The art of medicine dissected
"Isn't every human being both a scientist and an artist; and in writing of human experience, isn't there a good deal to be said for recognising that fact and for using both methods?" wrote James Agee in 1939.
The arts have always been part of medical practice, in visible and invisible ways. A new set of initiatives in South Africa plans to situate the field of the arts-in-medicine and the "medical humanities" within an academic context.
Beyond the established fields of art therapy and music therapy offered by the University of Pretoria, new conceptions of the transdisciplinary potential of drawing together the arts, the humanities and the health sciences through joint seminars, conferences, courses and international exchanges with already established programmes in arts-in-medicine are emerging at the University of Cape Town (UCT) and the University of the Witwatersrand (Wits).
As an entry point for launching the medical humanities in Cape Town, UCT's Gordon Institute for Performing and Creative Arts, in collaboration with the school of African and gender studies, anthropology and linguistics, hosted a public lecture series in July and August.
The series addressed the growing interdisciplinary field of medical humanities, which includes the social sciences and the arts, in pursuit of intellectual synergies and their application to medical pedagogy and practice.
Acclaimed playwright and cultural critic Jane Taylor discussed the historical and psychological significance of organ donation at the inaugural medical humanities lecture. Over the past decades she has had an abiding interest in the ways that human communities are tied together through the circulation of commodities, from the exchange of letters to the donation of vital organs.
Her 2009 novel, The Transplant Men, evokes the politics and culture of the 1960s in South Africa, in an exploration of the globally hailed "first human heart transplant".
In her lecture, Donation: The Give and Take of Human Organs, Taylor read selections from the novel and explored the meanings of the heart transplant as they became evident at the time, and what they have come to signify in the 21st century.
Professor Lorna Martin, internationally recognised researcher and head of the division of forensic pathology at UCT, presented a collage of experiences and events from her career to highlight the intersections of this branch of medicine with the humanities and the arts.
Using the public lecture as a forum for interdisciplinary discussion, she used the wide lens of forensic pathology to dissect the diverse range of human activity represented at death.
Eminent play activist and head of occupational therapy at UCT, Professor Elelwani Ramugondo discussed creative expression and the application of the arts in healing. Her lecture, Creative Expression: Some Do, Some Don't, departed from a broad perspective of health and healing, focusing on social contexts specific to South Africa.
She drew from a new construct in occupational science, termed "occupational consciousness", to highlight the politics of human occupation, and to explain how what we do (or don't do) influences health.
Foregrounding the potential of the arts as healing work and showcasing a number of local artists, she made a strong case for the arts as a form of inquiry.
Professor Mark Solms, the internationally acclaimed neuropsychologist and psychoanalyst, presented a lecture describing the foundational brain mechanisms of consciousness, feeling, emotion and value.
Solms is best known for his writings about the forebrain mechanisms of dreaming, and his pioneering use of psychoanalytic methods and theories in contemporary neuroscience.
In his lecture, Quality and the Brain, he addressed the basic cognitive processes that inform and translate human psychological experience.
Professor Raj Ramesar, head of UCT's division of human genetics, delivered a lecture highlighting the utilitarian, conceptual and ethical aspects of the field of human and medical genetics. His lecture acted both as an introduction to the world of human genetics and as a way to contextualise its use in Africa, with an emphasis on the specific opportunities and challenges it represents. Ramesar discussed the use of genetic mapping in pinpointing predispositions to disease and identifying human lineages.
Historian Catherine Burns pursued a dialogue between indigenous health cultures and biomedicine in the final seminar in the series, on August 29. She asked why an institutionalised, interdisciplinary relationship between the humanities and medicine has not existed until recently, particularly given the politicised and iniquitous history of South African health and medicine through the 20th century, the legacy of which continues.
In 2014, UCT is set to launch a new master's-level course, Medicine and the Arts, offered by the school of African and gender studies, anthropology and linguistics. As the course's convenors, we are targeting equal numbers of health science and humanities students who are interested in exploring the transdisciplinary spaces between their fields.
Twelve dynamic seminars will guide students through the life cycle as seen from the perspectives of artists, health practitioners and social scientists. Students will have the opportunity to learn about the emergent global intersections between art, illness and healing by engaging with conversations between scholars with a vested interest in the medical humanities.
They will be led through the life cycle from genetics to the death of the organism and stimulated to clarify points of connection and difference — and, in the process, develop synergies in the relationship between arts and medicine.
The seminars will be held in varied locations such as the Ramesar Molecular Genetics Laboratory, a maternity hospital, a community health centre, the Red Cross Children's Hospital, the Little Theatre, the Heart of Cape Town Museum and the Pathology Museum, each of which will contribute a specific context to the discussions.
Each seminar will be presented by an artist, a social scientist and a medical practitioner in discussion with one another in what have been called "radical trios". For example, the session titled The Heart of the Matter: A Matter of the Heart, will have Johan Brink (heart surgeon), Kevin Williams (heart recipient) and Peter Anderson (poet) discussing the heart at UCT's heart transplant museum at Groote Schuur Hospital, the site of the historic first heart transplant in 1967, and will provide a very real and tangible environment for this discussion.
As a pump, the heart is a biological organ that maintains our blood circulation and life; it is the subject of a number of procedures and manipulations, including its replacement by transplantation. But in social discourse, "heart" signifies a more subjective as well as existential part of our lives and often refers to love.
Cecil Helman (1944-2009), the great medical anthropologist, wrote in his 2004 memoir of his life as a medical doctor in England, Suburban Shaman: A Journey through Medicine: "In fact, the art of medicine is a literary art. It requires of the practitioner the ability to listen in a particular way, to empathise and also to imagine — to try to feel what it must be like to be that other person lying in the sickbed or sitting across the desk from you, to understand the storyteller as well as the story."
Finally, a recently awarded National Research Foundation grant will enable a group of academics to explore over the next 12 months the scope of medical humanities in an African context, where health is so clearly socially and economically determined. We will take strength from the great cellular pathologist Rudolph Virchow, who wrote in 1848: "Medicine is a social science, and politics is nothing else but medicine on a large scale."
Susan Levine is a medical anthropologist in the school of African and gender studies, anthropology and linguistics at the University of Cape Town and the editor of Medicine and the Politics of Knowledge. Steve Reid is a family physician and musician, and professor of primary health care in the faculty of health sciences at UCT