wonder—within the medical arena.
This article considers contributions that the medical humanities have made to biomedical ethics. Philosophy has contributed methods of ethical justification to case analysis and has given birth to the New Professionalism movement. Taking biography as its paradigmatic resource, this movement has refocused medical education on the formation of physicians who not only have certain responsibilities to their patients, but also a regard for the role of the medical profession in working toward social justice. However, reliance on biography is now giving way to a renewed emphasis on autobiography, as educators seek to support medical students through the personal and spiritual journey that confrontation with death, disease, and injustice naturally entails. Reflective methods and techniques characterize this emerging era as educators and students try to preserve and reinvigorate the soul of medicine.
Evaluating health requires visual assessment. From the meticulous self-scrutiny of a worried woman in front of the looking glass to the doctor's reaction at the sight of a patient in the examining room, external appearance plays an important role in appraising health above and beyond clinical assessment. However, this dominance of the visual in our image-driven culture has assumed a disproportionately prominent position. Media, businesses, and health care commonly misrepresent appearance as the reality of health. Industry mongers beauty-promoting wares and services as health-protecting products, and physical appearance contributes to clinicians' imperfect heuristics. An explanation for this focus on appearance is persistence of the ancient belief that looks indicate inner character. In this article we unmask the historical origin of this belief and reveal how it contaminates contemporary approaches to health assessment and maintenance.
With the rise in managed care and the changes in the organization and delivery of health care, the medical literature is rife with expressions of doctors' discontent. Less is known about how these changes have affected patients in the course of everyday interactions with their doctors. As an efficiency measure, many physician practices rely on voice mail to screen and direct calls to the appropriate party. This simple, low-tech alteration in communication between patient and doctor has the potential to interfere with the development and maintenance of a constructive doctor-patient relationship. This paper describes the author's experience communicating with her physicians. It focuses on making an appointment via voice mail and offers a perspective on how the process of appointment making through an electronic third party can have a negative impact on the doctor-patient relationship.
This essay explores the connections between health and illness, and the processes of salutogenesis, pathogenesis, and homeostasis. Written from an understanding of human embodiment and the consequences this has for our experiences of health and disease, this essay moves towards a positive definition of health, as an on-going outcome from the processes of a life lived well. "Well" here is measured in terms of wealth, relationships, coherence, fitness, and adaptability. Mencken's criticism that "Hygiene is the corruption of medicine by morality" is answered; the search for health is, in part, a moral as well as a biological enterprise. Both generative processes and remedial measures contribute to health. The patients in my consulting room usually need remedial medicine, but they would also like to flourish as human beings. Doctors should be able to provide a balance of measures towards this end.