Medical Humanities Provides a Script for Living and Dying

Nicholas Genes, MD, PhD

Disclosures

May 15, 2007

Daniel Goldberg is a lawyer, scholar, and author of Medical Humanities Blog. With its academic prose and extensive citation of the literature, it would be easy to write off this work as dry or detached. But a closer read reveals that the topics that inspire Goldberg -- such as end-of-life care and our concept of disability -- are issues that involve all of us. I corresponded with him recently about his ideas on blogging, humanism, and some things in between:

Dr. Genes: You make a conscious effort to keep your writing on this blog academic and detached, and yet the few forays into your own life (like the post about your mother's cancer) are very touching and surprisingly topical. Can you explain your decision to keep it academic? Doesn't this run counter to the vast majority of blogs, and perhaps the success of this new medium?

Daniel Goldberg: Well, my contributions to the blog are more academic than personal, which is obviously something of a false dichotomy to begin with, and I am eminently comfortable with the notion that any post I write ineluctably involves my own personal voice. However, I wanted to secure the blessing of my employers and my graduate program for launching the blog, and (a) I was disinclined to run a personal blog anyway; and (b) privacy considerations for my peers, professors, and employers led me to decide to adopt a more academic format. Once I graduate (on track for May '08), I may revisit this decision or add a personal blog.

Medical Humanities hosts Grand Rounds
May 15, 2007

Dr. Genes: Taking a step back for our readers (and, well, me), what exactly is a "humanist"? What is a core medical humanities curriculum? Are you working toward that, and what is your dissertation research?

Daniel Goldberg: Oh, good lord. These questions do not submit to short answers. In a very realistic sense, the entire blog is an ongoing attempt to answer these questions.

What is a humanist? Unfortunately, postmodern secular humanism has tended to co-opt the term. I deem this "unfortunate" because medieval and Renaissance humanists, for countless reasons, would be very unlikely to recognize secular humanism as a descendant of their traditions. The shortest answer I can give, à la Hillel, is that a humanist is a scholar who strives to apply erudition and learning to people's daily lives, to the daily attempts to live virtuously.

My dissertation research will be on pain and pain management. I aim to use the powerful cultural lenses of the medical humanities first to trace attitudes towards pain and to show how these attitudes continue to inform our current practices and beliefs about pain qualia. Tracking the humanists, my goal is to use this scholarship as a basis for proposing extensive and detailed policy recommendations for ameliorating some of the pain management problems that proliferate in "allopathized" nations. The hope is to translate the theory into actual practice, to remain faithful to the humanist ideal.

Dr. Genes: Throughout your posts, I see a (reasonable) wariness toward the trend of "medicalization." But how does your law degree inform your perspective? Your "Who's Who in the Medical Humanities" only contains a single physician -- Vesalius; is that a reflection of the available candidates or your selective process?

Daniel Goldberg: Actually, my work in the medical humanities is principally what sensitizes me to the dangers of medicalization. I'm sure my legal training and legal work informs this perspective, but less so on the overt, conscious level. Still, connections are likely there, as it is no accident that a large number of the medieval and Renaissance humanists trained in the law.

As for the Who's Who series only involving a single physician, that's a fascinating observation, but I think it is more a reflection of the fact that most of the humanists were not physicians. Physicians during the Middle Ages -- and through the early modern period all the way up to the mid-19th century or so -- did not generally enjoy a sterling reputation. Medicine was not a part of the humanist educational program (the 7 liberal arts), and medicine and science were not at all the cousins that they are today (indeed, the term "medical science" would not have made any sense to medieval and Renaissance humanists). Someone who wanted to engage the humanist tradition would not logically pursue training in physics, but would be much more likely to take training in law, or at a monastery, or in diplomacy, or all of the above.

Dr. Genes: What posts were particularly satisfying for you to write, or proved popular or controversial with your readers?

Daniel Goldberg: The most labor-intensive posts by far are the Who's Who posts and the lexicon posts on the social construction of disease and on the social model of disability. The latter post is the single post that comes up most frequently in hits and searches, I think.

Dr. Genes: You write frequently of the medical narrative. Perhaps your expertise gives you some unique insight into the narrative of medical blogging. Do you have any thoughts on the phenomenon of patients and caregivers telling their stories online?

Daniel Goldberg: Actually, blogging and narrative in the context of illness experiences would be a fascinating subject of scholarship. I've used the term "pathblography," tracking Anne Hunsaker Hawkins' coinage of the term "pathography," to describe narratives of illness. While I am interested in narrative studies, they are not my primary area of focus, so I will leave the project for others.

Dr. Genes: One project Daniel Goldberg has taken on himself is hosting Grand Rounds this week. Grand Rounds, the weekly collection of the best of online medical writing, could be considered the common thread that unites a variety of diverse narratives and perspectives in medicine. Check out the opinions and stories from doctors, nurses, students, and other healthcare professionals -- and the occasional humanist.

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