Cynthia Geppert has done it again! She has written a timely article that expresses what I have thought for a long time (“Why Psychiatrists Should Read the Humanities,” Psychiatric Times, February 2008, page 10). Recently, I was sitting in a nonscience course for first-year medical students wondering why it was difficult for some of them to respond to the professor’s questions.
Cynthia Geppert has done it again! She has written a timely article that expresses what I have thought for a long time (“Why Psychiatrists Should Read the Humanities,” Psychiatric Times, February 2008, page 10). Recently, I was sitting in a nonscience course for first-year medical students wondering why it was difficult for some of them to respond to the professor’s questions. The thought occurred to me, “Here is a group of (generally) younger students who have come straight from college with backgrounds in the hard sciences but may not know what to do with questions that require more abstract responses.” When the answer to a question comes from scientific data, it is relatively straightforward, but when students have to process information and form an opinion, it can be another matter.
I am reminded of a 1970s television program called The Paper Chase, in which Professor Kingsfield informs his students that they teach themselves the law while the faculty trains their minds. Somewhere along the way, we have gotten the idea that medical education consists of the accumulation of biological information about biological entities. Patients wish to be treated as persons by their physicians, but we insist on training physicians to relate to patients as nonpersons. At times, it seems our emphasis on evidence-based practice suggests that we are more concerned with fitting our patients into the broad categories of populations than we are with the microcosmic population that is the individual.
I came to medical school with a background in history, philosophy, and religion, and I cannot work with patients without thinking in terms of myth, story, fairy tale, and the ways in which the real world transcends appearances. In my former life as a hospital-based psychotherapist, patients would sometimes complain that they felt like their individuality was invisible to their cognitive-behavioral therapists. Issues about “splitting” aside, I think there is a valid point to be considered: instead of seeing the patient through the lens of our theoretical orientations, we have to learn how to see the patient as a person. And I think we do that by learning how to be persons ourselves.
Medical and graduate medical education has to be reshaped to develop and nurture, rather than suppress, the physician’s humanity. Honestly, I think this prospect probably unnerves the average student whose education is largely scientific. One of the best experiences I have ever had was with a great books program at the University of Dallas. I was a graduate student in theology, and my program required a minor in philosophy. We read Hegel, Plato, Machiavelli, and so on, and as a soon-to-be physician, I think that whole process was as meaningful as a graduate degree in neuroscience and perhaps even more so for understanding human nature.
It is hard to balance priorities, and we all feel the pressure of “keeping current,” especially in medical school and residency, but good reading habits can prepare students for the flexible and original thinking that characterizes the best in medical practice. For students who have yet to learn this, we need to be better teachers.