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Patients Are Humans Too: The Emergence of Medical Humanities

This essay describes the origins, growth, and transformation of the medical humanities over the past six decades, drawing on the insights of ethicists, physicians, historians, patients, activists, writers, and literature scholars who participated in building the field. The essay traces how the original idea of “humanizing physicians” evolved and how crises from death and dying, to AIDS and COVID -19, expanded humanistic inquiry into health, illness, and the human condition. It examines how a wide array of scholars, professional organizations, disciplinary approaches, academic units, and intellectual agendas came to define the vibrant field. This remarkable growth offers a counterpoint to narratives of decline in the humanities. It is a story of growing relevance shaped by tragedy, of innovative programs in medical schools and on undergraduate campuses, and vital new configurations of ethics, literature, the arts, and history that breathed new life into the study of health and medicine.

Keith Wailoo , a Fellow of the American Academy since 2021, is the Henry Putnam University Professor of History and Public Affairs at Princeton University. He is the author of Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette (2021), Pain: A Political History (2015), and How Cancer Crossed the Color Line (2011).

W riting in 1982, philosopher Stephen Toulmin observed that the study of ethics (which traditionally meant formal, theoretical moral philosophy) had been reenergized and transformed by its engagement with medicine. In “How Medicine Saved the Life of Ethics,” Toulmin explained that the ethical dilemmas of recent medicine–from death and dying, to contraception, and abortion–had catalyzed a resurgence in the once-moribund field of philosophical inquiry. Two years later, physician Eric Cassell painted a broader portrait of how problems of disease and health had nurtured humanities fields beyond bioethics. Celebrating “the place of humanities in medicine,” he wrote that “the enormously increasing power of medicine to change individual lives . . . and to profoundly influence social policy had all provided rich fare for philosophical, historical, and literary examination, interpretation, and analysis.” 1

In an era when health care had become powerful but also ethically challenged, new trends in the humanistic analysis and critique of medicine flourished. For many scholars drawn to the field, medicine and the humanities were entangled in a perverse love-hate relationship in which literature, history, and philosophy promised to soften medicine’s rough edges and revise its “present romance with technology.” 2 In a sense, the medical humanities sought to be a counterpoint to technological hubris; it sought also to encourage physicians to have a deeper personal understanding of the impact of new technologies, new powers, and new health care dilemmas on people’s lives. In the writings of Toulmin and Cassell, the medical humanities and ethics harbored a redemptive, utilitarian idea: that broad learning could nurture the soul of the doctor at a time when medicine, enraptured by science, was losing touch with the patient.

This essay draws on the insights of the ethicists, physicians, historians, patients, activists, artists, writers, literature scholars, and others who participated in the building of the medical humanities over the past six decades. The process began as an effort to “humanize medicine,” but the agenda grew and transformed remarkably over the years. The story they tell unfolds in three stages: the period from the early 1960s to the 1980s, in which developments centered in medical schools; the years of professional expansion in the 1980s and 1990s when new journals, associations, and teaching initiatives took shape; and the particularly stunning growth of medical humanities in undergraduate colleges in the 2000s, in programs taking varied institutional forms. In what follows, I allow those who participated in this transformation to describe the diversification of work done under the heading of “medical humanities.” This essay also traces how the original ideal of humanizing physicians evolved, while other goals such as exploring the human condition became more salient and as recurring crises in medicine and society catalyzed the fragmentation of the field.

T he criticism articulated by Cassell and Toulmin–that medicine, in turning to science, was losing touch with patients–had been evident since the late 1950s. Increasing medical specialization was said to push doctors toward a study of disease mechanisms, and away from an understanding of illness. There was also, for example, the problem of unethical human experimentation in the post–World War II era: the revelation that leading researchers conducted experiments such as testing drugs on vulnerable patients without their consent. Such excesses spanned from the testing of polio vaccines on children in mental institutions in the 1950s to the revelation in the 1970s about the decades-long Tuskegee syphilis study, in which Black men with the disease were observed rather than treated over four decades. The disclosures suggested a need for new regulations of professional conduct. But they also suggested a need for deeper introspection about virtue and the duties of caregiving.

As Cassell explained in the early 1980s, the events of the previous two decades had catalyzed medical humanities: for “while medical science can abstract itself and deal solely with body parts, doctors who take care of patients do not have that luxury–they must work with people . . . [and are faced with] the fears, desires, concerns, expectations, hopes, fantasies, and meaning that patients bring.” In this telling, the scientific guidance of physicians would always be morally impoverished without a fuller understanding of illness, suffering, and health, realities “better taught by literature and the other humanities.” 3

Both Toulmin and Cassell dated the birth of this humanistic critique to the early 1960s, when social movements and professional criticism produced curricular change. Over the decade, increasing numbers of women and students from minority backgrounds entered medical schools. The pressure for medical humanities programs was “initiated primarily by students,” explained Cassell. Rejecting the narrowness and perceived irrelevance of scientific medical training, they “were no longer content to be taught what their faculties believe important. It was essential to the students that their classes be ‘relevant’ to the problems of poverty, racial bias, and political ‘oppression.’” 4

With health and health care in flux, the turmoil of the era made medical humanities necessary for addressing concerns of the moment. The deinstitutionalization of the mentally ill and their social integration provoked new questions about the meaning of illness, stigma, and the role of psychiatry in society: was it the case, as critics charged, that institutionalization was merely a scientized form of social control? 5 New legislation expanded health insurance to the elderly. But why then did the American Medical Association fight so feverishly against passage of Medicare, failing to stop it? Was this an example of the profession’s commitment to economic interest and not, as they claimed, the well-being of patients? And when medical science failed in its quest to preserve life, what was the role of the physician in death and dying? 6 The subtitle of Elisabeth Kubler-Ross’s On Death and Dying captured the era’s conceptual inversions, and its shift to more patient-centered understandings: “What the dying have to teach doctors, nurses, clergy, and their own families.” Worries over the failures of “the biomedical model” ranged widely, gaining even greater force in early 1970s amid burgeoning political, legal, social, and moral debates over reproductive rights, abortion, and homosexuality. Trust in medical expertise was ebbing as core institutions were buffeted by social pressures. In the early 1970s, for example, the American Psychiatric Association gathered to debate removing “homosexuality” from its standard nomenclature of mental illnesses. Little wonder that medical ethics and humanistic understandings of patients, disease, health, and society expanded in significance in this tumultuous era.

The intense demands of the era made medical practice no longer “a field for academic, theoretical, even mandarin investigation alone . . . . It had to be debated in practical, concrete, even political terms,” explained Toulmin. 7 From the standpoint of the 1980s, Toulmin and Cassell saw medical humanities as a response to the “demand for intelligent discussion of the ethical problems of medical practice and research.” 8 By the early 1980s, the majority of medical schools had developed programs in the medical humanities, incorporating (in one way or another) the study of literature, history, and ethics into the training of physicians to be at least conversant with the issues swirling about the profession. Some schools had developed full-fledged departments. 9 But what neither the philosopher Toulmin nor the physician Cassell could see from the early 1980s was just how rich, diverse, and varied the field would become in the following decades.

A s Toulmin and Cassell were penning their thoughts in the early 1980s, medical humanities were also taking shape in undergraduate curricula. Between 1980 and 2000, the critical humanistic analysis of medicine and health produced new scholarship in every field: in the arts, the social sciences, and in literature, history, and philosophy. New crossdisciplinary departments were devoted to the social relations of medicine and science. One such program, the one in which I earned a PhD, had been created in 1962 as the “History and Philosophy of Science,” and then changed its name to “History and Sociology of Science” in 1970. The varied names suggest the multiplicity of lenses being brought to bear on the undergraduate and graduate study of science, health, and their implications for society.

In the 1980s, medical humanities shifted focus notably toward the patient’s experience and the human condition. AIDS , cancer, and other health struggles provided tragic catalysts for new works in literature, art, and history. The global AIDS pandemic, for example, raised a host of new questions not only about viral origins and epidemiology, but also about condoms, sex practices, religious tolerance, gay identity, and changing sexual politics, topics demanding integrated thinking about the human condition across the sciences, public health, social sciences, and humanities.

Where might one seek insight into this new health crisis? Was it perhaps Larry Kramer’s 1985 autobiographical play, The Normal Heart , about enduring the early years of AIDS prejudice, indifference, struggle, and fear in New York City? Or perhaps the reflections of physician Abraham Verghese in My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS ? 10 Reviewing Verghese’s book in Literature and Medicine , Joseph Cady explained that AIDS literature had become vast and had been produced mostly by people vulnerable to the disease. Verghese’s contribution was different, telling his story as a foreign medical graduate in small town Tennessee chronicling the social trauma: the “ HIV -positive heterosexual woman . . . infected by her bisexual husband, hemophiliacs with AIDS . . . and people with transfusion AIDS (Will and Bess Johnson, who posed an extra level of challenge as well-to-do, ‘pillar of the community,’ fundamentalist Christians who insist on keeping their infection secret).” 11 The nation’s AIDS experience made clear that to fully understand the unfolding health tragedy demanded creative story-telling, narrative insight, introspection, and deep sensitivity to the complexity of the human condition. Kramer and Verghese were only two among many medical humanities ideals.

In medical education, new texts were pushing the field forward; new lines of inquiry and pedagogy were opening. When I taught in the medical school at the University of North Carolina at Chapel Hill in the 1990s (in the department of social medicine), humanizing the physician remained the central driving conceit. The redemptive ideal generated a new textbook in 1997, the Social Medicine Reader , a collection of fiction, essays, poetry, case studies, medical reports, and personal narratives by patients and doctors compiled for teaching. The Reader aimed to “contribute to an understanding of how medicine and medical practice is profoundly influenced by social, cultural, political, and economic forces.” Elsewhere, physician Rita Charon and literary scholar/ethicist Martha Montello were also compiling essays for an edited collection for a new enterprise labeled “narrative medicine.” As they observed, storytelling underpinned all thoughtful caregiving: “How the patient tells of illness, how the doctor or ethicist represents it in words, who listens as the intern presents at rounds, what the audience is being moved to feel or think–all these narrative dimensions of health care are of profound and defining importance in ethics and patient care.” 12 Such developments transformed medical education in the 1990s. “By 2004,” wrote medical historian Emily Abel and sociologist Saskia Subramanian, “88 of the 125 medical schools surveyed by the American Association of Medical Colleges offered classes in the human dimensions of care, including treating patients as whole people, respecting their cultural values, and responding empathetically to their pain and suffering.” However, these courses were only “a tiny fraction of medical-school curricula.” 13

Driven by such initiatives, the 1980s and 1990s would be an era of acquisitions, new ventures, and mergers in the medical humanities: new journals established, professional associations combined, and novel academic collaborations explored. In 1980, for example, the Journal of Medical Humanities was founded, followed two years later by Literature and Medicine . In 1998, three organizations–each representing different facets of the emerging field–merged to produce the American Society of Bioethics and the Humanities ( ASBH ). The oldest of the three, dating to 1969, was the Society for Health and Human Values ( SHHV ). The Society for Bioethics Consultation had been founded in the mid-1980s, while the American Association for Bioethics had been established only four years before, in 1994. As the ASBH ’s founding president, bioethicist Loretta Kopelman, reflected, the term “humanities” was a reassuring rubric particularly for the non-ethicists, a group that encompasses a vast array of disciplines and specialties:

SHHV had members from many fields including health professionals, law, religious studies, literature, pastoral care, social science, history, visual arts and student groups. Some worried that this diversity of approaches would not be valued in the same way in a new organization. For many of those fearing such marginalization, “humanities” came to stand for inclusiveness and “bioethics” for the sort of rigor in addressing problems such as are found in publications in philosophy, law, social science or academic medicine. The title “American Society of Bioethics and Humanities” reflected that we wanted all groups to thrive in ASBH . 14

Many of these new ventures proved to be durable, creating the institutional supports, professional associations, journals, texts, and teaching practices necessary to sustain the field. Others, such as the Society for the Arts in Healthcare founded in 1991, were short-lived and difficult to sustain.

By 2000, divergences in the medical humanities agenda appeared, inevitably so. In medical schools, the humanities presence remained small and there would be unavoidable tensions as humanists worked within the overwhelming science-based curriculum. Reflecting on the challenge of balancing history, theory, and practice in medical education, bioethicist Thomas McElhinney observed that

the changes in medicine caused by scientific discovery and technological developments, on the one hand, and social and political transformations, on the other, increasingly highlighted the impossibility of a complete medical education structured only on theory and practice (i.e., basic science and clinical training). 15

Faced with the demands of science and clinical education, students’ responses to the little humanities they encountered varied, said McElhinney: “the humanities will be a distraction to some but an oasis in an otherwise arid environment for others.” 16 The serious and profound need for humanistic insight remained obvious even if curriculum space was limited. By contrast, however, undergraduate college education in the 2000s provided fertile soil for program building and expansive institutional development.

S ince 2000, “health humanities” in undergraduate education has expanded as a vibrant complement to the “medical humanities” in medical schools, a development that moved the field significantly beyond its narrow ideals of humanizing physicians. Between 2000 and 2010, the number of undergraduate baccalaureate programs in the health humanities jumped from eight to over forty, followed by another stunning increase in the next decade. By 2021, the number of such programs had reached 119, an eightfold increase since 2000 as one recent survey by humanities and bioethics scholars Erin Gentry Lamb, Sarah Berry, and Therese Jones observed. At the same time that a crisis in the humanities brewed, the once niche field was flourishing. As Lamb, Berry, and Jones noted, “at a time when Liberal Arts education, and humanities programs in particular, are under fire in many public quarters,” health humanities programs were serving a growing, keenly interested population of students (many of whom hoped to enter health care careers).

The utilitarian impulse to produce better caregivers persisted, but the locus of humanistic health education was shifting to undergraduate curricula. And in this context, the critical sensibilities of the medical humanities sharpened. Colleges across the nation discovered that these years were “an ideal time for students to develop skills valuable . . . to providing humanistic health care across a wide range of health care fields.” Reaching younger students prior to entering health careers cultivated “habits of mind that prepare students for critical and creative thinking, identification of internal biases, and ethical reasoning in decision-making processes–all of which are critical skills for participating in the complex system of U.S. healthcare.” 17 The model gained traction, drawing together students from across disciplines and a range of health-oriented humanities scholars in new teaching and research initiatives.

Commenting on the diverse expansion of such programs in 2009, historian Edward Ayers observed that “we need to understand the many contexts in which the humanities live. They live in departments and disciplines, of course; but they also live in new places, in new forms, and in new combinations.” 18 Medical humanities was one such novel combination. Drawing on cultural studies, women’s studies, disability studies, and other burgeoning fields, programs of medical humanities defined a “rapidly growing field, celebrating the ability of the humanities, as one program put it, to provide ‘insight into the human condition, suffering, personhood, our responsibility to each other.’” 19 Medical humanities became, for many commenters like Ayers, a leading example of the thriving humanities, a vibrant counterpoint to widespread narratives of decline.

That same year in an astute editorial in Medical Humanities , physician Audrey Shafer acknowledged the diverse field was showing new academic fracture lines. Not only did institutional and pedagogical goals differ, but gaps had opened between medical humanists who worked directly with patients or in health care settings and those who worked in other educational contexts. Collaborations suffered because “for instance, a performing arts department will have different theoretical underpinnings, methodologies, scholarly activities and products from a philosophy department.” 20 Medical humanities was an intellectual hodge-podge, in Shafer’s view, suffering from an identity crisis. Yet despite tensions among scholars with different qualifications, degrees, and agendas, the enterprise remained vibrant with new “demarcations, dilemmas, and delights.” For Shafer, the struggle to hold the field together was itself productive, for “when medical humanities ceases to struggle with what it encompasses . . . then it will cease to be medical humanities.” 21

Many program builders in undergraduate settings did not share Shafer’s worry about the field’s “identity and boundary bumping,” however. “Health humanities” and “medical humanities” proved to be popular, versatile, and decidedly flexible rubrics for program building in undergraduate contexts. Programs emerged under a growing array of headings: “History, Health, and Humanities,” “Health and Society,” and “Medicine, Science, and the Humanities.” 22 If some embraced narrative ethics and centered the study of literature while others foregrounded history or ethics, this diversity reflected the robust range of what medical humanities had become. The goal remained broad, cross-disciplinary education about the human condition, and deep introspection connecting scholars across fields who were drawn together in teaching and researching the challenges of health and healing.

The agenda of medical humanities had built over time, with no single discipline claiming exclusive ownership over the enterprise. Assessing the field, literature scholar Sari Altschuler pointed forward in the conclusion to her 2018 book, The Medical Imagination . In her view, the humanities agenda in medical schools had made modest gains, confining itself to a limited agenda by “mostly aiming at improving physician empathy rather than at shaping and expanding medicine’s ways of knowing.” 23 Meanwhile, programs run by humanists in undergraduate settings remained too heavily focused on the utilitarian task of preparing aspiring health care workers. Both approaches sought “to bring a sense of the human back to medicine that risked being too governed by dispassionate science, routinized procedure, and market logic.” 24 These foundational functions of the humanities in medicine (its redemptive capacity for humanizing caregivers and seeing the humanity of patients) had not changed. If anything, they had expanded remarkably in reach and scope, finding new audiences, and developing in new venues.

With this expansion, scholars in a field that had begun modestly (in hopes of humanizing physicians and exploring the human condition ) now confidently asserted that the very habits of analysis in humanistic inquiry exemplified, in themselves, important “ways of knowing” about health. To Altschuler, “the number and breadth of medical and health humanities programs offer a terrific opportunity” to move beyond empathy building in medicine, and to embrace a bolder vision: “the recognition that humanists have an important and distinct set of tools for knowing the world, as do health professionals.” 25 Building on the energetic developments of the past decades, she called on humanists to engage with medical science from a new standpoint–to find common ground with medical educators by embracing the language of “competencies”: practical skill development as the bedrock of medical training. By now, these skills could be clearly articulated as “humanistic competencies–which include narrative, attention, observation, historical perspective, ethics, judgement, performance, and creativity.” 26 The list offered a lovely shorthand for the approaches, methods, and practices encompassed within the health humanities. These competencies also highlighted the fraught challenge ahead; the building of medical humanities would involve ceaseless struggle over boundaries and demarcations, even as its core commitment remained restoring humanistic understanding to the vast biomedical and health enterprise.

I n the end, the remarkable growth of the health humanities over the past six decades is a story of tragic relevance, driven by the awareness not that medicine had “saved the life of ethics” as Toulmin had noted, but rather by recognition that new configurations of ethics, literature, the arts, and history were vital for breathing life into medicine.

As the medical humanities have widened their reach, one theme has persisted from the early years: professional and human crisis has spawned the search for meaning and introspection about life, illness, recovery, human suffering, the care of the body and spirit, and death. Medicine’s social dilemmas, its professional controversies, human health crises, social tensions over topics from AIDS to abortion and genetics, as well as the profession’s very identity and its claim to authority have catalyzed and fed a growing demand for answers about meaning. The recurring crisis has generated a style of humanistic insight that has flourished not only within traditional disciplines but also in the interstices.

The flourishing of medical humanities is a story of shifting energies: the emergence of new lines of inquiry, new institutional homes, and novel journals and professional associations. As the field has grown, its questions about illness, disease, and the pursuit of health have become more prominent across the academy and beyond its boundaries. The work has adapted to new trends in health movements, disability studies and activism, and questions of race and gender in relation to health. Even as new programs have developed, the work of health humanities has become ever more salient in the disciplines of history, literature, the arts, and in philosophy and ethics.

This expanding humanist venture–spanning from undergraduate and graduate teaching and research to broad public engagements–refutes the narrative of a “humanities in decline.” Redemption and humanization of the practitioner remain goals, as does the deep appreciation of suffering, recovery, and the illness experience. But the past decades have seen a wider critique: an insistence that the tools of the medical humanities are not merely restorative gap-fillers for what is lacking in scientific and technological insight, but that their discernment about the self and identity, suffering and illness are the primary lenses for understanding essential features of human experience, health, and society. The medical humanities provide, then, the means by which we understand the complex problem of how humans respond to illness, and how humans assess the role of science and medicine in the enterprise of healing.

In the same way that the human tragedy of AIDS confirmed the relevance of medical humanities in the 1980s and 1990s, today’s global coronavirus pandemic (and its underlying issues of disparate suffering, loss, blame, conflicted belief, social inequality, misinformation, and varied cultural responses) catalyzes yet another wave of interest in health humanities. And few of COVID ’s challenging questions revolve around doctoring or patients alone; in COVID , the health and well-being of a contentious and fractured public raised vexing questions well suited for medical humanists.

As we weather recurring waves of COVID , it has become commonplace for media to turn to medical humanities scholars for insight and guidance. What could literature or history teach us about the social responses to the current pandemic? asked National Public Radio. Could the history of past pandemics provide insight into the current crisis, or serve as guides for the building of effective social responses and healthier, more equitable societies? To answer such questions, public media has sought answers from scholars like French professor Alice Kaplan, who was busily writing a new introduction to Camus’s The Plague . In early 2020 during the first wave of COVID , sales of the book skyrocketed in Europe. “People are saying in the French press, what do you absolutely need to read in this time? You need to read The Plague ,” Kaplan explained. “Almost as though this novel were a vaccine–not just a novel that can help us think about what we are experiencing, but something that can help heal us.” 27

The medical humanities began in crises and critiques of medicine, and crisis continued to make the health humanities vital, timely, and necessary. To be sure, the utilitarian ideals remained focused on creating well-rounded medical practitioners. But the field now encompasses a grander and more widely institutionalized, and still richly debated, promise of healing and restoration through literature, the arts, history, and ethics. 28 So while it is true that medicine “saved the life of ethics,” it is also the case that over these decades, the medical humanities has breathed new life into the humanities while also offering society a kind of healing that medicine itself cannot provide. This remarkable growth offers a counterpoint to narratives of decline in the humanities. It is a story of growing relevance shaped by tragedy, of innovative programs in medical schools and on undergraduate campuses, and vital new configurations of ethics, literature, the arts, and history that have profoundly rejuvenated the study of health and medicine.

• 1 Daniel Callahan, Arthur Caplan, and Bruce Jennings, “Preface” to Eric Cassell, The Place of the Humanities in Medicine (Hastings-on-Hudson, N.Y.: The Hastings Center, 1984), 5.
• 2 Cassell, The Place of the Humanities in Medicine , 6.
• 3 Ibid., 47.
• 4 Ibid., 13.
• 5 Thomas Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (New York: Harper Collins, 1961).
• 6 Elisabeth Kubler-Ross, On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families (New York: Scribner, 1969).
• 7 Stephen Toulmin, “How Medicine Saved the Life of Ethics,” Perspectives in Biology and Medicine 25 (4) (1982): 749.
• 9 Cassell listed the four as Pennsylvania State, Wright State, Southern Illinois, and University of Nebraska. Cassell, The Place of the Humanities in Medicine , 12.
• 10 Larry Kramer, The Normal Heart: A Play (New York: Plume, 1985); and Abraham Verghese, My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS (New York: Vintage, 1994).
• 11 Joseph Cady, “ My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS (review),” Literature and Medicine 15 (2) (1996): 278–282.
• 12 Rita Charon and Martha Montello, “Memory and Anticipation: The Practice of Narrative Ethics,” in Stories Matter: The Role of Narrative in Medical Ethics , ed. Rita Charon and Martha Montello (New York: Routledge, 2002).
• 13 Emily K. Abel and Saskia K. Subramanian, After the Cure: The Untold Stories of Breast Cancer Survivors (New York: NYU Press, 2008), 141.
• 14 Loretta M. Kopelman, “ 1997: The Birth of ASBH in Pictures and Commentaries ,” American Society of Bioethics and Humanities .
• 15 Thomas K. McElhinney, “Reflections on the Humanities and Medical Education: Balancing History, Theory, and Practice,” in The Health Care Professional as Friend and Healer: Building on the Work of Edmund Pellgrino , ed. David C. Thomasma and Judith Lee Kissell (Washington, D.C.: Georgetown University Press, 2000), 271.
• 16 Ibid., 289.
• 17 Erin Gentry Lamb, Sarah Berry, and Therese Jones, “ Health Humanities Baccalaureate Programs in the United States and Canada ” (Cleveland: Case Western Reserve University, 2021), 5.
• 18 Edward L. Ayers, “Where the Humanities Live,” Dædalus 138 (1) (Winter 2009): 24–34.
• 19 Ibid., 32.
• 20 Audrey Shafer, “Medical Humanities: Demarcations, Dilemmas, and Delights,” Medical Humanities 35 (1) (2009): 3–4.
• 21 Ibid., 4.
• 22 Lamb et al., “Health Humanities Baccalaureate Programs in the United States and Canada,” 10–12.
• 23 Sari Altschuler, “Humanistic Inquiry in Medicine, Then and Now,” in The Medical Imagination: Literature and Health in the Early United States (Philadelphia: University of Pennsylvania Press, 2018), 198.
• 24 Ibid., 198.
• 25 Ibid., 199.
• 26 Ibid., 200.
• 27 Melissa Block, “‘ A Matter of Common Decency’: What Literature Can Teach Us about Epidemics ,” National Public Radio, April 1, 2020; and Audie Cornish, “ How Do Pandemics Change Societies? A Historian Weighs In ,” National Public Radio, March 11, 2021.
• 28 E. D. Pellegrino, “Medical Humanism: The Liberal Arts and the Humanities,” Review of Allied Health Education 4 (1981): 1–15; and E. D. Pellegrino, “The Humanities in Medical Education: Entering the Post-Evangelical Era,” Theoretical Medicine 5 (1984): 253–266.

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The Journal of Medical Humanities is a peer-reviewed, scholarly journal that publishes innovative research, creative scholarship, poetry, essays, reviews, and short reports in the health humanities. Please see the list of “What We Publish” on the Journal Updates page for more information about specific genres for submission and information about their length and format. Submissions to JMH should be oriented toward health humanities as a scholarly field, aiming to engage central questions, dilemmas, challenges, and imaginative opportunities that the health humanities offer. Readers are trained in a variety of disciplines, so submissions should avoid field-specific jargon. Readers also expect scholarship that is inclusive and attentive to social justice issues and scholarship, broadly construed.  

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Oxford Research Encyclopedias - new comprehensive collections of in-depth, peer-reviewed summaries on an ever-growing range of topics (African History, Economics and Finance, Literature, American History, Education, Natural Hazard Science, Asian History, Social Work, Neuroscience , Business and Management, Environmental Science, Oxford Classical Dictionary , Climate Science, International Studies, Politics, Communication, Latin American History , Psychology , Criminology and Criminal Justice , Linguistics, and Religion).

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Encyclopaedia of the History of Science, Technology, and Medicine in Non-Western Cultures   - as the title suggests, this encyclopedia is inclusive of scientific, technological and medical accomplishments of cultures outside of the United States and Europe. Each entry includes bibliographic reference to assist in further reading and sourcing.

Encyclopedia of Medical Anthropology: Health and Illness in the World's Cultures (2004) -  the first reference work to describe the cultural practices relevant to health in the world's cultures and to provide an overview of important topics in medical anthropology. More than 100 experts - anthropologists and other social scientists - have contributed their firsthand experience of medical cultures from around the world. - from the publisher's website

Health and Medicine through History: From Ancient Practices to 21st-Century Innovations (2019) - a comprehensive (1,127 pages) yet concise global exploration of health and medicine from ancient times to the present day, helping readers to trace the development of concepts and practices around the world (eBook)

Oxford Bibliographies - these authoritative research guides combine the best features of an annotated bibliography with a high-level encyclopedia across a variety of subject areas.  Subject areas include: African American Studies , American Literature, Anthropology , Art History, Atlantic History, Biblical Studies, British and Irish Literature, Cinema and Media Studies, Classics, Evolutionary Biology, Islamic Studies, Jewish Studies, Latin American Studies, Linguistics, Literary and Critical Theory, Medieval Studies, Philosophy , Psychology , Renaissance and Reformation, Social Work, Sociology, and Victorian Literature.

The Cambridge World History of Human Disease  (1993) - title link is of for the eBook; also in print ) - traces the concept of disease throughout history and in each major world region. It offers the history and geography of each significant human disease--both historical and contemporary--from AIDS to yellow fever, and touches on the variety of approaches that different medical traditions have used to fight disease. Accessible to lay people and specialists alike

Journal of Medical Biography  (London: Royal Society of Medicine, 1993-2012) - focuses on the lives of people in or associated with medicine, those considered legendary as well as the less well known. The journal includes much original research about figures from history and their afflictions

Books for the Medical Humanities

Brian Dolan, Humanitas: Readings in the Development of the Medical Humanities (2015) - This reader reprints critical essays published over the course of a 100-year history that grapple with the challenges of defining and justifying the presence of humanities instruction in medical education...with a comprehensive historiographical introduction." -  - publisher's website    

Thomas R. Cole et al, Medical Humanities: An Introduction (2015) - "Using concepts and methods of the humanities, the book addresses undergraduate and premed students, medical students, and students in other health professions, as well as physicians and other healthcare practitioners. It encourages them to consider the ethical and existential issues related to the experience of disease, care of the dying, health policy, religion and health, and medical technology." - publisher's website  

Paul Crawford et al, Health Humanities (2015) - "This is the first manifesto for health humanities worldwide. It sets out the context for this emergent and innovative field which extends beyond medical humanities to advance the inclusion and impact of the arts and humanities in healthcare, health and well-being." - Google Books summary  

Sander Gilman, Illness and Image: Case Studies in the Medical Humanities (2015) - case studies include: circumcision, face transplants, posture, obesity, pain, madness, self-harm, race, and death   

Therese Jones et al, Health Humanities Reader (2014) - "consists of nearly 50 chapters, some of which deal with classic medical humanities topics, such as the notions of health and disease and the theory of the body.  The majority of the book centers on more contemporary issues, such as gender and sexuality, disability, and aging.  The depth and rigor of the collection are equally varied as the  style and genre of writing (academic essays to short plays, poems, and comics .)  Novices or students may prefer to first develop a solid body of knowledge of the medical humanities to fully appreciate the richness of this collection ..." review by P. Rodriguez del Pozo, MD, JD, PhD, Weill Cornell Medical College (Qatar), for Choice

Journals for the Medical Humanities

Bulletin of the History of Medicine (1939-present) - As  the official publication of the American Association for the History of Medicine ( AAHM ) and the Johns Hopkins Institute of the History of Medicine, the Bulletin is a leading journal in its field spanning the social, cultural, and scientific aspects of the history of medicine worldwide. WUSTL  Libraries owns the full run but it is split between JSTOR and Project MUSE . 

Journal of Medical Humanities (1979-present) - publishes original interdisciplinary studies on the history, philosophy, and bioethics in the medical and behavioral sciences as well as pedagogical perspectives explaining what and how knowledge is made and valued in medicine, how that knowledge is expressed and transmitted, and the ideological basis of medical education. WashU Libraries' access is spread across  Academic Search Complete , Springerlink Contemporary, as well as print editions for years prior to 1997 (starting with v.10 in 1989).

Journal of Medicine and Philosophy  (1976-) - Published by Oxford University Press, J. Med. Philos . is a flagship, international scholarly journal in bioethics and the philosophy of medicine. WashU Libraries has print editions from v.7-33 (1982-2008) and electronic versions from the first issue through 1995 in Oxford Journals 2018 Humanities Archive and from 1996 to present in Oxford Journals A-Z Collection . If you search  Academic Search Complete , you will only find articles from 1997 to one year ago. 

Medical History (1957-present) - is an international journal for the history of medicine and related sciences published by Cambridge University Press. All issues can be found through PubMed Central .

Medical Humanities (2000-present) - Published on behalf of the Institute of Medical Ethics and the British Medical Association. All issues can be found through BMJ Journals and should not be confused with 

Perspectives in Biology and Medicine (1957-present) - is an interdisciplinary journal from the Johns Hopkins University Press which publishes essays that place biological and medical topics within broad scientific, social, or humanistic contexts for scientists, physicians, students, and scholars. All issues are available through Project MUSE .

Social History of Medicine (1988- ) - is the journal for the Society for the Social History of Medicine and is published by Oxford University Press. It began publication in 1970 as the  Bulletin for the Social History of Medicine  and publishes cutting-edge research on the history of all aspects of health, illness and medical treatment in the past, from antiquity to the present. WashU Libraries only has access to issues from 1988 to present. 

Studies in History and Philosophy of Science. Part C, Studies in History and Philosophy of Biological and Biomedical Sciences  -  (1998-present) is published by Elsevier and is devoted to historical, sociological, philosophical and ethical aspects of the life and environmental sciences, of the sciences of mind and behavior, and of the medical and biomedical sciences and technologies.WashU Libraries has access to all issues through Science Direct Journals . 

Additional Journal Databases

History of Science, Medicine, and Technology integrates four bibliographies: the Isis Current Bibliography of the History of Science, the Current Bibliography in the History of Technology, the Bibliografia Italiana di Storia della Scienza, and the Wellcome Library for the History and Understanding of Medicine. It is updated on a monthly basis and includes bibliographic records for records of journal articles, conference proceedings, books, dissertations, serials, maps, and other related materials.

History databases America: History & Life (1964-)   contains only journals related  history of the United States and Canada from prehistory to the present.

Historical Abstracts (1955- )  covers world history from 1450 to the present

Philosophy databases

PhilPapers is a comprehensive index and bibliography of philosophy maintained by the community of philosophers. We monitor all sources of research content in philosophy, including journals, books, open access archives, and personal pages maintained by academics. We also host the largest open access archive in philosophy.

Medical databases

PubMed (1946 - )  - includes over 3,500 journals published internationally, covering all areas of medicine. Includes the entire Medline database (1966+) PLUS PreMedline (recent articles that are not yet fully indexed for Medline) and links to publisher full-text web sites and other databases.

Hein Online  - more than 900 searchable full-text law journals and many legal resources, including the Code of Federal Regulations, United States Code, and U.S. Statutes at Large. Campus-wide access is due to subscription by the WU Law Library.

Classics Resources

Classics Librarian Christie Peters Research Guide to Classics

Multidisciplinary databases

JSTOR  - multidisciplinary, a lot of full text articles, but subject headings are too broad

Academic Search Complete (1975-present)  - multidisciplinary; subject headings may or may not be LCSH; also made by EBSCO, so overlaps with America: History & Life

JSTOR v. Academic Search Complete

Google Scholar  - articles from a wide variety of academic publishers, professional societies, preprint repositories and universities, as well as scholarly articles available across the web. While Google Scholar itself is free on the web, many of the citations it references are not.

Primo - is a "discovery tool" that searches WUSTL's library catalog as well as a number of newspaper and journal databases at one time, but it doesn't retrieve all of their content nor does it search all databases

Google Scholar v. Primo

Project MUSE  - a comprehensive collection of peer reviewed, interdisciplinary journals from leading university presses, not-for-profit publishers and prestigious scholarly societies.

Scopus  - The world’s largest abstract and citation database of peer-reviewed literature. Contains over 46 million records, 70% with abstracts, and also includes over 4.6 million conference papers.

Primary Sources

State Medical Society Journals  - this collection encompasses nearly 50 state medical journals published between and 1844 annd 2017 and is hosted by the Internet Archive. The older editions could be considered primary sources, as they reflect the historical perspective of the medical profession in their time. 

Making of Modern Law collections include:  Legal Treatises, 1800-1926; Trials, 1600-1926; Foreign, Comparative and International Law, 1600-1926; Foreign Primary Sources, 1600-1970; Primary Sources, 1620-1926, and U.S. Supreme Court Records and Briefs, 1832-1978.

Medical Heritage Library   is a collection of digitized medical rare books, pamphlets, journals, and films number in the tens of thousands, with representative works from each of the past six centuries, collaboratively curated from among some of the world’s leading medical libraries and made available through the Internet Archive.

Early American Medical Imprints; A guide to works printed in the United States, 1668-1820   - published in 1961 and compiled by the thirty-five year cataloguer at the National Library of Medicine, it contains every medical work, even some material pertaining to veterinary medicine, vital statistics and medical legislation, published in the U.S. for the period described in the title. 

Hathi Trust - a large-scale collaborative repository of digital content from research libraries including content digitized via the Google Books project and Internet Archive digitization initiatives as well as content digitized locally by libraries.

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• v.2(5-6); 2013 Nov

Humanities in medicine: preparing for practice

Daryl ramai.

1 School of Medicine, St. George’s University, True Blue, Grenada, West Indies

Shoshanna Goldin

2 Department of Interdisciplinary Studies - Global Health, Wake Forest University, Winston-Salem, NC 27109 USA

As medical curriculum continues to experience a renaissance into the twenty first century, there comes to birth a variety of seeded programmes in which there is no concrete definition for what is termed humanities in medicine. However, while the humanities continues to play an integral role in medicine, alongside the publication of numerous articles published by medical journals, medical institutions have tailored related programmes intended to support students’ learning about the social and cultural contexts of health, illness, and medical care. Others have defined a broader paradigm to include history, philosophy, literature, and arts. Though there is much versatility in these programmes, the expected outcomes have been collectively agreed upon. This article highlights three primary domains for why humanities should be incorporated into medical circular and the training of ‘tomorrow’s doctors’.

Firstly, according to the Association for Medical Humanities, the study of humanities contributes to the development of students’ and practitioners’ capacity to listen, interpret, and communicate, while fostering an appreciation for the ethical dimensions of practice [ 1 ]. This places more focus on the patient as a whole, assessing both objective and subjective experiences of illness and health. For example, by understanding the subjective nature of an individual’s behavioural patterns, a doctor could find it beneficial to under-prescribe. The study of humanities may assist in nurturing students in becoming more insightful, reflective, and hopefully more influential in shaping the course of health care. This degree of introspective thinking facilitates and encourages a willingness and capacity for innovation surrounding larger public debates such as with the Universal Health Care Act within the United States [ 2 ].

Secondly, humanities in medical education can foster an active professional conscience in students. Faunce [ 3 ] has suggested that this component of student education begins by encouraging the practical expression of foundational virtues such as empathy, compassion, fairness, and loyalty to the relief of patients’ suffering. With the rigors of medical study and practice, students and doctors sometimes lose sight of the patient, much less for these essential principles. It has been well documented that students lose empathy during their medical education. By incorporating and re-enforcing these values earlier and throughout medical school, students will eventually adapt and grow into these ideals as part of their own identity, making it an automatic and habitual response.

Thirdly, by creating a relationship between humanities and medicine, student doctors and physicians are provided with an outlet to express themselves in a safe and responsible manner. There is also evidence that suggests that humanities may aid in the health of students and practitioners. While practitioners are entrusted with the lives of others, they share in the burden of witnessing the toll of disease. The intensity of the constant struggle to provide care and fight potential loss can build barriers between patients and physicians. By incorporating humanities into medicine, we allow physicians to direct and express their fears, stress, and hopes in a secure arena. With such potential, medical schools are growing increasingly aware of the importance of incorporating humanities into the curriculum. In 2011, a medical humanities course was required for graduation at 52 % of American medical schools [ 4 ].

In conclusion, the value of humanities in the medical profession is multi-faceted. From the classrooms of medical school to the operating rooms of the hospital, tomorrow’s doctors will be responsible for absorbing and providing medical knowledge with attention and care. As the medical profession continues to include humanities in its curriculum, it will have an opportunity to develop practical and valuable skills such as critical and reflective thinking, a professional conscience, and a healthy emotional outlet for the next generations of physicians.

Biographies

is a medical student at St. George’s University. He is an avid researcher having a fervent interest in education, global health, and medicine.

is a Global Health student at Wake Forest University with a keen interest in paediatric epidemiology. She is president of Wake Forest University’s Hillel and co-founder of the Hunger Advisory Board.

Contributor Information

Daryl Ramai, Email: ude.ugs@iamard .

Shoshanna Goldin, Email: ude.ufw@11nsdlog .

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Using the Gold Foundation’s medical student essays to teach humanism

This post is part of our collection of “ Gold Nuggets ” —  our way of alerting the medical community to original artwork, poetry or multimedia that stimulate discussion and reflection.   If you have something you think would make for good discussion by the medical community, you can submit a Gold Nugget by  following these instructions . 

I teach several medical humanities classes– to medical students and undergraduates– and I lecture on the use of medical humanities in teaching humanism and clinical skills. In this process I’ve used some of the winning essays from the Gold Foundation’s Annual Essay Contest as a teaching tool because I’ve found them to be so very effective.

Why use medical student writing examples to teach medical students? The answer resides partly in the power, authority, and influence of a compellingly written narrative that brings a topic to life and finds a permanent place in the reader’s memory.  They show rather than tell; instead of giving an order to remember the key points, they show why a behavior is significant.

Recently, a fourth-year medical student told me that he wished medical humanities classes were required at the University of Florida (where these classes are currently electives) because the effort of reading narratives, watching movies, and listening to patient stories helped to create a permanent reminder that patients are human beings with personal stories and real lives. The development of humanism in medicine requires that these lessons be firmly imprinted, since there are so many factors in medical training and medicine that can throw people off track. Only when the message includes a compelling story that produces an emotional response does it truly become a lesson to be remembered.

The answer also resides partly in the power, authority, and influence of medical students themselves. Undergraduates tend to admire medical students for having successfully navigated the required medical school hoops, and feel that medical students can be trusted (since students may perceive that certain professors or other authority figures may not truly be on a student’s “side”). Medical students also lack the intimidating level of authority of some professors.

Thus, a written message from another medical student is a wonderful teaching tool. It works especially well when the author illustrates key points in his or her medical training and emotional development as a physician. Such a message may also reflect some of the concerns that the readers have (as there is great power in not feeling “alone”). If such a message additionally provides a valuable piece of information on how better to interact with and treat patients, it is particularly powerful.

A number of the winning essays from the Gold Foundation’s Annual Medical Student Essay Contest have proved valuable in illustrating significant points. Links to the full text of the top 3 essays of each year can be found here . Here are two examples of essays I have taught:

• My Most Famous Patient by Amit V. Khera, 3rd year student at University of Pennsylvania School of Medicine I use Khera’s essay primarily in a class for undergraduates who have been accepted into a 7-year undergraduate/medical school program. The course pairs the teaching of clinical skills with related humanities. Students do a Readers Theater  depicting physicians who put aside their stereotypes in favor of truly seeing the patient, and then we discuss the essay. We also practice the exercise in Khera’s essay by asking each student to identify something about himself or herself that makes each of them famous.   Thus, students come away with a practice that they can apply to their own patients– a reminder to ask patients about their life outside of the healthcare setting– and with substantial knowledge about how and why that practice can improve the physician-patient relationship.
• An essay  about the value of using art to teach observational skills  by Eliza Miller, 2nd year student at Columbia University College of Physicians & Surgeons This essay both illustrates the value of using art to enhance clinical observation skills, and comments on the ways in which art can humanize medicine. It provides a powerful reminder of the ways in which education can enhance or hinder the growth of humanism. As Eliza Miller wrote, “My reason points out that time constraints in medical training make this kind of learning far too inefficient. My heart argues that we cannot afford to ignore the lessons learned at the museum. If we neglect our creative learning process, we retreat, both from our patients and our humanity.”

Nina Stoyan-Rosenzweig serves as medical historian for the Health Science Center at the University of Florida and directs medical humanities programming in the College of Medicine.  She is an advisor for the UF Gold Humanism Honor Society and works on a variety of programs and projects on topics ranging from eugenics to arts in traditional African healthcare systems to the use of medicinal plants in Harry Potter.

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The Biomedical Ethics and Medical Humanities foundation area enables medical students to study a chosen area in depth as a complement to the breadth of knowledge and skills gained by general medical education. Biomedical Ethics and Medical Humanities is an opportunity for interested students to reflect on, analyze, and contribute to the meaning of medicine by focusing on one (or more!) of the diverse fields that contribute to bioethics and/or the arts and humanities as related to medicine. Resources and events related to medical humanities can be found by exploring the  Medicine and the Muse Program . Biomedical Ethics and Medical Humanities students will be able to examine the ethical and humanistic dimensions of research and practice, and focus on issues that they will confront whether at the laboratory bench or at the bedside. We define "Biomedical Ethics" as broadly encompassing the examination of the ethics of all biomedical research, medicine, and health care. We envision the "Humanities" to include the traditional humanities fields of literature, philosophy, history, religion, and the arts (visual, theatre, media), as well as humanities-oriented social sciences (including anthropology and sociology). Here are examples of topics within Biomedical Ethics and Medical Humanities: the impact of medical and technologic advances (such as genomics, stem cell research, etc); neuroethics; history of medicine; issues of health care access and public health policy; doctor-patient relationship and communication; end-of-life issues; medicine and the media; medicine and society; literature and medicine; medical anthropology; empathy and the experience of illness; the arts and medicine. There are many more. Biomedical Ethics and Medical Humanities is a richly interdisciplinary concentration. For example, a student who wishes to do a film on choices in the neonatal intensive care unit would study filmmaking and editing, communication, family interactions, neonatology, issues of limited resources, ethics of medical advances, informed consent issues, etc. Due to the medical school's ideal location on the same campus as the University, medical students in Biomedical Ethics and Medical Humanities benefit from multiple opportunities for interdisciplinary work across the campus.

• Research article
• Open access
• Published: 24 March 2021

The role of humanities in the medical curriculum: medical students’ perspectives

• Loukia Petrou   ORCID: orcid.org/0000-0003-0569-7882 1 ,
• Emma Mittelman 1 ,
• Oluwapelumi Osibona 1 ,
• Mona Panahi 1 ,
• Joanna M. Harvey 1 ,
• Yusuf A. A. Patrick 1 &
• Kathleen E. Leedham-Green 1  

BMC Medical Education volume  21 , Article number:  179 ( 2021 ) Cite this article

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The humanities have long been shown to play an important role in the medical school curriculum. However, few studies have looked into the opinions of medical students on the usefulness and necessity of the humanities as well as their extracurricular involvement with them. The aim of this study was to: a) understand medical students’ attitude towards the humanities in medical education and b) assess their understanding of the necessary qualities of doctors and how interaction with the humanities affects the development of such attributes.

A mixed methods survey was designed to elicit demographics, engagement, interest and perspective on curricular positioning, and to explore how students ranked the qualities of a doctor. It was distributed to medical students of all year groups in the 6-year bachelor of medicine, bachelor of surgery (MBBS) course at Imperial College London.

One hundred nine fully completed questionnaires were received. No significant difference was found in engagement or interest in the humanities between genders. Students felt strongly that humanities subjects shouldn’t be assessed (71:18) though some felt it was necessary for engagement, while no consensus was reached on whether these subjects should be elective or not (38:31). The majority of students wanted more medical humanities to be incorporated into the traditional medical course with a preference of incorporation into the first 3 years. Junior medical students were more likely to rank empathy as a highly desirable attribute than senior students. Students provided qualitative insights into curricular positioning, assessment and value.

Conclusions

This study provides the perspective of medical students on how and whether the humanities should be positioned in medical education. It may be helpful to medical schools that are committed to student involvement in curriculum design.

Peer Review reports

The humanities, including the arts and social sciences, are important aspects of everyday medical practice, and they are usually incorporated early into medical education. The General Medical Council emphasizes the importance of understanding a patient’s psychological, social and cultural needs, alongside their pathology [ 1 ]. Extending medical education beyond the biomedical sciences and clinical skills is a core strategy in the development of professional values and behaviours, including professional identity formation [ 2 ]. Medical humanities may encourage a deeper understanding of patients’ illness journeys through promoting cultural inclusivity by use of longitudinal case studies for instance [ 3 , 4 ]. The arts can nurture visual diagnostic and analytical skills [ 5 ], be an outlet for physicians at risk of burnout [ 6 ] and nurture the positive qualities of empathy, self-efficacy and efficient patient focused care [ 6 , 7 ]. The humanities may also support the development of interpersonal skills required to take on leadership and management roles within the multidisciplinary team. Physician-led healthcare management has been shown to result in better performance financially and clinically [ 8 , 9 ]. Humanities-based learning may also support the development of persuasive writing skills which support engagement in policy writing and global heath. Some essential tools needed to accomplish these are the humanity subjects of history, economics, law and sociology.

Previously researched stereotypes suggest a gender divide within the subjects, with men perceived as likelier to pursue sciences and women likelier to pursue the arts [ 10 ]. The UK’s Universities and Colleges Admissions Service (UCAS) service data reflects that science, technology, engineering and mathematics (STEM) subjects have been markedly less popular amongst female applicants, although women tend to predominate over most other fields [ 11 ], (Supplementary information, figure 1 ). However, it has been suggested that gender identity and society moderate these stereotypes and therefore students’ academic plans [ 12 ].

Many medical schools have introduced humanities-based courses into their curricula, which may be centering around poetry, prose, law and ethics. However, these elements are often elective in nature, predisposing to self-selecting students, which may bias follow-up surveys and questions to more positive outcomes [ 13 ]. These humanities are often introduced as isolated modules rather than integrated education, shying away from the holistic approach a modern doctor should embody and therefore prompting courses to be centered on the biomedical aspects of medicine [ 13 ]. Similarly, few studies have questioned how medical students would like the humanities integrated into their education, and their engagement with the humanities outside of these compulsory programmes, with little regard towards the temporal placement of these modules within the course [ 14 ].

Our study primarily aims to assess the opinions of medical students on the integration of the medical humanities into education courses. It focuses on factors such as the electivity, assessment and appeal of such courses and the practical implications of such additions to the curriculum such as the timing. This study also aims to analyse what students perceive as the main qualities and focal roles of a doctor, how factors such as gender influence this, and how this is affected by the students’ previous exposure and engagement with the humanities. Our study positions student involvement in curriculum design as important from a both values-based perspective [ 15 ] and from a more pragmatic perspective, recognising that student involvement is a precursor to intrinsic academic motivation [ 16 ].

This research was situated in a London-based university of science, technology and medicine, and as such students had limited exposure to the humanities, other than through elective components. The university has recently instigated a learning and teaching strategy [ 17 ] that has student engagement as a central focus, including a system of ‘student shapers’ to ensure that the curriculum is aligned to students’ needs and aspirations. The current study is part of the college’s commitment to incorporating the student voice into curriculum design.

Our research is situated in a post-positivist paradigm, where we believe there are real measurable differences between groups of students, however complexity and context make it difficult to draw conclusions that are widely applicable. We also believe that knowledge is necessarily situated in its context, therefore readers will need to make locally relevant inferences by taking into consideration our description of context and comparing it to their own.

A mixed methods survey research study was conducted using a simultaneous nested design [ 18 ]. This survey employs an exploratory design, and as such any patterns or correlations emerging from the data are not deductively proving a priori hypotheses. Instead we are using an inductive process to see which patterns emerge, in order to generate hypotheses [ 19 ]. The questionnaire was composed of three parts; the first collected information regarding student demographics (self-identified gender, year of study, age, previous study or regular engagement with humanity subjects). The second focused on students’ viewpoints with regards to the humanities, specifically focusing on their relevance to medical practice and training. The third section focused on the integration of humanities into the medical course. Students could select multiple years that they thought the course should be included into and could give free-text answers for the reasons behind their choices. The questionnaire was created and distributed using©Qualtrics [ 20 ] (Supplementary information, Figure 2 ).

The questionnaire was trialed on a small selection of current medical students to ensure ease of completion, simplicity and relevance to the course, as no similar studies have been undertaken in the past. Ethical approval was provided by the Imperial College Medical Education Ethics Committee (MEEC1819–111).

All year groups from Imperial College School of Medicine who were students during the academic year 2018–2019 were eligible for the study with no exclusion criteria. The study ran from 1st October 2018 until the 2nd November 2018. Recruitment was via post-lecture announcements, direct approach and notification on the monthly newsletter. Participant information was included within the questionnaire and completion of the questionnaire qualified as consent for participation. The questionnaire required approximately 5–10 min to complete.

We analyzed the quantitative data for significant relationships using a combination of Kruskal Wallis and Mann-Whitney U tests with respect to age/year group/gender/previous humanities involvement using SPSS software version 26.0 (IBM Corp., Armonk, N.Y., USA). For the free-text responses, a modified version of consensual qualitative research (CQR-M) was used, involving one person coding, a second person auditing one in five answers and all authors co-constructing meaning and checking themes and categories against the underlying data until there was a good fit. Disagreements were resolved through mutual discussion. All responses were read to ensure no minority themes were missed. Coding continued until saturation, which was determined by no new themes arising [ 21 ].

We received 123 responses of which 14 were excluded as incomplete, resulting in 109 fully completed questionnaires, (109/123, 88.6%). The average age of participants was 22, 51% identified as female, 46% as male, 1% non-binary and 2% preferred not to say. Participants' distributions across years are diplayed in Fig. 1 . There was no significant difference between the population of this study and the population of the medical school in terms of gender, based on statistics provided by the admissions data.

Pie chart of academic year distribution within the study population. Percentage of students per option stated

In relation to the types of humanities different groups of students were interested in, those who engaged in the university’s elective, extra-curriculum, humanities programme were found to be more likely to have engaged with the visual arts ( p  = 0.031). There was a significant difference between senior (years 5 & 6) and younger medical students (years 1–4), with a smaller proportion of senior students engaging in performing arts compared to their younger counterparts ( p  = 0.005).

Medical students at Imperial College study an intercalated bachelor of science (BSc) degree in a selected module of their choice. One of the largest influences on interest in the humanities was found to be participation in the Medical Humanities, Philosophy and Law BSc. These students were significantly more interested in the humanities ( p  = 0.016) and likelier to support the integration of more humanities into the course ( p  = 0.044). Quantitative analysis of factors prior to medical school, including study of humanities subjects, did not show any significant impact on students’ views of the medical humanities.

Medical students’ thoughts on which year of medical school humanities should be introduced into

We found that students recommended the inclusion of additional humanities subjects in the first year most and final year least (Fig.  2 ). The majority of students (71.98%) recommended humanities incorporation in the earlier years (years 1–3).

Recommended academic year for the introduction of a humanities course, split by current year group. (Relating to Q17: If more humanities subjects were introduced to the curriculum, in your opinion which academic year(s) would be most appropriate?) Bar chart split to represent response rates from different MBBS Year Groups

Results from the qualitative questions, 17–19, are shown in Tables  1 , 2 and 3 , along with some exemplar quotations. Three main themes identified by students’ written responses included: (1) time, (2) use and (3) vertical learning. These themes were then separated into subthemes and these, along with their frequency and representative quotes are summarized in Table  1 . Twenty-three responses were deemed unusable due to either being blank or incomprehensible.

Medical students’ opinions on whether humanities should be an elective module or not

We found that 31 students prefer humanities to be compulsory (‘No’) and 38 students showed preference in an elective course (‘Yes’). Forty students were indifferent and 64 written responses were unusable (Table  2 ). We found that the most common reasons for humanities to be an elective component were disinterest in the subject and that it was deemed unnecessary to the course. The themes, where given, are thematically summarized in Table 2 .

Medical students’ opinions on the assessment of humanities subjects

The final qualitative question related to whether the course, if introduced, should be assessed or not. In general, 18 students thought it should, 71 students thought it shouldn’t and 20 students were indifferent. Sixty-one written reasons were unusable. The reasons, where given, are thematically summarized in Table  3 .

Regarding ranking the important qualities of a doctor, senior medical students (years 5 and 6) rated ‘importance of empathy’ lower ( p  = 0.0001) with the ‘ability to manage a patient’ ranked significantly higher ( p  = 0.001). Finally, senior students are significantly more likely to agree that humanities play an important role in the MBBS course (p = 0.001).

There was no significant difference between the genders in engagement or interest in humanities. The median values between all cohorts were similar and a study involving a larger sample size and perhaps qualitative reasoning behind answers given would be needed in order to draw meaningful conclusions.

There is some discourse regarding how and whether to integrate humanities into medical curricula at present [ 14 , 22 , 23 ]. Imperial College provides an epidemiology & sociology of medicine course in earlier years, an ethics course in 3rd year and a ‘dermatology and art’ teaching day in later years. There is also a Medical Humanities, Philosophy & Law intercalated BSc option in year 4.

The majority of students believe that additional humanities subjects would be better incorporated in earlier years. Qualitative comments suggested an integrated approach was preferred by some students, with some specifically requesting vertical learning throughout education. Participants highlighted the need to keep a broad-minded perspective of medicine in the pre-clinical years, when students may feel there is a lack of insight towards the broader aspects of a physician’s training outside scientific knowledge, a viewpoint shared by some critics of the standalone approach [ 14 ]. Furthermore, many older years state that there is greater time-flexibility during younger years, allowing for greater stimulation with humanities, which provides a break from the science-focus. In contrast, other participants view the humanities as a separate entity to medical education, which would take away from the scientific focus.

This disparity in students’ understanding of how the humanities relate to medical education was most starkly demonstrated in Table 2 where participants were split 55 to 45% in favor of humanities being a compulsory component of the course. The main reasons against compulsory integration were either the humanities being unnecessary to medical education or that students would be disinterested in the topics, which may be due to the lack of discussion around the utility of humanities in medicine [ 24 ]. Disinterest as a reason to avoid compulsory teaching could strengthen the idea that many students perceive the medical humanities as a separate entity from medicine. Conversely, those in favor of integration, cited its importance to a well-rounded education, and proposed that students in “need” of the skills obtained by the study of the humanities are those who would opt out from elective courses [ 23 ].

There were varying conceptions of what the humanities are, and how they relate to medical education, with some conceptualising the humanities as solely the arts and some with more complex conceptions that might include philosophy, sociology or history. This varied view of medical humanities role within the medical profession is shared in the literature with some emphasising its ability to help the physician at work, while others stress its role is outside the realm of academia [ 25 , 26 ].

An area that many participants agreed upon is that engagement in humanities should be considered more important than assessment, citing the large number of exams already present in the medical school as a source of stress and concern [ 27 ]. Whilst outside the scope of this study, the role of exams in medical school was the largest detractor for assessing the humanities, yet those in favor of examination argue that students will only fully engage with a subject if it will be assessed. This evidently creates a challenge when trying to design a more holistic course which fosters learning through curiosity. Such antipathy towards examination is perhaps driven by concern over how the humanities could be assessed with the same objectivity analysed in more clinical and theoretical areas, with difficulties arising in the lack of measurable outcomes in areas such as empathy and professionalism, definition of terms and current pedagogical structures [ 28 ]. Expectancy theory would indicate that a lack of belief in the chance of personal success in such examination would lead to a decrease in motivation and effort invested towards these goals. Similarly, if self-perceived performance is not seen to correlate with assessment outcomes this disrupts the instrumentality of motivation, leading to further demotivation towards engagement with the topics [ 29 ].

Quantitative analysis found that there was no difference between genders in regards to interest in the humanities. This contradicts previous research and beliefs dictating that males tend to favour the more traditional STEM subjects, with females preferring humanities. Despite evidence to the contrary in this study, overall UCAS data still displays a major discrepancy between genders in regard to engagement in the humanities (Supplementary information, figure 1 ). This has largely been put down to societal pressures and a lack of role models in the field. However, this study shows that for those students who choose to study medicine, a science that combines humanistic care with science-based clinical practice, there is no significant difference in engagement or interest in the humanities. Whilst difficult to interpret, this may indicate that when exposed to similar societal pressures, which pushed these individuals to pursue a medical vocation, there is no inherent difference between genders.

The comparison between senior and junior students indicated a disparity wherein senior students were less likely to engage with the humanities. This is indicative of the culture of medical school where students approaching final exams often struggle to continue extracurricular pursuits they developed in their younger years. As described previously by Shapiro et al. [ 30 ], humanities-based learning is not valued by all students which prompted us to investigate further how these students value humanistic professional qualities. A focus on academia and in particular the management of a patient is especially important to senior medical students as the focus of their written and practical examinations. These may have influenced the results of senior students rating management significantly higher in contrast to their junior counterparts, who overall deemed empathy more important. This also resonates with the work of Hojat M et al., which suggests that the empathy of students decreases in later clinical years [ 31 ]. This may be an indication of a change in priority as students move towards a more goal-oriented outlook on medicine, focusing on final exams and imminently approaching careers, as opposed to the holistic view that can be afforded in younger years. Older medical students are thus framed as approaching their education in more of a survivalist manner, focussing on future career experiences. A lack of value attributed to non-clinical skills could parallel more negative responses towards incorporation of the humanities into medical education in more senior years as valence is seen to be a key factor in motivation stimulation.

Unsurprisingly, there is correlation between doing the humanities and thinking positively about the humanities, however it is difficult to see whether engagement in the humanities drives satisfaction or vice versa. There are elective opportunities for students more inclined towards the humanities within the medical curricula, for example the extra-curricular courses and the Humanities BSc. However, this doesn’t lean towards a more integrated nature afforded by the humanities, or elective modules more directly related to medicine. It also demarcates that the humanities are only related to medicine in a purely accessory capacity, something which was highlighted as problematic by the students surveyed in this study. As valence is intrinsically linked to motivation, this attitude detracts from students’ willingness to engage with the humanities. This is perhaps linked to wider biases in medical education, as seen through use of learning tools such as Bloom’s taxonomy [ 32 ]. A study of evidence-based medicine learning objectives across medical schools in Canada and the US showed that overall learning objectives more commonly focussed on knowledge, comprehension and application, rather than the higher levels of Bloom’s taxonomy, such as analysis, synthesis and evaluation [ 33 ]. It is possible that study of the humanities would allow access to the higher levels of Bloom’s taxonomy, but that these are pervasively not valued in medical education. This could constitute a form of social conditioning as students’ opinions become aligned with that of seniors and peers.

This study has provided the views of 109 medical students on the humanities in medical education, allowing us to explore a range of perspectives. The study is limited by being situated in a single institution and our sample is unlikely to be representative. As such our conclusions may not be generalisable, rather transferrable with an appreciation for the characteristics of participants and context. Our analyses of variance, for example between genders, rely on there being sufficient numbers in each group rather than representativeness, and therefore these findings may be more robust.

Overall this study found there is a significantly large cohort of the student body that desire medical humanities to be more integrated into a traditional medical course, with many seeing it as an important concept in younger years. These feelings towards the humanities extended throughout the genders self-identified in the research cohort and independent of previous humanities exposure, contrary to prior literature. However, the utilisation of this topic in an examinable format still remains an element of contention for students feeding into the larger area of assessment being necessary for engagement. Despite this, it is evident that many students see the medical humanities as an important part of the medical curriculum which is currently being underserved. This study provides a good starting point for discussion and further research on the role of medical humanities in medical studies and how it may subsequently influence the qualities of a doctor.

Availability of data and materials

The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Medical bachelor and bachelor of surgery

The universities and colleges admissions service

Science, Technology, Engineering and Medicine

Consensual qualitative research for simple qualitative data (modified)

Bachelor of science

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Acknowledgements

We would like to thank Mary Kelada for her help in the initial questionnaire design. We would also like to thank the participating students for taking the time to complete our questionnaire and share their thoughts with us.

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The authors alone are responsible for the content and writing of this article. LP conceptualised the project and in early planning, designed and developed the questionnaire, assisted in data collection and processing, and was a substantial revisor of the manuscript. EM provided major contribution to data analysis and manuscript writing and editing. OO worked in conceptualising the project and planning, to design and create the survey tool, and contributed to raw data analysis. MP assisted in data analysis and was major contributor to manuscript writing and revising. JMH assisted in qualitative data analysis and was a major contributor in writing the manuscript. YAP conceptualised the project and worked in early planning including questionnaire design and data analysis. KLG provided data analysis on SPSS software and mentorship to substantially revise the manuscript. All authors read and approved the final manuscript.

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Additional file 1: supplementary figure 1.

. Percentage of undergraduate applicants that are female, over the past 10 years. Created using data from: UCAS Analysis and Insights 2018 [ 11 ]. Supplementary Figure 2 . Questionnaire distributed to students using Qualtrics software

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Petrou, L., Mittelman, E., Osibona, O. et al. The role of humanities in the medical curriculum: medical students’ perspectives. BMC Med Educ 21 , 179 (2021). https://doi.org/10.1186/s12909-021-02555-5

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Now a second-year student in the College of Arts and Sciences , Max Brody entered the University of Pennsylvania knowing he wanted to go to medical school. Growing up in small-town Oklahoma, he saw the health impacts of tribes being forcibly displaced from their native lands—including vastly higher rates of diabetes among Native Americans.

Brody began college as a health and societies major, and he enjoyed the classes. He went into  Rita Copeland ’s first-year seminar on emotions simply trying to get his English requirement out of the way, but Brody was wowed, and then a gothic literature class solidified his interest in declaring an English major instead.

According to admission statistics from Career Services , the students applying to begin medical school in 2023 included 15 health and societies majors and zero English majors. Brody’s family and classmates didn’t quite understand his shift.

Brody wrote about the choice in a column for The Daily Pennsylvanian titled “In defense and in celebration of the humanities pre-med,” which he says was intended to show that English is a valuable major, imbuing a sense of empathy and ability to analyze a person. In it he touches on his frustration with the view that humanities requirements are a distraction for pre-med students.

“I want to take my knowledge of empathy, as well as the sciences that I’m learning through my pre-medical classes and combine them so I can clinically treat but also advocate for a person individually,” Brody says. While sitting for an interview amid balancing organic chemistry midterms with a 7-page essay on the documentary “Paris is Burning,” he continues, “Medicine is not disconnected from reality; it’s always connected into the context that we’re living in.”

While the most common majors for pre-med students at Penn are biology and neuroscience, there are other humanities majors on campus mapping out a career in medicine. Like Brody, they share a sense of satisfaction from the balance of courses engaging different parts of their brain.

Carol Hagan , has advised pre-health students at Penn for more than 15 years as senior associate director of graduate school advising. She says she reassures students “at the outset that they don’t have to do pre-med in a very specific way, that their pre-med journey at Penn can look very different from other people’s and be equally successful.”

Last year, Penn’s rate of applicants who matriculated into medical school was 79% compared to 44% nationwide, and Hagan says humanities majors do just as well as the others. She notes that regardless of major, all pre-medical students must take—and do well in—the same pre-medical classes, take the MCAT, and spend time around patients.

Hagan says when medical schools see students with humanities degrees applying, they know the applicants excel both in and outside the sciences. She says history majors, for example, have well-developed written and verbal communication skills, tend to be evidence-based thinkers, and are “very comfortable being in the gray areas of knowledge”—which are all assets in medicine.

Classically trained

When she had to take Latin in sixth grade, Sutton Grossinger hadn’t expected to love it as much as she did. The third-year says she felt that translating was like a puzzle—with the elements of problem solving and critical thinking that also drew her to science. While hearing from clinicians in a comparative anatomy and neuroscience class in high school solidified her interest in pursuing a career in medicine, she wasn’t ready to let go of Latin.

“I don’t think that just because I’m interested in one thing, I should have to sacrifice all the other interests, which is great that I don’t have to do that here,” says Grossinger, who is from Wynnewood, Pennsylvania. Applying to colleges at the height of the pandemic, she reached out to a few Department of Classical Studies professors at Penn and joined a class Kim Bowes taught on Zoom. Grossinger recalls logging off and telling her parents all about it.

“There aren’t as many schools that have amazing departments in both humanities and STEM,” she says. “But I found that Penn—with their amazing classics department and having all the opportunities of not only Penn Medicine but also all the hospitals in the surrounding Philadelphia area—made sense for me.”

Grossinger says she tries to do half pre-med and half classics courses each semester, balancing large lecture hall classes and small discussion-based ones. Outside of the classroom, she has done clinical sleep research with Philip Gehrman in the Perelman School of Medicine, and served as a student leader with CogWell , a nonprofit that empowers students to address mental health issues with their peers. Grossinger has also shadowed a plastic surgeon, orthopedic surgeon, and neurologists.

“When people ask me why I’m doing a classical studies major, I always say it teaches you how to think,” Grossinger says.

The world’s a stage

Like Brody, second-year student Emily Monfort wants to be a physician and entered Penn majoring in health and societies. She later decided to study music and neuroscience, thought about music and biology, and settled on theater and nutrition.

Monfort says theater was something she’d enjoyed childhood. She says, “I love that at Penn I can continue to study and continue to learn it more.” After taking Introduction to Theatre Arts her first year, she served as stage manager for the coming-of-age play “Athena,” which students performed at the Edinburgh Festival Fringe last summer . She is on the production team this semester, helping build sets, and sings in the Penn Glee Club .

“I saw a lot of transferrable skills between medicine and theater, in looking at character and analyzing character—what does this character do, what is this character interested in,” Monfort says. Comparing surgery and theatre, she says the teamwork and mechanics that go into building a set mirror skills involved in running an operating room.

Culture and medicine

As a second-year, Tova Tachau shadowed a living-donor liver transplant surgery and “had that eureka moment of ‘Wow, this is incredible, this is what I want to do,’” she says. Tachau compares it to the “amazement and fascination” she felt seeing Cirque du Soleil at age 12.

She entered Penn with a plan to double-major in biochemistry and biophysics. But then she took a 20th-cenutry Russian literature class to fulfill a prerequisite and says she “ended up falling in love with the subject.” Now in her third-year, she has kept the biochemistry major and declared comparative literature and Russian and East European Studies majors.

“It provided a release from constant memorization and problem-set-oriented studies,” says Tachau, from Wayne, Pennsylvania. Being in the MLS program, she got general chemistry, calculus, and physics out of the way her first year and says it’s been relatively easy to fulfill pre-med requirements alongside humanities courses.

“There are definitely really interesting ways that culture and medicine interact,” Tachau says, citing her interest in how the health care system struggled after the fall of the Soviet Union—and the response of physicians such as the British doctor Henry Marsh, who has worked with neurosurgeons in Ukraine since 1992. She hopes to professionally pursue her interests in tandem and is considering applying to MD/Ph.D. programs.

The view after undergrad

Alex Frumovitz graduated from the College of Arts and Sciences in 2023 with a bachelor’s degree in history. He has since been working at Columbia University Irving Medical Center in an immunobiology lab focused on natural killer cells, and is in the process of applying to medical schools for the fall.

“I always enjoyed science, especially biology, and my dad’s a doctor. He never really pushed me to go into that direction,” says Frumovitz, who is from Houston, but says he saw the way his father interacted with patients and how much he enjoyed his work.

Knowing that he was going to be doing “a lot of science in medical school and for the rest of my life,” he says he wanted to be able to pursue something different in undergrad. At Penn, he took courses as varied as Greek and Roman Medicine, East Asian Diplomacy, Witchcraft & Possession, and The History of U.S. Baseball.

Frumovitz says his advice to current pre-med humanities majors is to lean into classes on reading and writing, and to balance their time and get in a headspace “that allows you not to over-exert yourself or run out of steam.”

Zonía Moore, now a fourth-year student in the Perelman School of Medicine , wants to pursue a career in dermatology and was a humanities pre-med undergrad. She majored in Romance languages and literature and Hispanic studies at Dartmouth College, and says her knowledge of Spanish helped her as a clerkship student to translate the nuances of what patients are saying and understand how their suffering can be culturally dependent.

Being able to speak more than one language, Moore says, “you have more understanding of the human condition and you have more of an understanding of what your patients are going through.” Knowing Spanish helped her in completing a Fulbright Scholarship with a dermatologist in Mexico City last year.

Moore says she entered Dartmouth with the mindset, “I’m probably going to study more science than I ever wanted to study in any case, so why should I start that now?” She encourages students interested in the pre-med humanities path to plan out what that will look like so they don't end up having to pay for postbaccalaureate classes, and to not be afraid to take time between college and medical school. Moore took three gap years, during which time she worked in consulting, studied for the MCAT, and took a postbaccalaureate course in physics.

One of the biggest benefits of studying the humanities, Moore says, is being a better writer, noting that she thinks her personal statement got her more medical school interviews. Moore further touts the benefit of being well-rounded and having broad interests. “At a cocktail party on a Friday night,” she says, “no one wants to hear about the Krebs cycle.”

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Narratives of Health(s): Exploring Positionalities through the Medical Humanities Lens

Keeping in mind the theme of MMLA 2024, “Health in/of the Humanities,” the Women in Literature panels seek ways to explore the intersection of Medical Humanities and women in literature. Particularly, it aims to highlight the variety of representations and embodiedness of queer and women’s health, dis/abilities, illness, and motherhood in multiple sites and through various forms of media, including popular magazines, newspapers, television and film, fiction, advertisements, and medical records. In terms of temporal and geographic scope, the panel solicits contributions focusing on the late-nineteenth, twentieth, and twenty-first centuries, with no geographical restrictions.

Some of the questions that this panel seeks to respond to, but are not limited to, are:

• How can an interdisciplinary approach help explore the ideas of agency in conjunction with power relations and social hierarchies?
• How is the framework of care interlaced with power matrices?
• How can a postcolonial, Marxist, feminist, and queer critique contribute to the reframing/contesting of dominant narratives of modern medicine?  
• What is the politics of visualization, narrativization, and stigmatization of bodies of illness? Who determines whose body is to be stigmatized and how?
• What is the future of Medical Humanities and Graphic Medicine within Humanities?

Please send a 400-word abstract to Sayanti Mondal ( [email protected] ) by 20 April 2024.

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40 facts about elektrostal.

Written by Lanette Mayes

Modified & Updated: 02 Mar 2024

Reviewed by Jessica Corbett

Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Key Takeaways:

• Elektrostal, known as the “Motor City of Russia,” is a vibrant and growing city with a rich industrial history, offering diverse cultural experiences and a strong commitment to environmental sustainability.
• With its convenient location near Moscow, Elektrostal provides a picturesque landscape, vibrant nightlife, and a range of recreational activities, making it an ideal destination for residents and visitors alike.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy, materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes, offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

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Patients Are Humans Too: The Emergence of Medical Humanities

Keith Wailoo , a Fellow of the American Academy since 2021, is the Henry Putnam University Professor of History and Public Affairs at Princeton University. He is the author of Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette (2021), Pain: A Political History (2015), and How Cancer Crossed the Color Line (2011).

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Keith Wailoo; Patients Are Humans Too: The Emergence of Medical Humanities. Daedalus 2022; 151 (3): 194–205. doi: https://doi.org/10.1162/daed_a_01938

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This essay describes the origins, growth, and transformation of the medical humanities over the past six decades, drawing on the insights of ethicists, physicians, historians, patients, activists, writers, and literature scholars who participated in building the field. The essay traces how the original idea of “humanizing physicians” evolved and how crises from death and dying, to AIDS and COVID-19, expanded humanistic inquiry into health, illness, and the human condition. It examines how a wide array of scholars, professional organizations, disciplinary approaches, academic units, and intellectual agendas came to define the vibrant field. This remarkable growth offers a counterpoint to narratives of decline in the humanities. It is a story of growing relevance shaped by tragedy, of innovative programs in medical schools and on undergraduate campuses, and vital new configurations of ethics, literature, the arts, and history that breathed new life into the study of health and medicine.

Writing in 1982, philosopher Stephen Toulmin observed that the study of ethics (which traditionally meant formal, theoretical moral philosophy) had been reenergized and transformed by its engagement with medicine. In “How Medicine Saved the Life of Ethics,” Toulmin explained that the ethical dilemmas of recent medicine-from death and dying, to contraception, and abortion-had catalyzed a resurgence in the once-moribund field of philosophical inquiry. Two years later, physician Eric Cassell painted a broader portrait of how problems of disease and health had nurtured humanities fields beyond bioethics. Celebrating “the place of humanities in medicine,” he wrote that “the enormously increasing power of medicine to change individual lives … and to profoundly influence social policy had all provided rich fare for philosophical, historical, and literary examination, interpretation, and analysis.” 1

In an era when health care had become powerful but also ethically challenged, new trends in the humanistic analysis and critique of medicine flourished. For many scholars drawn to the field, medicine and the humanities were entangled in a perverse love-hate relationship in which literature, history, and philosophy promised to soften medicine's rough edges and revise its “present romance with technology.” 2 In a sense, the medical humanities sought to be a counterpoint to technological hubris; it sought also to encourage physicians to have a deeper personal understanding of the impact of new technologies, new powers, and new health care dilemmas on people's lives. In the writings of Toulmin and Cassell, the medical humanities and ethics harbored a redemptive, utilitarian idea: that broad learning could nurture the soul of the doctor at a time when medicine, enraptured by science, was losing touch with the patient.

This essay draws on the insights of the ethicists, physicians, historians, patients, activists, artists, writers, literature scholars, and others who participated in the building of the medical humanities over the past six decades. The process began as an effort to “humanize medicine,” but the agenda grew and transformed remarkably over the years. The story they tell unfolds in three stages: the period from the early 1960s to the 1980s, in which developments centered in medical schools; the years of professional expansion in the 1980s and 1990s when new journals, associations, and teaching initiatives took shape; and the particularly stunning growth of medical humanities in undergraduate colleges in the 2000s, in programs taking varied institutional forms. In what follows, I allow those who participated in this transformation to describe the diversification of work done under the heading of “medical humanities.” This essay also traces how the original ideal of humanizing physicians evolved, while other goals such as exploring the human condition became more salient and as recurring crises in medicine and society catalyzed the fragmentation of the field.

The criticism articulated by Cassell and Toulmin-that medicine, in turning to science, was losing touch with patients-had been evident since the late 1950s. Increasing medical specialization was said to push doctors toward a study of disease mechanisms, and away from an understanding of illness. There was also, for example, the problem of unethical human experimentation in the post-World War ii era: the revelation that leading researchers conducted experiments such as testing drugs on vulnerable patients without their consent. Such excesses spanned from the testing of polio vaccines on children in mental institutions in the 1950s to the revelation in the 1970s about the decades-long Tuskegee syphilis study, in which Black men with the disease were observed rather than treated over four decades. The disclosures suggested a need for new regulations of professional conduct. But they also suggested a need for deeper introspection about virtue and the duties of caregiving.

As Cassell explained in the early 1980s, the events of the previous two decades had catalyzed medical humanities: for “while medical science can abstract itself and deal solely with body parts, doctors who take care of patients do not have that luxury-they must work with people … [and are faced with] the fears, desires, concerns, expectations, hopes, fantasies, and meaning that patients bring.” In this telling, the scientific guidance of physicians would always be morally impoverished without a fuller understanding of illness, suffering, and health, realities “better taught by literature and the other humanities.” 3

Both Toulmin and Cassell dated the birth of this humanistic critique to the early 1960s, when social movements and professional criticism produced curricular change. Over the decade, increasing numbers of women and students from minority backgrounds entered medical schools. The pressure for medical humanities programs was “initiated primarily by students,” explained Cassell. Rejecting the narrowness and perceived irrelevance of scientific medical training, they “were no longer content to be taught what their faculties believe important. It was essential to the students that their classes be ‘relevant’ to the problems of poverty, racial bias, and political ‘oppression.’“ 4

With health and health care in flux, the turmoil of the era made medical humanities necessary for addressing concerns of the moment. The deinstitutionalization of the mentally ill and their social integration provoked new questions about the meaning of illness, stigma, and the role of psychiatry in society: was it the case, as critics charged, that institutionalization was merely a scientized form of social control? 5 New legislation expanded health insurance to the elderly. But why then did the American Medical Association fight so feverishly against passage of Medicare, failing to stop it? Was this an example of the profession's commitment to economic interest and not, as they claimed, the well-being of patients? And when medical science failed in its quest to preserve life, what was the role of the physician in death and dying? 6 The subtitle of Elisabeth Kubler-Ross's On Death and Dying captured the era's conceptual inversions, and its shift to more patient-centered understandings: “What the dying have to teach doctors, nurses, clergy, and their own families.” Worries over the failures of “the biomedical model” ranged widely, gaining even greater force in early 1970s amid burgeoning political, legal, social, and moral debates over reproductive rights, abortion, and homosexuality. Trust in medical expertise was ebbing as core institutions were buffeted by social pressures. In the early 1970s, for example, the American Psychiatric Association gathered to debate removing “homosexuality” from its standard nomenclature of mental illnesses. Little wonder that medical ethics and humanistic understandings of patients, disease, health, and society expanded in significance in this tumultuous era.

The intense demands of the era made medical practice no longer “a field for academic, theoretical, even mandarin investigation alone…. It had to be debated in practical, concrete, even political terms,” explained Toulmin. 7 From the standpoint of the 1980s, Toulmin and Cassell saw medical humanities as a response to the “demand for intelligent discussion of the ethical problems of medical practice and research.” 8 By the early 1980s, the majority of medical schools had developed programs in the medical humanities, incorporating (in one way or another) the study of literature, history, and ethics into the training of physicians to be at least conversant with the issues swirling about the profession. Some schools had developed full-fledged departments. 9 But what neither the philosopher Toulmin nor the physician Cassell could see from the early 1980s was just how rich, diverse, and varied the field would become in the following decades.

As Toulmin and Cassell were penning their thoughts in the early 1980s, medical humanities were also taking shape in undergraduate curricula. Between 1980 and 2000, the critical humanistic analysis of medicine and health produced new scholarship in every field: in the arts, the social sciences, and in literature, history, and philosophy. New crossdisciplinary departments were devoted to the social relations of medicine and science. One such program, the one in which I earned a PhD, had been created in 1962 as the “History and Philosophy of Science,” and then changed its name to “History and Sociology of Science” in 1970. The varied names suggest the multiplicity of lenses being brought to bear on the undergraduate and graduate study of science, health, and their implications for society.

In the 1980s, medical humanities shifted focus notably toward the patient's experience and the human condition. aids , cancer, and other health struggles provided tragic catalysts for new works in literature, art, and history. The global aids pandemic, for example, raised a host of new questions not only about viral origins and epidemiology, but also about condoms, sex practices, religious tolerance, gay identity, and changing sexual politics, topics demanding integrated thinking about the human condition across the sciences, public health, social sciences, and humanities.

Where might one seek insight into this new health crisis? Was it perhaps Larry Kramer's 1985 autobiographical play, The Normal Heart , about enduring the early years of aids prejudice, indifference, struggle, and fear in New York City? Or perhaps the reflections of physician Abraham Verghese in My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS ? 10 Reviewing Verghese's book in Literature and Medicine , Joseph Cady explained that aids literature had become vast and had been produced mostly by people vulnerable to the disease. Verghese's contribution was different, telling his story as a foreign medical graduate in small town Tennessee chronicling the social trauma: the “hiv -positive heterosexual woman … infected by her bisexual husband, hemophiliacs with aids … and people with transfusion aids (Will and Bess Johnson, who posed an extra level of challenge as well-to-do, ‘pillar of the community,’ fundamentalist Christians who insist on keeping their infection secret).” 11 The nation's aids experience made clear that to fully understand the unfolding health tragedy demanded creative storytelling, narrative insight, introspection, and deep sensitivity to the complexity of the human condition. Kramer and Verghese were only two among many medical humanities ideals.

In medical education, new texts were pushing the field forward; new lines of inquiry and pedagogy were opening. When I taught in the medical school at the University of North Carolina at Chapel Hill in the 1990s (in the department of social medicine), humanizing the physician remained the central driving conceit. The redemptive ideal generated a new textbook in 1997, the Social Medicine Reader , a collection of fiction, essays, poetry, case studies, medical reports, and personal narratives by patients and doctors compiled for teaching. The Reader aimed to “contribute to an understanding of how medicine and medical practice is profoundly influenced by social, cultural, political, and economic forces.” Elsewhere, physician Rita Charon and literary scholar/ethicist Martha Montello were also compiling essays for an edited collection for a new enterprise labeled “narrative medicine.” As they observed, storytelling underpinned all thoughtful caregiving: “How the patient tells of illness, how the doctor or ethicist represents it in words, who listens as the intern presents at rounds, what the audience is being moved to feel or think-all these narrative dimensions of health care are of profound and defining importance in ethics and patient care.” 12 Such developments transformed medical education in the 1990s. “By 2004,” wrote medical historian Emily Abel and sociologist Saskia Subramanian, “88 of the 125 medical schools surveyed by the American Association of Medical Colleges offered classes in the human dimensions of care, including treating patients as whole people, respecting their cultural values, and responding empathetically to their pain and suffering.” However, these courses were only “a tiny fraction of medical-school curricula.” 13

Driven by such initiatives, the 1980s and 1990s would be an era of acquisitions, new ventures, and mergers in the medical humanities: new journals established, professional associations combined, and novel academic collaborations explored. In 1980, for example, the Journal of Medical Humanities was founded, followed two years later by Literature and Medicine . In 1998, three organizations - each representing different facets of the emerging field-merged to produce the American Society of Bioethics and the Humanities ( asbh ). The oldest of the three, dating to 1969, was the Society for Health and Human Values ( shhv ). The Society for Bioethics Consultation had been founded in the mid-1980s, while the American Association for Bioethics had been established only four years before, in 1994. As the asbh 's founding president, bioethicist Loretta Kopelman, reflected, the term “humanities” was a reassuring rubric particularly for the non-ethicists, a group that encompasses a vast array of disciplines and specialties:

shhv had members from many fields including health professionals, law, religious studies, literature, pastoral care, social science, history, visual arts and student groups. Some worried that this diversity of approaches would not be valued in the same way in a new organization. For many of those fearing such marginalization, “humanities” came to stand for inclusiveness and “bioethics” for the sort of rigor in addressing problems such as are found in publications in philosophy, law, social science or academic medicine. The title “American Society of Bioethics and Humanities” reflected that we wanted all groups to thrive in asbh . 14

Many of these new ventures proved to be durable, creating the institutional supports, professional associations, journals, texts, and teaching practices necessary to sustain the field. Others, such as the Society for the Arts in Healthcare founded in 1991, were short-lived and difficult to sustain.

By 2000, divergences in the medical humanities agenda appeared, inevitably so. In medical schools, the humanities presence remained small and there would be unavoidable tensions as humanists worked within the overwhelming science-based curriculum. Reflecting on the challenge of balancing history, theory, and practice in medical education, bioethicist Thomas McElhinney observed that

the changes in medicine caused by scientific discovery and technological developments, on the one hand, and social and political transformations, on the other, increasingly highlighted the impossibility of a complete medical education structured only on theory and practice (i.e., basic science and clinical training). 15

Faced with the demands of science and clinical education, students’ responses to the little humanities they encountered varied, said McElhinney: “the humanities will be a distraction to some but an oasis in an otherwise arid environment for others.” 16 The serious and profound need for humanistic insight remained obvious even if curriculum space was limited. By contrast, however, undergraduate college education in the 2000s provided fertile soil for program building and expansive institutional development.

Since 2000, “health humanities” in undergraduate education has expanded as a vibrant complement to the “medical humanities” in medical schools, a development that moved the field significantly beyond its narrow ideals of humanizing physicians. Between 2000 and 2010, the number of undergraduate baccalaureate programs in the health humanities jumped from eight to over forty, followed by another stunning increase in the next decade. By 2021, the number of such programs had reached 119, an eightfold increase since 2000 as one recent survey by humanities and bioethics scholars Erin Gentry Lamb, Sarah Berry, and Therese Jones observed. At the same time that a crisis in the humanities brewed, the once niche field was flourishing. As Lamb, Berry, and Jones noted, “at a time when Liberal Arts education, and humanities programs in particular, are under fire in many public quarters,” health humanities programs were serving a growing, keenly interested population of students (many of whom hoped to enter health care careers).

The utilitarian impulse to produce better caregivers persisted, but the locus of humanistic health education was shifting to undergraduate curricula. And in this context, the critical sensibilities of the medical humanities sharpened. Colleges across the nation discovered that these years were “an ideal time for students to develop skills valuable … to providing humanistic health care across a wide range of health care fields.” Reaching younger students prior to entering health careers cultivated “habits of mind that prepare students for critical and creative thinking, identification of internal biases, and ethical reasoning in decision-making processes - all of which are critical skills for participating in the complex system of U.S. healthcare.” 17 The model gained traction, drawing together students from across disciplines and a range of health-oriented humanities scholars in new teaching and research initiatives.

Commenting on the diverse expansion of such programs in 2009, historian Edward Ayers observed that “we need to understand the many contexts in which the humanities live. They live in departments and disciplines, of course; but they also live in new places, in new forms, and in new combinations.” 18 Medical humanities was one such novel combination. Drawing on cultural studies, women's studies, disability studies, and other burgeoning fields, programs of medical humanities defined a “rapidly growing field, celebrating the ability of the humanities, as one program put it, to provide ‘insight into the human condition, suffering, personhood, our responsibility to each other.’“ 19 Medical humanities became, for many commenters like Ayers, a leading example of the thriving humanities, a vibrant counterpoint to widespread narratives of decline.

That same year in an astute editorial in Medical Humanities , physician Audrey Shafer acknowledged the diverse field was showing new academic fracture lines. Not only did institutional and pedagogical goals differ, but gaps had opened between medical humanists who worked directly with patients or in health care settings and those who worked in other educational contexts. Collaborations suffered because “for instance, a performing arts department will have different theoretical underpinnings, methodologies, scholarly activities and products from a philosophy department.” 20 Medical humanities was an intellectual hodge-podge, in Shafer's view, suffering from an identity crisis. Yet despite tensions among scholars with different qualifications, degrees, and agendas, the enterprise remained vibrant with new “demarcations, dilemmas, and delights.” For Shafer, the struggle to hold the field together was itself productive, for “when medical humanities ceases to struggle with what it encompasses … then it will cease to be medical humanities.” 21

Many program builders in undergraduate settings did not share Shafer's worry about the field's “identity and boundary bumping,” however. “Health humanities” and “medical humanities” proved to be popular, versatile, and decidedly flexible rubrics for program building in undergraduate contexts. Programs emerged under a growing array of headings: “History, Health, and Humanities,” “Health and Society,” and “Medicine, Science, and the Humanities.” 22 If some embraced narrative ethics and centered the study of literature while others foregrounded history or ethics, this diversity reflected the robust range of what medical humanities had become. The goal remained broad, cross-disciplinary education about the human condition, and deep introspection connecting scholars across fields who were drawn together in teaching and researching the challenges of health and healing.

The agenda of medical humanities had built over time, with no single discipline claiming exclusive ownership over the enterprise. Assessing the field, literature scholar Sari Altschuler pointed forward in the conclusion to her 2018 book, The Medical Imagination . In her view, the humanities agenda in medical schools had made modest gains, confining itself to a limited agenda by “mostly aiming at improving physician empathy rather than at shaping and expanding medicine's ways of knowing.” 23 Meanwhile, programs run by humanists in undergraduate settings remained too heavily focused on the utilitarian task of preparing aspiring health care workers. Both approaches sought “to bring a sense of the human back to medicine that risked being too governed by dispassionate science, routinized procedure, and market logic.” 24 These foundational functions of the humanities in medicine (its redemptive capacity for humanizing caregivers and seeing the humanity of patients) had not changed. If anything, they had expanded remarkably in reach and scope, finding new audiences, and developing in new venues.

With this expansion, scholars in a field that had begun modestly (in hopes of humanizing physicians and exploring the human condition) now confidently asserted that the very habits of analysis in humanistic inquiry exemplified, in themselves, important “ways of knowing” about health. To Altschuler, “the number and breadth of medical and health humanities programs offer a terrific opportunity” to move beyond empathy building in medicine, and to embrace a bolder vision: “the recognition that humanists have an important and distinct set of tools for knowing the world, as do health professionals.” 25 Building on the energetic developments of the past decades, she called on humanists to engage with medical science from a new standpoint-to find common ground with medical educators by embracing the language of “competencies”: practical skill development as the bedrock of medical training. By now, these skills could be clearly articulated as “humanistic competencies-which include narrative, attention, observation, historical perspective, ethics, judgement, performance, and creativity.” 26 The list offered a lovely shorthand for the approaches, methods, and practices encompassed within the health humanities. These competencies also highlighted the fraught challenge ahead; the building of medical humanities would involve ceaseless struggle over boundaries and demarcations, even as its core commitment remained restoring humanistic understanding to the vast biomedical and health enterprise.

In the end, the remarkable growth of the health humanities over the past six decades is a story of tragic relevance, driven by the awareness not that medicine had “saved the life of ethics” as Toulmin had noted, but rather by recognition that new configurations of ethics, literature, the arts, and history were vital for breathing life into medicine.

As the medical humanities have widened their reach, one theme has persisted from the early years: professional and human crisis has spawned the search for meaning and introspection about life, illness, recovery, human suffering, the care of the body and spirit, and death. Medicine's social dilemmas, its professional controversies, human health crises, social tensions over topics from aids to abortion and genetics, as well as the profession's very identity and its claim to authority have catalyzed and fed a growing demand for answers about meaning. The recurring crisis has generated a style of humanistic insight that has flourished not only within traditional disciplines but also in the interstices.

The flourishing of medical humanities is a story of shifting energies: the emergence of new lines of inquiry, new institutional homes, and novel journals and professional associations. As the field has grown, its questions about illness, disease, and the pursuit of health have become more prominent across the academy and beyond its boundaries. The work has adapted to new trends in health movements, disability studies and activism, and questions of race and gender in relation to health. Even as new programs have developed, the work of health humanities has become ever more salient in the disciplines of history, literature, the arts, and in philosophy and ethics.

This expanding humanist venture-spanning from undergraduate and graduate teaching and research to broad public engagements-refutes the narrative of a “humanities in decline.” Redemption and humanization of the practitioner remain goals, as does the deep appreciation of suffering, recovery, and the illness experience. But the past decades have seen a wider critique: an insistence that the tools of the medical humanities are not merely restorative gap-fillers for what is lacking in scientific and technological insight, but that their discernment about the self and identity, suffering and illness are the primary lenses for understanding essential features of human experience, health, and society. The medical humanities provide, then, the means by which we understand the complex problem of how humans respond to illness, and how humans assess the role of science and medicine in the enterprise of healing.

In the same way that the human tragedy of aids confirmed the relevance of medical humanities in the 1980s and 1990s, today's global coronavirus pandemic (and its underlying issues of disparate suffering, loss, blame, conflicted belief, social inequality, misinformation, and varied cultural responses) catalyzes yet another wave of interest in health humanities. And few of covid 's challenging questions revolve around doctoring or patients alone; in covid , the health and well-being of a contentious and fractured public raised vexing questions well suited for medical humanists.

As we weather recurring waves of covid , it has become commonplace for media to turn to medical humanities scholars for insight and guidance. What could literature or history teach us about the social responses to the current pandemic? asked National Public Radio. Could the history of past pandemics provide insight into the current crisis, or serve as guides for the building of effective social responses and healthier, more equitable societies? To answer such questions, public media has sought answers from scholars like French professor Alice Kaplan, who was busily writing a new introduction to Camus's The Plague . In early 2020 during the first wave of covid , sales of the book skyrocketed in Europe. “People are saying in the French press, what do you absolutely need to read in this time? You need to read The Plague,” Kaplan explained. “Almost as though this novel were a vaccine-not just a novel that can help us think about what we are experiencing, but something that can help heal us.” 27

The medical humanities began in crises and critiques of medicine, and crisis continued to make the health humanities vital, timely, and necessary. To be sure, the utilitarian ideals remained focused on creating well-rounded medical practitioners. But the field now encompasses a grander and more widely institutionalized, and still richly debated, promise of healing and restoration through literature, the arts, history, and ethics. 28 So while it is true that medicine “saved the life of ethics,” it is also the case that over these decades, the medical humanities has breathed new life into the humanities while also offering society a kind of healing that medicine itself cannot provide. This remarkable growth offers a counterpoint to narratives of decline in the humanities. It is a story of growing relevance shaped by tragedy, of innovative programs in medical schools and on undergraduate campuses, and vital new configurations of ethics, literature, the arts, and history that have profoundly rejuvenated the study of health and medicine.

Daniel Callahan, Arthur Caplan, and Bruce Jennings, “Preface” to Eric Cassell, The Place of the Humanities in Medicine (Hastings-on-Hudson, N.Y.: The Hastings Center, 1984), 5.

Cassell, The Place of the Humanities in Medicine , 6.

Thomas Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct (New York: Harper Collins, 1961).

Elisabeth Kubler-Ross, On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families (New York: Scribner, 1969).

Stephen Toulmin, “How Medicine Saved the Life of Ethics,” Perspectives in Biology and Medicine 25 (4) (1982): 749.

Cassell listed the four as Pennsylvania State, Wright State, Southern Illinois, and University of Nebraska. Cassell, The Place of the Humanities in Medicine , 12.

Larry Kramer, The Normal Heart: A Play (New York: Plume, 1985); and Abraham Verghese, My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (New York: Vintage, 1994).

Joseph Cady, “My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS (review),” Literature and Medicine 15 (2) (1996): 278–282.

Rita Charon and Martha Montello, “Memory and Anticipation: The Practice of Narrative Ethics,” in Stories Matter: The Role of Narrative in Medical Ethics , ed. Rita Charon and Martha Montello (New York: Routledge, 2002).

Emily K. Abel and Saskia K. Subramanian, After the Cure: The Untold Stories of Breast Cancer Survivors (New York: NYU Press, 2008), 141.

Loretta M. Kopelman, “1997: The Birth of ASBH in Pictures and Commentaries,” American Society of Bioethics and Humanities, https://asbh.org/uploads/FINAL_1997-The_Birth_of_ASBH.pdf .

Thomas K. McElhinney, “Reflections on the Humanities and Medical Education: Balancing History, Theory, and Practice,” in The Health Care Professional as Friend and Healer: Building on the Work of Edmund Pellgrino , ed. David C. Thomasma and Judith Lee Kissell (Washington, D.C.: Georgetown University Press, 2000), 271.

Ibid., 289.

Erin Gentry Lamb, Sarah Berry, and Therese Jones, “Health Humanities Baccalaureate Programs in the United States and Canada” (Cleveland: Case Western Reserve University, 2021), 5, https://case.edu/medicine/bioethics/education/health-humanities .

Edward L. Ayers, “Where the Humanities Live,” Dædalus 138 (1) (Winter 2009): 24–34.

Audrey Shafer, “Medical Humanities: Demarcations, Dilemmas, and Delights,” Medical Humanities 35 (1) (2009): 3–4.

Lamb et al., “Health Humanities Baccalaureate Programs in the United States and Canada,” 10–12.

Sari Altschuler, “Humanistic Inquiry in Medicine, Then and Now,” in The Medical Imagination: Literature and Health in the Early United States (Philadelphia: University of Pennsylvania Press, 2018), 198.

Ibid., 198.

Ibid., 199.

Ibid., 200.

Melissa Block, “‘A Matter of Common Decency’: What Literature Can Teach Us about Epidemics,” National Public Radio, April 1, 2020, https://www.npr.org/2020/04/01/822579660/a-matter-of-common-decency-what-literature-can-teach-us-about-epidemics ; and Audie Cornish, “How Do Pandemics Change Societies? A Historian Weighs In,” National Public Radio, March 11, 2021, https://www.npr.org/2021/03/11/976166829/how-do-pandemics-change-societies-a-historian-weighs-in .

E. D. Pellegrino, “Medical Humanism: The Liberal Arts and the Humanities,” Review of Allied Health Education 4 (1981): 1–15; and E. D. Pellegrino, “The Humanities in Medical Education: Entering the Post-Evangelical Era,” Theoretical Medicine 5 (1984): 253–266.

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