‘Where does it hurt?’ reviewed by Dr Véronique Griffith

Following our call for review, we have brought together multiple takes on a curious collection entitled ‘Where does it hurt?’. Commissioned by the Wellcome Trust (2014) and edited by John Holden, John Kieffer, John Newbigin, and Shelagh Wright, the collection explores the meanings and uses of the medical humanities. Dr Véronique Griffith offers her perspective here.

where-does-it-hurtWhere does it Hurt: The New World of Medical Humanities is a compilation of forty short essays edited by John Holden, John Kieffer, John Newbigin, and Shelagh Wright for the Wellcome Trust. It sets out to explore definitions of the medical humanities and allow people to visualise what it might entail by giving examples of practical applications of the arts and humanities to concepts of health and wellbeing. This book is not meant solely for an academic audience but also for those who are interested in thinking more about how medicine can be looked at more broadly than just as a biomedical science. The editors ultimately hope that ‘Where does it Hurt’ will encourage its readers ‘to make [their] own contributions to the debate around the medical humanities’ (p. 3).

Contributors include patients (Callie Clapp pp. 76-77), historians (Victoria Bates pp. 8-10, Mark Jackson pp. 38-39, Roger Smith pp. 58-59, and Gareth Maeer pp. 22-23), artists (Bob and Roberta Smith pp.12-13, Leah Gordon pp. 34-35), and medical consultants (Hugh Montgomery pp. 24-25, Sam Guglani pp. 60-61). Essays therefore range from tracing the history of the medical humanities to how graffiti art can provide a therapeutic space (Errol Donald pp. 18-19), to essays discussing what we may understand the medical humanities to be (Felicity Callard and Des Fitzgerald pp. 16-17). Such breadth allows for people from varying backgrounds and with different interests to find something of interest. Each essay is thoughtfully constructed, with some important ideas thrown in the mix, making for a book you want to read and re-read again just in case you missed anything the first time.

The book’s central theme is focused on defining the medical humanities. The task is clearly complicated, where what it is, how it should be implemented, and who has a voice at the table become fascinating topics of discovery. This collection allows for several perspectives to be put across while allowing the reader the time to engage with the different view-points. One essay asks whether the medical humanities are really separate from biomedical research and considers whether it is necessary to reconceptualise medical humanities as something else entirely (Victoria Bates pp. 8-11), while another posits that the humanities are essential to wellbeing (Hugh Montgomery pp. 24-25).

I found the essay on Medicine’s Humanity (pp. 60-61), authored by Sam Guglani (Director and Curator of Medicine Unboxed and Consultant Clinical Oncologist) to be particularly intriguing. Guglani suggests that perhaps the name ‘medical humanities’ is misleading. This name leads us to the conclusion that it is medicine that owns the humanities. This becomes problematic, according to Guglani, because medicine has done this in the past with regards to nurses (p. 60), as well as with regards to disease processes themselves where ‘human beings [are] recoded into patients’ (p. 60).

He argues that we should aim to think of the medical humanities as a tool to help us focus on the humanity of medicine. For him, the humanity of medicine is what allows us to move away from the ‘oesophogeal carcinoma in bed four,’ to ‘Jack’ who is ‘thirty-five next weekend and was planning a big night out […] was held once by his mother, ran for the under-11s, doesn’t like his job, wants children, is hungry, is in pain, can’t swallow and now is terrified for the first time’ (p. 60).

Guglani would rather we think of the humanities as an essential ingredient in medical practice, one which is as necessary as pharmacology, anatomy, or pathology. For him, they serve to illuminate the experience of being a person. It is the humanity of medicine that becomes important.

I found Guglani’s argument logically constructed and appealing. But I would have pushed the boundaries of his discussion further. I wonder if acknowledging the necessity of focussing on the humanity of medicine in medical practice is just the beginning. How do we incorporate this change into medical practice? How do we teach the humanity of medicine? Which medical humanities do we look to for this, and at what level of our training system do we teach these medical humanities? How do we fundamentally change the culture of medicine to embrace the importance of the discourse.

But this represents only one of the many essays in this thought-provoking book. I believe the whole text to be outstanding, easily accessible to those outside the academy and well worth the effort put towards reflecting on the subject. However, I would note that while the contributors range from patients, artists, and historians, to doctors, this book lacks contributors from medical anthropology. Including more social scientists would have allowed for us to move perhaps from an understanding of medical humanities as linked solely to literature, art and history to one in which we view the medical humanities as having a common goal: to highlight the patient’s experience of illness.

This guest contribution was written by Véronique Griffith, who completed her undergraduate degree at Harvard University in 2002 and her medical degree at the Yale School of Medicine in 2009.  She is currently studying for her PhD in medical anthropology at Durham University in the Department of Anthropology.  Her research focuses on endometriosis, illness narratives and doctor-patient interactions. 

Correspondence to Véronique Griffith

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