New Directions in Literature and Medicine Studies

New Directions in Literature and Medicine Studies. Hilger Stephanie M. Palgrave Macmillan, London, 2017. 415pp, price not mentioned. ISBN: 978–1–137–51987–0.

This book is the result of experiences gained during several seminars at the Congress of the International Comparative Literature Association in 2013 and annual meetings of the American Comparative Literature Association between 2013 and 2017. The objective is to create a dialogue between the fields of literature and medicine and more broadly between the humanities and the sciences.

Stephanie Hilger has assembled essays by experts on subjects as diverse as medical and magical remedies for managing the sexual body in Medieval Arabic, Hebraic and European Romance; woman criminals represented in British novels between 1850 and 1890; Taiwanese poetry; biomedical writing; literature and psychoanalysis; the medical works of Ambroise Paré, Montaigne and Rabelais; 19th century women writing on medicine; reproductive unconscious in medieval and early modern England; mental illness in 20th century women’s diaries and dying and loss. The sole author of Indian origin, Sandhya Shetty, teaches English at the University of New Hampshire.

Ms Hilger is Professor of Comparative Literature and German at the University of Illinois at Urbana–Champaign. Her researches have been on British, French and German literature. In her introductory essay, she refers to Johann Christoph Friedrich von Schiller, 18th century German poet, philosopher, physician, historian and playwright, who was already pointing to increasing specialization within disciplines and the lack of efforts at understanding ‘connection between things’. His ideal was the universal scholar who connected his studies to different disciplines in an effort at inserting them into the ‘wide whole of the world’. Being a physician himself, he was especially saddened by the separation of medicine from other fields of knowledge that explore the human condition. Hilger surveys the conditions that led to the development of journals such as Medical Humanities and Journal of Medical Humanities and points out that the emphasis in this book is on literature and medicine— a subset of medical and health humanities.

The book is subdivided into 4 parts that deal with history and pedagogy of literature and medicine; dualism of mind and body; individual bodies and the body politic and early modern scientific curiosity. Each chapter concludes with notes and references to Works Cited. The book ends with the index.

Let me start with Shetty’s essay on Anandibai Joshi’s passage to America and the making of a Hindu lady doctor (pp. 281–304). While describing her life and untimely death from pulmonary tuberculosis, Dr Shetty refers to the stimulus Anandibai offered to the concept of women practising medicine in India. Her conversion from a 9-year-old child bride to an intrepid high-caste Hindu woman who set a precedent by travelling to America for education is described briefly.

Anandibai’s thesis on obstetrics among the Aryan Hindoos is analysed carefully from several angles as is her speech at Serampore before leaving for America. The quotation on how despite the presence of woman doctors from England and America in India, ‘we Indian women derive no benefit’, stems from experience of the ‘growing need for Hindu lady doctors and I volunteer to qualify myself for one’. The references to the humiliations she suffered on account of travelling across the seas as an unconverted (to Christianity or the Brahmo Samaj ) Hindu woman did not deter her from her goal, which she diligently and successfully pursued. It is, indeed, a pity that she died young before she could fulfil her aspirations for her fellow-country women.

Janella Moy’s essay on reading and writing one’s way to wellness (bibliotherapy and scriptotherapy) reviews events in ancient Egypt, Greece and Rome to start with and then covers Europe and the USA. Under bibliotherapy, she includes the use of poetry, fiction, pamphlets, educational manuals and other texts, while scriptotherapy includes diaries, journals and composed literature. She deals, thus, with the use of words to heal individuals and humankind, the earliest example being poems chanted by the shamans and witch doctors of ancient times. A telling example of belief in the power of words came from Alexandria where the ill-fated library had the inscription ‘The healing place of the soul’ over its entrance (Arthur Conan Doyle reflected a similar sentiment when he entitled his book on myriad experiences in a library, published in 1907, Through the magic door. The book was a compilation of essays published in 1894 in a series of 6 essays entitled Great thoughts). In Moy’s essay, we learn that the 1st century ‘Roman physician’, Soranus, prescribed tragedy for manic patients and comedy for his depressed clients (Soranus hailed from Ephesus in present-day Turkey. In the 1st century, this territory was under Greece, so he is rightly a Greek physician. He practised in Alexandria and Rome). A comparative modern experience is that of Norman Cousins and his personal recovery from painful ankylosing spondylitis after watching comedy on film. He described this in Anatomy of an illness.

Anne Hudson Jones is more focused as she answers the question: ‘Why teach literature and medicine’ and while providing the answer starts with the appointment of Joan Trautmann as the first professor of literature to hold a regular full-time position in an American medical institution. In the process, Trautmann made literature a recognized subspecialty within medical humanities. Jones suggests that ‘practical immediacy’ may have governed the earlier entrance of the history of medicine, medical ethics and medical jurisprudence into the humanities programme. She refers to Trautmann’ s essay The wonder of literature in medical education in which she advocated teaching students to read in the fullest sense. Jones deals with Trautmann’s contributions in fair detail before passing on to the essays on medical ethics by Robert Coles in 1979, the journal Literature and Medicine (of which she is a founding editor), an essay by Edmund Pellegrino (1982), Kathryn Hunter’s book Doctors ' stories: The narrative structure of medical knowledge and other works. Her final sentence is thought-provoking: ‘Literature and humanities have enduring value and power in medical education no less than in all our lives.'

Giovanni Borriello provides a historical-guided tour of the introduction of moxibustion and acupuncture in Europe. The writings of early European travellers to the Far East resulted in the introduction to European physicians of these and other Chinese and Japanese practices. These practices, viewed through the eyes of 16th century European physicians and others who visited Japan and China, make interesting reading. We also gain a fair understanding of the history of these two medical procedures which contemporary patients found very effective in relieving symptoms and preventing disease. Even foreign visitors to these countries experienced relief of intractable symptoms and marvelled at the simplicity of the techniques involved.

Jennifer Wynne Hellwarth and Ronald L. Mumme provide a practical guide to how an interdisciplinary course can be set up using a model entitled ‘A cultural and evolutionary history of sexuality’.

Hester et al. describe the use of the literary narrative to explore and evaluate medical professionalism. The quote from D.T. Stern provides an apt definition: ‘Professionalism is demonstrated through a foundation of clinical competence, communication skills and ethical understanding on which is built the aspiration to and wise application of professionalism: Excellence, humanism, accountability and altruism. ' The authors provide us their definition of narrative medicine—using literary narratives for the purpose of exploring medical issues. Skill in such usage needs a study of literature, with the focus being on health, illness, medical care and the consequences of ill-health. The authors emphasize the need for phronesis—an Aristotelian term signifying practical wisdom. The sources for such narratives are varied, but the authors classify them broadly into heroic melodrama (epic), tragedy, comedy and irony. The authors have used Richard Selzer’s Imelda, written in 1982, effectively and commend it. If you are not already well acquainted with the works of Dr Selzer, may I suggest you start with the volume containing Imelda’s story—Letters to a young doctor (New York: Simon and Schuster; 1998). The authors of our essay provide the structure of a workshop on using the literary narrative along with a list of suggested texts that can be used. Paediatricians will find Appendix 2 of interest as the authors guide us by listing the attributes needed to achieve 5 escalating levels of excellence in empathy; duty; professional conduct (including ethics); awareness of one’s own knowledge, skill and emotional limitations; trustworthiness and the realization that ambiguity is inherent in medical practice. These milestones, of course, are equally applicable in other disciplines in medicine.

Those in the clinical neurosciences might find Janice Zehentbauer’s contribution L’Oeil gauche barré: Migraine, scotoma and allied disorders in Emile Zola’s novels and Sun Jai Kim’s The primacy of touch: Helen Keller’s embodiment of language of considerable interest.

Readers of all persuasions will be unable to skip Genice Ngg’ s The changing face of quack doctors: Satirizing mountebanks and physicians in 17th and 18th century England. It is of interest that in our country, even in 2018, we have individuals who repeat a claim made in 1750:

We come to cure whate’er Men feel,

Within, without, from Head to Heel,

We can Old Age to Youth restore,

And do a Thousand Wonders more.

Modern quacks may also find it worth their while to adopt another sales tactic used by quacks of yore, sure that the question of disbelief after death was not going to hurt their earnings!

Read, Judge and Try

And if you Die

Never believe me anymore

Rabelais’ creation, Garganelle, features in the chapter entitled Midwives and spin doctors, the rhetoric of authority. Here, as the title suggests, the allusions are to the segments in Rabelais’ book pertaining to midwifery. (Readers who have not yet enjoyed the bawdy and satirical masterpiece written by the French Renaissance physician and author [1493–1553] will find that the brief references to his book Gargantua and Pantagruel may stimulate them to seek the original text. Fortunately, all 5 parts can be downloaded from the internet at www.gutenberg.org/files/1200/1200-h/1200- h.htm. Gustav Doré's illustrations in this text are added attractions.) This chapter also includes discussion of Jacques Duval’s book (published in 1612) on hermaphrodites, deliveries by women and of Francois Mauriçeau’s treatise (1668) on pregnant women with its detailed anatomical plates of engravings.

I was especially struck by the author’s statement: ‘Pathos, however, as Duval, himself would have known from Aristotle, is nothing without ethos and logos.' This is in reference to Duval having described in his book the death of his own wife with ‘an unusual account of personal desolation, logical reasoning and medical credibility—in other words, a rhetorical tour de force’

There is, of course, much more. Federica Frediani analyses descriptions of breast cancer in Philip Roth’s The dying animal (the male perspective) and Isabel Coixer’s Elegy (a female perspective). Yuri Kondratiev’s essay on corporeal abnormality discusses double-headed and other monsters with congenital abnormalities described by Jean Fernel, Ambroise Paré and Michel de Montaigne—three leading figures from 16th century medicine in France. Marilyn McEntyre discusses anecdotal evidence provided by poets who were patients. This can be coupled with Vasiliki Dimoula’ s essay on the anatomical poems of the Ukrainian poet Paul Celan (1920–1970) who wrote in German. Excerpts (with English translations) provided in this essay also feature the trauma of the Holocaust in which both his parents perished.

I especially enjoyed Corinne Saunders’ Mind, breath and voice in Chaucer’s romance writing; Marilyn McEntyre’s Anecdotal evidence: What patient poets provide; Carl Fisher’s Doctor-writers: Anton Chekhov’s medical stories and the final essay by Maria Pia Pagani entitled Mikhail Berman-Tsikinovsky ‘s medical plays: Chekhov in Chicago.

All those interested in literature, medicine, history of medicine and the humanities, in general, will find this book of great interest.