Humanities in the ‘art’ of healing: A case for subject integration

“Medical intervention in someone’s life is a break-in to their world. In a way, it’s a violation of their world that turns them into dependents.”

Luce Irigaray (From her book, “Je, Tu, Nous”: toward a culture of difference)

by Susantha Hewa

Luce Irigaray’s (French feminist, philosopher, psychoanalyst and cultural theorist) above quote may, at a glance, seem defiant or even impudent. Perhaps, it is not so. Anyhow, the incorporation of “Medical Humanities” into medicine curriculum, which was the subject of Randima Attygalle’s interview with Dr. Santushi Amarasuriya, published in The Sunday Island of October 6, 2024, may perhaps resonate with the undertones of Irigaray’s quote above. Possibly, in light of what Dr. Santushi Amarasuriya, Clinical Psychologist and Head of the Department of Medical Humanities says about the new discipline- to quote: “It helps medical practitioners to reorient themselves into a holistic and person-centered approach to health care” – may help us to get a more nuanced understanding of Irigaray’s seemingly confrontational sentiment.

The above interview brings to light the important role the Department of Medical Humanities (established in 2016) is playing to improve the quality of medical education given to prospective healthcare professionals. In the words of Dr. Amarasuriya, the goal of medical humanities is “to foster compassionate care, professionalism and ethical practice among medical and other health care professionals, whilst also being sensitive to the socio-cultural context in Sri Lanka”. This will be good news for the citizens who certainly deserve a better healthcare service. It was not so long ago that there were tragic episodes related to “substandard medicine” undermining patients’ right to life and proper health. It goes without saying that the country was grateful to all those who helped expose the alleged corruptions related to it. Those who have read the text of the interview may have rejoiced at the news of the said upgrading of the syllabus. Surely, the society should be grateful to all those academics and professionals who have contributed to the creation of the new department.

As we know, empathy humanises the relationship between the doctor and the patient, which will be beneficial to both parties. Incidentally, as Dr. Joe Schwarcz, in an article titled, “Would Osler stand by his famous quote today?”, where he refers to Prof. William Osler- one of the founders of the Johns Hopkins University School of Medicine- says that the latter had used to tell his students, “Listen to your patient, he’s telling you the diagnosis”! And, more interestingly, Dr. Michael McCarthy in his article “The importance of humanities in medicine” notes, “Legend has it that Dr. William Osler prescribed a reading list to his students, books not only about physiology and science, but classic literature. He was able to see that “Don Quixote” and “Gray’s Anatomy” both had indispensable value to a physician”. Perhaps, no one would grudge the apportioning of due respects to Dr. Osler, who would have realized the crucial importance of medical students reading literature so as to become more proficient doctors- to cultivate a “holistic and person-centered approach to health care”.

In the above two extracts of Dr. Osler, the first – “Listen to your patient, he’s telling you the diagnosis” – underlines the importance of empathy between the medic and the patient. Consider the famous lines:

“A glance at our rags would be more

Revealing. One and the same cause wears out

Our bodies and our clothes.” (Bertolt Brecht’s poem, “A worker’s speech to a doctor”)

Surely, Brecht’s somewhat incisive “diagnosis” implied in the above lines is beyond the jurisdiction of the doctor, but it doesn’t detract from Dr. Osler’s advice to his students to listen to their patients with more empathy. Further, Brecht’s relevance in the context is felt more when we come to the second excerpt alluded to Dr. Osler, which says that he prescribed to his students “books not only about physiology and science, but classic literature”. It signifies the substantial role humanities can play in enhancing medical practice, which, by the way, is an illustration of the useable relatedness of all disciplines, which we usually keep separated for convenience.

It’s no news that frequently a result is produced by more than one seemingly dominant cause. Yet, it is easy to overlook all the underlying causes of an event. Often, we depend on researchers and experts to show us the numerous underlying causes of a single event, say – 9/11 attacks in 2001, tsunami in 2004 or Covid19 epidemic in 2019 – that we begin to appreciate there being more to something than meets the eye. Hence the need for the collaboration of customarily discrete disciplines, i.e. medicine, history, mathematics, literature, etc., for a fuller understanding of any issue, which highlights the value of the new-fangled programme (Medical Humanities).

Of course, in designing syllabuses, it wouldn’t be easy to strike a fine balance between a dogged focus on one field of expertise and an obsession with a more eclectic approach covering several subjects with the aim of bringing the best of benefits to the society. The best option may be to introduce the right amount of the seemingly “external” ingredient at the right time to enrich the quality of the cocktail, as the University of Colombo Medical Faculty has done. As Prof. William S. Beck has said, “Fields of learning are surrounded ultimately only by illusory boundaries—like the “rooms” in a hall of mirrors. It is when the illusion is penetrated that progress takes place. … science is a vital part of our culture, our culture is part of it, it permeates our thinking, and its continued separateness from what is fondly called “the humanities” is a preposterous practical joke on all thinking men. (Modern Science and the Nature of Life).

Perhaps, we can be optimistic that other “privileged” disciplines would take a cue from the Colombo Medical Faculty to broaden and enhance their programmes by integrating traditionally alienated disciplines. Surely it would help usher in a more people-centred education in the country.