Using the Humanities to Improve Healthcare
BU Health Humanities Project looks at how studying poetry, history, and religion can help doctors better connect with patients—and reduce their own stress
As an undergraduate at CAS, Suzanne Sarfaty studied biology with the goal of becoming a doctor. But she also had a deep passion for the humanities and paired her science major with a minor in religion. Today, she’s a primary care physician—who speaks fluent Spanish and still has a keen interest in languages, history, culture, and the arts. Sarfaty (CAS’84, MED’88) says that innate curiosity—fostered at CAS—makes her a better doctor. Having a genuine interest in all aspects of her patients’ lives—not just in the symptoms they present—helps her understand the needs of those who enter the East Boston Neighborhood Health Center and how to meet them.
“If you’re not curious,” she says, “you make assumptions, you have biases, and you don’t always take good care of patients.”
An assistant dean of academic affairs at BU’s School of Medicine (MED), it’s a lesson she tries to impart to the next generation of doctors. Whenever she has a chance to connect her medical students with the humanities, she says, “I leap at it.” The difficulty, though, is that the medical school curriculum is so packed, it’s hard to find the room.
Across town on the Charles River Campus, Anthony Petro shares Sarfaty’s conviction that the humanities can improve healthcare. An associate professor of religion, he wants to send Sarfaty more students who—like herself—explored the richness of the humanities during their pre-med, undergraduate years. In July 2020, Petro founded the BU Health Humanities Project, an initiative that aims to bring together students and faculty from the health sciences and the humanities and highlight the many beneficial connections between their fields. He’s undertaking the work as part of his three-year term as BU’s National Endowment for the Humanities Distinguished Teaching Professor.
So far, the project has organized a series of discussions on topics like domestic violence in Muslim communities and race and COVID-19 and awarded fellowships to CAS undergraduates pursuing health humanities research. The project also acts as a resource, connecting students with the many classes BU offers at the intersection of humanities and health, from Sociology of Mental Illness to Death and Immortality.
Medicine is a human discipline. Some of my students think of physicians as scientists. But for the most part, physicians are not just doing science, they’re dealing with humans.
In December 2020, the American Association of Medical Colleges published a report titled The Fundamental Role of the Arts and Humanities in Medical Education. The report urges medical schools to integrate the arts and humanities into their curricula, both because practicing medicine requires “a deep understanding of the human condition” and because interaction with the arts and humanities can enhance physicians’ well-being and keep burnout at bay.
“Medicine is a human discipline,” says Petro. “Some of my students think of physicians as scientists. But for the most part, physicians are not just doing science, they’re dealing with humans.” The more aspects of human diversity that future healthcare providers can immerse themselves in, he says, the better off they—and their patients—will be.
Understanding and Respect
Petro is the author of After the Wrath of God: AIDS, Sexuality, and American Religion (Oxford University Press, 2015) and teaches one of the Department of Religion’s most popular courses, Religion, Health, and Medicine. The class always attracts pre-med students, Petro says, and many have never considered the ways religious beliefs have shaped—and continue to shape—US health policies and practices. When HIV/AIDS appeared among gay men in the 1980s, for example, research funding was initially withheld because many considered homosexuality a sin and believed the crisis needed a moral solution, not a medical one. And current debates around abortion and end-of-life care hinge on the question of when life begins and ends—a question that, say, a priest may answer differently than a doctor.
Petro’s class also explores the types of conditions that are deemed worthy of medical attention and the behaviors that are considered “normal” or “healthy” and how those standards emerged. The American Psychiatric Association, he says, stopped labeling homosexuality a mental disorder only after social attitudes around sexuality shifted. It’s a history Petro believes future healthcare providers should know. “If every person who is becoming a physician understood something about the history of medicine—and how tethered that history has been to histories of racism, sexism, homophobia, and ableism, and how it continues to reproduce those things—I think it would better equip them to understand the context they’re entering into,” he says, and help them to avoid repeating the errors of the past.
The idea that not everyone defines health or healing in the same way is also a topic of discussion in Lance Laird’s medical anthropology courses. Laird is a scholar of Islam and the assistant director of BU’s master’s program in medical anthropology and cross-cultural practices. The program’s website points out that Boston is home not only to several major teaching hospitals but also to Vietnamese monk shamans, Chinese herbalist-acupuncturists, Haitian voodoo priestesses, African American root doctors, and Pentecostal faith healers. Studying anthropology and culture, says Laird, a MED assistant professor of family medicine, gives medical providers greater understanding of and respect for these many healing traditions.
“As a biomedical clinician, you are practicing a particular form of traditional medicine,” he says, “but your patients may be turning to people who are practicing other forms of healing that are just as important to them.” And working with—rather than against—a patient’s culture often leads to more effective care.
Modern doctors can also learn from studying the medical traditions of ancient cultures, says James Uden, an associate professor of classical studies who teaches a class on the history of medicine in Ancient Greece and Rome. “Studying the ancient world is all about sharpening your capacity for empathy with others,” he says. “You have to put yourself in the lives of people who come from a very different world and have completely different assumptions. You have to reconstruct all of their values. That’s great training, I think, for healthcare providers.”
Studying ancient medicine also tends to generate humility, Uden says. “We have a tendency to think ourselves at the top of the mountain and to believe everything that’s happened in history just leads up to us. But, actually, when you study history, you see that people throughout time have thought they were right about everything and then have been proved wrong.” Studying the misunderstandings of the past—long-standing beliefs that illness resulted from a wandering uterus or from an imbalance of bodily fluids—reminds us to be wary of certainty and open to the possibility of new discoveries, he says.
Medicine’s Gray Areas
For emergency room doctor Elizabeth Mitchell, immersing herself in the humanities has many benefits. They teach her to be comfortable with ambiguity. “A lot of medicine is not clear cut, black and white,” says Mitchell, a MED clinical professor of emergency medicine. “That’s hard for us in medicine. We want an answer. We want a diagnosis. We want a treatment plan. But in my practice in emergency medicine, so many interactions that I have with patients are unfinished and unclear. I think that spending time with poetry, music, art, and literature allows you to become more comfortable with the gray areas.”
Mitchell shares poetry with her students and residents during daily rounds, and she pens essays and poetry herself. In spring 2020, her poem “The Apocalypse,” about the anxieties of battling the emerging coronavirus pandemic, appeared in the New York Times. In 2018, the Annals of Emergency Medicine published “15 Rounds,” Mitchell’s poem about treating a gunshot victim and then sending him back to the same dangerous streets.
“Sometimes, I’ll have a really tough case, and I’ll just come home and write about it,” Mitchell says. “That is super therapeutic for me. It allows me to process what I saw. And then if I can turn it into something—a story or a finished poem—that somehow takes the experience and makes it less painful for me.”
A recent guest lecturer in Petro’s class talked about the immense pressures on today’s physicians to contribute more to the bottom line while still offering quality care—and the need for personal outlets to escape those burdens. Exposing future healthcare providers to the humanities, says Petro, expands the archive of interests they can explore to nurture their own health and happiness, as well as those of their patients.