Medical Humanities recent issues

[Editorial] The end of the beginning ...

Evans, H M., Macnaughton, R J. — 2008-05-29

[Original articles] Being Lister: ethos and Victorian medical discourse

Connor, J J, Connor, J T H — 2008-05-29

Stylistic analysis and rhetorical theory are used in this study to inform our understanding of impediments to the successful uptake of a new medical idea. Through examination of the work of the Victorian surgeon Joseph Lister, who was described by one biographer as suffering from "stylistic ham-handedness", the study provides insights into the difficulty that Lister had in explaining his theory of antiseptic surgery. Using three comparisons—Lister’s scientific style in public discourse with that of his students, and Lister’s scientific style in private discourse with those of both a surbordinate and a superior—the study suggests that the rhetorical concept of ethos played a major role in his communication difficulties. In this way, it presents a more nuanced perspective on modern presentations of "model" communications versus communication failures: that is, that problematic written discourse offers as useful a heuristic device as does exemplary discourse.

[Original articles] Evidence-based medicine? Patient case studies in English surgical treatises, 1660-1700

Sandassie, S — 2008-05-29

The implications of the presence of case information included in English surgical treatises published from 1660 to 1700 are discussed. While such casework has been frequently examined and cited, the phenomenon of including case information in treatises has yet to be studied in any depth. The context, presentation and origins of the case information are discussed, and the reasons behind the inclusion of casework are explored in terms of "blame-narratives", teaching models and evidence-based medicine. It was found that, while the reasons behind the inclusion of case information varied, English surgeons practised evidence-based medicine. This finding is significant, as it proposes that evidence-based medicine was practised a century earlier than—and across the Channel from—its supposed first emergence in modern medical practice.

[Original articles] The inference from a single case: moral versus scientific inferences in implementing new biotechnologies

Hofmann, B — 2008-05-29

Are there similarities between scientific and moral inference? This is the key question in this article. It takes as its point of departure an instance of one person’s story in the media changing both Norwegian public opinion and a brand-new Norwegian law prohibiting the use of saviour siblings. The case appears to falsify existing norms and to establish new ones. The analysis of this case reveals similarities in the modes of inference in science and morals, inasmuch as (a) a single case functions as a counter-example to an existing rule; (b) there is a common presupposition of stability, similarity and order, which makes it possible to reason from a few cases to a general rule; and (c) this makes it possible to hold things together and retain order. In science, these modes of inference are referred to as falsification, induction and consistency. In morals, they have a variety of other names. Hence, even without abandoning the fact–value divide, there appear to be similarities between inference in science and inference in morals, which may encourage communication across the boundaries between "the two cultures" and which are relevant to medical humanities.

[Original articles] Camille Claudel: trajectory of a psychosis

Cooper, B — 2008-05-29

The French sculptor Camille Claudel at about the age of 40 developed a psychotic illness that proved to be chronic. Delusions of persecution, focused on her former mentor and lover Auguste Rodin, gradually became systematised until they dominated her life completely. She abandoned artistic work, withdrew into social isolation and lived alone in conditions of squalor and severe self-neglect until eventually, after her father’s death, she was committed to an asylum and spent the remainder of her life in institutional confinement. Only within the past 20 years has her achievement been recognised and her fate drawn wide sympathy. Previous psychiatric studies have dismissed or downplayed the significance of Camille’s adverse life experiences for her case history. The present reassessment, drawing on modern interactionist models of the genesis and course of psychosis, sets out to place both her creative drive and her mental instability within a broader life-course perspective and to arrive at a more balanced judgement of the case.

[Original articles] Putting it bluntly: communication skills in the Iliad

Marshall, R J, Bleakley, A — 2008-05-29

In current undergraduate medical curricula, much emphasis is placed on learning the skills of communication. This paper looks at Homer’s Iliad and argues that from it we may learn that our skills can be mechanistic, shallow and simplistic. Homer was regarded in the Greek and Roman world as the father of rhetoric. This reputation rested greatly on book 9 of the Iliad, the embassy from the Greek leaders to the bitter, wrathful Achilles. The mission of the three emissaries is to persuade him to return to the ranks of the Greeks, who are being routed since his refusal to fight. We learn how the outcome of a conversation may be predetermined by the previous relationship of the speakers, and how a man beyond reason responds to reason; we should reflect that Homer’s audience heard the piece knowing the outcome, giving it a tragic inevitability. We, the audience, cannot analyse the discourse rationally, because in this, as in all communication, reason is disturbed by emotion.

[Original articles] The year of magical thinking: Joan Didion and the dialectic of grief

Brennan, F, Dash, M — 2008-05-29

Joan Didion is a prominent American writer. In late 2003, while her only child lay critically ill, her husband, John, died suddenly. Theirs was a marriage of great intimacy and love. Grief enveloped her. Eventually she began to write an account of the first 12 months of her bereavement and the vigil for her child: The year of magical thinking. Raw, insightful and challenging, it is a rich, generous and graceful document. Didion draws on the literature of grief, personal and professional. Here, those readings are examined and reflections are made on the singular, unique grief of the author in the context of current theories on bereavement.

[Original articles] "Writing is a way of saying things I can't say"--therapeutic creative writing: a qualitative study of its value to people with cancer cared for in cancer and palliative healthcare

Bolton, G — 2008-05-29

This paper reports on a therapeutic creative writing project undertaken at King’s College London and University College Hospital London, funded by Arts Council England. The project sought to increase understanding of experiences of personal expressive and explorative writing by cancer patients receiving palliative care. Narrative methods were used to analyse and interpret patients’ written and oral (transcripts of semistructured interviews) responses, researchers’ field notes and written responses of staff. These indicated that writing: (1) facilitated patients’ ability and opportunity to discover what they thought, felt, remembered; (2) enhanced their awareness of, and ability to express, issues to which focused attention needed to be paid; and (3) offered satisfaction and fulfilment of creative expression and exploration and the production of writings which to them and close others were vital. Illuminatively drawing upon patients’ writings and responses, this paper is underpinned by discussion of therapeutic writing and its relationship to creative writing, with reference to a range of previous research.

[Opening the word hoard] Opening the word hoard

Bolton, G, Howe, A, Battye, N, Ellis, A, Gelipter, D, McIlraith, J — 2008-05-29

[PostScript] Fourteen stories: doctors, patients, and other strangers

Knight, R — 2008-05-29

[PostScript] Doctors and paintings: Insights and replenishment for health professionals

Lazarus, P — 2008-05-29

[PostScript] Stories of illness and healing: women write their bodies

Gull, S — 2008-05-29

[PostScript] Leonardo da Vinci: the marvellous works of nature and man

Gelipter, D — 2008-05-29