Marc Keller considers the establishment of medical humanities in Switzerland as a diverse and institutionally open field and asks where the untapped potential of this multilingual country might lie.
Medical humanities has developed into a lively field in Switzerland over the last two and a half decades, with teaching and/or research programmes having become increasingly established at various universities, as well as universities of applied sciences. At several medical schools, the field is regarded as an integral part of the medical curriculum, with a number of compulsory courses moving beyond the mere instrumentalization of the humanities and seeking to contribute to a critical understanding of the practice of medicine in its respective historical, social and cultural contexts.
While the field emerged primarily from the initiatives of individual academic institutions, an additional impulse for its development came from the Swiss Academy of Medical Sciences (SAMS): their expert report, published in 2004, together with the Swiss Medical Association (FMH) and several medical faculties, advocated that medical schools should apply and expand the critical and reflexive insights of the humanities in teaching, research and patient care (Projekt “Zukunft Medizin Schweiz” 2004).
Since this series addresses multilingual medical humanities, a brief look at the geo-linguistic distribution in Switzerland seems appropriate. The country has four official languages, of which German is the most spoken (62%), followed by French (23%), Italian (8%), and Romansh (0.5%). Although in the Rhaeto-Romanic region there is no institutionalised presence of medical humanities, the field is vibrant in the other three areas. However, while each language has its own term for it – ‘Medizinische Geisteswissenschaften’ in German, ‘Sciences humaines en médecine’ in French, ‘Scienze umane mediche’ in Italian – the English term prevails. In Italian-speaking Switzerland, as Marta Arnaldi (2023) has already pointed out, the field is promoted by the Fondazione Sasso Corbaro, which is associated with the Università della Svizzera italiana. Even so, medical humanities at universities are, unsurprisingly, mostly spread across the regions of the two main languages, with three chairs, one centre, one institute, and two teaching programmes currently active in the country.
Literary studies leading the way
In terms of the two main languages, the chairs could hardly be better located, as there is one in French-speaking Geneva, one in the bilingual city of Fribourg and one in German-speaking St Gallen. However, their primary research areas are shaped less by the national-philological backgrounds of their locations than by individual researcher profiles.
In Geneva, the chair is held by literary scholar Alexandre Wenger, who was also trained in the history of medicine and has a strong interest in cinema and film studies.[1] His research has a distinctly interdisciplinary focus, such as his current project on syphilis as an example of never-ending disease. Geneva’s teaching programme is fundamentally interdisciplinary, as most courses are planned and taught jointly by a humanities scholar and a clinical researcher, seeking to provide medical students with a critical view of their future practice and to strengthen their reflective and interpretative skills.
These learning goals also apply to the University of Fribourg, which offers the most extensive compulsory medical humanities programme among Swiss medical schools, with a total of 120 hours at undergraduate level and 5 hours at postgraduate level. The chair is held by Martina King, who has a background in modern German literature, the history of medicine and medical science. Her research is particularly concerned with media history and cultural studies, but also with narrative theory and spatial studies, as in the current project: “Medical Spaces in Literary Prose of the long 20th Century.”[2]
Finally, the chair in St Gallen is held by Anna Elsner, whose background is in French literature, philosophy and film. Her research focus, which centers on death and dying, includes the philosophy of medicine and pays particular attention to the intertwining of literature and medicine.[3] She is currently leading a project which investigates the influence of cultural production on legal and political processes surrounding assisted dying in Europe and beyond. The project also seeks to further integrate the study of law-making, as well as digital humanities tools and methods, into the field.
While the strong contribution of literary studies to Swiss medical humanities is apparent, another emphasis – in Geneva and Fribourg, as well as in the teaching programme for medical students at the University of Bern – is the history of medicine, which has been an important precursor of the field. A central figure was the medical historian Henry E. Sigerist (1891–1957), who considered the history of medicine indispensable for the cultivation of medical humanism and, for this purpose, co-founded the Swiss Society for the History of Medicine and the Natural Sciences in 1921 (Diener and Condrau 2021). The first professorship in the history of medicine was established at the University of Zurich in 1951, under the influence of the Society (Bickel 1996). This chair, currently held by Flurin Condrau, is today part of the Institute for Biomedical Ethics and History of Medicine (IBME), directed by biomedical ethicist and physician Nikola Biller-Andorno. The institute is also home to the Centre for Medical Humanities, whose research and outreach activities are strongly shaped by biomedical and narrative ethics – the third important influence in Swiss medical humanities.
A similar fusion of biomedical ethics and the history of medicine is apparent in the Institut des humanités en médecine in Lausanne. The Institute, which is headed by physician and bioethicist Ralf Jox, is affiliated with both the University’s Faculty of Biology and Medicine and the University Hospital in Lausanne (CHUV). It has a strong clinical-ethical orientation in its research and an extensive compulsory teaching programme for medical students in the fields of history of medicine and public health, the social sciences, philosophy, ethics and health law.
Openness towards the literary scene and applied approaches
One of the Centre for Medical Humanities’ (Zurich) activities, which testifies to the institutionally open character of Swiss medical humanities, is the Premio Pusterla essay prize. Since 2018, the prize has been awarded to medical students for the best literary essay that deals with ethical problems and conflict situations in medical practice. In a public final, the three shortlisted essays are read out live and the audience, together with a jury of experts, which includes both medical professionals and writers, selects the winning text.
The other, longest-running writing prize for medical students in Switzerland, the Joseph and Marie-Anne Piller Prize, was set up by Alexandre Wenger, at the University of Fribourg, in 2016. The prize is awarded for the best French-language and the best German-language essay written as part of a compulsory reflective writing course. In its current form, students write about a particular case they have seen during their GP internship from a twofold perspective: firstly, from the doctor’s point of view, closely following the conventions of medical writing; secondly, from the subjective, first-person perspective of the patient. The winning texts of both the Piller Prize and the Premio Pusterla are published in the Swiss Medical Journal.
Literature and film are further represented in the medical humanities teaching programme at the University of Basel through two compulsory courses for medical students: “Film and Medicine” and “Literature and Medicine”. In the film course, after each of the three screenings, a medical and a film specialist first analyse the film from their own disciplinary perspectives, before opening the discussion to the students. In the three literature events, the literary scene is directly involved, by having well-known authors read from their works, which are first examined by experts from literary studies and medicine, before an open discussion with the students.
As indicated earlier, medical humanities are also much alive outside of medical schools, namely at various universities of applied sciences. To give just one example, the applied research project, “Sterbesettings” (“Settings of dying”), a collaboration between Bern’s University of Applied Sciences (BFH) and Zurich’s University of the Arts (ZHDK), under the co-direction of literary and cultural scholar Corina Caduff and health scientist Eva Soom Ammann, has recently taken an interdisciplinary perspective on experiences of incurable diseases and palliative care, combining expertise from cultural science, nursing science, sociology of religion and design research. The project aimed “to propose the redesign of communication materials and the design of care products, which should increase the scope of agency for dying persons, and promote their well-being” (Sterbesettings, n.d., n.p.).
What Switzerland can bring to global medical humanities
The metaphor that best captures the institutional situation of Swiss medical humanities may be that of a seascape, with many diverse islands which are nevertheless complementary and also cooperate with each other in various guises. In order to strengthen the exchange at a national level, however, the SAMS, together with the Swiss Academy of Humanities and Social Sciences, launched a project at the beginning of the 2000s, organising thematic lecture series, workshops and publications. In 2021, for example, they started the four-year series, “Growing Old”, which addresses the socio-medical challenges of the ageing population and focuses on age-appropriate healthcare and health promotion.
Nonetheless, despite medical humanities growing into a vibrant research and teaching community in Switzerland, there certainly remains potential for further development. For one thing, the events organised by the Academies of Sciences are primarily practice-oriented and aimed at healthcare professionals, while less emphasis is placed on critical and theoretical research and publications. Moreover, with the country’s multilingualism and the firm anchoring of medical humanities in several language regions, Switzerland has a particular potential with regard to what Steven Wilson (2023) advocated for in his manifesto at the beginning of this series: a more multilingual medical humanities. There are already many remarkable initiatives: the Academies of Sciences conduct their events multilingually; in Fribourg, 40% of courses are delivered bilingually and seminars are all conducted in both languages; and the Swiss Network of Ethics of Care holds its events in German, French and English.
Yet there are elements of this linguistic potential that remain untapped, notably with regard to a transnational medical humanities, as recently advocated by Marta Arnaldi and Charles Forsdick (2023), in which ideas of multilingualism are further enriched by the introduction of the translational, which “allows us to address the ways in which such multiplicity is negotiated, while also moving beyond the linguistic to explore the other variables – cultural, epistemological, practical” (Arnaldi and Forsdick 2023, n.p.). Swiss medical humanities could – and, arguably, should – use its position, within a multilingual country where translation is, in many ways, an everyday reality, to influence more strongly its research trajectory.
One way in which this could be done would be to examine the different linguistic-cultural approaches to “care” or “well-being,” which are then reflected in healthcare policy, in order to shed light on the role of multilingualism and translational practices therein. This could offer new ways of thinking not only about the place of language in healthcare, but also enable us “to ask, honestly and comprehensively, what translation is and does to, and in, contexts of health and illness” (Arnaldi and Forsdick 2023, n.p.). Swiss medical humanities could thus contribute to the wider field by offering a means of envisioning what such a translational model of medical humanities research could look like in practice.
Notes
[1] See, for example, the website CineMed, which he directs.
[2] See also Martina King’s forthcoming co-edited volume, Narrative Structure and Narrative Knowing in Medicine and Science (Berlin: De Gruyter, 20 November 2023).
[3] See Anna M. Elsner’s forthcoming co-edited volume Literature and Medicine (Cambridge: Cambridge University Press, 2024).
About the author
Marc Keller holds a PhD in German literature from the University of Bern, Switzerland. In his doctoral thesis, he examined how contemporary German- and French-speaking literature and film address the question of existential suffering as a motif for assisted dying. He is currently a postdoctoral researcher at the University of St Gallen, Switzerland, working on the ERC-funded research project “European Writing and Visual Culture: Reciprocal Interactions between Law, Medicine and the Arts since 2000.” You can find him on Twitter at @marcakeller and @assistedlab, as well as on Bluesky at @marcakeller.bsky.social.
References
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