"Medical humanities can help maintain the human face of medicine."
DOCTOR TO DOCTORS: DON'T FORGET THE PATIENT
by Carol Schmidt
A pale and thin man given to catching cold and prone to hysterics, Ivan ate little and slept badly. After a prolonged episode of strange behavior, his concerned landlady called Dr. Rabin, who sent Ivan to a hospital for treatment. The relationship that evolved between doctor and patient is immortalized in “Ward 6,” a short story by Anton Chekhov, who was a physician as well as one of civilization’s great writers.Such interaction between doctor and patient has been the grist of literature. Recently, however, the doctor/patient relationship has become the primary focus of medical humanities, an interdisciplinary melding of science and art, according to Kimberly Myers, an English professor at Montana State University. Myers studies, teaches and writes about medical humanities in addition to her work in English and Irish literature.
“Medical humanities works to re-humanize medicine, to remind physicians that while science and technology are important, flesh-and-blood human beings are still the heart of medicine,” explains Myers. She teaches a medical humanities course to first-year medical students from Montana enrolled in the Washington, Wyoming, Alaska, Montana, Idaho (WWAMI) program at MSU. The award-winning professor uses literature, film, patient narratives and case studies to focus on such issues as patient care and ethics.“It was courageous on WWAMI’s part to offer these courses so that students can think about these issues from the start,” Myers said.
Myers said that top medical schools began to include medical humanities courses and curricula in the late 1960s because medicine had become increasingly limited to curing a disease at the expense of caring for the physical and emotional well-being of the patient.“Before the mid-19th century, physicians were caring for patients at the bedside,” Myers said. “But in the mid-1800s, rapid advances in instrumentation and laboratory sciences took the doctor from the bedside into the lab. The patient became almost incidental. The goal of medical humanities is to restore a healthy balance of science and compassionate attention.” Dr. Herbert Swick, a physician at St. Patrick Hospital in Missoula, concurs. Swick, the executive director of St. Patrick’s Institute of Medicine and Humanities, a joint project with the University of Montana, said medical humanities counterbalances the highly technical aspects of contemporary medical education.
“It is so easy to become divorced from the patient as an individual because so much of what one needs to do involves diagnostic technology,” said Swick, who both teaches at UM’s Davidson Honors College and is a member of the clinical faculty at the University of Washington School of Medicine.“In my mind, we can never separate the technology that we bring to health care today from the fact that it (medicine) is still dealing with the very intimate condition of people’s lives,” Swick said. “Medical humanities can help maintain the human face of medicine that reminds physicians and other health care providers that a very important personal relationship occurs to make healing possible.”
Myers developed an interest in medical humanities while she was treated for a medical condition several years ago. It occurred to her that the way a patient uses language has a dramatic impact on the treatment she or he receives. As an English professor, she developed a scholarly interest in pathographies, or patients’ stories.
“They reveal a lot about how the patient thinks of his illness,” she said. “These clues can help a physician understand how to work with that particular patient so that he gets the best possible care.”
Myers requested personal illness narratives from fellow academics. Both the number of responses she received and the power of the work astounded her. These essays, from scholars all over the world, will appear in the book “Illness in the Academy,” scheduled to be published in 2006 by Purdue University Press. The book will be used in medical schools for physician education.
Myers’ book includes a previously unpublished poem by the Irish poet and Nobel laureate Seamus Heaney as well as a poem by physician and writer Dr. Abraham Verghese, an international leader in the field of medical humanities. Verghese is an award-winning writer of “My Own Country,” a memoir of the beginnings of the AIDS epidemic in rural Tennessee. Myers worked with Verghese last summer, and he is scheduled to speak at MSU in April. In addition to teaching medical humanities to medical students, Myers has also taught seminars in “Literature and Medicine” for the English Department and “Medicine, Literature and Culture” for the MSU University Honors Program, where she is currently associate director. Myers said she believes that all students benefit from the study of medical humanities because it not only enables them to consider topics from different perspectives, but also empowers them as current or future health-care consumers.