Medical Humanities and the Eighteenth Century

Abstract

Medical Humanities and the Eighteenth Century Stephanie M. Hilger The academic separation of the sciences and the humanities makes it difficult to explore the connection between the various aspects of the human condition, not least in the discipline of medicine. Even though medicine is not a hard science per se but an interpretive approach that combines scientific and humanities-based modes of knowledge and therefore also experiences what Catherine Belling has called the "hermeneutic anxiety" that informs humanities research,1 it is firmly located among other science buildings whose literal and figurative gates are jealously guarded. The current academic focus on evidence-based medicine further increases the distance between medicine and humanities-based approaches to the human body by implying that the humanities do not produce real evidence. At the same time, calls for narrowing this distance are intensifying. Reestablishing the connection between the humanities and the sciences has become more important than ever because of global processes of corporatization that affect both health care institutions and universities. Cost efficiency in medical education has made it increasingly difficult to offer courses that focus on the human aspect of medicine within the medical curriculum itself. At the same time, the perceived crisis in the humanities has encouraged literary scholars to emphasize that their work is not a self-referential field of inquiry but that it engages broad social and political processes. As a result of the convergence of these two trends, the need for interdisciplinary spaces in teaching and research has grown over the past years. The most forceful calls for bridging disciplinary divides already occurred in the 1970s, when the practice of "literature and medicine" gained ground as a reaction to the transformation of medical schools into high-powered research centers in the previous decade. As Anne Hudson Jones outlines, Edmund Pellegrino called upon medical educators to refocus their attention on the moral dimension of medicine.2 At the same time, Joanne Trautmann Banks highlighted the necessity of "read[ing], in the fullest sense" in order to increase medical practitioners' "tolerance for ambiguity" with the goal of improving patient care.3 With the establishment of the journal Literature and Medicine in 1982, these interdisciplinary endeavors found a home. The name of the journal reflected the reality that the majority of these interdisciplinary ventures originated in literature departments. In addition, literature, in the sense of belles lettres, is perhaps the most "humanistic" of all [End Page 301] humanities disciplines because it is often considered a production of art for art's sake. However, the contributors to the first issues of the journal demonstrated the exact opposite of this common notion. In fact, Rita Charon vehemently opposed an instrumentalization of literature that provided medical doctors merely with "a civilizing veneer" by arguing that writing a poem or quoting a philosopher does not necessarily make a better doctor.4 Many of the early scholars working in the field focused on the textual features not only of literature but also of other types of discourse, including medical texts. One incarnation of this practice is Rita Charon's concept of "narrative medicine," which puts medical practitioners face to face with the textuality of their patients' experiences. These close reading practices were geared at simultaneously uncovering the textual dimension of medical discourse and demonstrating that literature does not constitute a self-referential aesthetic discourse but a powerful vehicle for social commentary. Gradually, the designation "literature and medicine" became limiting in view of other humanities-based approaches to medicine such as history, philosophy, and theology, which do not necessarily focus on medicine's narrative dimension. As a result, the designation "medical humanities" began to be used with increasing frequency. The founding of journals such as Medical Humanities, published by the Institute of Medical Ethics in the UK (2000), and the Journal of Medical Humanities, based in the Center for Bioethics and Humanities at the University of Colorado (1981),5 signaled the expansion of the field and its increasing academic institutionalization. More recently, as Paul Crawford has observed, "medical humanities" has been replaced by "health humanities" to encompass not only the full range of disciplines involved in the delivery of healthcare but also the patients themselves.6...