Lucía López Serrano reviews The Routledge Companion to Health Humanities, edited by Paul Crawford, Brian Brown, and Andrea Charise (Abingdon and New York: Routledge, 2000).
Paul Crawford, co-editor of Health Humanities (Crawford et al, Palgrave 2015) and professor of Medical Humanities at the University of Nottingham, introduces this Routledge Companion by establishing the importance, scope, and history of the field. In particular, Crawford stresses the interdisciplinarity inherent to health humanities research and practices, as well as their increasing sensitivity to cross-cultural visions of healthcare. What emerges from this introduction as of primary importance to the Companion is an overarching focus on how the field of health humanities is championing a democratic, community-led vision of health that challenges the position of medical education as the central subject of interest, and centres applications of creative practice in “the health and well-being of the public, health care innovation, pedagogic developments, and policy influence” (p.3). Thus, Crawford’s vision of the health humanities as seen in this volume clearly departs from what has been widely regarded as first wave medical humanities. Indeed, as he states, the health humanities are “so much more than a switch in nomenclature” (p.2). However, he stresses that this approach is not leaving the medical behind, but building upon it to develop a “interdisciplinary, inclusive, applied, democratizing and activist approach” (p.3). Finally, Crawford’s introduction diffuses the divide between critical analyses and creative practices rooted in activism. The Companion, in both form and content, points to both analyses and practice of the humanities for the enhancement of human health as a cornerstone for development in the field.
The volume is formally divided into a first section of “Reflections and Critical Perspectives” and a second section of “Applications”. However, and contrary to what the formal organization of the book may indicate, both sections echo a firm vision of practice-based health humanities in which there is an open acknowledgement of the need to root critical work in the socio-political contexts of the lived experiences of health and its absences. Andrea Charise, co-editor and author of the chapter “On applying the arts and humanities in austere times”, analyses this perceived divide between theory and practice, expanding on a topic raised by Crawford in the introduction: the potential value of the health humanities in the revalorization of the broader humanities disciplines for the capitalist market. Charise stresses the anxieties that emerge from interdisciplinary encounters where the humanities may appear as “handmaiden” (p.18) to applied disciplines such as biomedicine, a vision that she characterizes as “gendered” and “unidirectional” (p.18). In assessing the theory/application divide of the “critical” and “applied” health humanities within the context of austerity politics brought by neoliberal economies, Charise evokes Rita Felsky’s turn to the “post-critical” to assert that, in breaching the fissure between theory and practice within the health humanities, the current challenges posed by neoliberal capitalism require that the field decentres “the longstanding elevation of theory” (p.24) and embraces its potential for the transformation of social conditions in making itself “legible to […] the multiplicity of sites and communities where . . . work is needed, shaped and experienced” (p.24). This is echoed by co-editor Brian Brown in his own chapter “Genealogies of Healthcare”, where he encourages the reader to untangle the interests of power from our understandings of illness and recovery. His chapter illuminates how research on the sociocultural contexts that have brought about current understandings of ailments can open up different conceptualizations of the subject as “ill”, and thus offer new avenues for recovery.
In line with this vision of theory that is firmly rooted in the sociopolitical, the section on “Reflections and critical perspectives” defends a vision of the health humanities that seeks to subvert dominant narratives of health. In the process, authors acknowledge the historical racial bias of Western medicine that still affects our time by analysing texts where, in the words of Sayantani DasGupta, “representatives of white supremacy wield medicine and biotechnology as their tools of subjugation” (p.32). However, concepts like “visionary medicine” (p.35) emerge as critical tools with potential to “imagine more racially just medical futures” (p.36); for Nehal El-Hadi these are not rooted in a “post-racial” utopia but in the knowledge that stems from the work of “racialized, marginalized, and oft-excluded individuals that explore narratives of the experiences of illness, disease, and the health-care encounter” (p.43). Following this line of thought, Crawford, Boivin and Richardson’s powerful chapter on “Indigenous health humanities” conceptualizes a third space for health epistemologies where Western medicine’s dominance does not obliterate Indigenous knowledges but allows for non-invasive interconnectedness (p.96).
Further proof of the viability of critical perspectives that strive for social change can be found on chapters like Peter Meinek’s “Post-Conflict Resolution and the Health Humanities: The Warrior Chorus Program”, where the author examines the benefits of introducing humanities-based programs into wider society. Exploring concepts like homecoming, the effects of combat trauma and post-war reconciliation on veteran communities through classical texts, his account of the Warrior Chorus Program exemplifies the correspondence between critical approaches and applied practice that the author explores further in a chapter on “Classics”, where he offers several examples of programs that have employed classical texts as a conduit to foster the healing from trauma amongst veterans in the United States. Interventions such as those described by Heike Bartel and Charley Baker in their chapter on poetry and male eating disorders do not use creative artefacts with an outwardly therapeutic objective, but work to “situate experiences of disordered eating within a wider sociocultural frame” (p.) and increase the visibility of groups such as male-identifying people suffering from eating disorders.
In her chapter on applying the arts and humanities in austere times, Andrea Charise notes the hierarchical nature of the spaces where the health humanities have found its development so far: the university and the hospital (p.24). It stands to note that Crawford et al, in the construction of this companion, have clearly worked to counter the standing bias of such institutions by acknowledging their history of racial and class discrimination, and focusing on applied creative practices that look at community-led and grassroot efforts. This is particularly evident amongst the chapters in the “Applications” section: ranging from quilting to horticultural arts and including other very different creative practices such as cooking or capoeira, the Companion’s range of “Applications” presents a useful repository of different creative interventions with therapeutic benefits. Community-centred and focused on the improvement of conditions for health and well-being with a marked attention to social contexts and the cultivation of agency, the existence of such a catalogue of carefully assessed programs facilitates the reproduction and re-interpretation of similar creative practices across the world and will undoubtedly prove a valuable resource for the cultivation of spaces of well-being outside the strictly clinical.
In conclusion, the Routledge Companion to Health Humanities presents a wide range of analytical perspectives and creative actions that work together to redefine mainstream notions of health and illness and address health inequities. Its many contributors acknowledge the hierarchical and racially biased roots of the clinical space and work to put the tools to address these issues in the hands of both those who experience illness and those responsible for their healthcare. With a pertinent and prominent focus on sociocultural contexts, the health humanities, as presented by the volume, do not leave the medical humanities behind, but broaden its focus to the wider contexts of health beyond the clinical.
Lucía López Serrano is a PhD candidate and research fellow at the University of Salamanca. Her doctoral project, funded by the Spanish Ministry of Universities, focuses on the notions of vulnerability and resistance in their intersection with the medical establishment, as represented by contemporary Canadian literature.