Dr. Anastasia Ebele Ugwuanyi reflects on her experience attending the 2024 Medical Humanities International Summer School for PhD researchers in Vadstena, Sweden, coordinated by the Centre for Medical Humanities and Bioethics at Linköping University, in collaboration with the Institute for Medical Humanities at Durham University.
The concept of a carousel, as a metaphor in my writing, reflects the concurrent and dynamic events shaping my professional learning journey. Currently navigating an evolving landscape that spans clinical medicine, academic medicine, and, more recently, an introduction to medical humanities. As a lecturer at the University of the Witwatersrand in Johannesburg in the Faculty of Health Sciences, I bring this perspective into my work as I attempt to curate a medical humanities angle for the course I coordinate, using an interdisciplinary lens to inform both teaching and curriculum planning. This journey continues to shape my professional identity and enrich my approach to education.
Views from a carousel are multi-dimensional, looking inwards to fix the gravitational forces and evert vertigo, looking outwards for frames of references while in a state of constant revolution and, at the same time, taking in the rapidly changing landscape. With some carousel experiences like mine, this constant revolution is a multi-sensory experience, there are sounds to take in, people on the ride as well as background music which evoke an atmosphere of excitement and discovery.
The Medical Humanities Summer School, hosted by the University of Durham and Linköping University, Sweden, in September 2024, was a captivating four-day journey of fun, intrigue, and multidimensional learning. Set against the scenic backdrop of a seaside location and the tranquil atmosphere of a convent-hotel, the experience was a carousel of emotions and sensory stimulation. Despite a pre-flight fiasco and the domino effect of missing a flight, the eventual arrival in picturesque Vadstena marked a remarkable turnaround, thanks to the unwavering support of the organizers. The diversity of participants, perspectives, and the dynamic disruptions of narratives stemming from the pre-reading resources created a rich tapestry of experiential learning. Arriving mentally fatigued, I found the course to be profoundly invigorating, offering high-yield conceptualizations and reflections that reawakened my critical thought.
The Summer school seeded new concepts of ‘instrumentality and non-instrumentality’ of literature in medicine, the non-linear, non-binary relationship of literature and medicine (Woods and Rakoczi, 2024). Medical Humanities is a nubile youth in my University and Faculty of Health Sciences, and at the time of attending this Summer School, the Medical Humanities faculty presence was very limited. This seems not for lack of scholars or a course at a post-graduate level, but for the deeply defined scientific scholarly positioning of research and writing, the reward systems that favour quantitative reasoning and scholarship, the geographical separation of the faculties and only quiet voices of literary collaborations in the faculty of health sciences. It seems that interdisciplinary teaching and learning praxis are still a haloed floor with few taking the lift to explore. How much intersectionality is ‘measurably’ possible in a space such as mine, where medical humanities as a concept in the faculty of Health Sciences is only beginning to gain traction? Or, to reframe my question: ‘How can a researcher, when they are part of an institution that is only beginning to embrace interdisciplinary approaches, ensure their work in the medical humanities is interdisciplinary and authentically collaborative?’
The research carousel comprised of medical humanities course facilitators and participants, engaging around background readings and the experiential narratives of all present, took me around the Baradian framework of the intertwining of power, discourse and materiality that co-constitute knowledge and reality (Barad, 2007). I reflected on the edge of Barad’s framework of ‘Agential realism’ that posits that objects and subjects intra-act and emerge through these interactions, challenging the orthodox views of objects and subjects being dichotomous (Barad, 2007). I also reflected on the parallel view through lens of sociomateriality theory on how practice is constituted by the assembling and reassembling of social and material forces, and learning and processes of education, are actually sociomaterial forces interacting or reassembling (Barad,1998; Fenwick, 2015). I went around the re-definition of the epistemological interactions between researchers and subjects where space is given to the methodology of second-person perspectives in conveying patients experiences in research outputs, re-appraising the reductionist approaches of patient/people categorizations based on symptoms. A world of categorization that I was familiar with as a former clinician, but somehow resented because I had too often been caught between the lines, wanting to have seen people as so much more, beyond only a ‘Stage 4 diagnosis’ but to engage them as father, a friend and beloved. At the Summer School, I struggled with the classification of my profession as one that had the potential to be both uncaring and biomedical, discussed by a roomful of literary humanities scholars as fingers were pointed from the outside at this ‘errant profession’ (Galbusera and Fellin, 2014).
I left Vadstena questioning my positionality as a healthcare practitioner evolving within the medical humanities. After the Summer School I am still immersed in the metaphorical carousel, yet deeply drawn to a future where interdisciplinarity in medical education transcends geographical and epistemological boundaries. This vision moves beyond traditional faculty structures toward a community-centered approach, where the patient’s experience defines research, teaching, and learning, driven by individuals whose agency resists rigid categorizations. It envisions competency as non-linear, fostering models that equip healthcare practitioners with the tools to confront the challenges of inequity, bias, and disparities in a complex world.
Reflecting back on this experience and also on a moment in the seminar around critiquing the writings of a ‘medical’ humanities researcher, gave me an ‘autoethnographic’ gaze on being the ‘other’ in a room filled with brilliant ‘non-medical’ art-discipline positioned colleagues. I came away, with this carousel turn, learning the intense need for epistemic humility in the trans-disciplinary future of adopting a redefined professional positioning.
I have allowed myself some room as the carousel continues to revolve, to reflect on how much ‘co-ownership’ space has been afforded the faculties of sociology and psychology? Was organising an art therapy session, a theatre in education presentation by the Faculty of Arts, lectures by anthropologists and psychologists enough? Is there a framework to measure or standardise as ‘acceptable’ globally, an undergraduate course offering as being interdisciplinary enough? How do I measure the ‘weighting’ of medical humanities on the developing identity of undergraduate medical students? The carousel turns again, and I think of my PhD project, how much of a medical humanities worldview can I present to assessors as I prepare for protocol assessment that will make it pass the grade in a space dominated by biomedical research, as I explore competency frameworks of learning in distributed spaces from the lens of the students in those spaces.
Thankfully, the carousel mechanism is still revolving and the disequilibrium will provide an opportunity for assemblage.
About the Author
Dr. Anastasia Ebele Ugwuanyi is a Lecturer in the Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg. They head up the Graduate Entry Medical Programme for fifth and sixth year medical students, and is currently working on a doctoral thesis with a special interest in community-based learning and social accountability approaches in medical education.
References
Barad, Karen. (2007). Meeting the universe halfway: Quantum physics and the entanglement of matter and meaning. Duke Up.
Barad, Karen. (1998). ‘Getting Real: Technoscientific Practices and the Materialization of Reality’, differences, Vol. 10, Iss. 8, pp. 87-128.
Fenwick, Tara (2015). ‘Sociomateriality and learning: a critical approach’, in The SAGE Handbook of Learning, SAGE publications, p. 83-93.
Galbusera, Laura. and Lisa C. Fellin (2014) The Intersubjective endeavor of Psychopathology research: Methodological reflections on a Second-person Perspective approach. Frontiers in Psychology, Vol. 17, Iss. 5.
Woods, Angela. and Rákóczi, James (2024). ‘Literature in Collaboration: The Work of Literature in the Critical Medical Humanities’, in A.M. Elsner and M. Pietrzak-Franger (eds.) Literature and Medicine. Cambridge: Cambridge University Press (Cambridge Critical Concepts), pp. 357–374.
