Medical Humanities as an Intersection: Fostering Cross-Disciplinary Intellectual Spaces, A Commentary

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This Wednesday we’re pleased to have a post from Julia Knopes. Julia is a PhD candidate in anthropology at Case Western Reserve University, and serves as the administrative coordinator for the newly-launched MA Track in Medicine, Society & Culture in the CWRU Department of Bioethics. Julia’s research examines the socio-material basis of professional role development amongst American medical students. She holds an MA in Humanities from the University of Chicago and a BA in English from Washington & Jefferson College. You can learn more about Julia’s work and current research here.

When I set out to write this commentary, I first intended on penning a blog piece about my own definition of the medical humanities as someone trained in both the humanities and the social sciences. Having come to medical anthropology from a past life in literary studies, my work has straddled the fissure between humanities and qualitative social sciences. I have presented work both on the history and theatrical presence of anatomical learning in the English Renaissance, and on my ethnographic research with medical students in the gross anatomy lab today. Sometimes, my work is focused solely on the present; in other instances, I turn to the historical past to inform my work as a scholar of contemporary medical training. My vision of the medical humanities is one that arrives from both within and beyond traditional disciplinary boundaries.

My approach, however, is but one. I recognize that the medical humanities do not offer a single or unified outlook on human health, illness, and medical practice. In fact, the medical humanities are populated by historians and artists, poets and literary scholars, philosophers and social scientists. Our individual professional identities may be firm—I identify now as an ethnographer and anthropologist, not a literary scholar—but the social, cultural, historical, experiential, and existential study of medicine is simply too complex to be dominated by a single field. The medical humanities (and its ally, social medicine), welcomes perspectives on the humanistic study of medicine informed by our varied native disciplines. More than a single field, the medical humanities often serve as a crossroads: an intellectual intersection (physical, virtual, or social) at which scholars across fields gather in dialogue, whether they identify with a single specialty or as interdisciplinary scholars. For this reason, and regardless of disciplinary allegiances, we can all benefit from the medical humanities as a site of discussion that welcomes myriad voices. Diverse perspectives encourage us to analyze human health and medical problems from numerous angles. As we all carry with us our own analytical methods and theories to this junction, so too do we leave these dialogues having ourselves learned and gained the critical perspectives of our peers. This sharpens our focus anew on social, cultural, and medical problems for which one discipline lacks all answers.

The value of the medical humanities is that they enable all of us to see medical and social problems through multiple lenses. If we cannot fully grasp a complex medical problem through ethnography alone, we turn to historical approaches to complete our understanding of the issue at hand. If individual illness narratives beg to be woven together through other data, we look to sociology and economics to conceptualize the underlying health inequities faced by diverse populations, amongst other socio-medical problems. And, further, when we strive to understand how medical science is confronting illness and suffering today, we turn to nurses, social workers, therapists, physicians, and other health professionals whose day-to-day interaction with patients is deeply informative for our own research. Indeed, clinicians also benefit from our work: the humanities have been widely integrated into coursework for physicians in the United Kingdom[1] and the United States[2]. While obstacles remain in the creation and implementation of medical humanities curricula for future medical practitioners[3], this coursework has widened the intellectual space in which medical humanists exchange ideas with multiple audiences.

Whether medical humanities programs are physically housed within humanities departments, or whether they are exported into numerous health education venues, they remain a space for invaluable cross-disciplinary conversation. I have been fortunate to serve as the administrative coordinator of a medical humanities and social medicine collaborative that has overcome departmental boundaries in creating a new space for scholarly dialogue. This new university-wide initiative in medical humanities and social medicine (MHSM) is anchored by a Bioethics MA degree track entitled Medicine, Society and Culture at Case Western Reserve University. Though the degree program is housed in the School of Medicine, our MHSM (Medical Humanities and Social Medicine) advisory committee (which oversees university-wide activities in medical humanities[4]) includes historians, philosophers, literary scholars, social scientists, rhetoricians, and many others. Across the university, we facilitate lectures, administer competitive conference and research grants for students, and support faculty scholarship and teaching innovation. In the region, we collaborate with neighboring institutions to spearhead events that bring together scholars in all disciplines to discuss common themes in the social and contextual study of medicine, illness, and human health. In addition, we look forward to welcoming our first entering class of graduate students in the Medicine, Society, and Culture track in the Bioethics graduate program this Fall 2016. These students will complete clinical rotations, bioethics coursework, and multidisciplinary training in medical humanities and social medicine.

In sum, the Medicine, Society and Culture initiative has become another significant intersection at which scholars—both practicing academics and new graduate students alike—are able to trade theories, exchange methods, and discuss contemporary intellectual issues with fellow medical humanists and social scientists. Thus, our program seeks to both produce new scholars who approach illness and medicine as inherently multi-faceted human experiences, and to facilitate dialogues with current scholars within various departments who strive to complicate their own understandings of health and the human condition.

Beyond university programming, however, there are many ways that all medical humanities scholars strive—and should continue—to reach across departments and disciplines to share our methods, theories, approaches, and reflections on medicine with one another. This blog is one such space that beautifully forges virtual connections across academic audiences with a shared interest in health, illness, and medical practice. My own field, medical anthropology, by its nature requires researchers to inform their claims through many kinds of data that necessitate several forms of analysis: all which dovetail approaches in other fields. So too did my previous training in literary studies require me to be conversant in historical methods, in close reading techniques, and in the same inductive reasoning skills that I now apply to my ethnographic work. No discipline is an intellectual island: and if there is a universal value of the medical humanities, it is that it has made junctures out of disparate disciplines. It is at once clinical, scientific, and humanistic.

~~~References~~~

[1] Macnaughton, Jane. (2000). “The humanities in medical education: context, outcomes and structures.” Journal of Medical Ethics: Medical Humanities 26: 23-30.

[2] Hunter, KM; Charon, Rita; Coulehan, Jack. (1995). “The study of literature in medical education.” Academic Medicine 70(9): 787-794.

[3] Shapiro, Johanna; Coulehan, Jack; Wear, Delese; Montello, Martha. (2009). “Medical Humanities and Their Discontents: Definitions, Critiques, and Implications.” Academic Medicine 84(2): 192-198.

[4] Information on members of the CWRU MHSM advisory committee can be found here: http://case.edu/medicine/msc/about/advisory-committee/

Hope in an Age of Violence: Quote Quilt

It has been a difficult year. But for some, this year’s seeming upsurge of violence represents only the now-visible crest over a lifetime of submerged struggle and frustration against systemic abuse. History tells a different tale. We are not experiencing a new and dangerous age; No, for there remains a long record of racism, lynch mobs, violence against women, and murder of people professing different faith or gender orientation than those with power and motivation to silence them. In the face of terror–in light of Orlando, of Dallas, of Nice, of Syria, of Turkey, and of tragedies in our own towns and cities–we are apt to feel helpless and overwhelmed. We may be tempted to silence, to the feeling that nothing we say will matter. This is true of victims, who feel their words go no where. This is also true of allies and of those whose race or gender keeps them safe (or safer) from the abuses they witness. What could I possibly have to say? We may think, in shame, or in anger, that silence is all we have…

Continue reading “Hope in an Age of Violence: Quote Quilt”

MedHum Monday: Compassion against Fear

DailyDose_PosterI attended an Episcopal service this past Sunday (Palm Sunday). My rector spent much of the message talking about things both crucial and–at first glance–incidental to the season’s readings. She talked about racism. And hatred. She spoke about police shootings and bullies and Tamir Rice. And mostly, she described how our compassion dries up in the face of fear. It’s worth revisiting, especially here, in my community and others like it, where segregation and division build frightening walls between “us” and “them.” And it’s worth revisiting now, in this election cycle, when division makes headlines, spits venom, and influences votes.

The US Department of Health still identifies Cuyahoga County as critically under-served. Statistically, that under-served population is made up of minority communities rendered invisible by segregated urban centers—what the Cleveland Foundation’s Greater University Circle Initiative (GUCI) calls the “invisible divide.” In an article by Alexander Kent & Thomas C. Frohlich earlier this year, Cleveland ranked as the number one more segregated urban area, with an equal disparity of income rates [1].

Click to see the full image in Huffington Post.

You need only look at the image to note the significance of that division. At the same time, this small minority community mobilized to swing a vote away from County Prosecutor McGinty (whom many faulted in the Tamir Rice case), sweeping these precincts for challenger O’Malley. Again, the picture tells the story.

prosecutor-city-map.png
Click to see the full image at Cleveland.com

As Rich Exner’s article explains, O’Malley was supported by U.S. Rep. Marcia Fudge, a Warrensville Heights Democrat “who represents parts of Cleveland and eastern suburbs,” and “by prominent members of Cleveland clergy” who believe McGinty mishandled the prosecution of police officers in the death of 12-year-old Rice [2].

 

What does this mean? I won’t use this example of voter mobilization to declare ‘good things come out of tragedy,’ though some may. And while it proves, on one hand, that minority populations can influence outcomes, it also continues to reinforce that same old racial divide (O’Malley won all 282 precincts estimated to have a majority black voting-age population, while incumbent Timothy J. McGinty still won in majority white areas [2]). Efforts have redoubled to close these health-race-income gaps, such as the Greater University Circle Initiative, which aims to build better connections between under-served communities and institutions. Additionally, Tom O’Brien runs a project called Neighborhood Connections, with monthly “Neighbor Up” meetings in the circle. But one of the principle themes has been a lingering sense among at-risk neighborhoods that even now, institutions have not done all they could to reach out. How we build trust in these communities, and how we aid in fostering dialog and growth, continues to be a major obstacle… for all of us.

How do we foster compassion and trust? How do we drive out fear? How can we change the fact that, in this urban center and among leading cultural and medical institutions, we still have the most segregated city, with the greatest disparities of income and health (and one of the highest infant mortality rates)? It’s a medical humanities question because it is a human question; our health and well-being depends on it, on those willing to stand up in the face of wrong, or to stand in the gap and help to bridge it. We cannot do that in fear–we cannot do that and fear.

The rector’s Palm Sunday message reminded me that the world surrounding a certain small band of Galileans likewise surged with racial divide, mistrust, tension, and threat from their own authorities and ‘peace keepers.’ And it reminded me, too, of our personal responsibilities. She ended with a call to action: when you feel tempted to shout “someone ought to do something,” be the someone and do the something. As historians, and health professionals, as sociologists and anthropologists, as students and teachers, as employees and business leaders, as neighbors, as friends–as human beings: let us stand against division. Let us unite in compassion and drive out fear.

Let us tear down walls, instead of building them.

REFERENCES

  1. Alexander Kent & Thomas C. Frohlich 24/7 Wall St. The 9 Most Segregated Cities In America. Huffington Post. Aug, 27, 2015.
  2.  Rich Exner. Vote in black communities sweeps Michael O’Malley to victory over Cuyahoga County Prosecutor Timothy McGinty. Cleveland.com. March 17, 2016.

 

 

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