In early October, I attended the Examined Life conference in Iowa City. If you’re thinking, “Really, Maureen? That sounds kind of philosophical and introspective for a button-down, pragmatist like you,” let me tell you a little bit more about the conference. The Examined Life conference is hosted by the medical colleges at the University of Iowa hospitals; the conference focuses on the role of humanities and particularly of writing in the education of medical professionals. Because I’m piloting a healthcare professionals focus section of composition this spring (and because the conference was a short 30-mile drive to my folks’ house and was held on my birthday), I gave it a try.
This is a conference that makes you think. Some of the sessions I attended had a very familiar feel – for example a session on something called “The Waiting Room Project” detailed a public writing project similar to ones we have had here. In the Waiting Room Project, blank paper cut outs of culturally significant flowers were placed in the waiting rooms of intensive care units in Brazilian and Chinese hospitals. Family members and loved ones were encouraged to decorate the flowers and write their wishes, prayers, regrets or memories on the paper flowers before fixing them to the wall.
There was also a “mental make over” session conducted by a pediatric cardiologist who routinely does a writing exercise with his patients and their “wellness teams.” When the doctor senses tension or a lack of hope, he asks if people would like to do the exercise. For the mental makeover, everyone in the room writes three things that they are grateful for, a six-word story of their life, and three things they wish for. When the doctor does this, everyone (doctor, patient, family members, nurses, orderlies) participates and shares. When nurses hear that family members are thankful for small kindness they thought were overlooked, or when a doctor tells the patient his first wish is that they identify her problem as soon as possible, the stress level in the room goes down. At the same hospital, there is a group that does a “writing meditation” once a month, where they start with the mental makeover, then a member leads an original. writing exercise focused on reflection, and the groups end with sharing. The Amherst writing workshop rules apply (non-hierarchical organization, treat every piece of writing as though it is fiction, do not talk about the writing outside of the group). Generally, relaxation activities make me nervous, but this I would try if others were interested.
One surprising theme that was prominent at multiple sessions was the importance of indeterminacy and doubt. Before addressing doubt, Dr. Rita Charon, the director of Columbia medical school’s Medical Humanities Program, spent time talking about the more often discussed reasons given to justify humanities and writing courses in medical schools: the desire to hone observational skills and to create empathy. Indeed, Charon argued that does happen. She recounted the story of a resident in a psych rotation who was assigned to spend 40 minutes looking at a modern painting at the MET. The resident could barely stand still for the last half of his time because about 20 minutes into the experiment he had had the realization that the chaotic picture he was looking at paralleled the world that a patient he been struggling with had been describing to him. The painting gave him an insight he had not had. These breakthroughs are dramatic and rewarding when they happened, she acknowledged, but to her, the real value of the humanities was it brought doubt backed into the world of medicine.
Bud Shaw, author and pioneering transplant surgeon, picked up on the same theme about doubt versus control, noting that before anyone picks up a scalpel, cuts into a living person, removes their liver, and puts in a donor organ, they make every effort to control as much as possible and to eliminate all doubt about what will happen. It is natural in these instances to crave control and attempt to banish indeterminacy, but it is also dangerous – both for the patients who sometimes become victims of hubris and for the doctors themselves because not everything can be controlled in medicine. Biology is not physics, and where there are human beings, there is always an element of doubt as to how things will go that cannot be eliminated.
But beyond learning to balance caution and chaos, for both Dr. Shaw and Dr. Charon, the element of doubt or uncertainty introduced by a humanities curriculum not only prompts medical professionals deal with the emotional and personal side of medicine, it also engenders a type of creativity not captured in checklists but that is critical if a medical professional is going to get through cases that are not “textbook.” Both doctors said that doubt and creativity are often twinned in medicine. My favorite quote of the weekend came from Dr. Charon, who said “Doubt is the grey fog of indeterminacy that creativity navigates through—a creative person requires the ability to tolerate doubt, and the doubt can only be tolerated through creativity.”
Other random facts
- Over 15% of medical students majored in the humanities as an undergraduate (note: not the liberal arts, which include the sciences – humanities like literature, history, etc.).
- According to several studies, patients who write about trauma without sharing their work had measurably positive effects on their health: the data collected showed decreased visits to doctors, reduced asthma attacks, and even faster healing of wounds compared to control groups: the evidence did not show that sexual abuse victims benefited to the same degree, if at all. Again, this was writing without sharing, so assigning a trauma paper for class is unlikely to help heal wounds, according to the research they cited.
