Medical Humanities Blogs Comments

REFLECTONS ON BRIAN DOLAN’S BLOG

The intriguing musings of Brian Dolan and the incisive commentary by Schuyler Henderson inevitably provoke further reflection on the medical humanities and what they are doing in medical education.  I would like to add, somewhat discursively but I hope ultimately relevantly, to the discussion as follows.

In his inaugural speech as first president of the Czech Republic after the so-called Velvet Revolution brought about the downfall of communism, Vaclav Havel, also an internationally renowned poet, reflected on how new societies must be built.¹  He observed that everyone was looking toward the new government to tell them what to do, to lead them into a new way of living and a new way of being. But Havel claimed that the established political and institutional structures were unavoidably compromised, having been constructed during, and based on the assumptions and priorities of, the communist dictatorship.  The people could not rely on existing bureaucracies and institutions – what already was – for guidance. Instead, they had no choice but to turn to each other. Stumbling and staggering, they would have to risk building a new world together.

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Despite the obvious value, as indicated above, of taking critiques of the medical humanities at face value, discussions at a less-than-systemic, paradigmatic level about the role of the humanities in medical education themselves risk irrelevance. Whether faculty solicit feedback or don’t care what students think; whether students are self-protective and resent personaq l exploration or value self-awareness; whether bodies of knowledge outside of medicine and teaching modalities other than those traditionally used in medicine are given a place within the curriculum; whether the humanities are relegated to the outskirts of the curriculum or whether they are integrated across four years of training do depend in part on individual instructors’ commitment, skill and effort ; but more importantly, they depend on systemic values, priorities, and assumptions within the culture of medicine. 

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Commentary: The United States is not the only country contemplating significant political change. This week, the Nepalese are holding national elections that may eventually bring to an end the country’s 240 year old Hindu monarchy. Although on an infinitely smaller scale, it is nonetheless thrilling to think of the changes in medical education that Prof. Ravi Shankar and his colleagues are attempting to foster by introducing a medical humanities program to the system of physician training in this mountain kingdom.  Despite the exotic location, what surprised me was how similar are the struggles in both countries to implement change and enlarged, more nuanced worldviews as part of our medical education enterprises. 

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