Literature & Medicine
in Department of Veterans Affairs Hospitals

With support from a recent major grant from the National Endowment for the Humanities, the Maine Humanities Council in 2010 and 2011 is offering Literature & Medicine to the staff at 20 Veterans Administration hospitals and health care facilities (VA hospitals) through partnerships with state humanities councils. Partners with MHC include:

Arizona: Carl T. Hayden VA Hospital, Phoenix
California: VA Central California Heathcare System, Fresno
California: VA Northern California Health Care System, Sacramento
California: VA Palo Alto Health Care System, Palo Alto
Illinois: Edward Hines Jr VA Hospital, Chicago
Maine: Togus VA Medical Center
Maryland: VA Medical Health Care System, Baltimore
Maryland: VA Medical Health Care System, Perry Point
Massachusetts: Northampton VA Medical Center, Leeds
Missouri: St. Louis VA Medical Center
Missouri: Kansas City VA Medical Center
Nevada: VA Sierra Nevada Health Care System, Reno
New Jersey: VA Health System New Jersey, Lyons/East Orange
New York: VA NY Harbor Healthcare System, Manhattan
New York: Northport VA Medical Center, Northport
North Carolina: Durham VA Medical Center, Durham
South Carolina: Ralph H. Johnson VA Medical Center, Charleston
South Dakota: Black Hills VA Medical Center, Fort Meade
South Dakota: Sioux Falls VA Medical Center, Sioux Falls
Vermont: VA Medical and Regional Office Center, White River Junction.

Pilot programs in Maine and Vermont VA hospitals demonstrate that the impact of Literature & Medicine is very significant for the participants from VA facilities, where work and stress loads have been both changed and increased by the influx of severely wounded soldiers from Afghanistan and Iraq, and where their patients often face particularly severe physical and physic wounds.

VA hospitals present the dedicated professionals working there with one of the most challenging settings in health care. Not only are the resources of VA facilities under great strain, the needs and number of patients they care for are increasing every day. The veterans being served often struggle with post-traumatic stress disorder (PTSD), severe physical disabilities, substance abuse, chronic illness, homelessness, poverty and a system that at times is not able to meet their needs. Unfortunately, the veterans’ anger and frustration can often be directed at those who care for them. The humanities can make a difference in this setting, as we have seen in the Maine and Vermont VA hospitals. As the Chief of Staff at Maine’s Togus VA Medical Center wrote:

I have first hand knowledge of the value of this program to the staff of the VA Medical Center in Augusta, Maine. I am convinced that the reading and discussion of these works has enhanced our staff’s empathy for the veterans we serve, and has reduced the potential of provider burn-out.

A physician from the White River Junction, Vermont, VA, a national trauma center, writes:

The Literature & Medicine group attracts a range of people at the hospital who might not have much opportunity to talk and reflect with one another. This is very important, especially as the VA is undergoing a lot of changes. We are all being tested and stressed in new ways as we move from treating a primarily geriatric population who faced combat years ago to veterans in their 20’s, many with young families, who may only have been out of the war for a few weeks. This shift raises many ethical issues and demands a change in our approach. The Literature & Medicine group provides an outlet for us all to talk about these issues, and this is very helpful.

The humanities councils that will partner with Maine to take Literature & Medicine to a VA facility within their state include: Arizona, California, Illinois, Maryland, Massachusetts, Missouri, Nevada, New Jersey, New York, North Carolina, South Carolina, South Dakota and Vermont. There is a desire among these councils to do what they can, consistent with their respective missions, to address the needs of veterans who have served, and may still suffer for, their country. The Maine Council will provide training and technical assistance but each humanities council will organize the VA program in its own state.

Because of the particular context and needs of health care professionals in VA hospitals, the Maine Humanities Council has adapted the established Literature & Medicine trainings and materials, and has created, Echoes of War, an anthology of appropriate readings, edited by Suzanne Hunter Brown, a professor of literature at Dartmouth College and a long time Literature & Medicine facilitator in New Hampshire and Vermont.

A training institute was held 2009 to jump-start the program. A major national conference took place on November 12-13th, 2010, and featured Jonathan Shay, M. D., author of Achilles in Vietnam, and acclaimed author Tim O’Brien among the keynote speakers.

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Comments

Literature & Medicine programs have been held at the Veterans Administration Medical Centers in Togus, Maine and White River Junction, Vermont since 2001 and 2004, respectively. Here is how some L&M participants describe their experience:

 

“[Before this program] I didn’t understand the depth of what our veteran patients were bringing in with them; the extent and depth of what they may have experienced [presented in the readings] was amazing to me.”


“[The Literature & Medicine group] makes my everyday life easier because it helps me to be able to separate from the person who comes in my office angry...The [program] helped me to separate [from patients] in an EMPATHETIC way—a boundary—instead of creating a wall of separation between me and the patient like we are taught. The readings help remind you what has brought people here.”


“I am more open to how we can try to force patients to do what we think is best for them without really trying to communicate and understand them.”

“I have a deeper awareness of my colleagues’ empathy and appreciation for the complexity of our work. This has contributed to my efficacy when helping patients with complex needs or health conditions.”

“It really helped me with post-traumatic stress disorder insights and care. This has made me less frustrated with patients and happier in my work.”