Two Solitudes of Humanities in … What?

People of the academy love disputes over terminology; it’s so much easier than, well, doing a lot of other things we might be doing. And so, feeling like doing something easier myself, let me offer a comment on the ongoing question of whether it’s medical humanities or healthcare humanities.

First, I agree with something Rita Charon once wrote that neither usage is commendable English, and using language that is commendable ought to be a core objective in this work. Neither medical nor healthcare is a felicitous adjective–even a minimally meaningful adjective–to modify humanities. We should say either humanities in healthcare or in medicine. But we probably won’t. So at least add my objection to Charon’s.

Of more interest is which adjective to use. Medical is the older term, so far as I know. The objection, in this context as in others, is that medical at least privileges physicians and at worst is exclusionary of non-physicians. Healthcare came in as the more inclusive term, promising a bigger tent, welcoming everyone. Tess Jones and colleagues published the Health Humanities Reader, but I now gather that health humanities is disfavoured, which is fine with me, although maybe new editions of the book should be retitled. Point is, until now most of the usage controversy was over a mostly symbolic adjectival signifier, a question of word choice. I see that changing. The politics are intensifying.

Some of my recent experiences disturb me. I’m seeing medical humanities and healthcare humanities not as two names for what was fundamentally the same enterprise, but rather as two distinct enterprises. Distinct in terms of what is taken as important topics for study, what counts as a good or publishable study (writing templates and expected citations), what counts as being a proper study at all in terms of meta-reviews, who is accredited as doing the work, whose work is accredited as counting for what, and what the credited publication outlets are–which journals count and whether books count at all. That’s a partial list of what separates academic cultures. Of course there are still significant overlaps in what’s of interest and in who’s doing the work. But I see an increasing drift that I hope will be talked about and written about. What is at issue is central to the politics of the medical-academic complex.

To complicate matters, narrative medicine, with the Columbia program as its flagship, seeks to bridge both, especially the social-justice concerns that are central to healthcare humanities and the medical-education focus of medical humanities. The limitation lies in both words, narrative and medicine. Many of the projects and media of interest to both healthcare humanities and to medical humanities are non-narrative except in such an inclusive sense that narrative loses all specificity of reference. And the possibly exclusionary designator medicine remains, although nurses and other non-physicians study at Columbia and call what they do narrative medicine. I’m interested that the phrase narrative medicine just doesn’t appear on some institutional websites that proudly present their medical humanities work. I count that as what’s lacking in those programs, but for now my point is that straddling both worlds may get more difficult, not less.

If what I see is representative, and there are increasingly two solitudes of healthcare humanities and medical humanities, I’d count that as a loss to everyone. Inter-professional education, by which I mean occasions when students from different healthcare disciplines learn with and from each other, each valuing the other, is something everybody is supposed to approve of, although I have trouble finding venues where it actually takes place (I’d appreciate news of such happenings, which I’m sure are there, somewhere). Humanities in improving care for the ill, and in improving the lives and work of all persons working in healthcare, would seem like the ideal opening for inter-professional education. Can humanities be the level playing field where everyone’s expertise, especially the expertise of persons living with illness, can be valued equally? Because that’s the issue as I see it. Can medical/healthcare spaces offer equal respect for multiple forms of expertise, acknowledging in which moments one expertise or another may be most relevant? It’s all about hierarchy, and the insidious ways that hierarchies are perpetuated, including conventions of academic work, as well as program funding and much, much else.

Or will commitments to sustaining forms of hierarchy create a further drift into two solitudes, neither reading or listening to the other, alternatively suspicious of each other and tacitly deprecating each other? I truly hope my perceptions are skewed. I’d love to be wrong about this.