Ugly, as in ‘unpleasantly suggestive, causing disquiet, likely to involve violence of some sort, repulsive.’ Underbelly, as in ‘beneath the surface, hidden, vulnerable, corrupt, sordid.’ Health humanities, as in the relatively new transdisciplinary field linking the arts and humanities with health and healthcare. Health humanities is both the term and the international movement intended to widen the more traditional field of medical humanities with its focus on physician practice and physician education. (See The International Health Humanities Network for more information.)
I have just returned to my life in Seattle after four days in Denver spent pondering the ugly underbelly of the health humanities. I was a participant-observer at the 4th Annual International Health Humanities conference, Health Humanities: The Next Decade, held at the University of Colorado School of Medicine Center for Bioethics and Humanities. The stated purpose of the conference was to “…bring together scholars, educators, clinicians, health advocates, students, patients and caregivers in an effort to identify the core issues and guiding values as well as define the expanding scope of the health humanities.”
Out of 100 or so conference participants, I believe I was one of only three nurses. Professor David Flood from the College of Nursing and Health Professions at Drexel University served as a conference committee member, but there were no nurses (unless they were deeply closeted nurses) who presented at the conference. The third nurse was Jamie Shirley, PhD, a terrific nurse ethicist and lecturer at the University of Washington Bothell campus. At the risk of adding to the tiresome ‘whiny nurse syndrome/trope in academese,’ I can’t help asking, “Where were the nurses?” As this was hands-down the best, most thought-provoking conference I’ve ever been to–and was, correctly I think, proclaimed as a historic conference with far-reaching consequences–why weren’t there more nurses at ‘this table?’
What I most loved about the conference was that the planners, speakers, and participants all openly acknowledged and explored the ugly underbelly of the health humanities. Not just who/what groups of people are included and excluded within the theory and practice (and international conference) of the health humanities, but other and perhaps more uncomfortable questions, such as:
By attempting to train medical, nursing, and other healthcare professions students in ‘narrative competence,’ are we turning this into yet another skill to include on a checklist? (The ‘tyranny of competencies’ as it has been called.) And, as Katie Watson, JD of Northwestern University Feinberg School of Medicine pointed out in a session on narrative advocacy, is a focus on narrative competence ignoring the fact that perhaps this is intrusive, itself a form of violation–of violence? Do we as teachers of the health humanities understand what it costs our students (as well as ourselves) to be opened up/made more vulnerable to the emotional pain of patients, of families, of communities, and of the world? Do we do enough to help our students ‘learn how to carry’ (or perhaps how to carry and then let go of) traumatic patient/community stories? Where does the ‘enterprise of narrative medicine’ fit within the health humanities? What are the professional consequences of doing radical art, radical writing, radical practice, and I’d add, radical teaching? By attempting to widen medical humanities to health humanities, are we adding to the cult of healthism?
And an ‘ugly underbelly’ question that I asked in a session yesterday (when I stepped outside of my observer role): why is religion/spirituality seemingly a taboo topic within the health humanities? Throughout the conference people tip-toed around religion and spirituality. Don’t people see that the privileging of secular humanism, the marginalizing–or worse, belittling–the role of religion and spirituality within our world, within healthcare practices, within health policy, within our own lives, is a grave danger? I’m not referring to a grave danger to our ‘souls,’ whatever that may mean, but rather to our lives together in communities, to the common good, to the civil discourse necessary for democracy.