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Beyond Sparking Joy: A Call for a Critical Medical Humanities

Adams, Zoe; Reisman, Anna MD

doi: 10.1097/ACM.0000000000002871
Letters to the Editor
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Third-year medical student, Yale School of Medicine, New Haven, Connecticut.

Associate professor, Department of Internal Medicine, and director, Program for Humanities in Medicine, Yale School of Medicine, New Haven, Connecticut; anna.reisman@yale.edu; @annareisman.

Disclosures: None reported.

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To the Editor:

Since the 1970s, many medical humanities scholars have elevated empathy, enrichment, and observation as key concepts in justifying the field’s existence.1 Medical humanities program mission statements and calls for proposals often echo this language. Even the Association of American Medical Colleges’ recent call for systematic scoping reviews of arts and humanities in medical and interprofessional education stated, in the accompanying press release, that medical humanities initiatives can improve empathy and skills-based outcomes as well as “spark joy and enhance renewal.”2 But this emphasis misses the mark.

We worry that focusing on these conventional concepts will limit the trajectory and evolution of medical humanities programs. Granted, it is harder to delve into larger, thornier, and often systemic issues that require difficult self-examination. That is why frameworks in the medical humanities promoting social justice or antiracism work remain sidelined even now when issues such as institutional racism, health inequities, and diversity and inclusion are finally receiving more attention in medical schools.

Medical humanities programs should follow suit by considering a large-scale shift to a critical medical humanities.3 A critical medical humanities moves beyond empathy and wellness to prioritize the intersection between humanities scholarship and social justice. Medical schools should introduce students to critical theory, health activism, the history of medicine, and queer and disability studies—topics that may be unfamiliar but encompass issues that all students should grapple with, including how bias, race-based medicine, and societal structures have created and perpetuate health injustice, as well as how medical institutions, built through the oppression of women and people of color, are complicit in negative health outcomes.

Medical humanities programs must shrug off the security blanket that language like “enrichment” and “empathy” provides and acknowledge that medicine has not always been a force for good. A critical medical humanities prioritizes a rhetoric of discomfort and disruption,4,5 reinforces the idea that the study and practice of medicine are inherently political, and catalyzes deeper and actionable change.

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References

1. Wear D, Aultman JM. Creating difficulties everywhere. Perspect Biol Med. 2007;50:348–362.
2. Association of American Medical Colleges. The role of arts and humanities in physician development: From fun to fundamental. https://www.aamc.org/initiatives/meded/494588/roleofartsandhumanitiesinphysiciandevelopment.html. Published 2019. Accessed June 12, 2019.
3. Viney W, Callard F, Woods A. Critical medical humanities: Embracing entanglement, taking risks. Med Humanit. 2015;41:2–7.
4. Kumagai AK. Beyond “Dr. Feel-Good”: A role for the humanities in medical education. Acad Med. 2017;92:1659–1660.
5. Boler M. Feeling Power: Emotions and Education. 1999.New York, NY: Routledge.
Copyright © 2019 by the Association of American Medical Colleges