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Midweek Review

Making Sense of ‘Literary Sensibility’

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By Dr. Siri Galhenage

(Psychiatrist)

The exclusive role of literature is the transmission of complexities of human experience, calling into play our emotional and intellectual faculties. Literary analysts observe, that great works of art and literature have the capacity to ‘convey serious truths and significant ideals’, ‘broaden our understanding’, ‘kindle our imaginations’, ‘raise our spirits’ and ‘enhance our sensibility’. Seen from a psychological perspective, such therapeutic ingredients in Literature have the potential to assist us in elevating our lives to a higher plane of existence, bringing order and meaning to the seeming chaos of daily living.

At the heart of the above observation is the concept of literary ‘Sensibility’ – an idea that has shaped modern consciousness with regard to the evaluation and interpretation of literature. Variously interpreted, the concept has undergone transformation over time. The purpose of this essay is to explore the many nuances of its meaning and to underscore its worth.

Origin and Transformation

The term sensibility is an offshoot of the word ‘sense’ with its roots in Latin [‘sentire’: to feel]. Borrowed by neuroscience, ‘sense’ refers to the faculty of ‘perceiving’ by the five senses of sight, hearing, smell, taste and touch. The term is broadly synonymous with the higher cerebral functions of cognition, judgement, discernment and intuition [‘the sixth sense’] governed by the ‘sensorium’ – the component of the brain that deals with receiving and interpreting external stimuli.

The word ‘sense’ has made a vast contribution to the English vocabulary by generating a range of derivatives with shades of meaning. It has given birth to such kindred words as ‘sensitive’ [being sympathetic when dealing with the needs or feelings of others]; ‘sensible’ [having good sense or judgement]; ‘sensuous’ [coined by Milton to suggest the idea of being alive to sensations], transcending the baser term ‘sensual’ with connotations of sexual arousal; and SENSIBILITY, amongst many others.

Geoffrey Chaucer, the legendary English poet of the middle Ages, widely considered to be the father of English poetry, is credited for having conceived the notion of sensibility. The idea was fostered in the 18th Century by a group of philosophers and writers who formed the so called ‘literary cult of sensibility’. Initially used to refer to individual response to physical and emotional stimuli [exaggerated and self-indulgent, implying individual susceptibility], the meaning of the word transformed into understanding and experiencing the feelings of others, akin to empathy.

The above themes were soon picked up by novelists, such as Jane Austen, who created her masterpiece, ‘Sense and Sensibility’ as a parody of emotional response, featuring two sisters who both seek love, endure loss and find happiness in their own way – Marianne: passionate and impulsive; Elinor: dignified and thoughtful, in their responses.

Sensibility, from a modern perspective, appears to cover the whole spectrum of literary activity, suggesting a highly developed emotional and intellectual capacity for both literary creativity as well as literary analysis.

The Deeper Realm in Literature

Every reader could be considered a latent literary analyst. But those with literary sensibility are regarded as having developed a more refined ability to elicit, discern, comprehend and respond to the deeper layers of meaning of a text [the subterranean realm], signifying a heightened level of consciousness.

What is the source of this subterranean realm of knowledge [wisdom] in great art and literature which the discerning mind could draw from? The legendary poet Milton believed that it is God given. But there is evidence to suggest that great literary figures drew heavily from mythological tales and folklore which the celebrated Swiss Psychiatrist Carl Jung asserted embodied ancient wisdom – ‘the storehouse of universally shared experience’ which he called our ‘collective unconscious’ – lying deeper than the ‘individual unconscious’.

Ancient wisdom regarded the universe as alive, and all its objects – humans, plants, animals, celestial bodies – and natural phenomena, in continuous interaction within it, bringing about both favourable as well as adverse outcomes. The preliterate humans were yet unaware of the biological and physical forces that controlled the ecosystems around them. Confined to their natural habitat, they were, by necessity, constantly in tune with their environment, inventing narratives loaded with myths, creating images on rocks, performing spiritual ceremonies with totems and taboos necessary to bring order and meaning to their lives. The experience of their daily life merged imperceptibly into mythological tales and folklore which has now gained the tag of ‘art’.

Jung hypothesised that the collective unconscious was a reservoir of ‘predispositions and potentialities’ to act or react in certain ways which have universal meaning. He called them ‘archetypes’. These predispositions which are inherited collectively compel us to experience life in a manner conditioned by the past history of mankind. By endless repetition such experiences have become engraved in our psychic constitution but with some modifications during psychological evolution. The archetypes generate an abundance of metaphors which make up the arts and are the building blocks of creative thought.

Thus, the arts appear to have originated in antiquity, in the real world; it’s defining quality being the expression of human experience. The works of art that endure embody universal traits that are deeply humanistic and are faithful to nature. They are judged by their precision and their adherence to human nature. Over centuries such universal themes have strengthened the creative powers of the human mind and expressed in ‘original’ works of art.

Shakespeare and the Archetypal Legends

Shakespeare, unarguably the greatest dramatist and poet of all time in the English language, and perhaps in any language, drew heavily from archetypal legends and folklore. For example, Hamlet, widely regarded as his magnum opus, has its roots in the archetypal legend of Amleth, first recorded in the Gesta Danorum written by the 12th century Danish historian Saxo Grammaticus – a legend with parallel plots in the folklore of other cultures, embedded in the ‘psychological heritage of humanity’. Hamlet portrays a wide array of patterns of emotion, behaviour and relationships drawn from our deeply embedded storehouse of universally shared experience.

Shakespeare, by using this knowledge, exercised his creative genius to give dramatic expression not only to the concerns of his contemporary audiences of the Elizabethan era but also spoke to us in the modern world. Many literary analysts and others in recent history have exercised their sensibility in exploring the moral, socio-political and psychological depths in Hamlet while romancing his written word – Carl Marx and Sigmund Freud amongst them.

Possibly drawn in by Hamlet’s invitation to ‘pluck out the heart of my mystery’, Freud made psychoanalytic explorations into the psyche of the young prince and his relationship with his mother who in ‘indecent haste’ married the usurper who killed his father.

Many a psychiatrist would be in awe of Shakespeare’s descriptions of ‘Melancholia’ and ‘Mania’ in Hamlet and Ophelia, respectively, long before theoretical frameworks were developed in the diagnosis of such mental disorders. Modern day neurochemistry has established a biological predisposition to the above conditions bringing about a consilience of literary sensibility and science. Sensibility, thus, has the potential to act as a driving force in expanding knowledge.

In his monograph ‘What Is Art’, the celebrated Russian author Leo Tolstoy, renowned for his deep social conscience, asserted that a moral message should transcend aesthetic beauty in a piece of Art, including literary Art. His work is abounding in psychological insights too. All such ingredients are amply depicted in his literary artistry. If the young reader is unable to afford the much needed sustained attention in reading Tolstoy’s novels, ‘War and Peace’, ‘Anna Karenina’ and ‘resurrection’, I suggest reading his popular novellas, ‘Cossacks’, ‘Death of Ivan Ilych’, ’Kreutzer Sonata’, Hadji Murad’ and ‘How Much Land Does a Man Need’, which provide a window to his literary landscape.

A good piece of literature provides a basis for the cultivation of social conscience, fostering of moral wisdom, development of psychological insights and the appreciation of beauty [aesthetics] in varying degree, elevating human existence to a higher plane. In my view, the word sensibility in modern terminology encompasses the ability to explore the above matters of considerable human interest, entombed in the deeper vaults of literary treasures.

Early Reading and Sensibility

There is a close association between brain development, reading ability and literary sensibility. We are not born with reading aptitude; the ability does not develop automatically. Reading has to be learned. Helping children learn to read early in their lives facilitates neuronal development by the integration of several systems of the brain enhancing its cognitive capacity – an important dynamic in developing literary sensibility in later life. Reading a story regularly to a child and engaging him or her in meaningful conversation that flows on from the stories, helping them to look beyond the narrative, is considered to be the best predictor of later reading interest and the accomplishment of literary sensibility.

In addition, research shows that early literacy in children plays a key role in academic achievement in later life by facilitating their cognitive skills such as attention, concentration, working memory and flexibility in thinking. It also places them on a trajectory of personality development helping them in enhancing their self-esteem, interpersonal skill, organisational skill and emotional stability, assisting them to comprehend and cope with the crises that we confront in daily living – thus strengthening the structure of individual personality and by extension the nature of society and civilisation.

Losing Our Romance with the Written Word

There is a growing perception that we are losing our romance with the printed word. We live in a hurried world, and most people, especially the young, are showing a decline in the amount of time spent on reading. Intellectual and emotional engagement with a text demands time, motivation and focussed concentration. The digital age we live in fosters ‘light reading’: entranced before the computer or phone screen we cruise websites for a quick pick up of information and entertainment, and to remain connected. The Net has come to stay and it plays a vital role in our modern day living. But it does not provide a platform for ‘deep reading’ [a notion advocated by Sven Berkerts] that fosters sensibility a good text of literature can offer.

We have an ancient literary tradition, the custodian of our values – the very foundation of our civilisation. People of my generation will well remember the following verse from Vadan Kavi Potha: ‘Allata singawath rasa nethi kevili kaka/ Walkola bima athuta nidhi noleba duk thaka/ Kalgiya redhi verali henda deli kunen waka/ Elmen akuru uganivu idiri weda thaka’ – a crude translation being, ‘Learn your letters with love, for future benefit, despite having to face hardship and impoverishment’. The word ‘akuru’, here, connotes a broader education.

The decline of the printed word, and hence the decline of sensibility, and the rise of much less civilising forms of communication and entertainment, has led to the poverty and emptiness of our popular culture. The decline in morality, intimately linked to the decline of sensibility, is more degrading than the economic woes that we are afflicted with today. At the root of so much social disorder we witness around us, such as the wanton destruction of nature, our lack of understanding of our common humanity, our greed and self-indulgence and the heinous crimes that we often hear of, are but the outward manifestations of a collective soul deprived of sensibility.

[sirigalhenage@gmail.com]

References

David Mikics: [2013] Slow Reading in a Hurried Age. Belknap Press of Harvard University Press

Edward O. Wilson [1998] Consilience – The Unity of Knowledge Vintage Books, A Division of Random House. Inc.

J.A.C. Brown: [1961, 1964] Freud and the Post-Freudians, Penguin Books.



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Midweek Review

A dilemma like no other!

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Indian leader Modi greets President Dissanayake

Two contentious issues that may never be resolved are disagreement between India and Sri Lanka over granting police and land powers to Provincial Councils, arm twisted by New Delhi into establishing them here along with the signing of the Indo-Lanka Accord following the infamous parippu drop over the North in 1987 and organized poaching by Tamil Nadu fishers, a problem that can be addressed only by India deploying its powerful Coast Guard, backed by the Navy, to prevent violation of Indo-Lanka maritime boundary.

By Shamindra Ferdinando

Sri Lanka is in a tight spot. Joint statements issued by India and Sri Lanka on Dec, 16, last year, and China and Sri Lanka on January 16, this year, following President Anura Kumara Dissanayake’s state visits to New Delhi and Beijing, respectively, underscored the daunting foreign policy challenges faced by the new Sri Lankan leader whose National People’s Power (NPP) secured a landslide victory at the Nov. 2024 parliamentary election, promising a literal sea change.

Dissanayake is also the leader of the Janatha Vimukthi Peramuna (JVP), a once rabidly anti-Indian political movement that waged two unsuccessful insurrections, in 1971 and 1987-1990. Under the JVP’s leadership, the NPP was formed in 2019, just ahead of that year’s presidential election.

Against the backdrop of an unprecedented political environment that had been created by the routing of existing major parties and the emergence of the NPP as the dominant political force here, the Asian giants are determined to consolidate their own separate position here. The joint statements emphasized their agenda.

The issues at hand cannot be examined without taking into consideration the strong and growing US-India relationship, in spite of the latter playing safe in the Russia-Ukraine war and the US-China conflict, as well as the US and India teaming up against Beijing. It appears, however, neither the US nor India trust each other. Their game plan is to try use the other for one’s own benefit in their current marriage of convenience. Washington, without doubt, considers both China and India are a threat to US hegemony.

Whether hapless Sri Lanka likes it or not, or regardless who wields political power here, the major powers won’t change their strategies. That is the unpleasant reality.

In the wake of President Dissanayake’s four-day visit to Beijing (January 14 to 17), a section of the Opposition engaged in the usual criticism of the NPP government, though they generally remained silent on the outcome of his New Delhi visit. China and India dominate major political parties represented in Parliament and the continuing political-economic-social turmoil facilitated their agenda. Our treacherous political party system is obviously incapable of addressing developing challenges. They have pathetically failed to reach consensus on national response to external interventions thereby allowing major powers to manipulate the country.

Having perused the two joint statements, the writer is of the view that in spite of Sri Lanka being party to both, they are contradictory and seem unrealistic to a certain extent. The bottom line is Sri Lanka cannot play ball simultaneously with China and India suspicious of each other. They are hell-bent on undermining each other and Sri Lanka is caught up in an utterly dangerous game. Sri Lanka is stuck in the China-India conflict and obviously there is no way out. Whatever Sri Lanka does may antagonize either party and Colombo seems helpless. The joint statements highlight Sri Lanka’s predicament. Nothing can be as absurd as Sri Lanka declaring a shared future with both India and China. In fact, the 34-point Indo-Lanka joint statement was headlined ‘Fostering partnerships for a shared future.’

While India based its relationship with Sri Lanka on the basis of Premier Narendra Modi’s ‘Neighborhood First Policy’ (read India first policy) and ‘SAGAR’ vision (Security and growth for all in the Indian Ocean region) meaning our giant neighbour is primus inter pares, China focused on what the joint statement described as deepening traditional friendship and advancing high-quality Belt and Road cooperation widely discussed as a massive China-led infrastructure project.

But unlike China, India being our giant neighbour she is overbearing and it would be wise of us to handle India with extreme care. Therefore allowing her to have a monopoly position in any part of our economy is asking for trouble to say the least.

Launched in 2013 the China project is also known as ‘Belt and Road Initiative’ (BRI) and ‘New Silk Road.’ The US and its allies are strongly opposed to the Chinese project, originally called ‘One Belt One Road’.

India strongly opposes any Chinese initiative here hence the joint statement issued following President Dissanayake’s visit must have disappointed New Delhi greatly. The truth is that the statement from Beijing questions the very basis of the joint statement issued on Dec. 16th last year. Regardless of Western and Indian pressure, Beijing has constantly advanced its own project here and elsewhere.

India’s main grouse is the sea and land-based China-Pakistan Economic Corridor (CPEC) that may give China a strategic advantage over India.

Key points in Jan. 16 statement

President Dissanayake’s delegation to Beijing included two Ministers – Foreign Affairs, Foreign Employment and Tourism Vijitha Herath, and Transport, Highways, Ports and Civil Aviation Minister and Leader of the House Bimal Rathnayake. Both are senior JVPers who stood by Dissanayake during the internal turmoil within that party during Mahinda Rajapaksa’s tenure as the President (2005-2014).

President Dissanayake met President Xi Jinping, Premier of the State Council Li Qiang and Chairman of the Standing Committee of the National People’s Congress Zhao Leji.

In line with the overall Chinese approach, their focus was on Belt and Road cooperation. Against that background, the joint statement emphasized the pivotal importance of advancing what the Chinese called ‘high quality Belt and Road cooperation.’

They reiterated unwavering commitment to what the joint statement described as expanding China-Sri Lanka strategic cooperative partnership.

Then they also decided to sustain ‘close high-level exchanges in keeping with ‘strong strategic guidance’ given by the Chinese and Sri Lankan leaders.’

Sri Lanka repeated its longstanding commitment for ‘One-China’ policy or principle in line with the United Nations general assembly Resolution 2758 passed on Oct. 25th, 1971. In other words, that Resolution accepted Taiwan as an inalienable part of China. It would be pertinent to mention that India, too, accepted the ‘One-China’ principle but over the years refrained from reiterating its position. According to the joint statement, Sri Lanka fully backed all efforts by China to achieve national reunification.

Sri Lanka also assured that the country wouldn’t be a platform for anti-China activity and also backed Beijing in respect of issues related to Xizang (Tibet) and the predominantly Muslim Xinjiang regions where China is under Western fire over purported human rights violations.

The UN that often echo Western line saw its Human Rights Chief Volker Turk jumped to criticise Chinese actions in the above-mentioned regions and the Chinese alleged that the UNHRC strategy is meant to undermine China.

In the fifth paragraph of the joint statement with Colombo that dealt with the contentious Xizang and Xinjiang issues, China reiterated its ‘commitment to an independent foreign policy of peace’ whereas Sri Lanka repeated its pledge for ‘an independent non-aligned foreign policy.’

Having been trapped in Chinese, Indian and Western machinations, declaration of ‘an independent non-aligned foreign policy, ‘seemed ridiculous.

The focus on Belt and Road cooperation was underscored with Sri Lanka’s acceptance of President Jinping’s flagship project key to economic and social development. Therefore, the reiteration of the pivotal importance of the Colombo Port City and Hambantota Port, both built by China, didn’t surprise anyone. However, eyebrows were raised that China and Sri Lanka entered into a Belt and Road cooperation plan meant to upgrade/strengthen the Chinese flagship project.

Once Gotabaya Rajapaksa told the writer how Indian National Security Advisor (NSA) Ajit Doval pressed him to cancel major Chinese projects here. Responding to queries raised by the writer in Dec., 2016, Gotabaya Rajapaksa explained the dissimilarity between Doval and his predecessor Shivshankar Menon (January 2010 to May 2014) who had served as Foreign Secretary before receiving the appointment as NSA.

The former Defence Secretary said Menon, in his memoirs, Choices: Inside the Making of India’s Foreign Policy had acknowledged the understanding between the Mahinda Rajapaksa government and India during the war and post-conflict period. However, Menon’s successor Ajit Doval had taken an entirely different stand vis-a-vis Sri Lanka, Rajapaksa said.

Rajapaksa said Doval called for the cancellation of the USD 1.4 bn Chinese flagship project, the Colombo Port City. In addition to that demand which Rajapaksa said was very unfair, India demanded that Sri Lanka take over the Colombo International Container Terminals Limited (CICT), a joint venture between China Merchants Port Holdings Company Limited (CMPH) and the Sri Lanka Ports Authority (SLPA).

CMPH holds 85% of the partnership whilst the balance 15% is with the SLPA.

Rajapaksa quoted Doval as having told him that India wanted all Chinese funded infrastructure projects stopped and for Sri Lanka to have full control of the Hambantota Port. Rajapaksa quoted Doval as having told him: “Sri Lanka is a small country, you don’t need such development projects.”

Maritime issues, etc.

In addition to Sri Lanka seeking early implementation with China of what the joint statement called an agreed debt restructuring plan and early conclusion of a comprehensive free trade agreement, they dealt with maritime cooperation. They agreed to conduct regular bilateral consultations on maritime matters.

China and Sri Lanka decided to sign a Memorandum of Understanding (MoU) on Ocean Cooperation to pave the way for what the joint communique called Blue Partnership. The Blue Partnership is obviously an integral part of the Belt and Road Cooperation.

The joint statement conveniently refrained from making reference to the contentious issue of Chinese research vessels’ visit to Sri Lanka. Repeated Indian and US protests during the early phase of Ranil Wickremesinghe’s presidency (2022 July-Nov 2024) compelled the beleaguered leader to declare a moratorium on such foreign vessels. That decision was meant to prevent Chinese research vessels entering Sri Lankan waters. The Indian media had routinely categorized all Chinese research vessels as spy ships.

President Dissanayake’s government is yet to announce its stand on Wickremesinghe’s moratorium on such foreign ship visits. In spite of Minister Vijitha Herath’s declaration on Dec., 20, 2024, that a special committee would be established to implement a national policy in respect of foreign vessels seeking to enter Sri Lankan waters nothing has been heard so far of the proposed committee.

Regardless of repeated assurances that Sri Lankan territory won’t be used against India’s security interests, the Modi government is seriously concerned over Chinese moves here. India hardened its stance after the Yahapalana government (2015 January to 2019 November) leased the strategically located Hambantota Port on a 99-year lease to China in 2017. That increased Indian concerns as China consolidated its position here. It would be pertinent to mention that China secured what it wanted in spite of the Yahapalana government initially taking an extremely hostile position towards Beijing. The Yahapalana government went to the extent of suspending the Colombo Port City project in March 2015. But, China Communication Construction Company (CCCC) resumed the project in August 2016 after China and Sri Lanka settled differences over the project that was finalized in Sept. 2014 in the presence of President Jinping in Colombo.

Chinese leader Jinping with President Dissanayake

In addition to the USD 1.4 ban Colombo Port City project, China invested USD 1.2 bn in the Hambantota Port. But, President Disanayake’s Office claimed that it secured a fresh investment of USD 3.7 bn for a state-of-the-art oil refinery in Hambantota. That investment declared as the single largest FDI by the President’s Office is part of the Belt and Road cooperation.

However, the UNP has challenged the President’s claim, emphasizing that the agreement on an oil refinery with China was finalized in Nov. 2023 by President Wickremesinghe’s administration.

According to the UNP, Sri Lanka reached consensus on Chinese investment due to the delay in construction undertaken by a consortium that included Silver Park International (Private) Limited of Singapore (controlled by India’s Accord Group) and Oman’s Ministry of Oil and Gas. Interestingly, that agreement had been signed in March 2019 during Maithripala Sirisena’s presidency.

China hasn’t allowed domestic politics here to derail their plans. The Chinese strategy is on track. The Hambantota Port agreement and the proposed oil refinery at Mirijjawila are cases in point. Having signed a deal on the construction of a brand new international port at Hambantota during Mahinda Rajapaksa’s presidency, China secured the port for a mere USD 1.2 bn from the Wickremesinghe regime.

Later President Gotabaya Rajapaksa found fault with the Yahapalana administration for leasing the port to China. Declaring that the leasing of the Hambantota Port was a mistake, Gotabaya Rajapaksa, in his first interview as President with Nitin A. Gokhale, Editor-in-Chief of Bharat Shakti.in and SNI, in late Nov. 2019, said he wanted to renegotiate the deal. The Yahapalana deal covered the port and approximately 15,000 acres around it. China simply dismissed that notion about an agreement concluded with the previous Yahapalana regime. Since then no one dared to take up that issue. China obviously intends to consolidate its position in the South around Hambantota, just as India tightens its grip around Northeast Sri Lanka, which includes the world’s fourth largest natural harbour at Trincomalee earlier coveted by the US.

Post-Aragalaya developments

In the run-up to the presidential election last Sept, India indicated what it desired from the new President. On behalf of India, Pathfinder Foundation presented a comprehensive proposal meant to consolidate Indo-Lanka partnership to all presidential candidates.

During President Disanayake’s visit, India built up on the agreement Premier Modi finalized with President Wickremesinghe in July 2023. Like China, India, too, since the successful conclusion of the war in 2009, advanced its strategy, here, meticulously.

However, China never matched Indian financial assistance during the unprecedented crisis here. India provided assistance posthaste. According to Premier Modi, India extended grants and Lines of Credit worth USD 5 bn to Sri Lanka during the presidencies of Gotabaya Rajapaksa and Ranil Wickremesinghe. In fact, NPP leader Disanayake in the run-up to the presidential election thanked India for unprecedented assistance provided in the hour of Sri Lanka’s need.

New Delhi also paid USD 20.66 mn to settle payments due from Sri Lanka for Indian projects here completed under operational Lines of Credit.

A major difference between India-Sri Lanka joint statement and China-Sri Lanka communique is the former’s focus on defence relations. During a joint media briefing with President Dissanayake in New Delhi Premier Modi declared that he and President Dissanayake decided to quickly finalize the Security Cooperation Agreement. However, the Indo-Lanka joint statement differed from Premier Modi’s declaration in respect of the proposed Security Cooperation Agreement.

According to the joint communique, India and Sri Lanka agreed to explore the possibility of concluding a framework agreement on defence cooperation. Under a section headlined ‘Strategic & Defence Cooperation’, the communique dealt comprehensively with Sri Lanka’s needs. India addressed the issues at hand while assuring backing for defence needs. But, entering into a Security Cooperation Agreement /Defence Cooperation Agreement as mentioned in the joint communique, cannot under any circumstances be taken by the government without having consensus with all political parties represented in Parliament.

India’s offer should be examined keeping in mind Sri Lanka never sought a defence agreement with any particular country, even during the difficult war to defeat LTTE terrorism that lasted for about 30 years, but somehow procured arms, ammunition and equipment as well as training from a wide range of suppliers, including China, Israel, Pakistan, Czechoslovakia, Ukraine as well as Russia. The matter is definitely bone of contention for obvious reasons.

Although India caused terrorism here in the ’80s and should be held responsible for massive death and destruction caused, the war couldn’t have been brought to a successful conclusion without New Delhi’s silent, but invaluable backing to defeat the LTTE during the final Eelam War (2006 Aug. to 2009 May). That is the hard truth. Many people may find that hard to accept. With the LTTE getting too big for its shoes, with subtle backing from the West, especially by turning a blind eye to its terror infrastructure like drug running and arms smuggling from their countries, India, too, was left with no other option, especially after it daringly assassinated its beloved former Premier Rajiv Gandhi on its own soil.

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Midweek Review

Humanities in Medical Education

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By Dr. Siri Galhenage
sirigalhenage@gmail.com

‘They are shallow animals, having always employed their minds about Body and Gut, they imagine that in the whole system of things there is nothing but Gut and Body’

Samuel Taylor Coleridge [1772-1834]

The above derisive comment regarding doctors was made by the renowned romantic poet and philosopher, over two centuries ago. He was aggrieved by the predominantly biological preoccupation by doctors in the practice of their craft, giving less credence to a broader perspective about life. He was perhaps roused by the growing interest in a natural basis for disease and healing during the Renaissance period [14 – 17 centuries] in the West, with the emergence of anatomically based scientific medicine, moving away from mystic and spiritual traditions.

A HOLISTIC APPROACH to the PRACTICE of MEDICINE: A HISTORICAL PERSPECTIVE

Over the years, scientific medicine has progressed, with the development of high-tech diagnostic techniques exploring deeply into the body, its tissues and cells, and the discovery of effective pharmaceutical weapons against organic disease. This powerful science-based biomedical tradition spread globally and has remained dominant, despite a greater conceptualisation of social and psychological issues pertaining to health and well-being. As a result, the medical profession has tended to develop a sense of therapeutic self-confidence, with a tendency to ignore the psychosocial aspects of medicine and the benefits of the doctor-patient relationship, giving less importance to a display of humanity. It is true to say that, as a result, there is a growing discontent towards the medical system and the medical profession in recent times.

The above disparity in healthcare has attracted the attention of medical educators around the globe, who have started introducing a holistic [broad-based] approach to training of doctors by incorporating Humanities in the medical curriculum. ‘A Good Doctor Treats the Disease; A Great Doctor Treats the Patient’.

It was heartening to read Randima Attygalle’s interview with Dr. Santhushi Amarasuriya titled, ‘Medical Humanities: an interdisciplinary approach to holistic health’ regarding the initiative by the Faculty of Medicine, Colombo, in establishing a Department of Medical Humanities [Sunday Island: Oct. 6, 2024]. I also read with interest the scholarly articles by Susantha Hewa, ‘Humanities in the ‘art’ of healing: A case for subject integration’ [The Island: Oct. 16, 2024] and by Prof. Liyanage Amarakirthi of the University of Peradeniya: ‘Increasing scholarly mutuality for holistic understanding of life: Some initial reflections’ [The Island: Nov. 6, 2024], addressing the need for subject integration.

ROLE of HUMANITIES in MEDICAL EDUCATION

The aim of including Humanities in medical education is to nurture the desirable personal qualities in a medical practitioner in becoming a healer in the true sense of the word.

1. In gaining a broader understanding of the human condition in order to adopt a more holistic approach towards the practice of medicine.

2. In developing empathy and compassion towards one’s patients while maintaining professional boundaries.

3. In acquiring appropriate and effective communication skills in dealing with patients, as well as respectful discourse with colleagues and the team that the doctor works with.

4. In maintaining professional boundaries and ethical and moral standards.

5. In cultivating personal growth and resilience in having to confront the many challenges and adverse circumstances faced during the course of a doctor’s professional life.

HUMANITIES: ETYMOLOGY AND SCOPE

The base word ‘human’ with its Latin root ‘Humanus’, which refers to the characteristics of mankind has generated a range of derivatives with shades of meaning. It has given birth to such terms as ‘humane’ [which refers to being compassionate]; ‘humanitarian’ [having the welfare of mankind at heart; ‘humanism’ [the belief in human effort rather than divinity]; ‘humanity’ [which connotes mankind and civilisation]; and ‘humanities’ [a collective of academic disciplines that study the human condition].

Humanities, as opposed to biological and physical sciences, embody a wide range of disciplines, such as languages, literature, the arts, history and philosophy, and their critical evaluation. Religion and divinity are not within the range of interest of humanities, although their relevance in the spiritual growth of mankind cannot be disregarded.

RELEVANCE of CLASSICAL LITERATURE

in MEDICAL HUMANITIES

My focus here is classical literature which is an integral part of the discipline of Humanities. Great works of literary art attempt to explore and transmit the full range and depth of human experience, calling into play our emotional and intellectual faculties. Literary analysts observe that art and literature have the capacity to ‘convey serious truths and significant ideals’, ‘broaden our understanding of human nature’, ‘kindle our imaginations’, ‘raise our spirits’ and ‘enhance our sensibility’ [to quote Prof. Frodsham, late Professor of comparative literature, Murdoch University, Perth, Western Australia]. Those works regarded as of high quality are deeply humanistic and provide insights which enrich human existence, elevating our lives to a higher plane of functioning.

Works of literary artistry provide socio-cultural awareness, psychological insights, moral and ethical consciousness, in addition to aesthetic appreciation – the confluence of all of which has now evolved into the notion of literary sensibility, first conceived by the legendary English poet Geoffrey Chaucer of Canterbury Tales fame. It is a sensibility every human being should aspire to develop, the doctor in particular, who is expected to take on the task of healing.

Great writers tend to exercise their literary talent in directing the reader in achieving personality growth vicariously through the portrayal of characters and the situations they create. It is an enriching experience which generates an appreciation of beauty, use of metaphor, psychosocial insights [intra-psychic and interpersonal] that reflect societal attitudes, and moral instruction.

NURTURING LITERARY SENSIBILITY

While strongly advocating the introduction of Humanities in Medical Education, I believe that there should also be a greater emphasis by educational authorities on nurturing reading ability in children from their early formative years, as a way of sensitising them to literature in their later life. Reading with children and exploring their thoughts about what is read and helping them to understand and articulate their thoughts about life within their capacity, is called ‘conversational reading’.

The more young children read, are read to, and are engaged in conversation that flows on from stories read, the more they begin to love books [and words], increase their vocabulary and enhance their communication skills. It enhances a child’s self-worth and personal identity sadly lacking in those who lag behind reading for whatever reason. What better way for children to be introduced to the world that they are to be part of than be immersed in a story that is all about beings that surround them? What better way for children to learn about ideas and speech patterns, how people interact and react, how dialogue reveals more about a person than what they say, and gain an understanding of empathy and compassion? There is no better way to convey moral instruction than by vicarious learning through reading, and no better way to enhance their thinking and reasoning, to generate creativity and to introduce them to a life rich in meaning.

We in Sri Lanka are endowed with an ancient literary tradition that fosters literary sensibility. As far back as between the 7th and 10th century AD, our ancestors scribbled their sentiments in poetry on the mirror wall of Sigiriya Rock [Sigiri Kurutu Gee]. Our ancient scholars produced great literary works such as Sandesha Kavya, Kavya Sekaraya, Guththilaya, Subhasithaya [to mention a few], and in the 15th Century AD, King Parakramabahu the 6th. gave patronage to literary discourse. As a nation, we hold a predisposition to develop literary sensibility.

A FEW EXAMPLES of LITERARY ART to

ILLUSTRATE THEIR VALUE IN

MEDICAL HUMANITIES

I have cited below, a few examples of literary art, many of global fame, in order to illustrate their value in understanding human nature by tapping into their allegorical meaning. It was not my intention to suggest including them in a reading list in medical humanities; although some of them may attract the interest of the medical educators and the general readership.

Rudyard Kipling, in his narrative masterpiece, ‘Kim’, takes a Tibetan Lama and his disciple across what he calls ‘the great and wonderful land of Hind’ [India] along ‘the grand trunk road, teeming with life’ [a metaphor he uses for the path of life’]. The travellers are on a quest for understanding of humanity with the hope of achieving personal growth.

In an inspiring piece of lyrical ballad, The Rhyme of the Ancient Mariner, Samuel Coleridge, places his protagonist on board a ship and sends him off on a voyage – an archetypal journey of life with its trials and tribulations. The poet exposes the vulnerability of the human condition by making him commit an impulsive act of killing the albatross that guides him. He faces the wrath of nature, takes on board a burden of guilt and suffering, and on reaching the shore, embarks on a spiritual path, elevating him to being a productive human being.

Viktor Frankl, the celebrated Austrian psychiatrist of Jewish descent proposed the theory that the primary motivational force in man is to find meaning in life. He developed his theory, which gained wide application in medical practice through his direct personal experience as a prisoner in Auschwitz, the Nazi concentration camp, which led to his popular publication, ‘Man’s Search for Meaning’.

Leo Tolstoy, the Great Russian author skilfully constructs the character of Ivan Ilych in his much celebrated novella, ‘The Death of Ivan Ilych’. The author takes his protagonist, an upwardly mobile lawyer, to the top of a ladder, and makes him fall off it, both literary and metaphorically, into an abyss of misery. The crisis precipitates a terminal illness that makes him evaluate his life and gain insight into the inescapable truth about life – suffering – which reflects the author’s spiritual leaning towards Buddhism. In addition, the novella provides a brilliant portrayal of the patient’s ‘Abnormal Illness Behaviour’ and the ‘Doctor- Patient Relationship’ that should attract the attention of the student of Medicine.

As many scholars believe, there is no other literary artist than William Shakespeare who has had an in-depth understanding of the human condition, long before formal study of the human mind was undertaken by psychologists and psychiatrists. In his Magnum Opus, ’Hamlet’, he gives dramatic expression to the mourning and melancholy of Prince Hamlet, and the flight into a state of mania of grief-stricken Ophelia – two of his skilful character developments. He depicts the genesis of morbid jealousy in ‘Othello’ [a favourite of Psychiatrists!], and the existential dilemma of old age in ‘King Lear’, to mention a few. In his narrative poem ‘Lucrece’, Shakespeare poignantly gives lyrical expression to the agony and the psychological consequences of a victim of a sexual assault.

William Wordsworth, the lake poet of ‘The Daffodils’ fame maintained a high degree of resilience throughout life despite a series of personal losses including the loss of both his parents during his early development. He gained his inner strength by being nurtured by nature, the source of his creative energy-his sorrows sublimated through poetry. Wordsworth raises nature to a divine level to underscore her importance to man as teacher and healer.

Prose, verse and song often merging into one, and carried into a musical crescendo with matching melody was the main channel through which Rabindranath Tagore directed his creative energy. His wisdom is embodied in the ‘primordial truth’ of the interconnectedness of man and nature and the cosmic whole which formed the philosophical basis of his musical compositions. The predisposition to such confluence of feeling and nature occurred during his formative years: born to a family of 14 he was alone but not lonely, having nature as his companion, allowing his imagination run wild.

Many critics believe that Martin Wickremasinghe’s novel ‘Viragaya’ [dispassion] displays the best of his literary prowess. His skill in crafting the personality profile of Aravinda Jayasena, the protagonist of the narrative, makes it unique amongst his many works of creative literary artistry. It depicts the journey towards peace and tranquillity of a young man attempting to shed off all his passions. Often dubbed the ‘psychological novel’, Viragaya’s appeal is in the behavioural profile of Aravinda, which leaves the ‘psychological minded’ reader to mull over the complexities of his character.

Sinhabahu,

the mythical tale of the origin of the Sinhala race given dramatic expression by our greatest playwright, Prof. Ediriweera Sarachchandra, depicts a deeper psychological meaning of a young man’s separation and individuation by breaking away from his family to develop his own identity. The play enjoyed by many of us at the ‘wala’ at my alma mater in Peradeniya, oblivious then to its allegorical meaning!!

METHODOLOGIES in INCORPORATING

HUMANITIES in MEDICAL EDUCATION

Reorientation of the student of medicine by integrating humanities into the demanding medical curriculum is a challenge due to wider issues in our education system. Students who follow a science-based education with the intention of entering medical school perceive a dichotomy between natural sciences and literature. The dichotomy is a spurious one as both disciplines deal with the human condition! Those educated in evidence-based science subjects with ‘hard facts’, consider literature as a ‘softer’ area of study. The highly competitive tertiary entrance examination encourages the gathering of factual knowledge giving the student less time to be engaged in the arts and literature and to be absorbed in reflection.

As stated above, our nation is endowed with an ancient literary tradition well-placed to nurture literary sensibility. But many educationists today lament that we have lost our romance with the written word. Starting from the pre-school stage a significant restructuring of our education system is warranted to realise our literary potential.

A wide range of methodologies are used globally in incorporating Humanities into the medical curriculum. These include role play, use of video clips etc.

A common methodology used in the application of literature in Medical Humanities is the technique of ‘Close Reading’. It involves looking at a specific piece of text eg. a narrative poem, a short story or novella, and examining it in close detail in order to draw the imaginative and analytic skills of the student. It involves the exploration of characters, their personality profiles, the way they communicate with each other and the events and crises they create; appreciating the sociocultural context in which they occur; the student’s emotional response to the characters and situations; the allegorical meaning beneath the literal narrative; and the recognition of any underlying moral instruction. The intention is to create a safe environment for the students to freely discuss their observations. The facilitator navigates the discussion towards a clinically meaningful territory.

CONCLUSION

With the rapid progression of medicine into a technologically advanced profession, Social Sciences and Humanities as essential aspects of the Art of practice of medicine has struggled to occupy space in the heavily loaded medical curriculum. Classic literature, as a component of Humanities, has a role to play in meeting this need, vicariously, by fostering literary sensibility [and hence psychosocial and moral cognizance] through the allegorical themes presented by great works of literary art. Also, an added challenge posed by technological advances is the loss of our romance with the written word with the loss of sensibility during formative years, requiring an overhaul in our education system.

‘Wherever the art of medicine is loved there is also a love of humanity’ – Socrates.

[The writer is a retired Consultant Psychiatrist resident in Perth, Western Australia. He is a former examiner to the Royal Australian and New Zealand College of Psychiatrists, and the recipient of the 2023 Meritorious Service award of the RANZCP [WA Branch]. sirigalhenage@gmail.com

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Midweek Review

Wielder of the Victorious Pen

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By Lynn Ockersz

He stormed the bastions of power,

With sharp ideas and a golden pen,

Exposing their foundations of sand,

Cutting through shams and hypocrisies,

And giving in shining silver the hard truth,

All the while pointing to quality standards,

Which in the noble art of journalism,

Should be jealously held and kept,

And verily Victor Ivan we could say,

That the Fourth Estate of this stormy Isle,

Will be very much the poorer without you.

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