Doctors Need Lit To Stay Human

Goya, "Order and Disorder"

Goya, “Order and Disorder”

Wednesday

Earlier this summer I came across this New York Times article about “Reading novels at Medical School.” Daniel Marchalik, M.D. , a urologist who also heads the literature and medicine track at the Georgetown University School of Medicine, uses literature to help his interns handle the pressures of medicine and maintain a healthy perspective on life and death. 

For instance, an Emily Dickinson poem helps the hospital’s interns acknowledge both their own grief and that of their patients. The poem begins with the kind of grief that one might encounter in a hospital ward but then expands beyond to include a generalized human depression and aching heart. I quote the first five stanzas as the most directly applicable to a doctor-patient relationship: 

I measure every Grief I meet
With narrow, probing, Eyes—
I wonder if It weighs like Mine—
Or has an Easier size.

I wonder if They bore it long—
Or did it just begin—
I could not tell the Date of Mine—
It feels so old a pain—

I wonder if it hurts to live—
And if They have to try—
And whether—could They choose between—
It would not be—to die—

I note that Some—gone patient long—
At length, renew their smile— 
An imitation of a Light
That has so little Oil—

I wonder if when Years have piled— 
Some Thousands—on the Harm— 
That hurt them early—such a lapse
Could give them any Balm—

 

Literature is vital for doctors, Marchalik argues, because medical routines can become deadening:

The students are here [in the book group] after long days in class and on the wards because they have discovered that medical education is changing them in ways that are unsettling. I remember that uneasiness well. My own medical education began with anatomy lab. The first day with the cadaver was unnerving, but after the first week the radio was blaring as we methodically dissected the anonymous body before us.

Two years later, on my first clinical rotation, I discovered that it does not take long to acclimate to the cries of patients as I hurried past their rooms, eager not to fall behind in a setting where work must be done quickly and efficiently. This practiced detachment feels necessary, a form of emotional and physical self-preservation. But with little time to slow down, ignoring our own thoughts and feelings quickly hardens into a habit.

Marchalik also mentions leading a discussion of Haruki Murakami’s latest novel, Colorless Tsukuru Tazaki and His Years of Pilgrimage,  and he recounts an experience that is familiar to literature teachers: the work elicits a response that he does not anticipate. The story, he notes is about

a depressed middle-aged Tokyoite’s attempt to retrace his past in order to understand how his life became so empty. We talk about the main character’s colorless perception of the world, and why his mind feels so inaccessible to us.

I receive an email from a student later that evening. He, an aspiring psychiatrist, tells me the story of a much-admired college mentor. “I heard last week that he committed suicide. I am still crushed,” he writes. “He was diagnosed with depression but seemed to be doing great.” If he so misjudged his teacher’s state of mind, he worries, how will he make it as a psychiatrist?

Another novel, Karen Joy Fowler’s We Are All Completely Beside Ourselves, gets Marchalik’s group talking about the ethics of animal testing:

The novel is narrated by a woman whose “sibling,” we later discover, is a chimpanzee who was raised with her as part of a human-chimp experiment. We used the book to think through real-life examples like the Silver Spring Monkeys — a series of gruesome primate experiments that both galvanized American animal-rights groups and led to breakthrough scientific discoveries.

A third-year student talked about the three years he spent working with rhesus macaques. Research from his lab led to breakthrough discoveries about memory and behavior and contributed to therapies such as deep brain stimulation. “Doesn’t that answer the ethical questions?” he asked.

Another student talked about studies that she worked on for several years before starting medical school. “Have you heard of professional testers?” she asked the room. “People whose only source of income is volunteering for different studies, mostly college kids and immigrants? Shouldn’t we be talking about human research also?” For me, the discussion proved transformative. I walked into that class firmly supporting animal research and walked away still supporting research but no longer eating meat.

Meanwhile, a novel about a dystopian future in which people are raised to be organ donors elicited this response:

As I’m walking out of the classroom at the end of the evening, a third-year student approaches me to tell me he’s been thinking more deeply about his experience of being an unrelated organ donor to his step-uncle, a man he barely knew. “It’s been on my mind since we read Ishiguro’s ‘Never Let Me Go’ last month,” he says. “I want to write about it. I don’t even know how I feel about it, and I need to figure it out.”

Even when the novels don’t have direct application to medical issues, Marchalik says, they serve a vital function:

Our busy jobs on the hospital wards require precision and efficiency, but in literature class we can slow down and explore human lives and thoughts in a different, more complex way. The class is an anatomy lab of the mind. We examine cultural conventions and conflicting perspectives, and reflect on our own preconceived notions about life and work. Reading attentively and well, we hope, will become a sustaining part of our daily lives and practice.

More proof that literature is a vital resource in our survival packs.

This entry was posted in Dickinson (Emily), Fowler (Jaren Joy), Kazuo Ishiguro, Murakami (Haruki) and tagged , , , , , , , , , . Bookmark the permalink. Post a comment or leave a trackback: Trackback URL.
  • Dana Huff

    Are you familiar with the writing of Richard Selzer? I have used part of “The Knife” with my AP Lit students (though it would be beautiful for AP Lang). https://kentcomp0100.files.wordpress.com/2013/08/selzer-the-knife.pdf

  • Robin

    This sounds really interesting, Dana. I’ll track it down.

  • Robin

    I just read it, Dana. Wow! Thanks for sharing it.


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