140.04: MEDICAL HUMANITIES AREA OF CONCENTRATION

Meeting 1
Meeting 2
Meeting 3
Meeting 4
Meeting 5
Meeting 6
Meeting 7
Meeting 8

Pre-meeting 1:

Bring to the first meeting a 1 – 2 page statement offering your opinion about the following statement: “Medical technology, as it has emerged throughout the 20 th -century, has led to the dehumanization of medical practice.”

Meeting 1: September 19
WHAT IS “MEDICAL HUMANITIES?”
Introductory discussion by Dr. Brian Dolan, Course Director

Readings:

R. Puustinen, M. Laiman, AM Viljanen, “Medicine and the Humanities: Theoretical and Methodological Issues”, J Med Ethics; Medical Humanities 29 (2003), 77-80.

• •  What is meant by reductionism in science? Holism?
• •  What is a ‘participant observer'?
• •  Why is the clinical interaction offered by some as the best place to bring the humanities into medicine?

Susan Squier and Anne Hunsaker Hawkins, “Medical Humanities and Cultural Studies: Lessons Learned from an NEH Institute”, Journal of Medical Humanities 25 (2004), 243-253.

• •  Since when did medicine need humanizing ?
• •  Explain the ‘missionary tendency' (p. 248).
• •  What do you think might have been lost by not having a MD, or medical student, participate in this discussion?

Jonathan Moreno, “Call Me a Doctor? Confessions of a Hospital Philosopher”, Journal of Medical Humanities 12 (1991), 183-196.

• •  “ ‘No one is trained for this', I repeated to myself.” (p. 184) Would a difference between a pure clinical training or a pure philosophical training make any difference to the author's dilemma?
• •  What is the difference between medical humanities and medical ethics?

ASSIGNMENT: Bring to the next meeting a 1-2 page “vignette” – a short tale – reflecting on a personal experience, at whatever stage in life, where medicine struck a very human chord within you.

Meeting 2: September 21
LITERATURE AND MEDICINE

An open discussion of the readings listed below; some thoughts/questions to consider in bullet points.

Readings

(list might seem long, but it is only about 100 pages total)

1) Leslie Fiedler, “The Tyranny of the Normal ”, pp. 3-11

2) William Hoskin, “Neurology Rounds”, pp. 262-3

Both from The Tyranny of the Normal : An Anthology, Carol Donley and Sheryl Buckley, eds. (Kent State,1996)

• •  Does Leslie Fielder have any legitimate authority to talk about normal and deviant?
• •  Public obsession with ‘freaks': why does there seem to be a pop culture surrounding the abnormal?
• •  (Neurology rounds): Why are medical references placed in quotation marks?
• •  Why do patients get put into “categories of anonymity”?

3) Emily Martin, “Immunology on the Street: How Nonscientists See the Immune System”, from Sarah Nettleton and Jonathan Watson, eds., The Body in Everyday Life (Routledge, 1998) pp. 45-63

• •  What does Martin's research tell us, if anything, about the “public understanding of medicine”?

4) Oliver Wendell Holmes, “The Stethoscope Song, a Professional Ballad”, pp. 25-6

5) William Carlos Williams, “The Use of Force”, pp. 73-76

• •  WCW: What frames the story? How is the context created and how does that lead to certain tensions?
• •  How has power here? Doctor? Parents? Patient?
• 6) Ernest Hemmingway, “Indian Camp”, pp. 102-105
• •  Compare to William Carlos Williams: one ethical problem compounding another. Why did the husband kill himself?

7) Lewis Thomas, “House Calls”, 145-50

8) Randall Jarrell, “The X-Ray Waiting Room in the Hospital”, p. 154

9) Anatole Broyard, “Doctor, Talk to Me”, 166-172

• •  What kind of doctor does Broyard want? Is this the desire of a ‘mad' patient?

10) David Hilfiker, “Mistakes”, 325-36

All (4-10) from On Doctoring: Stories, Poems, Essays, Richard Reynolds and John Stone, eds. (Simon & Schuster, 2001).

11) Raymond Carver, “A Small, Good Thing”, in A Life in Medicine, Robert Coles and Randy Testa, eds. (The New Press, 2002), 180-203.

Meeting 3: September 26
NARRATIVE MEDICINE - Guest speaker Louise Aronson, MD, UCSF
A discussion of the readings, a short writing exercise, and “close reading” of the exercises and, if there’s time, of the O’Brien story.

Medicine as Narrative
1) Trisha Greenhalgh, “Why study narrative?” BMJ 2003; 327: 1424-1427.
2) Thomas Newman, “The power of stories over statistics”, BMJ   2003;327:1424-1427 (20 December)
3) Rita Charon, “Close Reading” in Narrative Medicine: Honoring the Stories of Illness. Oxford University Press, 2006.

Narrative as Medicine
1) Carol A Horowitz et. al., “What do doctors find meaningful about their work?” Ann Intern Med. 2003;138:772-775.
2) Abraham Verghese, “The physician as storyteller.” Ann Intern Med. 2001;135:1012-1017.
3) Jon Stewart, “The shared terrain of narrative medicine and advocacy journalism.” The Permanente Journal, Spring 2004, Vol 8 No.2.

Short story
1) Tim O’Brien, “How to tell a true war story.” The Things They Carried. Houghton Mifflin, 1990.

Meeting 4: September 28
MEDICINE IN THE MOVIES – Guest speaker Dr. John Tercier, MD/PhD, UCSF

Dobson, Roger. “Can medical Students learn empathy at the movies?” BMJ, 329, 2004, 1363.

O’Connor, M. “The Role of the Television Drama ER in Medical Student Life: Entertainment or Socialization?” JAMA, 1998 280.9 845-7.

American Academy of pediatrics Committee on Public Education. “Media Education” Pediatrics, 104:2, 1999, 341-2.

Lederer, S., N. Rogers. “Media” In Medicine in the Twentieth Century. eds. R. Cooter and J. Pickstone, Amsterdam: Harwood Academic Publishers, 2000, pp.487-502.

Turow, Joseph. “Television entertainment and the US health-care debate” Lancet 347:9010, 1996, 1240-9

Diem, Susan, Lantos, John, Tulsky, James. “Cardiopulmonary resuscitation on television: miracles and misinformation” NEJM, 1996, 1578-82.

Gunning, Tom. “An aesthetic of astonishment: Early film and the (in)credulous spectator.” In Film Theory and Criticism, (eds) L. Braudy and M. Cohen, New York: Oxford University Press, 1989, 818-32.

Meeting 5: October 3
POETRY IN MEDICINE – Guest speaker Dr. Guy Micco, MD, UC Berkeley

Readings might be added to in class; there will be some writing exercises for this class, but nothing to prepare for (except mentally).

Richard Selzer, Rituals of Surgery (Touchstone, 1980), Short Stories.

Various authors, Collection of assorted poems.

ASSIGNMENT: Bring to the next meeting a 1 – 2 page statement describing briefly what you think the most significant developments (how ever many you care to discuss) have been in the history of medicine.

Meeting 6: October 5
ART AND REPRESENTATION IN MEDICINE –

First half an exhibit of the history of anatomical illustration through rare books at the Kalmanovitz Library, Lisa Mix; Second half a presentation on the impact of new media on medical illustration, guest speaker Thom Dickerson, Educational Graphic Arts Department, UCSF

Readings:

Roger French, “The Anatomical Tradition” in W. Bynum and R. Porter (eds.) Companion Encyclopedia of the History of Medicine (London: Routledge, 1993), pp.81-101.

S.R. Detwiler, “Anatomy as a Science”, Science 70 (1929), 563-566.

Check out these web sites on the digital representations of the body:

Visible Human Project -

http://www.dhpc.adelaide.edu.au/projects/vishuman2/mpegs.html

http://www.uchsc.edu/sm/chs/gallery/gallery.html

http://www9.biostr.washington.edu/da.html

http://www.anatomy.wright.edu/qtvr/library/library.html#

http://www.nlm.nih.gov/research/visible/applications.html

http://www.nlm.nih.gov/research/visible/products.html

Anatomies online :

http://www.nlm.nih.gov/exhibition/historicalanatomies/browse.html

http://www.nlm.nih.gov/exhibition/historicalanatomies/addlinks.html

http://archive.nlm.nih.gov/proj/ttp/books.htm

Meeting 7: October 10 Moved to October 11

Meeting 7: October 11 WEDNESDAY !!!!!!
A PHOTO-ETHNOGRAPHY OF HOMELESS ADDICTS – Guest speaker Jeff Schonberg, PhD candidate, UCSF

Readings :

Martin Kemp, “Reading the Signs”, in M. Kemp and M. Wallace, eds., Spectacular Bodies ( Berkeley : University of California Press, 2000), 94-123.

M. Kemp, “Mad and Bad: Addled and Atavistic”, in M. Kemp and M. Wallace, eds., Spectacular Bodies ( Berkeley : University of California Press, 2000), 124-147.

The Kemp readings were assigned to get into visual culture. In “Reading the Signs” Kemp says that “we care deeply about what someone looks like”. Imagine yourself as a writer or an artist, think about how that desire to know about appearance affects the way one represents the subjects/characters of one's work.

Beverly Ann Davenport, “Witnessing and the Medical Gaze: How Medical Students Learn to See at a Free Clinic for the Homeless”, Medical Anthropology Quarterly 14 (2000), 310-327.

Meeting 8: October 12
HISTORY OF MEDICINE – Guest speakers Dr. Robert Bartz, MD/PhD, Dr. Victoria Sweet, MD/PhD, UCSF

Some illustrative histories of major moments in medical history; discussion about the impact of studying history on the lives of two physicians.

Readings:

Roy Porter, “Scientific Medicine in the Nineteenth-Century”, in his Greatest Benefit to Mankind: A Medical History of Humanity (London: HarperCollins, 1997), 304-347.

James Le Fanu, “Twelve Definitive Moments in Modern Medicine”, in his The Rise and Fall of Modern Medicine (London: Little Brown, 1999), reduced to Four definitive moments: Penicillin (1941), Cortisone (1949), Streptomycin (1950), Open-Heart Surgery (1955).

Guenter Risse, “Hospitals as Biomedical Showcases”, in his Mending Bodies, Saving Souls: A History of Hospitals (New York: Oxford University Press, 1999), 569-618 (about Moffitt hospital).