Will reading Tolstoy make you a better doctor?

In an increasingly technology-oriented world, genuine human connection is becoming rarer. Physicians are taught to emotionally disassociate from their patients for mental self-protection. This detachment can result in a loss of human connection between a doctor and patient, which may interfere with patient health outcomes. Studying great literature, such as Tolstoy’s The Death of Ivan Ilyich, allows health care professionals to adopt the patient perspective and gain insight into how their approach to practicing medicine affects others. Tolstoy boldly explores the distance that humans keep between themselves and death, as he depicts the frigid relationship Ivan Ilyich has with his doctor, who avoids discussing Ivan’s impending death at all costs. Applying lessons from works such as Tolstoy’s helps physicians alter their language utilization and emotional responses to improve their patient communication skills. In addition, exposure to art forms such as theater, film, and dance in pre-med and medical school coursework allows physicians to develop social competence and emotional awareness.

Health care workers are often uncomfortable and at a loss for words when caring for patients in end-of-life stages. There are many coping mechanisms that patients utilize when faced with death, which a physician must be able to maneuver and accommodate for. An automatic human reaction to traumatic experience is to attempt to find structure in the chaos that is illness. Meaning and order can be discovered through the use of narrative, as patients devise a storyline of their lives that has led them to their undesirable fate. By relating events through chronology and causation, many patients will attempt to “fill in the gaps” of their story in order to find

meaning in their lives. Understanding this process through studying how storytelling and literature play into the human mind will help a doctor gain the awareness needed to treat their patients in a holistic way.

As an undergraduate student interested in a career in health care, I have taken primarily STEM classes for the last four years in preparation for medical school. For most STEM majors, general education humanities classes are seen simply as “easy A’s for boosting GPAs.” I, too, had fallen into this mentality, as I found myself all too often memorizing amino acids during Greek Mythology lectures and studying reaction mechanisms in Intro to Buddhism. It was not until I enrolled in my first medical humanities course, the first one to be offered at my university, that I started to see the value of my liberal arts courses. Learning about the history of medicine, culture in relation to health care, and medical ethics from both humanities professors and physicians opened my eyes to the relevance of the humanities to medicine.

For the last two years, I have worked as a medical scribe in Santa Barbara Cottage Hospital Emergency Department, seeing patients with different doctors each shift. Once I began learning about the role of the humanities in health care, I started to notice clear differences in patient contentment depending on their interaction with the doctor I was scribing for that day. Some patients would feel comforted and understood by their provider, while others were left feeling uneasy and unheard. I began to wonder whether patient well-being could be improved by exposing doctors to the humanities prior to or during medical school.

Unfortunately, medical schools today rarely have classes dedicated to the humanities. A consequence of this is that these schools are producing health care professionals who have technical skills but often lack the tools needed for human communication, such as the ability to empathize. The modern-day Hippocratic Oath states, “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” Health care professionals are taught to treat the physical conditions of their patients, but if a patient leaves the hospital feeling emotionally unsatisfied, have their needs been met?

The fight for implementing humanities into medical school curricula starts at the undergraduate pre-med level, where changes have begun to take effect. Health humanities programs for undergraduates have quadrupled since 2000. The Medical College Admission Test (MCAT) has been revised to address behavioral, professional, and ethical issues. Since 2015, the MCAT has included a “Psychological, Social, and Biological Foundations of Behavior” section, which tests on the comprehension of these domains.

Understanding the human condition is a requirement when practicing medicine. As soon as a physician loses their humanity, they lose their ability to advocate for their patients. Health care professional schools should implement humanities courses into their curricula to inspire empathy and compassion in their medical students. Shifting away from an educational lens that values efficiency over compassion will be the key to improving patient health and well-being.

Charlotte Botz is a graduate student.

Image credit: Shutterstock.com

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