Highly Personal Exceptional Visions…

Karen J Leadertrump-berger (1)

I admit to being unusually disarmed by the pairing of a film still of the young and brilliant John Berger (1926-2017) with a distinctly unflattering photo of the then president-elect of the United States, Donald J. Trump. A clickbaity move by Salon, the pairing draws us academic types in through our own mourning of the recently deceased Berger, the first “celebrity” death of the new year. Instantly recognizable from his iconic BBC series “Ways of Seeing,” the long-haired art historian with rock-star looks jumps out from beyond the grave, warning us of the mystifications inherent in the analysis of images, which occlude evidence of exploitation, oppression, objectification, or class struggle. The keen edge of every sentence, the razor blade he uses to “cut up” a Botticelli, these are fresh in our grieving minds, having re-watched the series or reread the book, to forestall the feeling of loss, despite his long life, well lived.

How do we see Mr. Trump through Berger’s eyes? The mugging, shrugging, unserious and shockingly incurious reality TV star billionaire exudes artifice. The presence of the American flag pin (was it made in China like most of his products?) clings to an expensive but ill-fitting suit. The fake tan and comb-over bespeak someone utterly lacking aesthetic discernment.

The colliding of the two works into one banner image accompanies art writer Noah Charney’s meditation on “Why art history might be the most important subject you could study today.” Charney, reflecting on Brexit, the near axing in the UK of the art history A-Level exam, and the American election of Donald Trump, turns to Berger as a provider of armor against fake news in visual form: “He is the most overt of art historians who taught us how to see differently. That is about as good an argument as I can think of for why art history is an important field of study, and a good antidote to the narrow-minded, horse-blinder mentality that plagues many politicians and American citizens, and perhaps even certain presidents who need not be mentioned.” Touting the interdisciplinarity of art history, and its relation to optics, psychology, and a multitude of other fields, Charney suggests that the visual acuity demanded of art history fosters an ability to “open one’s mind to alternative viewpoints.”

OK to be fair, the visual pairing of these two figures is completely, and utterly incongruous, to the point of absurdity. The two men share a photoshopped field, a pale blue background unifying their space, and jockey for positional hierarchy. Mr. Trump in the foreground shrugs, smirks and squints, his demeanor is evidence of the emptiness of his utterance. Mr. Berger wins. You can see it in his eyes.

The designer who crafted the above banner chose his Berger image carefully. The eyes are animated, the mouth shaped around a brilliant utterance. And of course, there is the caption, freezing the exact moment from “Ways of Seeing” that these words are spoken. Those who know the series or the book, recognize that Berger’s description of “their own highly personal and exceptional visions” is not a compliment to the artists, it is the language of mystification. It is verbiage as interpretively slippery as Mr. Trump’s use of “tremendous” or “terrific” or “beautiful” or “best;” empty rhetoric that masks ideological obfuscation. Mr. Trump describes a “beautiful” wall, which in reality is an ugly barrier to keep out brown people. He brags of an electoral victory that was huge. It was not.

My colleague Shaoni Bhattacharya has already launched the conversation here at AHHE about how we might utilize our research to borrow some of the successful tactics of the ascendant authoritarians: “Charismatic leaders, as some might say Trump is, know how to tap into the primeval human mind. An emotive message switches on brain pathways that are hard to reverse with straightforward facts later…Add to that the power of groups – being persuaded that you are a member of any type of group – can cloud individual judgment, however smart you are, and it’s hard to overturn emotionally-seeded opinions.” Emotional appeals seem unserious, and playing to the passions is the domain of the demagogue. And yet linguists and others have for years been saying to personalize the message, to tell stories. So Bhattacharya might be worth paying attention to, especially in the realm of the visual.

The censorship of images usually stems from the belief that they bypass the rational mind. In the nineteenth century caricatures, a newly caustic form of criticism in France, met particularly harsh restriction from the censor’s scissors. Seen to speak directly to the eyes and emotions, and thus incite violence, caricature, as a visual medium, threatened power. In our visually saturated 21st-century, with the world coming to us through our devices and our screens, in an almost inescapable barrage, what has the power to speak to our eyes, open them to alternative viewpoints, allow us to separate the fake or falsified from the witnessed, the testimonial? Art history can help hone and refine our discernment, but also trains us to recognize, beyond the what, exactly how images mean.

A poet, novelist, screenwriter and art critic, Mr. Berger’s vision was exceptional, his writing often highly personal. In an essay called “On Visibility” Berger wrote: “Not to say that behind appearances is the truth, the Platonic way. It is very possible that visibility is the truth and that what lies outside visibility are only the ‘traces’ of what has been or will become visible.” In the image above Berger is coming into visibility, staring us down and compelling us to look, to hold the gaze, to refuse to look away. Watch this space.

#ArtHistoryEngaged – you can follow the author on Twitter @proftinkerbell.


John Berger, “On Visibility” (1977-78) in The Sense of Sight: Writings by John Berger (New York: Pantheon Books, 1985), 219.

Shaoni Bhattacharya, “The Brexit/Trump Phenomenon: Why did they happen, and what are the ramification for arts and humanities higher education?” Arts and Humanities As Higher Education (December 7, 2016.) http://www.artsandhumanities.org/uncategorized/the-brexittrump-phenomenon-why-did-they-happen-and-what-are-the-ramifications-for-arts-and-humanities-higher-education/

Noah Charney, “The art of learning: Why art history might be the most important subject you could study today” Salon (January 15, 2017) http://www.salon.com/2017/01/15/the-art-of-learning-why-art-history-might-be-the-most-important-subject-you-could-study-today/

Author Biography

Karen J. Leader is Associate Professor of Art History, and Faculty Associate in the Center for Women, Gender and Sexuality Studies at Florida Atlantic University. Her activities on behalf of art history and the humanities can be found here. You can follow her on Instagram and Twitter @proftinkerbell.

20 years of Marie Skłodowska-Curie Actions

Elizabeth Evenden-Kenyonmarie curie post 1


At the close of 2016, the European Commission celebrated 20 years of the Marie Skłodowska-Curie Actions. 2017 sees the MSCA support their 100,000th researcher, and the Actions continue to attract high numbers of applicants from across STEM and the Humanities in Europe and beyond.

I am the European Editor for Arts and Humanities in Higher Education, and I was fortunate enough to receive one of the MSCA Fellowships, under FP7 (2012-15). As an International Outgoing Fellow, I was given three years of funding to focus entirely on my research into European History. Thmarie curie post 2e ‘Outgoing’ phase of my project was based in the History Faculty at Harvard University (Cambridge, Massachusetts); Phase 2 (the ‘reintegration’ part of my fellowship) saw me return to my home institution, Brunel University in London, UK.

The assistance provided by the Fellowship was two-fold. First of all, it allowed me time – at a prestigious American university – to focus entirely on my research. It also meant that I could benefit from training programmes, in my case: language lessons and management training, via the American system. Secondly, it allowed me to refocus my work in a new direction. Previously, my work had looked primarily at English-language history. A solid amount of time spent honing my language skills, with time to familiarise myself with the Spanish and Portuguese holdings in the key collections at Harvard and elsewhere, enabled me to move my career in a new direction. I now teach and write about Anglo-Iberian relations and the press – a career swerve that would have been extremely difficult without the time and support afforded by the Fellowship.

My Fellowship Project was entitled:  Reshaping the Black Legend – Conflict, Coalition and the Press in Early Modern Europe. Acronym: CONCOPRESS. Further details are available here: http://cordis.europa.eu/result/rcn/192071_en.html.

What are the Marie Skłodowska-Curie Actions?

Since 1996, the Marie Skłodowska-Curie Actions (MSCA) have provided grants to train excellent researchers at all stages of their careers – be they doctoral candidates or highly experienced researchers – while encouraging transnational, inter-sectoral and interdisciplinary mobility. The programme is named after the double Nobel Prize winner Marie Skłodowska-Curie to honour and spread the values she stood for. The c. 100,000 researchers who have benefited from the programme include five Nobel laureates and an Oscar winner – and many projects (including my own) are in the field of Arts and Humanities (or cross-sector collaboration). So don’t be put off by the name: the MSCA are very keen to support the Arts and Humanities too!

20 years of MSCA: Celebrations in Brussels

I was very proud to be chosen to represent the Arts and Humanities at the European Commission’s celebration of 20 Years of the MSCA in Brussels, on 29 November 2016. Official speakers included Martine Reicherts (Director General of Education and Culture) and Tibor Navracsics (Commissioner of Education, Culture, Youth and Sport) but MSCA recipients filled the majority of the programme – showcasing their work funded under the Actions, via a series of TED-style talks. Research speakers were able to meet the day before the event and received training from the team who trained Barack Obama in public speaking, and – as always – the training opportunity was superb. The live-streamed event was an excellent chance to network and meet with policy officials, commissioners and other researchers, and our talks are now available to watch online: http://ec.europa.eu/research/mariecurieactions/news-events/events/year/2016/1129-20-years-msca_en.htm

MSCA applications – from the UK and beyond

I am a British passport holder, and am acutely aware of how fortunate I am to have been funded under the Marie Skłodowska-Curie Actions. As the UK awaits the triggering of Article 50, and in light of Theresa May’s decision to withdraw the UK from the Single Market, it remains unclear if UK-based researchers will benefit fully from these Actions in the future. UK-based scholars interested in these Actions should follow announcements by the UK Research Office (UKRO) for further information. The UKRO is the European office of the UK Research Councils. It delivers a subscription-based advisory service for research organisations [in the main UK HEIs] and provides National Contact Point services on behalf of the UK Government. UKRO’s mission is to maximise UK engagement in EU-funded research, innovation and higher education activities.

If you are interested in applying for funding via the Marie Skłodowska-Curie Actions, further details are available here: https://ec.europa.eu/programmes/horizon2020/en/h2020-section/marie-sklodowska-curie-actions

My MSCA talk and my research

My talk for the MSCA celebrations was entitled ‘Text and Image: what are they good for?’ and it enabled me to relate my historical research to present-day interactions with printed text and images. My specialisms lie in the field of printed propaganda, and my Fellowship allowed me to undertake several outreach activities – with schoolchildren and with the general public. One of the excellent features of the MSCA Fellowships is that they encourage you to think about the ‘public worth’ of our research, and how our work can reach out to and help others.

In my talk I explored the use of text and image historically, and their use during the lead up to the EU Referendum in the UK and the American election in 2016. I also referenced the outreach work embedded into my fellowship, where I have worked with schoolchildren and young adults, to tackle stereotyping in the media. Questions afterwards stimulated some vibrant discussion about how to help young people navigate real/fake news in the media. It gave me a chance – in a room full of policy makers – to emphasise how important it is to encourage Humanities research if we are to stem the tide of hate speech and propaganda in the world today.

In the current climate within Europe and beyond, it is essential that we continue to promote our work in the Arts and Humanities to a wide audience, and that we engage with both our peers and our communities, to remind our societies – and our politicians – just how vital our work is to our local and global communities, and to undertake research-led teaching that inspires the next generation of scholars.

In my next entry on this blog, I will detail more work undertaken by Humanities scholars under the aegis of the Marie Skłodowska-Curie Actions.

Dr Elizabeth Evenden-Kenyon is a Senior Lecturer at Brunel University in London. See her webpage for contact details: http://www.brunel.ac.uk/people/elizabeth-evenden (You can also follow her on Twitter: @codexhistoria)

If you are a current recipient of an MSCA fellowship and have not yet joined their vibrant alumni association, see here for details: https://www.mariecuriealumni.eu/

A “merged sensibility”: Poetry from an early medical humanist, John Mcfarland

john macfarlandJonathan Mcfarland (Poems by John Mcfarland)

“In him, we cannot easily discern separate medical and humanistic sensibilities” (Joanne Trautmann describing William Carlos Williams)

John McFarland was born into a medical family in Liverpool in 1930. His father was an orthopaedic surgeon and mother a paediatrician. He later studied medicine in his home town and proceeded to have a very successful career as a general surgeon.

Even though the facts paint a straightforward story I truly believe that he was always torn between the arts and science, and here are some of the reasons that we might consider him a medical humanist:

  • He always said that he studied medicine because he loved people, thinking that it was the best way to discover more about them.
  • He was deeply passionate about all the Arts, but his main loves were Paintings and Poetry, his greatest friends were normally artists or poets, and from an early age to his death he painted and wrote poetry.
  • In fact, he had considered architecture before medicine and, as a medical student, he also went to Art School classes.
  • He was one of the first to introduce painting into hospitals, and in the late 1970s he commissioned leading British artists to paint murals at his own teaching hospital.
  • After an early retirement he spent three winters teaching and operating at a tiny fisherman’s hospital in Cochin, Kerala in India, another of his lifelong loves.


The surgeon said “It’s an ulcer.

But you’re fortunate, we can cut it away”.

They laid me on my back.

The knife was clean, I suppose, unforgiving.

and afterwards there was great pain

and someone else’s blood dripping into me.

I thought of you and my heart turned.

I wished to see you sitting in the sun,

to run my hand lightly down your back

and think those things that one thinks

in the warm afternoon.

There were those days walking together,

you will remember them,

when it was you and the sky

in those warm us-days

and we crossed the clear, pebbled streams,

always your hand in mine.

The microscope confirmed the diagnosis.

But there’s no need to worry,

they have cut it all away.

“Crab” was written in the 1980’s when he was practising medicine, and it is a personal reflection on breast cancer, which was one of his specialties.


Sing of Africa the fierce, Light and shade, trees and jungle.

Care for those who care for these things,

The dark people who to the river come and go

Where murky waters slide through mud and crocodiles.

At this place occurs, one day, a disastrous battle;

A crocodile drags a screaming girl towards the strand

Where villagers attempt to save her, just alive.

Her bones now pierce her skin, also periosteum

Which send to her brain messages of fear and pain.

Her mangled leg will not destroy her but foreshadows death.

For three weeks, infection stemmed, she does not die,

She waits.

The plane, with steady throb, dips through the silent clouds.

The pilot, old time adventurer, right hand severed in the past,

Jams his stump into the controls, a three-point landing.

The girl, leg splinted Tobruk style, is lifted to the tiny plane.

The pilot turns his craft and takes off towards the hills.

He reaches back to check a flapping door and finds, writhing in agony, The girl who must be tended. I inject her arm,

Prepare to sit out the night with the bundle of my keeping.

Suddenly her breathing stops, she’s pulseless, damp and cold,

I who put the morphia in cannot take it out.

Nor does the dawn which splits the night give any comfort.

The pilot from his cockpit, flickering green, says,

“We’ll sight Nyeri Station soon, not far ahead”.

Above, the omnipresent vultures gyre, raiders for Zoroaster,

They cast no patterns in the air, nor plane a shadow on the sand.

We home in on the runway, draw up beside the kerosene flares,

Many pilots receive some small applause for this, but reaching back

We find a twisted ghost just breathing, a heart just pumping.

When death is fragile prepare for life.

She is alive. It is enough.

The hospital built, no doubt, so man himself could salve

The ills of life, is near.

There the surgeon, supple fingers, agile knife,

Stabs the pus to find more pus, all anatomy corrupted.

Gently the blade moves in, the leg is eased away.

Thus, without a poisoned limb to drag down the bloody show,

The healing process may begin.

“A matter of opportunity” was specifically written for a poetry prize, about a year before he died in 2013. Here, he looks back in hindsight to an event that happened when he was serving in the army as a doctor in Kenya during the Mau Mau uprising in the early nineteen fifties. This war made a big impact on his life, and interestingly enough, he was employed as an anaesthetist.


The Brexit/Trump phenomenon: why did they happen, and what are the ramifications for arts and humanities higher education?

Trump BrexitShaoni Bhattacharya AHHELogo-e1420559902593

This year has seen the anti-expert backlash in full swing. First there was the UK referendum’s vote for leaving the European Union, a Brexit, against much expert advice, and then there was the unexpected election of Donald Trump as the next US President. In both instances, professional polls were proved wrong.

For many in the academic community – be it science, humanities or arts – these seismic political ructions, backed by a large proportion of the public, seem hard to understand in the context of expert advice that warned against them.

The UK is currently in the throes of Brexit anxiety – Brexit may mean Brexit according to our politicians – but what exactly does that mean? And how will the will of the people be carried out?

As well as political consequences, Brexit has had deep social and economic ramifications. And the world is waiting to see what turmoil a Trump Presidency will likewise bring. With both events, stock markets tumbled the world over and planning for the future, whether at national or individual level has become harder overnight.

For the academic community – international and outward-looking, the implications may be worrying especially when it comes to the movement of talent across the globe. The science journal Nature’s news site noted that researchers are more than concerned about their academic positions and funding, with some foreign academics in the US considering returning to their home countries. If this is the case in higher education in STEM subjects, one can only speculate the situation that arts and humanities researchers find themselves in. And as racist incidents have increased after both events, some academics have found themselves at the receiving end of abuse in the UK.

In the wake of the referendum, the UK’s Russell Group of universities put out a statement to condemn xenophobic incidents and reassure the academic community:

“Now more than ever we should ensure our campuses are places where diversity is welcomed, cherished and respected,” said Professor Sir David Greenaway, at the University of Nottingham, and Chair of the Russell Group, and Dr Wendy Piatt, Director General and Chief Executive of the university group.

So why did the public in both countries vote the way they did? Is it down to the disenfranchised protesting at neglect from successive governments? It’s hard to understand in the UK, when Brexit will leave the average household £4,300 worse off a year by 2030 and every year thereafter. It’s difficult to see how Brexit will make already impoverished groups any better off – with fewer jobs in a falling economy, Brexit is likely to hurt the poorest most.

And how does Trump, the billionaire in the gilded Trump Tower, strike a chord with the ordinary, working man that he professes to represent? Harness people’s emotions, stir up their deepest fears. That’s how. Our brain neurology responds best to emotive pleas, not cold, hard facts. This is where the experts are getting it wrong. To reach people, to disseminate research and expert advice based on it, academics need to engage their passion.

That is at least, the message I learnt from a recently published book, Denying to the Grave: Why we ignore the facts that will save us by daughter and father duo, Sara and Jack Gorman. The focus of this book was not politics, but health. Why don’t we look after ourselves the way we should, or carry on with negative health behaviours in the face of good scientific evidence? Given Brexit could be the UK’s ultimate act of self-harm: might there be answers here too?

The book’s answers were complex but simple too – and much of it comes down to our basic evolutionary hardwiring. Charismatic leaders, as some might say Trump is, know how to tap into the primeval human mind. An emotive message switches on brain pathways that are hard to reverse with straightforward facts later. And us humans have a strong “confirmation bias”; that is, we don’t like changing our minds once made up. Add to that the power of groups – being persuaded that you are a member of any type of group – can cloud individual judgment, however smart you are, and it’s hard to overturn emotionally-seeded opinions.

So what next? 2017 is an unknown and unpredictable prospect. Experts, academics and higher education in general may need to fight their corner harder not to lose the gains made in terms of freedom of movement and valuing diversity. They might do well to employ some of the tactics (in a positive way) used by negative campaigns – that is, to use the fruits of higher education research and reach out to the public’s psyche, not just its reason.

Are you feeling concerned by the outcomes of the recent election in the US, and Brexit in the UK?

CfP ‘Reading Bodies, Writing Minds’ Uni of Nottingham, 13 April 2017

reading-bodies-writing-minds-2017-poster‘Reading Bodies, Writing Minds’ is a one-day conference exploring mental health issues in the medical humanities, and will be held 13 April 2017at Highfield House, The University of Nottingham’s University Park Campus. The conference is intended to stimulate interdisciplinary discussion on modern and historical aspects of medical humanities. The keynote speakers include Dr Mary Ann Lund (University of Leicester), specialising in Elizabethan-era melancholy, and Dr Chantelle Saville (University of Auckland), speaking on medieval theory of emotion.

This interdisciplinary event is intended to foster communication between different study areas and subjects and to that end we invite abstracts addressing historical and modern entanglements of medicine and the humanities. Submissions might include, but are not restricted to, the following topics:

  • Historical perspectives on mood and emotion
  • Metaphors and artistic forms commonly or historically associated with mental health
  • Modern treatments or analogues of historical artistic approaches to mental health
  • How medical texts and texts about mental health and illness represent and construct their ideal reader

Colleagues who wish to be considered to present a paper please submit by 1 February 2017 an abstract of no more than 250 words which outlines the paper and the area of research. Submissions should be sent by email to the conference organisers here. All accepted papers will be considered for peer-review and potential publication in an edited volume of conference proceedings.

For general enquiries or further information about the conference, please contact Martin Brook


la_laguna-tenerife_3Stories Matter; Story Matters

in health and illness

At the centre of the teaching of Narrative Medicine in medical schools (originally in the US but increasingly across the world) is the need for health professionals to understand relationships of caring as well as curing; to develop skills of attentive listening as well as diagnosing.

At the centre of the International Conference on Narrative of Health and Illness (http://www.healthnarratives.org/; see http://www.artsandhumanities.org/conferences/international-conference-on-narrative-of-health-and-illnessprogramme/ & http://www.artsandhumanities.org/conferences/international-conference-on-narrative-of-health-and-illnessprogramme-day-2/) international gathering in La Laguna, Tenerife, was a network of stories of health and illness: –DIPEx http://www.dipexinternational.org/ which ‘conducts rigorous and systematic, qualitative research into people’s experiences of health and illness’ and Healthtalk.org, gathering People’s experiences of health

So the meeting was a joyous gathering of medical professionals committed to disseminating their *qualitative* research – into stories of health and sickness.

Framing understandingsKleinman

The sfrankseminal books framing the project including Arthur Kleinman’s The Illness Narratives: Suffering, Healing, and The Human Condition which first pointed out that such stories – of those who, as Susan Sontag memorably said, hold citizenship in the kingdom of the ill’, for ‘illness is the night-side of life’ – beat the bounds of the human condition.

And Arthur Frank’s analysis of ‘sickness stories’ within the framework of narrative theory in The Wounded Storyteller:Body, Illness and Ethics, at this conference added to with a challenging and inspiring call to look to ‘companion stories’: from folk stories to classic literature, that act as companion support structures for individuals left alone by and in their illness (see http://www.artsandhumanities.org/uncategorized/conf-on-narrative-of-health-illnessarthur-franks-on-demoralisation-remoralisation/).

This was a call and challenge – as always from Arthur Frank – to go beyond ‘Medicine and Literature’ as medicine in literature/literature about medicine/medical training use of illness narratives and indeed Propp type research into the ‘deep  structures’ of folk tales, to ask what literature is good for, for those in the exigencies of the human condition.

Why do ‘illness stories’ matter?

‘Narrative representations of health and illness offer a strong counter-balance to the dominant biomedical focus’ said the conference organisers (http://www.healthnarratives.org/) and this vital objective was everywhere demonstrated. Narrative Medicine courses are primarily aimed at the training of healthcare professionals, including in all branches of medicine. So many of the panels were literally exemplary: showing how [not] to talk to patients: ‘I had bad headaches and I was getting tired of telling this doctor’ (Maria Stubbe) and Learning to listen: Use of an illness narrative interview protocol to promote patient-centered care (Alicia Navarro de Souza).And a whole panel was dedicated to ‘What can research into patient experiences teach us about good communication in health care?’ ; the prize winning video “I like to know and make my own choices”. Personal Experiences of Severe Asthma: A Review (Eassey, Daniela; Pickles, Kristen; Reddel, Helen; Foster, Juliet; Smith., Lorraine) allowed the patients’ voices to come through vividly and informatively.

But more: many of the papers were concerned with changing treatments of and attitudes to certain conditions:mental health, chronic pain, dementia, inflammatory bowel disease; others with challenging public and public health care perceptions of, eg, complementary and alternative medicine, cannabis and, importantly, with combating stigma – Towards Reducing Stigma: New Media Mental Health Narratives (Michael Birch), A tale of two “burdens” – everyday morality and stigma resistance in narratives of type 2 diabetes and mild cognitive impairment (Tim Gomersall) and dismissive and stigmatising labels – eg Mónica Portillo et al’s video La empatía en la narrativa como herramienta de cambio en pacientes con Síndrome de Fibromialgia and On personal narratives, addiction and resistance (Anna Lydia Svalastog).

Challenging the frames

              ‘Disease interrupts a life, and illness then means living with perpetual interruption. …                            Telling an interrupted life requires a new kind of narrative’  (Arthur Frank, The Wounded Storyteller)

An interrupted life comes to what the Greeks called – both in the theatre and in medical textbooks – the krisis, the turning point. The conference showed that today as in Ancient Greece, stories of those interruptions, those crises, demarcate and beat the bounds of the human experience.

That is to say that in the accounts of the deficits of care in a critical and life-changing situation, much is also revealed about that life, about the life-story that has been interrupted. I was reminded of this forcefully in Lisa Hinton and colleagues’ “It’s not your baby, you know the baby belongs to the hospital”; parent narratives of neonatal surgery and recovery. For, illuminating as this is for all involved in neonatal care, it as also challenges as it illuminates what the presenters call the ‘lenses’ that could be focussed on the data: gender and identity theory, transitioning to parenthood, masculinity and more. For what the new parents were denied – autonomy, choice, a chance to bond, an imagined future [of parents of a vital baby] – showed nuanced facets of the transitions involved in motherhood beyond the hormonal and biomedical accounts of being ‘postpartum’, and fatherhood, beyond masculine definitions and self image.

Likewise, so many other papers had still-to-be-explored implications beyond medical practice, such as the similar facets of self and body image of Karen Groven and colleagues’ “I will claim that I am a very good success story”: gender and men’s narration of long- term experiences of WLS [weight loss surgery]; Spector-Mersel’s video Preserving a masculine self in face of illness and disability: The case of older Sabra men; Ahlsen chronic pain narratives, Palant et al inflammatory bowel disease, Lamerichs  et al  dementia care education and so very many more: all had implications outside medical sociology and clinical and other training.

For, as Brian Hurwitz said in his opening plenary,(see http://www.artsandhumanities.org/conferences/conf-on-narrative-of-health-illness-1st-thoughts/ -HURWITZ, COCHRANE & DOCTORS’ SHAME) ‘taking the history’ of a patient, constructing the case story, fell into disuse as an important clinical skill in favour of diagnostics, algorithms and collecting [and treating the patients as] data. But if conditions can be diagnosed and quantified, patients cannot: they are singular and charon stories matter2their condition affected by particulars. As Rita Charon showed in her introduction to Stories Matter: The Role of Narrative in Medical Ethics (Reflective Bioethics), the narratives, plural, of care and cure form a multifaceted case when crises or choices have to be made.

jurecicAnn Jurecic in Illness as Narrative has pointed to the expansion and challenge to literary theory and narrative hermeneutics that Narrative Medicine has demanded of English studies, pointing to the complexities of ‘real life’ narrative presentation, of the implications of the evident (sic) cultural formation of narrative possibilities for humanistic understandings of such as ‘self’, of integrity, autonomy, will, ipseity and the interactions of mind and body.

Attending to the narratives of those whose lives have been ‘interrupted’ clearly demands a different narratological hermeneutic from studying the meaning-making in quasi fictional and/or autoethnographic ‘illness memoirs’ and from avowedly fictional accounts of such: they have personal, clinical as well as humanistic implications. For narratives of health and illness presented in this conference show the fracturing of a ‘sense of autonomous, narrative self’ in a way that complements or even, I would suggest, supersedes some of the literature used in Medical Humanities courses.(Literature discussed by Isabel Fernandes in The Challenges of the ‘new medicine’ and the place of narrative: see http://www.artsandhumanities.org/conferences/international-conference-on-narrative-of-health-and-illnessprogramme-day-2/)

So this is a call for all those presenting and involved in Patient Experience narrative gathering, to go beyond addressing the medical profession in their dissemination of material, results and implications. For this conference showed the need for Humanities, and humanity, as a whole to take up the multifaceted analysis and implications of illness stories.

Some of the papers were ‘Broken Narratives’ (as the papers presented at the ‘Broken Narratives and the Lived Body’ conference http://artsonline.monash.edu.au/broken-narratives/, some to be published shortly in a Special Issue of Arts and Humanities in Higher Education: an international journal of theory, research and practice Sage (http://ahh.sagepub.com)) – narratives constructed by the researcher of pain, of trauma, of disenvoicing conditions.

These also have implications for both medical and humanities research: trauma is popularly understood as disenvoicing; the now discredited condition ‘hysteria’ as being emotional distress written on the body. Nuanced accounts of the specifics of such disenvoicings can have implications for trauma and identity as well as dementia studies.

‘Brokered’ Narratives

Some of the papers presented what I want to describe as ‘brokered’ (rather than broken) narratives: of cases where care and/or cure broke down.Here the record of the patient experience can do more than call attention to the specifics of the breakdown, but rather provide an ethnography covering such factors as the power relations between the parties, the prejudices and prejudgments in play and the role of disenvoicing factors not sufficiently understood – fear, shame, the loss of autonomy and so much more, in being a patient.

After listening to and learning from so many stories, one session invited us, implicated us, in intervening.Theatrelab sdu

Preben Friis and colleagues’ University of Southern Denmarks Theatre Lab, as Boal’s Forum Theatre as explained in Rogelio Altisent and colleagues’ ‘Teatro-Foro: una metodología innovadora para aprender ética‘, set up a scenario: a man with chronic back pain, seen interacting with his doctor and then, decisively, with his daughter who decides he shouldn’t/can’t look after his beloved grandchildren any more. What is this situation about?What intervention is needed? Some said, the back pain, some the disabling effect of the back pain, some the drugs prescribed – and so advised his being referred to a pain clinic.

Others pointed to the irremediable psychosocial effects of the chronic condition, of accepting or refusing to accept (and so being marked down as a ‘resistant’ or ‘non compliant’ patient) more referrals. Still others saw ‘the problem’ as intergenerational and interpersonal – of the daughter/father roles being reversed and/or as a power struggle over the grandchildren.

Many heated interventions, many impressive scenarios later (played out with audience members) we were left [not just] understanding some of the ramifications of a ‘typical lower back pain chronic patient’ but also the different readings and interventions to be chosen from, the different stories in which we had intervened, the different stories we had stopped being told, as each course precluded others and had, sometimes unappreciated, consequences in terms of interpersonal and family relationship and/or sense of autonomy and selfhood in the teeth of aging.

Do the medical professionals sometimes demand that we go compliantly into serious illness and ‘gentle into that dark night’?

‘Do not go gentle into that good night’ by Dylan Thomas

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.




logo_definitivo_inglesSaturday 12.11.2016

09:00 – 10:00 PLENARY LECTURE The role of narrative in Person Centred Care     Nicky Britten

The term Person Centred Care has many definitions and few practitioners. At the University of Gothenburg Centre for Person Centred Care (GPCC) in Sweden, there is a shared definition which informs research and practice. This involves three ‘routines’: eliciting the person’s narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person’s narrative and shared goals.  I will explore the work of implementing the GPCC model with particular attention to the challenges of integrating people’s narratives with everyday clinical care.

10:00 – 11:30 Parallel Session J     Exploring chronic pain narratives by using participatory theatre methods (Theatre performance) Larsen, Henry; Heape, Chris; Preben, Friis

10:00 – 11:30 Parallel Session K Narrativas en la educación de ciencias de la salud

1. Narrativas y práctica reflexiva en enfermeríaChoperena Armendáriz, Ana

2. Medicina Narrativa: una mirada diferente para la formación integral de médicos en la Pontificia Universidad Javeriana, Cali. Florez Villafañe, Gloria Ines

3. La vida de un ahogado: explorando la empatía por los pacientes desde una clase de fisiología de la respiración. Gómez, Leonardo; Martínez Sánchez, Miguel Eduardo; Parra Chico, Wilson Andrés

4. Caminhos da Criação para promoção da SaúdeOrofino, Maria Marta; Kurtz, Diego Monroe; Pekaman, Renata

5. Papel político del Médico en el conflicto colombiano. Percepciones desde un curso de Medicina NarrativaParra Chico, Wilson Andrés

6. Narrativa crítica: aprendiendo a cuidarOlivé Ferrer, M Carmen

11:30 – 12:30 PLENARY LECTURE by Isabel Fernandes

The Challenges of the ‘new medicine’ and the place of narrative

My talk intends to be a tribute to João Lobo Antunes [1944-2016], distinguished Portuguese physician, humanist and professor, who allied the practice of neurosurgery with a vast erudition and a profound passion for literature throughout his life. Lobo Antunes argued for the relevance of literature in medical education and training and his writings make manifest his profoundly humane approach to the medical profession. I will take as a starting point topics from his two last published volumes of essays; A nova medicina [The New Medicine] (2012) and Ouvir com outros olhos Listen with other eyes] (2015) where he addresses the challenges doctors have to face in view of the new scientific, technological and socio-political developments in the  health care area in general which he terms “the new medical-industrial complex” (following Arnold S. Relman).

This brief overview will pave the way for addressing the role/s literature can play in this new scenario: in medical education and in in-service training, the importance of bringing first- person illness narratives to the attention of professionals and how the scrutiny of the use of metaphors in such narratives can contribute to make both medical students and other healthcare professionals aware of unexpected or neglected aspects of illness as experienced by patients.  I will resort to two more or less known cancer illness narratives: Christopher Hitchens’s Mortality 2012) and David Servan-Schreiber’s Not the Last Good-bye (2011).

14:00 – 15:00 PLENARY LECTURE by Rachel Grob 

The Singular Importance of Plural Voices

The idea that patients deserve a voice in health care has gained considerable traction in the U.S. and around the world.  A combination of factors have created an unprecedented opening in the public domain for the patient’s perspective — among them grassroots movements advocating “nothing about me without me,” shifting politics around inclusion, and evidence suggesting patient-informed care is most effective.  That space, however, is usually just large enough to allow room for “voice” in the singular.  It remains far too small for the chorus of voices we as patients represent in the plural.

In this talk I will trace the evolution of patient voice in the United States, highlighting progress to date and focusing on the imperative to move from voice to voices.  What conceptual commitments are implied by such a transformation? What methodologies do we need to make it happen?  Why is creating a chorus of patients’ voices complicated, and why is it difficult for that chorus to be heard with all the nuance it deserves? How can health care and health policy be improved by the move from singular voice to plural voices? What does all this have to do with DIPEx, with democracy, and with daring to move beyond simplistic conceptions of “patient engagement?”  Exploring these questions, and the ones you add in the course of our discussion, will be at the heart of this keynote session.

15:00 – 16:00 Parallel Session L Arte y Literatura

1. Quantas intençoes: educaçao da saúde e conexóes com a culturaValdez Poletto, Ana Lucia; dos Santos Valdez, Maria Elisabete

2. Médicos Escritores ou Escritores Médicos? – interseções entre medicina e literaturaGeovanini, Fátima; Andrade, Luciana; Mallet, Ana Luisa; Kestenberg, David; Monteiro, Renata; Barros, Aurora

3. Ante el poder de la palabra médica. Cordero Villamizar, Luz Elena

4. José Saramago e as interiténcias da morte. Carelli, Fabiana

15:00 – 16:00 Parallel Session M “La narrativa como elemento clave en el proceso de salud-enfermedad-atención: experiencias etnográficas aplicadas a los cuidados enfermeros”

1. “Percepciones de las mujeres y parejas durante el embarazo, parto y posparto tras someterse a técnicas de reproducción asistida”Crespo Mirasol, Esther

2. El apoyo informal en la enfermedad desde la perspectiva del paciente crónico”. Fernández Peña, Rosario

3. “De las narrativas de la locura: ¡Yo no estoy loco! ¿Por qué estoy aquí?”Márquez Romero, María Isabel

4. “Narrativas de las percepciones y vivencias de estar ingresado en una Unidad de Cuidados Intensivos a raíz del episodio mediático de Gripe A”. Prat Caballol, Rita

15:00 – 16:00 Parallel Session N Health narratives and Subjectivity / Patient relationship

1.  ‘A smile costs nothing but means absolutely everything’: a qualitative study of young people’s view and experiences of what makes a good consultation with the GPPrinjha, Suman

2. My driving was everything to me” Narratives of driving as a marker of identity. Locock, Louise; Stepney, Melissa; Kirkpatrick, Susan; Prinjha, Suman; Dumelow, Carol; Ryan, Sara;

3. Destruction and reconstruction of retirement narratives: poor health, mobility and revisions of a future life. Tudball, Jacqueline; Team, Victoria; Ryan, Kath; Smith, Lorraine

4. The DNA of the doctor/patient relationship. Plapler, Hélio; Carelli, Fabiana Buitor

16:00 – 17:00 Parallel Session O Psicoterapia y Enfermedad crónica

1. La participación informada en la detección precoz del cáncer colorectal. Chávarri, Ana Toledo; Perestelo Pérez, Lilisbeth; Abt Sacks, Analía; Pérez Ramos, Jeanette; Burón Pust, Andrea; González Hernández, Nerea; Serrano Aguilar, Pedro

2. Historias potenciales e historias contadas: La teoría narrativa de Paul Ricoeur para la práctica de la Psicología Clínica y la Psicoterapia. Trujillo Trujillo, Servando David

3. La deconstrucción y reconstrucción narrativa de las historias clínicas según la indicación formal de Martin Heidegger. Trujillo Trujillo, Servando David

4. La autobiografía en el abordaje de las psicosisMartínez Jambrina, Juan José

16:00 – 17:00 Parallel Session P Narrativas de salud y subjetividad (B)

1. Repertorios de objetos evocadores de recuerdos en padres que perdieron hijosGarcía-Hernández, Alfonso Miguel

2. Narrativas en torno a la ausencia del hijo fallecido versus tiempoGarcía-Hernández, Alfonso Miguel

3. La narrativa en la vivencia de la fibromialgia: estrategia de empoderamiento y contribución científica. Olivé Ferrer, M Carmen; Costa Abos, Silvia; Isla Pera, M Pilar

4. ¿Qué aportan la narrativas de las personas con distrofias hereditarias de retina para mejorar la práctica clínica?. Chávarri, Ana Toledo; Trujillo Martín, Mar; Sedeño, Tasmania del Pino; Perestelo Pérez, Lilisbeth; Abt Sacks, Analía; Serrano Aguilar, Pedro

16:00 – 17:00 Parallel Session Q : Chronic Illnesses

1. Mental Illness at work, authenticity in question: Experiencing, concealing and revealing depression at work. Ridge, Damien; Broom, Alex; Kokanovic, Renata; Hill, Nicholas; Ziebland, Sue

2. The Good Citizen with cancer: managing an ambivalence in Sweden, Denmark and the UKZiebland, Sue

3. Patient Narratives and the Unvoiced Other: The Centrality of Pets in the Lives of People with Chronic IllnessSchlesinger , Mark; Grob, Rachel

4. ‘Sigh of relief’: Narratives about the use of medical Cannabis.  Lavie-Ajayi, Maya

Translating Theatre: ‘Foreignisation’ on Stage’

Reflections from the AHRC Translating Cultures Project and 21st Nov Symposium (http://www.translatingtheatre.com/)

by Jan Parker


                          The playwright creates a game for actors. The translator creates the game of translation. The translator enters the labyrinth of translation and seeks the words that will draw the actors back to the centre of interpretation. The translator invents the game of the translator’s own choosing…(Kate Eaton, from ‘The Darkness of the Stage – A Provocation’, 21st Nov symposium)

Translation, Adaptation, Otherness:‘Foreignisation’ in Theatre Practice Project

‘Translation scholar Lawrence Venuti champions the translation strategy he calls ‘foreignisation’, as as opposed to ‘domestication’, in that the former tries to limit the degree to which the unfamiliar is forcibly turned into the familiar, silencing cultural difference. Despite the recent academic interest in ‘foreignisation’, theatre studies still lack a debate on what a ‘foreignising’ approach to stage translation would mean for text and performance, and whether theatre – as opposed to literature – requires a distinctive approach’ (http://translatingcultures.org.uk/awards/related-awards/translation-adaptation-otherness-foreignisation-in-theatre-practice/)

What an excellent question! Venuti’s dichotomisation between translation strategies – domestication, whereby you bring the text to the reader against foreignization, whereby the text demands the reader move to the world of the source – has long both held sway and been objected to by literary translators. The standard examples are the theoretical implications of, eg Walter Benjamin’s Brot vs pain: objects that have similar substance but different semantic ‘intentions’; the foreignization v domestication strategy evident in the test case of, say, ‘Sunday Lunch’. Do you conceal or emphasise cultural difference: by either transferring the setting to a festive family meal or keeping the term’s strangeness, leaving the reader to work through the gendered and generational resonances and implications of roast beef, the post Sunday worship, somewhat compulsory, traditional, family gathering…

The question of translating such a scenario depends on whether it matters: if the dynamics of the scene rests on those ‘foreign’nesses or if it is, literally, incidental.

There is no such freedom in theatre: nothing in the scenography is ‘incidental’. So, what are the implications for directors, actors and audiences of privileging or suppressing foreignnesses?

The symposium considered in interesting and passionate discussion what this meant for the theatre in post Brexit Britain: what the [limited] possibilities and [evident] dangers of staging international theatre in domesticizing translation (appropriating to the dominant monolingual culture by translating into English, with the concomitant dangers of excluding & marginalising actors and audiences from the source culture; contributing to the univocality of ‘Englishness’).

And the implications for the international project of ‘foreignising’ – of including into ‘English’ multilinguality, the sheer imaginative possibilities of thinking otherwise, were stressed as well as lamented.

The many case studies, provocations and reflections introduced rich questions about ‘translation’ as an interlingual and sometimes as an intercultural process: foreignising the ‘Other’ raises the various spectres of exoticising, demonising, romanticising or marginalising that ‘other’; domestication that of cultural appropriation. Meanwhile the wider implications for ‘authorship’ were touched on, as were issues of vocality. But, what exactly is the relationship between diversity of texts and the inclusion of diverse actors and accents into texts produced in English? The conflation of the two in discussion is significant, as it raises the question of, what exactly is being translated in theatre?

I remember a student telling me he wanted to do his dissertation on ‘language poetry’. It was the first time I’d heard the term and I laughed, but in the symposium I wanted to set up a category of ‘linguistic-’ or ‘translation-theatre’ – theatre where what is at issue, what is en procès, is the formation of identity and transmission of culture in [inter] lingual translation.

It was said of one of the projects workshopped plays, Marie Ndiaye’s The Snakes (Les Serpents), that the play’s questions: ‘Who are these women? What force – what deity – draws them to this house? What or who is the snake?’ troubled actors and translator, the language ‘prickled in the mouth’ and demanded of all involved in the production, and the audience, that they work hard to create meaning:

The opening dialogue feels like two threads, pulled in different directions, meeting only incrementally. Later France’s language begins to shed its own skin in defense. ‘Where I am from, one laughs at such disparities, even if one has no chance of being elsewhere than on the side of ridicule, of the inferior side of the comparison and of all possible comparisons.’

In the almost baroque, fractured dialogues…all we have are three female bodies speaking of histories without continuity.(Diana Damian Martin review article http://exeuntmagazine.com/features/foreignisation-stage-les-serpents/)

It may be that the difficulty of creating and communicating meaning is the point, is ‘at issue’ in the play; if so, that seems to render it a ‘translation theatre’ play?

But, ‘The Snakes’ was billed as exploring and destabilising ‘rules of a pluriverse’: all kinds of identity, ontological and cultural constructs, including ‘a mythological exploration of colonialism’. The first responsibility of the dramaturg is to set up the rules of the game: where, when and how the drama is to be played out. Scenography instantiates those rules of that game; it seems to me that it cannot simultaneously problematize, undercut, parody, render ontologically ambivalent or even, perhaps, explore such multiple constructs of both rules and game: to do any such risks rendering the drama incomprehensible – not meaningful but finally meaningless.

The project’s questions are large; they are perhaps not answerable, or even, honestly, not askable, in the theatre performance. I wonder if what is being investigated is metatranslation theatre which questions the processes of ‘translation theatre’: theatre that questions translation of ‘thought worlds’, cultural-specific aesthetics, dramatic conventions, classic tradition, construction of character and identity…..everything to do with how a culture constructs itself in language and views itself in relation to a.n. and the ‘other’. Like metatheatre, perhaps what is being claimed for the theatre event is not an experience but a new consciousness? But don’t ‘effect/affect/identification’ in the theatre work more complexly than delivering an awareness?

The project is most tightly illuminating, rather, when the translation process, subject and dramaturgy were simultaneously, mutually questioning: when text, director, translator, actors all workshop the process of being lost or disenvoiced in translation; when what is ‘at issue’ in the play is linguistic and cultural heritage and identity:

‘Gliwice Hamlet [the second workshopped play] is a palimpsestic, poetic play in which two actors in a rehearsal setting enact episodes from Piotr Lachmann’s childhood in German Gleiwitz, which in 1945 became Polish Gliwice  The story is emblematic of German-Polish relations around WWII, when national borders and identities changed rapidly in the turmoil of political transformations. Interwoven in the evocation of multiple locations and historical moments, and in references to Greek theatre and to Shakespeare’s tragedy, is a self-reflexive commentary on the nature of theatre as a medium and the role of media in contemporary society.’ (Gliwice Hamlet by Piotr Lachmann http://www.translatingtheatre.com/gliwice-hamlet.html)

What we need is the implications of this nexus of translations and [dis]envoicings to be fully explored during the theatrical process and after as well as in the performance.

What is needed is research which engages with all the interrelations of the theatre studio as a multifaceted translation ‘exploratorium’, to ‘workshop’ the research questions. To go back to Kate Eaton, the researchers need to enter the labyrinth of [the many processes of] theatre translation and seek the images and thick descriptions that will draw practitioners and theorists alike

‘back to the centre of interpretation’.

This is a very important project and terribly timely. As Diana Damian Martin said in her review article:

[recent theatre criticism] signals to me a very noisy, fragmented ecology of talking about foreign theatre in UK… and make visible cultural difference through strategic, but misguided cultural policy that makes a spectacle of otherness, a pure exercise in visibility. This is a very problematic way of talking about several issues: the issue of translation of dramatic texts; the issue of adaptation and direction of foreign dramatic texts; the issue of domestication; the issue of visibility of those processes, and their centrality in different institutional and artistic agendas. And to top that off, the assumption that there is only one way of theatre doing politics, or doing cultural difference: the British way.

What we need is for the project is to carefully, caringly discriminate and map, not to answer, the multifaceted and vitally important questions it has set itself.

CONF. ON NARRATIVE OF HEALTH & ILLNESS:Arthur Franks on Demoralisation &Remoralisation

logo_definitivo_inglesBeing ill is demoralising, Franks argues, to both patient and to the system and institutions of ‘care’: a demoralisation involving moral and morale denudation: a sense of futility, disconnection, a sense that noone has a stake in one’s life and you have no stake in others’ lives.

The shared task is of remoralisation: one that involves the development of an ‘ecology of shared lives’, a renewed care for and restoration of the loss of, the patient’s personal dignity.

(A telling phrase comes from Tom Wolfe, who mentions the transit vans bringing in accused prisoners – to be digested by court system – being referred to as ‘bringing in the chow’. Although patients are not similarly named, the medical emphasis on metrics and performance process gives ‘throughput’ similar connotations: a language of metrics, a way of seeing individuals as ‘conditions’ with which Franks engages and battles in his 2004 book The Renewal of Generosity:illness, medicine and how to live.See also Arthur Kleinman The Illness Narratives: Suffering, Healing, and the Human Condition. )

This task is of remoralisation of the system is not, Arthur Frank said deprecatingly, good work for old men but they can cooperate in the shared task of helping those in the institutions re-moralise themselves and help those patients, administrators, clinicians who are held hostage to a system that will not change completely in their lifetime.

What is a task for even ‘old men’ is to tackle the question of narrative medicine texts not only for medical training and academics but to ask ‘What’s in it for the patient? In a sickness story for the sick?’

What that is to say, can be a ‘companion story’ for the sick, a companion story rather than a sickness memoir (brutally often called ‘misery memoirs’)?

There is a prevalent metaphor of shipwreck in Narrative Medicine: illness as resulting in narrative wreckage, the loss of access to an individual life story and thus a storied life.

There is no companion available in the Literature and Medicine corpora, no companions that make the sick feel less alone. What would be the stories that can help them re-moralise a condition that demoralises, that offer dignity in a state of indignity?

Two implications raised in questions:

Stories are in fact shared – any contact with folk lore and with dramatists’ use of same makes clear that identity is constructed from stories: nobody has his/her own story. But medicine and identity as well as narrative medicine theory is deeply imbued with the self as identified with a sense of having one’s own unique story.

Patients are demoralised by the sense that there is noone around – in some illnesses – who is willing to share their story: often patients find themselves in the care of people who don’t share their cultural and traditional stories and so can’t be involved in a co-construction.
NB Arthur Franks continues to be involved in an aspect of narrative therapy – of finding stories which are *dangerous* to one. For, stories lock down selves into narratives, they set boundaries, are culturally divisive, those create disconnections…

CONF. ON NARRATIVE OF HEALTH & ILLNESS:Hurwitz,Cochrane & Doctors’ Shame


09:30 – 10:30 PLENARY LECTURE

 What Archie Cochrane’s Case Narrative of 1943 Teaches

 Brian Hurwitz

Known as the founder of evidence-based-medicine, Prof Archie Cochrane’s fascinating memoir, published after his death, is about his ‘misdiagnosis’ of a dying POW screaming. A newly qualified clinician in chest medicine, he diagnosed the young Russian as in pain from pleural rub; having no morphine he did the only thing, held him in his arms – whereupon the screams stopped – until he died, peacefully.

Of especial interest was his report of his ‘shame’: at his misdiagnosis (the screams were presumably fear: of death, of dying alone) and/or of his breaking the clinician-patient boundary, becoming instead ‘co-present’, as human to human.

Is there still a sense of shame in modern clinicians, despite all the hospice care and Rita Charon’s writing and moving TED talk – Honoring the stories of illness | Dr. Rita Charon | TEDxAtlanta – YouTubehttps://www.youtube.com/watch?v=24kHX2HtU3o

And is there more to be said about medical shame? Ie, not that of the patient (about which more should be said in any case!) but of the clinician? Caryl Sibbett talked about the sort of knowledge: of the human condition, of the limitations of medicine, of the vulnerability/lack of vulnerability of doctors to disease, of the shame of being a patient especially when a doctor….that medical practitioners find difficult to – sic – grasp. (Nettlesome knowledge

Nettlesome knowledge, liminality and the taboo in cancer and art therapy experiences: implications for learning and teaching. / Sibbett, Caryl; Thompson, W.T.)

Threshold Concepts within the Disciplines. ed. / R. Land; J.H.F. Meyer; J. Smith. Rotterdam: Sense Publishers, 2008. p. 227-242.