After a 50 year absence, the humanities return to medicine

Medicine remains one of the fields that is defined by a hierarchy that would rival the world of Downton Abbey at its pinnacle. Over fifty years ago medical training lost track of the humanities and with it the ability to effectively connect with colleagues and patients as fellow humans.

The intensity of preparation for acceptance to a top medical school only deepens with competition for internships and residencies. Doctors in training represent the best and the brightest, but often not the top of the class when it comes to emotional intelligence.

At a time when college is increasingly defined as vocational prep, with students choosing majors based on perceived guarantees of post-grad employment, medicine is stepping back from its singular focus on the sciences and reintroducing the humanities to remove barriers created by hospital hierarchy, promote teamwork and improve patient communication.

Dr. Tara Narula, a medical contributor for CBS This Morning, reported Thursday on a program in Boston that “teaches physicians in training to use their eyes and ears to connect with patients and enhance the practice of medicine.”

“At the Brigham and Women’s Hospital, doctors, nurses and Harvard medical students are helping reshape medical education. By day, members of the integrated teaching unit, or ITU, focus on treating patients. But at night, they fix their sights on works of art.

At the Museum of Fine Arts in Boston, art becomes a catalyst to strengthen clinical and interpersonal skills, softening the hard science of medicine with creative expression.

Dr. Joel Katz designed the art curriculum at Brigham and Women’s, which has become a model for other hospitals.

Katz chose the art museum because it “allows everybody to focus on an external object in a way that I would say takes the personal aspects out and lets them solve problems together.”

Activities are carefully designed to enhance team-building, and to break down the hospital hierarchy, junior staff members are paired with more senior colleagues. Observing and describing art is used to promote problem solving, communication, thinking outside the box and appreciating other perspectives.”

Increasingly, schools of medicine are recognizing the need to ‘humanize’ medical practitioners, including Columbia University’s program in Narrative Medicine and Stanford University’s Medicine and the Muse program. And a quick review of the best seller lists over the past decade, will reveal an impressive list of physicians who have exercised their talents in the humanities: Adam Verghese, Atul Gawande, Oliver Sachs, Siddhartha Mukherjee, and this month, Paul Kalanithi.

“With this program, Dr. Joel Katz hopes to find some of the human interaction that has been lost in medicine.

In fact, as recently as 50 years ago, humanities were at the core of medical practice. While research into this program’s effects is still ongoing, there is strong anecdotal evidence that both patients and practitioners benefit.”

 

 

 

 

The Saturday Read – a selection of the best articles of 2015 from Jon Ronson, Oliver Sacks, Kathryn Schulz and Nikil Saval

This week the recommendations for ‘The Saturday Read’ come from journalists who wrote some of the most popular long form articles of the year. Instead of a book, which might seem daunting in the midst of holiday shopping and celebrating, sample the writings of these four storytellers who tackled a range of topics including internet shaming, death, earthquakes and the origins of the white collar worker.

On Wednesday, ‘The Upshot’ covered ‘The Stories That Held You The Longest in 2015’. “We measured the favorite Times articles of 2015 in a new way — by the total combined time readers have spent looking at them. It’s a mix of ambitious investigative projects, big breaking news, features and service journalism.”

Number two on the list first appeared in the February 12, 2015 New York Times Magazine. Written by Jon Ronson, ‘How One Stupid Tweet Blew Up Justine Sacco’s Life’ tells the story of the world of public ‘internet shaming’ through the experience of its victims.

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“In the early days of Twitter, I was a keen shamer. When newspaper columnists made racist or homophobic statements, I joined the pile-on. Sometimes I led it…

Still, in those early days, the collective fury felt righteous, powerful and effective. It felt as if hierarchies were being dismantled, as if justice were being democratized. As time passed, though, I watched these shame campaigns multiply, to the point that they targeted not just powerful institutions and public figures but really anyone perceived to have done something offensive. I also began to marvel at the disconnect between the severity of the crime and the gleeful savagery of the punishment. It almost felt as if shamings were now happening for their own sake, as if they were following a script.”

Number ten on the list was an Op-Ed piece by neurologist and writer, Oliver Sachs, ‘My Own Life’, on learning he had terminal cancer.

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“Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well).”

A New Yorker article received a lot of attention when it first appeared in July. ‘The Really Big One’ was researched and written by contributor, Kathryn Schulz.

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“Most people in the United States know just one fault line by name: the San Andreas, which runs nearly the length of California and is perpetually rumored to be on the verge of unleashing “the big one.” That rumor is misleading, no matter what the San Andreas ever does. Every fault line has an upper limit to its potency, determined by its length and width, and by how far it can slip. For the San Andreas, one of the most extensively studied and best understood fault lines in the world, that upper limit is roughly an 8.2—a powerful earthquake, but, because the Richter scale is logarithmic, only six per cent as strong as the 2011 event in Japan.

Just north of the San Andreas, however, lies another fault line. Known as the Cascadia subduction zone, it runs for seven hundred miles off the coast of the Pacific Northwest, beginning near Cape Mendocino, California, continuing along Oregon and Washington, and terminating around Vancouver Island, Canada. The “Cascadia” part of its name comes from the Cascade Range, a chain of volcanic mountains that follow the same course a hundred or so miles inland. The “subduction zone” part refers to a region of the planet where one tectonic plate is sliding underneath (subducting) another. Tectonic plates are those slabs of mantle and crust that, in their epochs-long drift, rearrange the earth’s continents and oceans. Most of the time, their movement is slow, harmless, and all but undetectable. Occasionally, at the borders where they meet, it is not.”

Longreads.com selected their ‘Best of 2015’ which included an excerpt from the book, ‘Cubed: A Secret History of the Workplace’. The fifth most popular article was ‘I Would Prefer Not To: The Origins of the White Collar Worker’, written by Nikil Saval.

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“When does the office begin? It’s a question without an easy answer. One can associate the origins with the beginning of paperwork itself—until recently, the most common mental association with office work (think of the derogatory phrase “paper pusher”). In other words, since the invention of writing and the corresponding ability to keep records in a systematic manner, there have always been places that resemble offices: monasteries, libraries, scholars’ studies. Banking furnished an especially large amount of paperwork; the Uffizi, an incomparable gallery of Renaissance art in Florence, was also one of the first office buildings—the bookkeeping offices of the Medici family’s groundbreaking financial operations. Clerks, too, have existed for ages, many of them unclinching themselves from their desks to become quite famous: from Samuel Pepys, the British government diarist who reported on the gossipy world of seventeenth-century England, to Alexander Hamilton, who had cut his teeth as a merchants’ clerk before he became the first secretary of the Treasury of the United States; Benjamin Franklin, paragon of pecuniary restraint and bourgeois self-abnegation, started out as a dry goods clerk in 1727. Perhaps some of the tediousness of Franklin’s own writing was honed in the conditions of his first job: since clerks have had the opportunity to keep diaries, they have bemoaned the sheer boredom of their tasks—the endless copying, the awkward postures, the meaninglessness of their work. When not doing writing for the job, clerks have cultivated the habit of writing about the job—or literally around it…”

 

 

The week@work – Why everyone should take a geography class, Angela Merkel’s humanity, and the legacy of Oliver Sachs

The week@work was one of stories that urge us to open our minds and hearts to what we may not at first understand.

If you don’t understand geography you won’t comprehend the on-going global political struggles. If you live in Europe, you are overwhelmed imagining the impact of the vast number of immigrants arriving daily. German Chancellor Angela Merkel has taken on the role of champion for the dignity of common humanity and is guiding the discussion of the consequences if Europe fails on the question of refugees. Closer to home, Dr. Oliver Sachs has left us a legacy of writings and research that helps us understand ourselves, our brains, and appreciate the interconnectedness of life.

Joshua Keating writing for Slate, asks ‘Where In The World?’ While enrollment in university geography classes is increasing, many departments have been eliminated and courses are no longer available. Digital literacy without geographical literacy is not a good thing.

“Geographical literacy remains vital—particularly for those of us who live in (for the time being at least) the world’s preeminent military and economic superpower. Geography is necessary for understanding why the overthrow of a government in Libya contributed to an unprecedented surge of migrants into Europe, why Ukraine has been split between East and West amid its conflict with Russia, and why China’s neighbors are alarmed at the new islands under construction in the South China Sea. And as we learned during last year’s Ebola panic, an understanding of African geography could have helped explain why an outbreak in West Africa should not lead to the quarantining of people from Kenya or Tanzania. In the years to come, as the effects of climate change on everything from sea level rise to deforestation to drought quite literally reshape the world we live in, an understanding of geography will be necessary for mitigating and adapting to the consequences.”

If you have been wondering when the U.S. media would begin leading the news with the story of the immigrant crisis in Europe, this was the week and the focus was on the Keleti train station in Budapest, Hungary. As the route of immigrants shift toward the Balkans anti-immigrant sentiment is growing. Germany expects to receive 800,000 refugees and asylum seekers this year.

In an editorial on Tuesday, ‘The Guardian view on Europe’s refugee crisis: a little leadership, at last’, the staff praised the courage of the German Chancellor.

“There can be no tolerance of those who question the dignity of other people,” she said, standing in front of placards accusing her of being the people’s traitor. “There is no tolerance of those who are not ready to help, where, for legal and humanitarian reasons, help is due.”

Confronted by forces that would overwhelm British leaders, the woman the Greek left (and many on the British left who should know better) mistakenly accuse of being the leading advocate of conservative neoliberalism has stood up to be counted. Being the country to which so many want to migrate should be a source of pride, she says. She wants to keep Germany and Europe open, to welcome legitimate asylum seekers in common humanity, while doing her very best to stop abuse and keep the movement to manageable proportions. Which demands a European-wide response. So far, her electorate and her press back her.”

Dr. Oliver Sachs died this week. There have been countless obituaries and remembrances, but my favorite is from The New York Times’ Michiko Kakutani, the Pulitzer Prize winning book critic.

“It’s no coincidence that so many of the qualities that made Oliver Sacks such a brilliant writer are the same qualities that made him an ideal doctor: keen powers of observation and a devotion to detail, deep reservoirs of sympathy, and an intuitive understanding of the fathomless mysteries of the human brain and the intricate connections between the body and the mind.

Dr. Sacks, who died on Sunday at 82, was a polymath and an ardent humanist, and whether he was writing about his patients, or his love of chemistry or the power of music, he leapfrogged among disciplines, shedding light on the strange and wonderful interconnectedness of life — the connections between science and art, physiology and psychology, the beauty and economy of the natural world and the magic of the human imagination.”

Other articles of interest this week@work offered advice on choice of college major, how to eliminate interruptions in the office and quitting your job before you have another.

‘Major Choice Shouldn’t Define a Career’ Jordan Holman – Sage advice from a senior writing in the student newspaper of the University of Southern California. “In this job economy it matters more about how you can apply the skills you acquired from the classes taken and lessons learned than just the titles on your resumé. It’s about taking that difficult class that you’re frightened of, but which could also serve as the perfect anecdote during an interview.”

‘5 Strategies to Eliminate Constant Interruptions’ Lisa Evans – “Did you know that the average manager gets interrupted approximately once every eight minutes? That’s about seven interruptions each hour. What’s worse, after every interruption, it takes an average of 25 minutes to fully regain cognitive focus. No wonder at the end of an eight-hour day, you still feel like you haven’t accomplished anything.”

Should You Quit Your Job Before You Have Another One? –  Stephanie Vozza – Multiple news outlets covered the release of ‘Leap: Leaving a Job With No Plan B to Find the Career and Life You Really Want’ by former Public Radio Marketplace reporter Tess Vigeland“When I left, one of the biggest questions I got was, ‘What the hell are you doing?’ and there are plenty of times I miss it,” she admits. “I miss being in a newsroom. I miss the microphone and the audience. Those are the times when I beat myself about the head, but they’re becoming rarer and rarer. You have to go through the process. I feel it was absolutely the right thing to do. I used to spend a chunk of day miserable. If it’s Sunday and you never look forward to Monday, you need to make a change. Life is too short to live for Friday afternoon.”

And one more time, The New York Times reported on the continuing trend of wage and salary lag as corporate profits continue to surge.