Medical Humanities: A Q&A With Kirsten Ostherr

Kirsten Ostherr, the Gladys Louise Fox Professor of English, is the founding director of the Medical Humanities program at Rice. In addition to offering an interdisciplinary minor, Medical Humanities developed a first-of-its-kind “facilitated admission” program with the McGovern Medical School at UTHealth for qualified humanities majors. Her goal is to change the way we train doctors and to revalue skills that are essential to healthcare — the ability to think critically, to develop ethical frameworks that can handle ambiguity and uncertainty, and to communicate effectively about complex challenges in patient care.

Learn more about the Medical Humanities at Rice, including how you can support this important program. Visit medicalhumanities.rice.edu.

 

WHAT IS MEDICAL HUMANITIES?

Medical humanities is a field of research and teaching that looks at the complex experience of being sick and healthy — and how these states influence our daily lives. For example, we may look at how religion shapes how people understand illness, or how they think about death, or what kind of care they may want at the end of their life. Medical humanities examines history and race, and how the legacy of harms to underrepresented communities results in continued health disparities today. And we look at the ways that media and technology are changing how doctors and patients relate to each other.

Medical humanities is an interdisciplinary field. It encompasses history, religious studies, literary studies, media studies, art history, anthropology and sociology. It looks at the broader set of influences that shape how both doctors and patients understand health and disease.

WHAT WAS THE MOTIVATION BEHIND THE MEDICAL SCHOOL HUMANITIES PROGRAM AT RICE?

The McGovern Medical School at UTHealth recognized that students with a narrow STEM focus have emerged as the prototypical medical school applicant. While these students are extremely bright and high achieving, STEM training alone can leave students without the broad perspective needed to understand the human dimensions of medicine — like understanding the cultural contexts in caring for patients or the ethics underlying various medical issues. McGovern zeroed in on a particular subset of the total qualities that they wanted in doctors, and they recognized that those are qualities that training in the humanities develops in students — the ability to think critically and synthetically about ambiguous topics, to develop ethical frameworks and to communicate. All of these things are strengths in the humanities.

McGovern approached us with an interest in developing a joint program so that we could start recruiting some of our best humanities students into their medical school classes. The hope is that those students would not only be part of the incoming class, but would also change the perception of the desired attributes of future doctors across the board, even for STEM majors. They are not trying to move away from STEM majors, but to expand the range of preparation that might make sense as a pathway to medical school.

IN WHAT WAYS DOES THE PHILOSOPHY OF MEDICAL HUMANITIES DIFFER FROM CURRENT THINKING ABOUT HEALTHCARE?

If you talk to anyone who has recently been hospitalized in the United States, they will likely have complaints about their experience, and the word “dehumanizing” comes up a lot in those conversations. And that speaks to how the process of healthcare is really organized around sick care and disease, not around health and prevention. It doesn’t currently take into account what Medical Humanities scholars call the illness narrative — that is — how illness impacts your daily life. The illness narrative considers how disease might interfere with things that are meaningful to you, not just what is happening inside your body or the pathophysiology of disease. It’s a completely different frame of reference from how a doctor might think about and understand disease as affecting one body part that is separate from a whole person’s lived experience.

HOW IS TECHNOLOGY CHANGING HUMAN INTERACTION IN MEDICINE?

Right now, a lot of my research is on digital health technologies including telehealth, virtual healthcare or digital therapeutics. This is healthcare enacted through apps or other kinds of devices that allow remote connection between two human beings who are not in the same physical location (or sometimes, between a human patient and a non-human care robot or A.I.). One of the motivating factors for developing this technology is getting care to people who are in remote places. But these systems are also being developed to scale up healthcare delivery so that a lot more people can be cared for by fewer providers. The end goal is meant to be human-centered, but the emphasis on models of efficiency or cost-savings often produces results that are not very human-centered. My concern, and the focus of my research, is on the ways that these developments might inadvertently reproduce health disparities and other unintended harms.

WHAT ARE YOUR GOALS FOR THE MEDICAL HUMANITIES PROGRAM?

One of my goals for the program is for pre-med students to really see the medical humanities as conveying skills and modes of thought that are integral to being a good doctor. The goal is to reach more students who will internalize expansive ways of thinking about what it means to be a doctor, what factors to consider when you are caring for patients, and how patients are perceiving their bodily experience. All of those things are on the minds of patients, but they are rarely part of the dialogue they have with doctors.

I want humanities-trained medical students to be intellectually curious and to be critical thinkers. I want them to be open-minded and willing to consider multiple ways of knowing and explaining a patient’s experience. I want them to be intellectually humble, to feel a sense of social responsibility in the ways they practice medicine. I want them to be expansive in their understanding of what kinds of learning are relevant to their careers in health care.

HOW CAN ALUMNI AND FRIENDS SUPPORT RICE’S VISION FOR GROWING THE MEDICAL HUMANITIES PROGRAM?

We have lots of students, but to reach them most effectively we need to preserve the low faculty-student ratio that is the hallmark of the Rice educational experience. We need more diverse scholars who understand the comparative dimensions of different models of health care and the comparative histories of health in the U.S. and around the world. We also really want to grow our connection with creative writing. We’d love to hire a creative writer who focuses on medical narratives and can bring that to our students. We would also like to develop a medical humanities study abroad research practicum. Many of our students and faculty are invested in global health issues, and the comparative perspective that comes from studying abroad is invaluable for cultivating a global ethos in our future healthcare leaders.

 

 

 

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