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Web Extra: Exploring connections between humanities and medicine

By Carole Bartoo
February 2012

Jonathan Metzl, M.D., Ph.D., an expert in American culture, psychiatry and medical humanities, arrived in Nashville in August to direct Vanderbilt’s Center for Medicine, Health and Society, which has quickly become a popular undergraduate program for pre-medical students. We spoke with Metzl about the future of the emerging Center, as well as the greater meaning of this new foundation from which students begin their medical education.

What is the Center for Medicine, Health and Society?

It is two things. First, it is a popular major at Vanderbilt, one that is gaining footing on leading medical campuses around the country, including Harvard and Johns Hopkins. At Vanderbilt, in the six years since it became an official major, MHS has grown to include 364 student majors, offering 24 undergraduate courses and now offers both a minor and masters program as well.

Secondly, it is an innovative platform to cultivate dialogue among research and teaching faculty committed to exploring links among the humanities, social sciences and academic medicine.

Is Medicine, Health and Society itself a “new discipline,” a philosophy of teaching/learning, or something different?

The field began several decades ago in medical schools, using the tools of other disciplines-- for example literature-- to make more empathetic doctors.

Photo by John Russell

Photo by John Russell

Today these “tools” have become part of mainstream medical discourse. There is a desire from within medicine to understand its role in society and to pay attention to culture. With this desire comes the need to develop methods to understand culture. Medicine, Health and Society is about the nexus. Here, methods are developed to form an interdisciplinary conduit between medical knowledge and cultural knowledge.

Can you give an example of how medicine is being transformed by this desire to understand itself within our culture?

Any practicing clinician has an example of a patient who came to them asking about a certain brand of medication because of pharmaceutical advertising. A historical view of pharmaceutical ads shows how the politics of particular moments in time shape our understanding of illness and popular views. For example, you can see how depression was “gendered” a couple of decades ago. Ads for Valium featured images of threatening single women as markers of the need for treatment. It suggests the cultural concern of the time; the increasing fears of how married white women’s traditional roles might be changing. In Medicine, Health and Society, we want to teach thoughtfulness about context within culture.

You have spoken in the past about a change to a “post-modern” view of medical knowledge that embodies the work of HMS. What do you mean by this?

In traditional medical school programs we’re asked to memorize facts, but in this age of information explosion, five or 10 years later you’re out of date. Critical thinking and related skills you will use for the rest of your career are an important part of post-modern medical training. Physicians will need to know how to get the most current information, and apply it as care changes and evolves.

The MCAT exams already include questions about things like health care disparity and critical thinking. The AAMC is also beginning to require competency in areas like cross-cultural analysis, writing, teamwork and critical thinking.

Why do you think this field’s time has come?

If the public just wanted the doctors to tell them all the answers, they wouldn’t go to the Internet; there wouldn’t be a market for drug apps. It’s important to recognize that people come into clinical offices highly informed, having researched the issues. Health care providers realize it and want to know what steps to take to engage the patient, to better inform the patient, and to connect with patients. This requires the methods and critical thinking skills we teach in MHS.

Who is the ideal student in Medicine, Health and Society?

Certainly pre-medical students are among the most common. They are still studying science as part of their education, but they are also learning about economics, the literary basis of medicine. Those who go to medical school will be much more knowledgeable about how illness is defined across many cultures. We are also developing an evaluation strategy that uses AAMC core competencies like critical thinking, writing, teamwork and bioethics to assess learning.

What is at the top of your list as the new leader of this division?

This summer MHS will build infrastructure. I’ve been going around campus asking what works and what doesn’t, and themes have developed for going forward. We want to know how can the Center be the most use for students, faculty and the community? We are also hiring new faculty and moving into an exciting new space.

Metzl is the Frederick B. Rentschler II Professor of Sociology and Medicine, Health, and Society and professor of Psychiatry.


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