The Humanities and Health

Dr. Richard Berlin is experienced in psychiatry, psychotherapy, expert psychopharmacology—and poetry. He treats patients at his private psychiatric practice in the Berkshire Hills of Western Massachusetts and has published over 60 professional papers in scientific literature. He also judges the William Carlos Williams Poetry Contest and has published award-winning poetry chapbooks.

Although Berlin’s career in medicine and interest in poetry may seem an unusual combination, he is in good company. There is a rich tradition of physician-poets, which includes John Keats, Oliver Wendell Holmes Sr., William Carlos Williams, and Rafael Campo (who is also a professor at Harvard Medical School). Many physicians have turned to poetry as a way to express their experiences and use more creative language than is possible in medical charts.

Poet-physicians occupy a niche within the medical humanities, an interdisciplinary field which consists of endeavors to connect the arts, humanities, and social sciences to medical education and practice. Although many healthcare professionals, such as Berlin, attest to the positive impact that the humanities have on their medical practice, the medical humanities face significant critique. Students and educators at medical schools question the value and structure of humanities curricula, and academics debate about the position of the medical humanities—whether they are multidisciplinary or interdisciplinary and how it connects to other branches of academia.

Despite these controversies, the medical humanities are expanding as more medical schools incorporate the arts and social sciences into their curricula, more academics investigate this field, and individual health care professionals continue to explore how the arts relate to their work. In this atmosphere of development and controversy, it becomes vital that all of those involved in this field—patients, healthcare providers, and academics alike—are familiar with the current state of the medical humanities.

Medical school instructors often incorporate the humanities in order to foster empathy or diagnostic skills, which are essential for effective medical practice. For instance, Elizabeth Gaufberg, an instructor in medicine at Harvard Medical School, leads seminars that focus on reflection through literature. She explains that incorporating the arts into medical education can “help the developing student figure out how to navigate both kinds of intelligence”—which she defines as empathetic understanding and scientific objectivity—“in the service of caring for patients.”

For instance, by discussing a text, medical students can reflect on difficult experiences they have had in clinic instead of attempting to ignore those experiences and closing themselves off from emotional engagement. Gaufberg explains that involving the humanities in these types of difficult conversations makes the students feel safer because “a work serves a kind of modulating function” and “you move back and forth between your own response to the poem and your own experiences in the conversation.” If the conversation becomes too intense for a medical student, he or she can immediately revert to simply analyzing the text.

Although Gaufberg observes students commenting more empathetically about patient experiences by the end of these reflections, she also acknowledges that it is difficult to empirically study reflective exercises. Because little quantitative evidence supports the impact of these reflections, medical students often question their value, according to Gaufberg.

However, other approaches to link the medical humanities with medical education are easier to empirically analyze. At Harvard Medical School, an elective course called “Training the Eye: Improving the Art of Physical Diagnosis” offers medical students the opportunity to hone their “visual literacy,” or observation and interpretation skills, through examining artwork at the Museum of Fine Arts. Empirically, students who complete this course exit with improved diagnostic skills; they produce more observations and more sophisticated descriptions about physical images during a post-course evaluation than during a pre-course evaluation.