The Medical Humanities is a growing area of research, as indicated by Durham University’s own Centre for Medical Humanities. In this post, Niall Hodson and Jamie McKinstry outline some of the ways in which studies of literature can help us not only to understand how culture has responded to medicine, but also how the humanities in turn can beneficially influence medical practise.
All literature could very well be a vast hospital ward, accommodating literal and metaphorical conditions, patients, and physicians, both within and outside texts. Of course, specific diseases or injuries often appear: Samuel Beckett’s older characters suffer from dementia, Thom Gunn writes AIDS elegies, and, if we jump back around five hundred years, medieval knights suffered grisly war wounds which poets were not squeamish about describing in their most graphic form. As readers, we trust in our ability to treat, cure, or prevent conditions of body, mind, and soul – indeed, this can be how we connect with a character, author and text. Yet how reliable is literature as a vehicle for medical evidence and discussion, in its very broadest sense? Literary studies probe the boundaries between social, political and private worlds, including the physical and psychological experiences of life itself. This could serve as an equally accurate description of medical research, particularly that of recent decades which has recognised the inter-relation of health, environment, and the individual – what we might term the paradigm of humanities.
“The desire is to create a more accurate impression of the human as a living, breathing, bleeding, thinking and surviving unit”
Literature also communicates directly with medicine – sometimes promoting medical advances or challenging their assumptions. Indeed, we might like to believe that writers can provide the most penetrating view of an individual, more revealing than the most sophisticated CT scan. Our very use of this somewhat awkward analogy is telling: to what extent is literature affected by the status of medicine in a particular time or culture? In the arena of Medical Humanities (MH), researchers explore medicine’s relationship with social and environmental factors, and how this is reflected and shaped by literature, art, history, philosophy, and religion. The desire is to create a more accurate impression of the human as a living, breathing, bleeding, thinking and surviving unit.
In MH, there is no simple combination of sciences and arts, rather a chain of cyclical and dynamic responses. In other words, we know that certain non-medical factors play an important role in the advancement of medicine, including literature. The current Broadcasting Science exhibition at the Royal Society, for example, underlines how radio and television came to play a crucial part in communicating and developing scientific ideas from the early 20th century. The languages of science – public and private, written and spoken – have also been intrinsically linked to its progress. Engaging with social and cultural aspects of medicine in the seventeenth century, Niall Hodson’s work analyses this complex relationship. Focussing in particular on Henry Oldenburg, the first secretary of the Royal Society, a large part of Hodson’s work considers the role played by formal and informal correspondence in communicating scientific ideas. Oldenburg managed the international correspondence of the early Society, receiving scientific treatises from overseas and translating them for the Society’s members, and for publication in its journal, Philosophical Transactions; thus offering an early blueprint for the peer-reviewed scientific journal, as well as the translation of scientific texts. Sharing and scrutinizing scientific ideas across social and cultural boundaries remain topical to this day.
This direct and indirect relationship between literature and medicine explains the diverse research clusters that have emerged in the Centre for Medical Humanities at Durham University. The CMH’s special areas of interest comprise “Imagination and Creativity”, “Practice and the Practitioner”, “Mind/Body/Affect”, “Transfigurings”, and “Policy, Politics and the Collective” and also the two distinct, but connected, research of the authors of this blog.
In addition to direct influences of medicine in society and subsequent human responses, MH discovers the less obvious relations that exist today and have done throughout history. These are reflected in cultural attitudes to life, health and wellbeing or the ways in which a society thinks, behaves, writes, and learns. Jamie McKinstry’s PhD research took examples of classical and medieval medical understanding and looked at their transformation in literature and culture. The first question addressed involved memory: how was an inherent human desire for recollection and order reflected in the memorial places offered by medieval chivalric romances? The conclusions reached suggest that such literature offered the creative freedom for recollection within a set framework. We always need to manufacture a relevance between past and present and this often involves a degree of imagination that was actively promoted and performed in the medieval period. This has resulted in additional post-doctoral research involving mind, body and affect: namely, how did the medical treatments of “depression” become exaggerated into metaphorical expression in medieval poetry, and was this also influenced by certain social attitudes? These non-medical responses may actually have been more acute and, in turn, could be influential to later medical practise.
“MH not only examines the response of the humanities to medicine, but demonstrates how that very response can then influence medicine”
It is this final point which is vital. MH not only examines the response of the humanities to medicine, but demonstrates how that very response can then influence medicine. The worlds of medicine and humanities have, in the process, gained a better impression of personal and social responses to care, treatment, prevention, and symptom. Indeed, the very practical application of this can be seen in the Durham CMH’s study of the use of arts as a therapeutic tool and a vital seam of education in medicine, for the lay and professional.
In a recent review of Michael Mack’s How Literature Changes the Way We Think, the reviewer seeks a definition of MH. He is disappointed, as this is a discipline which is always evolving by its very nature. A common misconception is that the literary arm in MH limits itself to illness-spotting, making bedside notes on the characters suffering from chronic obesity in Dickens, or considering what might be the strange electro-cardio rhythms that allow Shakespeare’s tragic heroes to versify during their death throes. The literary ambitions of MH are much greater than this.
The late medieval Scottish poet at the court of James IV, William Dunbar (c.1459-c.1515), is a writer who delighted in exploring the physical body and employed the imagery in biting social commentaries. He gives an energetic view of the court around him, using the body as effective (and affected) metaphor, as Jamie McKinstry has shown. However, his work also embodies the fascinating possibilities of MH. He once wrote a short poem about a headache, a medical condition of course, but in ways such that the illness reveals so much more about the man and his time. The poem uses “migraine”, interesting in itself in ways that Niall Hodson’s study of medical translation would address (it dates from twelfth-century Old French and first appeared in English in the early fifteenth century). Yet there are additional, subtle nuances that intertwine the literary, medical, socio-historical and philosophical.
His pain is likened to arrows piercing the brow and he shuts himself away. This we know is a way to soothe a headache, but it also allows him the solitude to compose his verse, in effect an appeal to the King to “cure” his distress by increasing his salary. The physical symptoms, or maybe their exaggeration in poetic metaphor, become blurred. Do we always employ specific language of illness and, if so, where does this come from? Or do we often use imagery and hyperbole to give an accurate indication of its severity? In what ways do we communicate our wellbeing to others, and how does society then respond? Does it intervene or remain distanced, outside Dunbar’s bedroom door? Other questions then emerge from the headache: why was he in such distress, what remedies might have existed, and what imaginative worlds do we create to combine the body and mind? MH can begin to answer these questions by seeing the human figure as both individual and yet connected to a maze of socio-historical attitudes, medical advances, even religious colourings.
Although this current blog post has focused upon earlier literature, in reality of course the work of MH spans all centuries, examining the latest philosophies and writers alongside the most recent medical advances, speaking to current communities, patients, and artists, and engaging with the very latest policies on healthcare provision.
As in the pre-Cartesian medieval period, we are now more familiar than ever with the inter-related nature of body and mind. Indeed, this is thrown into sharp relief when the relationship is compromised as people continue to live beyond their mental or physical capabilities, and we debate how this should be financed. No doubt much new research will soon emerge on the human response to such enforced immobility or mental weaknesses and this should not be restricted to medical evidence or individual literary musings. MH is a way to approach the struggle for understanding that has always afflicted the individual mind and body as it attempts to negotiate its place in society, history, and life.