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The Healing Arts: an Oxford Illustrated Anthology
  1. N C F Stott, Professor
  1. Emeritus Professor of General Practice, University of Wales College of Medicine

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    Edited by R S Downie Oxford Oxford University Press, 2000

    “The essence of the arts is that they speak directly to us”, and so the readers of this anthology of poetry, prose and music will each have a different experience. This is one of the reasons why the sciences that seek generalisability and reliability of observation are so complementary to the arts. Some readers will dip into the book in a chaotic way and find gems. Others will choose one of the important themes to focus upon, and a few will read from cover to cover. Yet it is not the comprehensiveness of coverage that will determine the experience of the reader. It is the remarkable interaction between an author who provides content, and the reader who provides unique context that results in a new experience with every piece

    “Holistic” approaches to health and healing are elusive concepts because the word implies a total understanding of the subject and it is only the very arrogant or narrow minded who would ever lay claim to complete understanding of these subjects. Within medical circles holistic approaches usually imply a rejection of both mind/body dualism and the compartmentalisation of knowledge

    Downie's anthology touches a very wide range of human experiences through the eyes of chosen artists. The topics he and his writers cover range from sex and conception to disaster and death. Each piece is freestanding within a theme and each will invigorate or prick the consciousness and conscience of the reader, particularly if the reader is medical or nursing in orientation

    The first theme in the book is “The way we are”. Here pictures by Leonardo de Vinci and Rembrandt are followed by a poignant poem, First Foetal Movements of My Daughter, (Penelope Shuttle). The theme deals with the ages of mankind. Numerous powerful pieces are included and it closes with T S Eliot who captures the cycles of life and learning. Eliot leaves the reader to ponder a personal interpretation:

    “We shall not cease from exploration
 and the end of all our exploring
 will be to arrive where we started
 and know the place for the first time.”

    Disease and mental illness come next and this theme is launched by Hippocrates but teased out by many. Among them are John Milton writing about his blindness, Beethoven lamenting his deafness, Bacon and Shakespeare on deformity and Jackie Kay's, Dance of the Cherry Blossom, which deals with advancing death in two lovers who ask “why?”. Nietzche (1844–1900) closes the theme with his definition of collective insanity : “Insanity in individuals is something rare—but in groups, parties, nations and epochs it is the rule”

    Doctors and psychiatrists come into focus next with a range of views that vary from deep appreciation and recognition of high ideals to cynicism and humour about quackery. Nurses, patients, chaplains and hospitals are dealt with under theme 4

    Healing is the focus of theme 5 and no student should pass the Final examination without reading Fanny Burney's letter to her sister in the late 1700s, describing a mastectomy without anaesthetic. The hopes, fears and cares of those who have found healing then flow forward into therapy from music and art. Spiritual healing is dealt with through Manley Hopkins, John Keats and others. Theme 6 is on suffering, funerals, and the experience of dying. Research (theme 7) and “Ethics & Purpose” (theme 8) are next

    In the closing chapters of this book the nature of ethics and life's purpose are teased out. We are reminded that medical codes of practice still draw heavily on ancient Greek and Christian teachings. Yet it is in the ordinary activities of life that most people must find purpose and meaning. Civilised codes must resonate in ordinary people living now and in the recent past. Downie quotes Flanders and Swan, Aristotle, Persig, Twain, Austen, Waugh, Sondheim, Richardson, Hurwitz, Warnock, Wittgenstein, Mahler, and Wisdom: they all contribute to themes that echo belonging and discovery of meaning in ordinary lives

    This remarkable “miscellany of art forms” reveals the richness of our language and the huge number of works that a student would have to read to find this collection. Downie has helped us to break through this daunting barrier and has given us an anthology that sensitises the reader to a public view of medicine and healing. This is as relevant in the 21st century as ever, because the National Health Service is creaking and groaning under the weight of public pressure to be more holistic and people friendly

    Should this text become required reading for all clinical students? Deans have already responded to the injunctions of the General Medical Council and reduced the taught factual content of medical courses by 30%. That 30% has created space for self-directed learning, optional in-depth “special study modules” and time for reflection. A special study module on the healing arts would be a valuable addition to most curricula. Those students who remain with mainstream scientific options may well be advised to borrow or buy Downie's book for a weekend of reflection and discovery in their final years. The anthology is readable over a weekend but it is not digestible in so short a time, which does not allow time for the reflection and discussion which make reading a book of this kind such an enriching experience

    Undergraduate deans would be well advised to find a place for this text in their courses on medical ethics, communication, or clinical skills training. A short essay question or even the OSCE (objective structured clinical examination) would be a good place to test whether students can describe both evidence and art that conveys the lay person's experience of medical and nursing care

    In his foreword to The Healing Arts Kenneth Calman quotes R S Peters who said: “the measure of an educated person is his or her ability to converse in a civilised and intelligent way across a wide range of subjects”. This well produced softback anthology would help many students in the health sciences to draw closer to that goal