LITERATURE AND THE HEALING ARTS

LITERATURE AND THE HEALING ARTS

A Course in Medical Humanities

LBST 383: Senior Seminar

Fall 2006

MWF 11:15 - 12:10

PC 1218

(This course is dedicated to the memory of Dr. Cherie Haeger.)

Instructor: Berwyn Moore, Associate Professor of English

Office: PC 3240

Office Hours: MWF: 12:15 - 2:00

TTH: 11 - 12

Phone: 871-7504

Email: moore001@gannon.edu

TEXTS

Required:

Davis, Cortney, and Judy Schaefer, Eds. Intensive Care: More Poetry and Prose by Nurses. Iowa City: University of Iowa Press, 2003.

Reynolds, Richard, M.D., and John Stone, M.D., Eds. On Doctoring: Stories, Poems, Essays. 3rd Edition. New York: Simon & Schuster, 2001.

Optional:

Coles, Robert. The Call of Stories: Teaching and the Moral Imagination. Boston: Houghton Mifflin, 1989.

Library:

Carmichael, Ann G., and Richard M. Ratzan, eds. Medicine: A Treasury of Art and Literature. New York: Beaux Arts Editions, 1991.

Downie, R.S., ed. The Healing Arts: An Oxford Illustrated Anthology. London: Oxford University Press, 1994.

DESCRIPTION

Literature and the Healing Arts is a senior seminar that uses literature as the basis for examining universal concerns of health, illness, and healing. These include the health care worker-patient relationship and its accompanying moral and ethical issues, historical approaches to healing and their implications for modern medical practices, the emotional and mental challenges of health care workers, and the cultural, racial, and ethnic dimensions of all these issues. While the course benefits anyone interested in literature and the medical arts, it will be especially useful for students planning careers in medicine, nursing, medical technology, or health administration.

Through the selected poems, stories, and essays, students will appreciate their roles not just as healers or caregivers but as compassionate human beings. They will see the importance of fostering the humane side of medicine: understanding the needs of patients as unique individuals, communicating with people who have limited medical knowledge, expressing compassion and empathy in the face of tragedy and grief, and making sound judgments in complex ethical situations. In particular, they will read about people living and dying in a variety of circumstances: individuals with cancer, AIDS, diabetes, depression, and other illnesses; women having babies, suffering miscarriages, and considering abortion; family members grieving the loss of loved ones; communities coping with epidemics and war; young people attempting suicide or overdosing on drugs; the elderly struggling with failing health and loss of independence, health-care workers making grave misjudgments about patients' care, and many others.

METHODS

This course is conducted as a seminar with guided group discussion. The interdisciplinary basis of the course will foster independent critical and creative thinking and challenge preconceived and faulty assumptions. The seminar format will provide a supportive environment conducive to the discovery and formative exchange of ideas among all participants – students and instructor. Students are expected to participate actively in a collaborative learning process and to be responsible for their own learning.

At the beginning of the course, students will be asked to design their own heuristic, a set of questions about their specific medical interests and concerns. The heuristic will then be used as the basis for exploring the literature for the ways others have addressed such questions, in both imagined and actual situations. Some sample questions include the following:

Cultural Assumptions:

*How do health care practices reflect cultural assumptions, beliefs, and mythologies?

*How have cultural assumptions about health and healing changed over time, particularly in the 20th century?

*Why are some diseases stigmatized? How can cultural stigmas be disconnected from individuals with certain diseases (e.g. TB or AIDS)?

*How does popular culture portray doctors? Nurses? Patients? What are the implications of these portrayals in the practice of real medicine?

Healer/Patient Relationship:

*What are the characteristics of a "good" doctor? A good nurse or technician? How does one become a "good" health care worker?

*What criteria do doctors use to make crucial decisions about treatments for their patients who are terminally ill? Who are elderly? Or who are in uncertain economic situations?

*How should medical professionals view a patient’s death?

Medical Ethics:

*What are the principles of medical ethics? In research (e.g. DNA research, human embryo research or human cloning)? In practice (e.g. abortion, passive euthanasia and active euthanasia, or the use of marijuana)?

*How does one reconcile a personal medical ethic with a standard medical practice?

Communication:

*What is the role of communication in providing effective health care?

*What metaphors are used for illness? For patients? For healing? Do these metaphors affect the way medical workers view their roles and responsibilities?

*How important is language when describing pain, fear, or hopelessness?

OUTCOMES

Students in this course will:

· read, think, and write critically

· analyze the elements of literature from a sound critical perspective

· discern the emotional, psychological, and cultural contexts of literature

· interpret literature in the context of medical arts

· evaluate literature as a catalyst and as a source of information about medical humanities issues in general and the health worker-patient relationship in particular

· define the characteristics of an effective health care worker

· assess the role of communication between health care workers and their patients

· understand the implications of medical ethics both professionally and personally

· appreciate the ethnic and cultural diversity of peers and prospective patients

COURSE REQUIREMENTS

Participation and Attendance:

Be prompt; we won’t wait for you. Be prepared (i.e. read all assignments!!) to participate actively in discussion and other activities; this participation will contribute toward your final grade. Each absence above three will result in a five-point reduction of your final grade.

Individualized Heuristic:

Early in the semester, you will write a heuristic, a set of questions used for the exploration, discovery, and self-education of your concerns about being a health care worker, a patient, or both. The questions may focus on a particular area of medicine, such as pediatrics, internal medicine, geriatrics, public health, or mental illness; on a specific disease, such as cancer, AIDS, or schizophrenia; or on a controversial health care issue, such as abortion, euthanasia, or genetic manipulation. However, all heuristics must ultimately address medical humanities issues, the universal concerns of the individual and his or her community; for these concerns, you may incorporate the questions suggested on this syllabus under "Methods."

Reflection Papers:

You will write eight brief papers in which you respond to one or more readings, a guest speaker, videos, and/or class discussion. I may assign a specific focus for some reflections. These papers will help you explore your position on the difficult issues of the course, including the ones presented in your heuristic. The papers should be one to two typed pages.

Book Report:

You are to report on a book (see “Appendix of Additional Resources” at the end of this syllabus) related to medical humanities issues which you read outside of class. Your report should be two to three typed pages.

Group Presentation:

Groups comprised of three students will work collaboratively on a project to be presented orally to the class. Groups may lead class discussion about a literary work, a movie, a television show, or actual experience, as long as it addresses medical humanities issues. You are encouraged to be creative with this assignment. Each member of the group will receive the same grade.

Heuristic Response / Research Paper:

At the end of the semester, you are to write a thorough analysis of your position on one or two of the questions formulated in your heuristic. This 5 - 8 page paper should incorporate sources effectively and document them correctly using either the APA or MLA style of documentation. This paper will provide you with the opportunity to “integrate the concepts and methodologies presented in earlier Liberal Studies courses” (Gannon University Undergraduate Catalog) as well as material from your major courses, if appropriate. This paper should represent your best work and will be evaluated meticulously on both content and readability.

Academic Integrity:

Plagiarized papers will warrant an F for the course. Refer to your student handbook for information.

GRADING

Participation 25 points

Heuristic 40

Reflection Papers (10 points each) 80

Group Project 30

Book Report 25

Heuristic Analysis / Research Paper 100 points

_____

300 points

Final Grade: 300 - 270 = A

269 - 260 = B+

259 - 240 = B

239 - 230 = C+

229 - 210 = C

209 - 180 = D

SCHEDULE

Abbreviations: OD (On Doctoring) IC (Intensive Care)

W 8/23 Introduction to Course

Haeger’s poem, “Magnetic Resonance Imaging”

F 8/25 Discussion of medical humanities

Brief overview of medical history

Florence Nightingale Pledge (hand-out)

Hippocratic Oath (hand-out)

M 8/28 OD: Edwards’ poem, “The Shot,” 401

IC: Waring’s poem, “Shots,” 235-236

Ahlman’s poem, “Medical Ward,” 1-2

Bryner’s poems, “Call and Response,” 41-41 and “What Nurses Do...”, 45-46

W 8/30 Preparation for heuristic

Discussion of book reports, reflections, and group presentations

F 9/1 Film clips from Patch Adams

M 9/4 Labor Day: no class

Health Care: Early Perspectives

W 9/6 OD: Thomas' essay, "House Calls," 145-150

Coles' excerpt from The Call of Stories, 248-251

Merck Manual: 1899 facsimile (in-class)

IC: Brooks’ letter, “The Essence of Nursing: 1967,” 30-33

Rahn’s essay, “Car Spotting,” 173-184

F 9/8 OD: Williams’ stories, "The Girl with a Pimply Face" and "The Use of Force," 62-76

Bulgakov’s essay, “The Steel Windpipe,” 78-85

M 9/11 OD: Altman's essay, "Don't Touch the Heart," 288-301

Reflection #1 due: write about your choice of readings so far

W 9/13 Group presentation workshop: topics and schedule

Heuristic due

The Patient's Perspective

On Being Ill:

F 9/15 Reflection #2 due: Write about a time you were ill or injured: What did you think about? How did you feel emotionally? What helped you feel better?

M 9/18 OD: Broyard's essay, "Doctor, Talk to Me," 166-172

Plath's poem, “Tulips” (hand-out)

Ciardi's poem, "Washing Your Feet," 155-156

W 9/20 OD: Dickey's poems, "Diabetes," 199

Carver's poem, "What the Doctor Said," 302

IC: Mysko’s story, “That Mystique,” 158-167

Webster’s poem, “Doppelganger,” 242-243

F 9/22 OD: Vonnegut’s play, Fortitude, 175-190 (oral reading)

M 9/25 OD: Carver's poem, "What the Doctor Said," 302

poems by Olds and others (hand-outs)

IC: Bernichon’s poem, “Chemo,” 18

Haddad’s poem, “Conversations with Wendy,” 100-101

W 9/27 Group Presentation #1

On Public Health: Infectious Disease / Catastrophe / War / Bio-terrorism:

F 9/29 Reflection #3 due: Write about what you believe are the most

important current public health issues and why. Explore the role of fear (if there is one) in these issues.

M 10/2 PBS film: Typhoid Mary

W 10/4 IC: McDonald’s poem, “The Politics of Disease,” 147

Schaefer’s poem, “Long Distance Call,” 190-191

Roeser’s poem, “What Did the Children Know...?” (hand-out)

F 10/6 Film clip from Philadelphia

OD: Verghese's excerpt from My Own Country, 360-367

Ritchie's essay, "Hospital Sketchbook: Life on the Ward through an Intern's Eyes," 373-381

Poem by M. Williams, “Thinking about Bill, Dead of AIDS” (hand-out)

Poetry by Rafael Campo (hand-outs)

M 10/9 Group presentation #2

10/11- 10/15 Fall break

On Mental Illness:

M 10/16 Brief history of treatments

NPR audio tape: “My Lobotomy: Howard Dully’s Journey”

W 10/18 Gilman’s story, “The Yellow Wallpaper” (hand-out)

Poems by Plath and Sexton (hand-outs)

F 10/20 Guest speaker: Chuck Joy, M.D., child psychiatrist / poet

M 10/23 IC: Tripp’s essay, “The Door Locker, 230-232

Film clips: A Beautiful Mind, As Good As it Gets

W 10/25 Reflection #4 due: write about readings and guest speaker

F 10/27 Group presentation #3

Pregnancy, Birth, Childbearing

M 10/30 OD: Pastan's poem, "Notes from the Delivery Room," 268

Williams' poem, "The Birth,” 60

Bulgakov’s essay, “Baptism by Rotation,” 86-94

IC: Bortz’s poem, “Dar a Luz,” 25-26

Bernardini’s essay, “Does this Date Mean Anything to You?” 11-16

W 11/1 OD: Olds' poem, "Miscarriage," 319-320

Hemingway's stories, "Indian Camp" and "Hills Like White Elephants," 102-109

Reflection #5 due: write about your choice of readings

F 11/3 OD: Hellerstein's essay, "Touching," 354-357

Clifton's poems, "the lost baby poem" and "poem to my uterus," 286-287

Selzer’s essay, “What I Saw at the Abortion” (hand-out)

IC: Tisdale’s essay, “We Do Abortions Here: A Nurse’s Story, 221-229 (Due to its graphic contents, this reading is OPTIONAL.)

M 11/6 Group presentation #4

On Culture and Race:

W 11/8 OD: Bontemp's story, "A Summer Tragedy," 110-118

Hurston's essay, "My Most Humiliating Jim Crow Experience," 119-120

Excerpt from Coles’ essay, 251-258

F 11/10 Excerpt from Anne Fadiman's The Spirit Catches You and you Fall Down (hand-out)

IC: Klassen’s essay, “The Facts of Lice in Nueva Vida, Nicaragua,” 111-113

Masson’s essay, “Nurse in Neighborhood Clinic Disappeared,” 144-146

M 11/13 PBS film: Oliver Sacks on Usher’s syndrome

W 11/15 Reflection #6 due: write about your choice of readings

Workshop for Heuristic Response / Research Paper

On Aging:

F 11/17 OD: Grumbach's essay, "Coming into the End Zone," 158-165

Joseph’s poem, “Warning,” 264

Jarrell's poem, "Next Day," 152-153

Brooks' poem, "The Bean Eaters," 157

M 11/20 Book report due

IC: Campbell’s essay, “The Radio,” 47-48

Wentz’s essay, “Smile! You’re in a Nursing Home,” 244-246

Yakimo’s poem, “Hands Beckoning,” 248-249

Grant’s essay, “Edna’s Star,” 95-99

11/22-26 Thanksgiving Break

M 11/27 Group Presentation #5

On Dying, Death, and Grieving:

W 11/29 Reflection #7 due: write about your choice of readings

PBS film: Bill Moyers on death and dying

IC: Bailey’s poem, “Night Shift,” 6

Bernichon’s poem, “Mercy and Hemlock,” 20

Kovach’s essay, “Mourning Coffee,” 115-117

Lamont’s poem, “Four Men, Sitting,” 126-129

F 12/1 OD: Dickinson's poem, "I Heard a Fly Buzz," 28

Pastan's poem, "The Five Stages of Grief," 266-267

Carver's poem, "My Death,” 303

Selzer's essay, "Mercy," 213-228

Seivers’ essay, “Girl,” 199-202

Health Care: Contemporary Perspectives

M 12/4 OD: Eisenberg’s essay, “It is Still a Privilege to be a Doctor,” 19-21

Hilfiker's essay, "Mistakes," 325-336

Klass' essay, "Invasions," 368-372

Hardison's essay, "The House Officer's Changing World," 272-276

W 12/6 IC: Studer’s essay, “Mercy,” 207-220

Deppe’s poem, “One on One with Dylan Thomas,” 81-83

Schaefer’s poem, “Terminal Nurse: Reflections of New Millennium Nursing,” 193-194

Webster’s poem, “Stuff I Learned in Nursing School,” 241-242

Spencer’s poem, “RX or Nurses: Brag!” 203

F 12/8 Reflection #8 due: write about your choice of readings in last unit

M 12/11 Research paper due by 1:00

(Deliver to Palumbo 3240)

APPENDIX OF ADDITIONAL RESOURCES

In addition to the titles below, you will find an abundant list of annotated resources on the New York University School of Medicine Literature and Medicine Database at:

<http://endeavor.med.nyu.edu/lit-med/lit-med-db/index.html>.

* Indicates work or other works by this author available in Nash Library.

**Indicates work you may borrow from me.

Books:

**Abbas, M.D., Maher Aref. Beyond the Magic Scalpel

*Albom, Mitch. Tuesdays with Morrie

Anderson, Charles M. Richard Selzer and the Rhetoric of Surgery

*Armstrong, Lance. It’s Not about the Bike: My Journey Back to Life

Bailin, Miriam. The Sickroom in Victorian Fiction

Bonvillain, Nancy. Native American Medicine

Brallier, Jess M. Medical Wit and Wisdom: The Best Medical Quotations, from Hippocrates to Groucho Marx

Bremen, Brian A. William Carlos Williams and the Diagnosis of Culture

**Brooke, Elisabeth, ed. Medicine Women: A Pictorial History of Women Healers

**Brookes, Tim. Signs of Life: A Memoir of Dying and Discovery

*Caldwell, Taylor, Dear and Glorious Physician

**Carter III, Albert Howard. First Cut: A Season in the Human Anatomy Lab

**Campo, Rafael. The Healing Art

**Campo, Rafael. The Poetry of Healing

**Campo, Rafael. What the Body Told

*Camus, Albert. The Plague

*Chopin, Kate. The Awakening

Clark, Bruce. The Body and the Text: Comparative Essays in Literature and Medicine

**Coles, Robert, M.D. and Randy Testa, Eds. A Life in Medicine: A Literary Anthology

**Cytowic, Richard. The Man Who Tasted Shapes

DeSalvo, Louise. Writing as a Way of Healing

**Davis, Cortney. I Knew a Woman: The Experience of the Female Body

Diamond, John. The Healer: Heart and Hearth

Driscoll, Frances. The Rape Poems

**Fadiman, Anne. The Spirit Catches You and You Fall Down: Collision of Two Cultures

**Flitter, Marc. Judith’s Pavilion: The Haunting Memories of a Neurosurgeon

Fox, John. Poetic Medicine: The Healing Art of Poem-Making

**Gawande, Atul. Complications: A Surgeon’s Notes on an Imperfect Science

**Gordon, Richard. An Alarming History of Famous and Difficult Patients

Groopman, Jerome, M.D. The Measure of Our Days: A Spiritual Exploration of Illness

*Groopman, Jerome, M.D. Anatomy of Hope

*Harrower, Molly. The Therapy of Poetry

Helman, Cecil. The Body of Frankenstein's Monster: Essays in Myth and Medicine

Henke, Suzette. Shattered Subjects: Trauma and Testimony in Women’s Life-Writing

Herman, Judith Lewis. Trauma and Recovery

**Hodges, Barbara. In the Arms of Morpheus

Jacob, Krista. Our Choices, Our Lives: Unapologetic Writings on Abortion

*Kafka, Franz. The Metamorphosis

*Kesey, Ken. One Flew Over the Cuckoo’s Nest

**Kraut, Alan M. Goldberger’s War: The Life and Work of a Public Health Crusader

*Kraut, Alan. M. Silent Travelers: Germs, Genes, and the “Immigrant Menace”

*Kubler Ross, Elizabeth, On Death and Dying

**Kurland, Geoffrey, M.D. My Own Medicine: A Doctor’s Life as a Patient

Lachenmeyer, Nathaniel. A Journey into My Father’s Struggle with Madness

*Lamb, Wally. And She’s Come Undone

**London, Oscar. Kill as Few Patients as Possible

Lorde, Audre. The Cancer Journals

**Lowenstein, Jerome. The Midnight Meal and Other Essays About Doctors, Patients, and Medicine

**Mazza, Nicholas. Poetry Therapy: Interface of the Arts and Psychology

Mckeithen, Madge. Blue Peninsula: Essential Words for a Life of Loss and Change

*Mitchell, S. W. The Autobiography of a Quack

**Miller, Engelberg and Broad. Germs: Biological Weapons and America’s Secret War

*Morrison, Toni. The Bluest Eye

*Mukand, Jon. Articulations: The Body and Illness in Poetry

*Nuland, Sherwin B. How We Die: Reflections on Life's Final Chapter

*Nuland, Sherwin B. The Wisdom of the Body

*Ober, William B. Boswell's Clap and Other Essays

Oz, Mehmet. Healing for the Heart

Ober, William B.. Bottoms Up! A Pathologist's Essay on Medicine and the Humanities

Pennebaker, James W. Opening Up: The Healing Power of Confiding in Others

*Plath, Sylvia. The Bell Jar

*Preston, Richard. The Demon in the Freezer

**Regush, Nicholas. The Virus Within: A Coming Epidemic

Rodin, Alvin E., and Jack D. Key. Medicine, Literature, and Eponyms: An Encyclopedia of Medical Eponyms Derived from Literature Characters

*Roberts, Marie. Literature and Medicine During the 18th Century

Rothfield, Lawrence. Vital Signs: Medical Realism in 19th Century Fiction

*Sacks, Oliver. Awakenings

Sacks, Oaxaca

*Sacks, Oliver. The Man Who Mistook His Wife for a Hat

*Sacks, Oliver. Seeing Voices: A Journey into the World of the Deaf

**Sandblom, M.D., Ph.D., Creativity and Disease

*Scarry, Elaine. The Body in Pain

Schaefer, Judy. The Poetry of Nursing: Poems and Commentaries of Leading Nurse-Poets

*Schweitzer, Albert. Out of My Life and Thought

Seigel, Bernie S. Love, Medicine and Miracles

Selzer, Richard. Letters to a Young Doctor

**Selzer, Richard. Mortal Lessons: Notes on the Art of Surgery

*Selzer, Richard. Raising the Dead

Scheidermayer, David L. House Calls, Rounds, and Healings: A Poetry Casebook

*Shelley, Mary. Frankenstein

*Sontag, Susan. Illness as Metaphor

**Songtag, Susan. AIDS and Its Metaphors

*Stevenson, Robert Louis. The Strange Case of Dr. Jekyll and Mr. Hyde

Stone, John. In All This Rain

*Thomas, Lewis. Notes of a Medicine Watcher.

*Tolstoy. The Death of Ivan Ilych

**Voigt, Ellen Bryant. Kyrie

**Weisman, Jamie, M.D. As I Live and Breathe

*Williams, William Carlos. The Autobiography of William Carlos Williams.

Williams, William Carlos, The Doctor Stories.

Journals:

**The Bellevue Literary Review

The Journal of Poetry Therapy

Literature and Medicine (Inter-library loan and on-line)

**Mediphors

Stitches, The Journal of Medical Humour (Inter-library loan)

Internet:

http://endeavor.med.nyu.edu/lit-med/medhum.html

Web Searches: Literature and Medicine

Medical Humanities

Movies:

And the Band Played On