Concern that the scientific growth of medicine has come at the expense of the art of medicine is not new. However, should we consider that not only does this impact the quality and practice of medicine, but might it also contribute to the rampant burnout in physicians? Does a narrow focus on the linear, scientific thinking that characterizes medical education and training mean that physicians are more vulnerable to the strains of living in a volatile, uncertain, complex, and ambiguous (VUCA) world where behaviors and habits that may have worked in the past are no longer sufficient to thrive in changing times?
Time, energy, and finite resources are genuine constraints for introducing new concepts into medical education, training, and practice. That being said, with burnout and suicide looming darkly and tragically over the profession, is it not time to fast track solutions that might appear as novel in an evidenced-based world, but which may, in fact, represent the wisdom that remains at the heart of medicine? In their article “The old humanities and the new science at 100: Osler’s Enduring message,” Mangione and Kahn offer a comprehensive and enlightening discussion of the impact that the humanities have on both the practice of medicine and the well-being of physicians, particularly as seen through the eyes of Sir William Osler. As quoted in the paper above, in his last public speech in 1919 delivered to the Classical Association at Oxford, Osler states that “Humanists have not enough Science and Science sadly lacks the Humanities…this unhappy divorce…should never have taken place”. Is there not a certain arrogance, foolishness, and emptiness in a professional culture that allows data and technology to overwhelm the wisdom, empathy, emotional intelligence, understanding, and human creativity that have been passed down through the ages? Inspirational figures in medicine have so often been those who have built and married their personal evolution and growth as creative, insightful human beings to their excellence in scientific knowledge.
It is encouraging to know that the humanities are beginning to make their way into the educational curriculum. These courses will likely have the most impact if they are a requirement rather than an option. They may otherwise cater to the already converted and bypass those most in need. Also, an optional offering contains an implicit message that the teachings’ fundamental importance and value is both unnecessary and questionable.
Humanities can be seen as part of the fabric, society, and culture of human experience. In many ways, they might be seen as the disciplines that make us human and make life meaningful. They broadly encompass ancient and modern languages, literature, philosophy, religion, visual and performing arts, such as music and theater. Even more expansively, they may also include, amongst others, history, archaeology, anthropology, law, and linguistics. These diverse fields explore and foster empathy, compassion, beauty, joy, awe, love, reasoning, tolerance, curiosity, possibility, community. Are we richer as human beings or physicians without this education, or are we abandoning ourselves to the loneliness, sadness, and despair of a more sterile, rigid, negative, and dysfunctional way of thinking?
Apart from encouraging the humanities in medical school or even in undergraduate school, how can we reach those who are already in practice facing burnout, currently compounded by the additional stresses of working in a pandemic? Is it naïve, insensitive, and even absurd to suggest that dipping a toe into a totally different discipline, let alone “a non-scientific” one, might have value in these troubled times? Partaking in the humanities does not mean having to take a formal course or getting another degree. Many physicians would undoubtedly acknowledge that at some point in their lives, they have experienced profound benefits from incorporating one or more of the humanities into their lives, but that time constraints and lack of professional support have caused them to drop the very interests that had been a source of sustenance and comfort to them. Although contemporary research is beginning to accumulate regarding the benefits of the humanities in medicine (see, for example, studies in music, art, and theater), is it worth denying ourselves the benefits of the creative, soul-penetrating beauty and wisdom of the humanities while we wait for this sine qua non of medicine to deliver permission to indulge? I remember how I once dramatically decreased my non-medical reading (a previous source of happiness for most of my life) because there seemed to be more legitimate pursuits for my minimal time. The profound emptiness and sadness that I experienced without this pursuit in my life was a wake-up call for me to commit to finding innovative ways to develop a schedule that once more kept this vital source of sanity, joy, and renewal as an integral part of my day and life.
As the late John O’Donohue says in his book Anam Cara, “Sometimes it is easy to be generous outward, to give and give and give and yet remain ungenerous to yourself. You lose the balance of your soul if you do not learn to take care of yourself.”
I want to suggest that despite time constraints and whether or not there is currently research-based evidence, physicians reconnect and discover ways to bring the time-honored, stimulating, and thought-provoking thinking, knowledge, and wisdom of the humanities back into their personal and professional lives. The disciplines to choose from are many, varied, and profoundly personal. If we are to survive and thrive in the world we live in today, we must allow ourselves to discover and cultivate sources of wisdom that will nurture and enliven our innermost being.
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