Rooting for humanities majors in medical school


Medical schools traditionally admit pre-med students who are science nerds, and later wonder why their graduates aren’t well-attuned to their patients’ emotions.

The Icahn School of Medicine at Mt. Sinai Hospital in New York City hopes to correct that. It now operates a program, called “Hu-Med,” that admits humanities majors. They’re selected after their sophomore college year, and don’t even need to take the infamous MCAT admissions test. In my mind, this project is more than welcome.

For the past century, medical education has been shackled to hard-nosed objective science, to the point that subjective qualities like imagination, meaning, and emotion are all but deliberately ignored. Indeed, this tenacious legacy is responsible for the bulk of pains in today’s health care mess.

The strategy that brought us here came largely from Andrew Carnegie and John D. Rockefeller, who determined to morph American’s horse-and-buggy medicine at the turn of the last century into a sleek scientific vehicle. They hired respected educator Abraham Flexner to survey the entire existing system. After Flexner recommended that medical education be exclusively scientific, Carnegie and Rockefeller funded science-based chairs and departments around the country, and soon the unfunded went belly-up.

It wasn’t a bad thing to do. Scientizing medicine has benefited us hugely. It’s helped us lengthen average life span, eradicate smallpox, employ antibiotics, and re-code genes, among other miracles. But it’s cost us plenty, too. Now we know how to replace organs, but are ill-equipped for today’s major challenges — altering pathogenic lifestyles, guiding the hurting aged, and comforting the sick and dying.

This deficit was foreseen. Flexner’s revered contemporary, Dr. William Osler, warned that exclusive scientific focus would injure health care:

The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with powders or potions …

And decades later, Flexner agreed. In the 1920s, he charged that,

… scientific medicine in America … is today sadly deficient in cultural and philosophic background … The imposition of rigid standards by accrediting groups has made the medical curriculum a monstrosity, leaving medical students little time to stop, read, work or think.

So the notion of backing away from science a bit and injecting more humanities is nothing new. It was even tried in my medical school in the early 1960s, when I was applying. I was no science nerd, so not a prime candidate, yet I was good at languages. The school took a breath and invited a few of us humanities types in. (Of those, I’m the only one, by the way, who didn’t become a psychiatrist.)

It’s been a fine ride. I can’t remember biochemical pathways to save my life, but I am grateful for the awe that has come from immersion in hundreds or maybe thousands of fascinating lives. You don’t want me ever operating on you, but I am pretty good at the bedside. I’ll listen carefully to you and do my best to comfort you. Another of my humanities cohorts never asks his patients what’s wrong. Instead, he says, “Tell me about yourself.”

Hats off, then, to the Icahn School of Medicine. Its “Hu-Med” graduates won’t have it easy when they enter the medical-industrial complex, an institution that deliberately downplays their humane impulses. But a few of us have made it successfully to the other shore, and we’ll be rooting for them.

Jeff Kane is a physician and is the author of Healing Healthcare: How Doctors and Patients Can Heal Our Sick System.

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