Political Mythologies   /   Spring 2022   /    Notes & Comments

Medical Humanities and the Specialist

The art of medicine is the art of thinking.

Ronald W. Dworkin

Anatomy of the shoulder and arm (detail), 1510–1512, by Leonardo da Vinci (1452–1519); Universal Art Archive/Alamy Stock Photo.

Whenever I put a patient to sleep, all conversation, all culture, comes to an end. My job as an anesthesiologist is to take care of a patient’s organs, not to debate the meaning of life. That logic might well explain why most medical specialists ignore the field of medical humanities, now taught in almost half the nation’s medical schools. They think the field benefits primary care doctors, who spend a lot of time talking to patients, rather than specialists, who perform procedures and focus mostly on a few body parts.

Yet this is shortsighted thinking on the part of specialists, ironically abetted by medical humanities itself. The original purpose of medical humanities was to expand a doctor’s way of thinking in a general sense, by widening the doctor’s horizon. In some ways, it was to make doctors more thoughtful without their even knowing it. Over time, the field grew and divided into professional subfields, such as bioethics, narrative medicine, and social justice. Rather than help future doctors slowly develop through broad education, the subfields dispensed information and taught specific behaviors, making medical humanities a kind of profession in its own right. For example, through narrative medicine, doctors learned how to approach issues of death and dying, knowledge that prepared them for work on the cancer ward. When medical humanities also became an undergraduate field of study, disconnected from medical practice altogether, it drifted even further from its original mission.

The drift was understandable, as medical humanities needed to justify itself in a cash-strapped health-care system. This meant giving doctors useful tools. And indeed, bioethics, narrative medicine, and social justice in medicine are useful tools. Yet they mainly help doctors who talk to patients rather than those who work on body parts. A primary care doctor who reads a patient narrative of what it is like to live with heart failure may learn empathy, but the story is of no help to an anesthesiologist struggling to intubate a patient. According to the American Academy of Family Physicians, more than half of American doctors today are specialists.

To help all doctors, not just primary care doctors, medical humanities might do well to revisit its roots, which include the careful study of works of literature, art, history, and philosophy. Medical humanities should continue to dispense knowledge and teach technique, but it should also cultivate in doctors an interest in the humanities more generally, to help them learn the art of thinking.

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