1.
Cover Page
4.
The Humanities Interview
6.
Back Cover
THE HUMANITIES INTERVIEW
Literature & Medicine
 Dr. Charles Alexander is an internist who divides his time between clinical practice and serving as medical director of the 54-bed Maine Coast Memorial Hospital in Ellsworth. He helped organize the first year of participation by his hospital last winter in the Maine Humanities Council's project Literature & Medicine: Humanities at the Heart of Health Care. A specialist in geriatrics and in palliative care, he recently discussed his impressions of the program with Maine Humanities editor Charles Calhoun. |
Q: How did the seminar get going?
A: We have 40 active members on the medical staff here, and a number of them do a lot of reading outside of their professional journals. So we had three or four immediately interested and, as soon as word got around, we were over-subscribed. We had done a mailing to the rest of the hospital staff, our board, staff at local nursing homes, and local hospice volunteers, resulting in a diverse group of 25 participants. There were physicians, a trustee, nurses, therapists of various kinds, a couple of lab technicians, and three hospice volunteers.
Q: Did you know each other already?
A: Those of us who were hospital-based had at least a passing, professional knowledge of each other, but some of the community representatives, like the hospice volunteers, were not known to us. The group bonded pretty closely. It did take a session or two for the hierarchical barriers to fall away and for the discussion to open up. We're now faced with the problem in the second year of whether to stay with the participants who have come to know each other so well, or to open up the experience to a new group.
Q: In the early stages, who encouraged the conversation?
A: Our facilitator was Marli Weiner, who teaches history at the University of Maine and who picked the readings. We had a lively group of people who didn't need a lot of direction, but she was always there focussing the discussion and seeking out those who were shy and gently cutting off people if they were dominating the talk.
It helped that our first book was Anne Fadiman's The Spirit Catches You When You Fall Down. It's a book everyone who takes care of other people should read. It's about a young girl in a Laotian community in California who has a very bad case of epilepsy. It starts off contrasting the Eastern approach to medical care with the Western medical system – both competing to treat the girl – and it leads into a deep consideration of such things as appreciating cultural diversity and tolerance and the very good reasons people sometimes have for not complying with what a physician tells them they should do.
Q: Which was the hardest book to read?
 |
| Photo by Asad Butt |
A: Camus's novel The Plague. Some people just hated it. But it inspired probably the richest discussion of all six books. There are so many levels to that text. Everybody saw something different in it. Everyone came away enriched. It's that sense of depth that really works the best. You can read a lot of case-study books that are too one-dimensional. It's that sense of literary quality that keeps a group engaged.
Q: Which book surprised you the most?
A: Marianne Paget's A Complex Sorrow: Reflections on Cancer and an Abbreviated Life, which we read last. It's really about medical mistakes. There was some very frank discussion about medical mistakes that would not have taken place had we read the book earlier on. It's also about communication – with patients, with each other.
Q: So you trusted each other by then, but did you always agree?
A: There was some amazing point-counterpoint discussion between a physician and a lab technician – quite vocal disagreement at times – and that was very refreshing to see. It had very quickly become unimportant where we fit in the hierarchy. On the other hand, we learned a lot about each other's cultural backgrounds – about where we came from or what religion we had grown up in – and how such things would cause us to approach a piece of medical work very differently. And because Ellsworth is a relatively small community, some of us had been patients of some of the others in the group, which added another interesting perspective to things. Our daily lives at the hospital are spent talking about dry, scientific stuff. The humanities-oriented topics that engage us deeply are not part of the business.
Q: What would participants have changed about the program?
A: Some people said the list was too much about death and dying – which they found somewhat depressing. But we have the opportunity to deal with other subjects as the program continues. I think it's important in a series like this to mix the classics with contemporary works. We read, for example, both Tolstoy's The Death of Ivan Ilyich and the poet Mark Doty's Heaven's Coast, which is about his partner's death from AIDS.
Q: It is a pleasure to talk about books, but was life different for any of you at the end of the six months?
A: Somewhat different. People who had worked together before now interrelate differently because they are closer friends and have a closer appreciation of each other's specialties. We certainly are more aware of the problems of how we communicate with our patients. I don't know if this feeling has spread beyond the 25 participants. I do know that for one nurse who admitted she wasn't much of a reader, it really changed her outlook on reading and the humanities. Reading these same books in isolation would not have given what we got out of them.
Q: And personally? Are you different for having read these books?
A: The experience raised my awareness of the value of the arts in what I do, which is largely to care for older people. For instance, at the Maine Center for the Arts in Orono I just saw Dulcinea Langfelder's performance in her play Victoria. It's similar in its staging to W;t, but it's about a woman with Alzheimer's. All you see on stage are the woman, a wheelchair, an orderly, and a white, hospital-like curtain. The playwright is also a choreographer, so a dance in that wheelchair actually takes place. It's the most powerful thing of its kind I've ever seen. It's about human creativity despite the loss of traditional reason and memory.
Photos courtesy of St. Mary's Regional Medical Center
4.