Tuesday, February 21, 2012

A Brief Introduction to the Wondrous Field of Medical Humanities (Not to Be Confused With Disabilities Studies)

I'm going to begin this post with a description of "the medical humanities" put out by the NYU School of Medicine: 

"We define the term "medical humanities" broadly to include an interdisciplinary field of humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice. The humanities and arts provide insight into the human condition, suffering, personhood, our responsibility to each other, and offer a historical perspective on medical practice. Attention to literature and the arts helps to develop and nurture skills of observation, analysis, empathy, and self-reflection -- skills that are essential for humane medical care. The social sciences help us to understand how bioscience and medicine take place within cultural and social contexts and how culture interacts with the individual experience of illness and the way medicine is practiced."

Though there doesn't seem to be any one-stop shop for a concrete definition of "medical humanities" (Wikipedia agrees with me), after perusing the medical humanities (heretofore referred to as "MH") sections of various medical school websites and from the Association for the Medical Humanities blog, I've come to conceptualize the field in the following ways:

- MH tries to introduce a new kind of critical thinking to medical cases. It situates them in a sociocultural context and looks beyond pure physiology (and individual psychology) in searching for a diagnosis. MH asks, "What's going on in the larger community? In the world? How might that impact not only this particular patient's diagnosis, but his interpretation of his illness and his outlook on the same?

- On a larger scale, MH asks what will happen to the practice of medicine in the context of developing political and cultural issues.

-MH is concerned with patient identity before, during, and after illness. How does illness change a person? And how might a physician be sensitive to that change?

- MH seems more willing to explore alternative therapies for illnesses.

-MH looks toward greater physician empathy through deep analysis of a patient's condition and mental status.

- MH considers the representation of illness in narratives, art, etc. How does such representation affect how we define an illness and, more importantly, how we define those affected with that particular illness?

- Finally, and perhaps most prominently, MH is concerned with the ethics of healthcare - what do providers, as humans, owe to their fellow humans? how should patients be treated not only on a political level, but an emotional one? how great of an understanding must a care provider have of both patient and illness before, during, and after treatment?

MH tries to change our attitudes towards healthcare from within the medical community. The field isn't necessarily trying to change the classification or practice of healthcare itself - it's trying to reconstruct how we go about giving care in a humane way and how we narratively describe that care and the patients it affects. MH isn't so much concerned with challenging the given definitions of illness - to it, breast cancer is breast cancer is an illness is a disability - but rather how illness is represented. Illness, and by extension, disability is a given, and the social constructions that give rise to disabilities aren't questioned - they are simply and implicitly accepted as present.

And this is where MH deviates from DS. DS questions the structures that give rise to disability. It asks us to reform our definitions of illnesses where MH only asks us to represent them in a more empathetic way. DS isn't looking to change things from within the medical field - it is looking to challenge the roots of disability as we know it, asking the larger population and the medical population to consider redefinition - not reframing.

I'm wondering now if Hornbacher's memoir is swinging between two representations of illness and women - the MH representation and the DS representation. The MH representation seems to lie in the plethora of clinical literature used to describe the eating disorder, and in how that clinical literature is twisted to fit one particular case study. The DS representation, by contrast, seems to be situated in the multiple selves of Jelinek. These "selves" say, "Here's another way of looking at eating disorders. Here's something that doesn't fit. And, most importantly, here's a way that we've constructed the feminine condition as a disability and that, perhaps, eating disorders are just extensions of the disabled feminine ideal."

I think it will be interesting to further examine where feminist studies, women's autobiography, DS, and MH all fit together. I don't have the greatest grasp on the connection between these fields now, but hopefully in my next posts, I'll be able to fit the puzzle together.

1 comment:

  1. There's an essay by Paul Tough, “The Poverty Clinic: can a stressful childhood make you a sick adult?” The New Yorker (March 21, 2011), about a new, holistic approach to public health and poverty, that essentially makes education a focal part of "treatment"--and operates as a GREAT example of what you describe as the work of situating medical cases in a sociocultural context.

    I'm also wondering, in this context, about today's NYTimes article, "If You Feel O.K., Maybe You Are O.K.: Overdiagnosis as a Flaw in Health Care," which challenges the conventional contemporary medical practices of assessing the well, rather than treating the sick.

    I think the comparison you make between medical humanities and disability studies may be a useful one for your thesis; but can you say more about it? For example, what's the difference between "redefining" and "reframing"? Mightn't the differences go deeper/wider? Accepting the medical framework, as opposing to deconstructing it? And does Hornbacher's text "swing" between these poles? Describing eating disorders as a medical condition, then deconstructing that diagnosis with a cultural re-framing?