Health Humanities and Medical Education: Joined by a Common Purpose

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Excerpt

I learned the art of storytelling from my father. He would tell us bedtime stories upon his return from a day of delivering fuel oil to his various customers around Boston, his hands reeking of the acrid smell of oil that would not wash away in spite of scrubbing with abrasive soaps. But my brothers, sister, and I did not mind the smell. In fact, it was the familiar smell of Dad that settled us down for the story to come as we huddled around him on one of our beds. We were in for an adventure, a true story no less, usually based on his experiences in World War II. Every story had unexpected dangers, battles of good versus evil, villains, heroes, and a happy ending that sent us off to a restful sleep. Later in my life, I tried to follow his example by telling stories to my own children. I remember how I would sometimes be wide awake and animated as I built up to a story’s climax, only to notice that the children were already asleep. I was tempted to wake them up so that they could appreciate the clever plot twists of my tale, but then I realized that the purpose of the story was to get them to drift off to a peaceful sleep, not for me to win the Pulitzer Prize for bedtime stories.
The purpose and value of bedtime stories are easy to understand and support. But what are the purpose and value of stories and other art forms in medical education and health care delivery? In short, what are the contributions of the medical humanities? This important question is worthy of our consideration because as medical education has become competency based with measurable milestones requiring evidence of outcomes, the role of the medical humanities as a contributor to physician competence has come into question. In a literature review, Ousager and Johannessen1 describe the problem of the medical humanities well: “It is, however, very difficult to measure with any certainty to what extent the inclusion of humanities in medical curricula makes better doctors.” Their extensive review concludes that
The historical basis for including the humanities in medical education may provide some guidance about how to approach the threat identified by Ousager and Johannessen. Jones et al2 note that the history of medical humanities is marked by the need for a “cultural transformation that would address the imbalance between technological aspects of medicine and the human facets of health and caregiving.” The authors describe the historical description of medical humanities as “the intersection of medical phenomena (e.g., physicians, patients, illness) and the traditional disciplines of the humanities, including history, literature, philosophy, and visual arts.” Thus medical humanities programs developed partly to provide a counterbalance to the technological and scientific information dominating medical education curricula. Jones et al propose to replace the term medical humanities with a more inclusive term, health humanities, to recognize the numerous nonmedical elements that affect health, such as poverty, education, and race, as well as the participation of many nonphysicians in the health care delivery system.
Health humanities may be justifiably included in curricula for health professionals if the goals of the health humanities and the purpose of medical education are aligned. But what is the purpose of medical education? I suggest that a reasonable purpose of medical education is to prepare students through educational experiences to be doctors who can meet the goals of the Triple Aim: better health, better health care, and lower cost described by Berwick et al.
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