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{shortcode-be29865d8a9c7908fa05930b7f2d42574eaa573c}n July, Sorcha R. Ashe ’22 began her M.D.-Ph.D. at Harvard. While typical Harvard Medical School M.D.-PhD. candidates pursue doctorates in neuroscience, microbiology, or genetics, Ashe is taking a different route: a graduate degree in English literature.

“There is a big tendency for institutions to separate the science and the humanities into two separate disciplines,” Ashe said. “They like to draw a sharp line.”

“I think the world would be much richer and much more vivid if the two sides of that line, or that gradient, talk to one another a little more,” she added.

Ashe, who is considering exploring mental health literature in her Ph.D., is just one of many people at Harvard probing the medical humanities.

But according to several Harvard professors and administrators, the University has seen a lack of concerted effort toward expanding and sustaining the medical humanities.

‘Understand the Human Condition’

In the last decade, universities across the country have rapidly expanded their medical humanities programs.

Sari Altschuler, the founding director of the Health, Humanities, and Society Program at Northeastern, estimates that the number of schools with health humanities programs is now about 130 — significantly more than existed 10 to 15 years ago.

According to those who study it, the field — which is interdisciplinary by nature — is designed to encourage physicians to think beyond the confines of the bedside.

“At its most basic level, medical humanities places the physical aspects of medicine back within the social, cultural, and environmental contexts which help to define and shape an individual’s experience of illness or wellness,” Ashe said.

History of Science professor David S. Jones ’97 said the medical humanities are also instrumental, training future physicians in core skills and modes of thinking.

Physicians and patients inhabit a world of narratives, Jones said, so teaching students about medical narratives can improve their patient communication skills. Viewing works of art can also help future doctors better interpret images of medicine, such as X-rays or patches of skin, he said.

Medical students can also use literature to imagine what they might do when they encounter ethical dilemmas, Jones added.

“What the humanities do is help people understand the human condition,” he said. “The better trained you are in the medical humanities, more or less, the better human you can be.”

For Altschuler, the medical humanities also takes on a pressing practical value in the modern world with new advances in artificial intelligence and technology that rapidly change the health care landscape.

“The more tools you have at your fingertips to be able to think about things and to think about them from a variety of angles, the better you’re going to be at being able to solve problems that come up,” Altschuler said.

‘Not the Owner of the Truth’

In August 2018 Harvard Medical School associate professor Joel T. Katz and colleagues surveyed HMS faculty, residents, fellows, and students about whether the integration of the arts could improve medical education and patient care.

Published in the “Journal of Medical Humanities,” the study found that, respectively, 67 and 74 percent agreed or strongly agreed.

But according to some professors, HMS faces a dichotomy of limited medical humanities programming despite strong student and faculty interest.

The school currently boasts an Arts and Humanities Initiative led by Jones that, he said, “tries to create a community amongst the students and faculty who are interested in the arts and humanities.” The group funds activities like writing retreats and student groups such as the Longwood chorus.

Despite the Initiative’s ability to support extracurricular activities, “the arts and humanities themselves don’t have a position in the formal, required curriculum of the medical school beyond ethics,” Jones said.

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Since 2003, Katz has taught a humanities-based elective for HMS first-years. The course — “Training the Eyes: Improving the Art of Physical Diagnosis” — teaches first-year students how to examine patients by matching artistic concepts to physical exam concepts.

For example, In one session — out of 10 total — Katz connects form to respiratory physiology. During this, students view a limestone bodhisattva sculpture, which goes from a two-dimensional, flat relief to a full figure as one walks around it.

Then, students apply their observations about form to diagnosing patients with different breathing abnormalities.

“It’s a question of deep looking — looking really carefully — and linking the observations they see to the physiology,” Katz said. “Is the stomach rising or falling with inhalation? Is the person using their accessory muscles to get air in?”

Dominique Harz — an orthodontist who took the course and is now a teaching fellow — recalls a session during which she and her peers viewed “El Jaleo” by John Singer Sargent.

Because the painting was “so ambiguous,” all of Harz’s peers had very different interpretations.

The experience taught students that “you’re not the owner of the truth,” she said.

Other sessions in the course include linking analyses of texture and pattern to dermatologic diagnoses and symmetry to cranial nerve abnormalities.

“We’re not teaching students how to be artists or writers,” Katz said. “We’re teaching them about core physician competencies that just happened to be best taught through the arts.”

Though Katz’s class is offered to all first-years, it is not a required part of the HMS curriculum. The only course all students must take is PWY120: “Essentials of the Profession: Evidence, Ethics, Policy and Social Medicine,” which covers bioethics — a field that some scholars have distanced from the medical humanities.

“Medical humanities and bioethics both emerged in parallel in the 1960s,” Jones said. “Bioethics has been much more successful as a field, at least in the U.S.”

Medical humanities, on the other hand, has struggled to gain significant traction.

‘The Label On The Can’

Across Harvard College and the Graduate School of Arts and Sciences, “most of the work on the medical humanities in the FAS here at Harvard is done by faculty in the History of Science Department,” Arts and Humanities Dean Sean D. Kelly wrote in an email.

Despite the presence of the History of Science department — which boasts some of the nation’s most preeminent historians and historians of science — some scholars still draw distinctions between the medical social sciences and medical humanities.

“I don’t think there’s currently any course in the Harvard College course catalog that has ‘Medical Humanities’ in the title,” Jones said.

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Karen L. Thornber — a professor of Comparative Literature and East Asian Languages and Civilizations — also pointed to the scattered nature of medical humanities courses.

“One thing for Harvard to consider seriously for the future is some version of a more formalized medical humanities or health humanities program,” Thornber said.

Though a formal academic department has yet to be established, some professors still believe the College offers adequate opportunities for undergraduates to explore the medical humanities.

According to History of Science professor Anne Harrington ’82, medical humanities at the undergraduate level should incorporate interdisciplinary perspectives towards “making sense of health and illness and healthcare and medical science in its broadest human context.”

“Even though we train our students in historical methods, we also are deeply interdisciplinary in the kind of broad training that we invite our students to pursue,” Harrington added.

The History and Science concentration offers two tracks: History of Science and Science and Society. Within the latter track, the Medicine and Society focus field allows students to study auxiliary disciplines like literature in medicine, take courses on illness narratives, and even cross-register at the Harvard Divinity School.

In the spring, Harrington will teach History of Science 1770: “Broken Brains: A Patient-Centered History,” where students will read memoirs and consider ethical dilemmas.

“I would consider that to fall squarely into any reasonable definition of a medical humanities course,” Harrington said.

“I think it’s kind of a suggestion to not get too distracted by the label on the can, but look at what’s inside,” she added.

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Beyond the History of Science department, the FAS also hosts a lively Anthropology faculty — some of whom also engage with medical anthropology and the medical humanities.

Harvard Anthropology professor Arthur M. Kleinman has long been a leader of medical humanities. In 1988, he published “The Illness Narratives: Suffering, Healing, and the Human Condition,” a book that probes the art of diagnosing illness and physician-patient relationships, focusing particularly on the autobiographical and biographical accounts that describe illness and the patient experience.

At the time, Kleinman wasn’t familiar with the concept of medical humanities.

“The way I learned about it, frankly, was that I received a bunch of awards” in the 1990s, Kleinman said. “People told me, ‘Well, the kind of work you do is the medical humanities.’”

“We didn’t use it much in the United States before that time — the term really came from the UK,” he said. “Today, I think it is a broadly encompassing term.”

For Kleinman, training future physicians in the medical humanities could help remedy many of the problems with the current medical system — serving to “emphasize the human aspects of care and improve things like communication, emotional and moral dimensions of care.”

Kleinman’s last course at Harvard — Anthropology 1826: “Medical Anthropology: Advanced Topics” — will bring 14 of his former students, most of whom have written books in the field, as guest lecturers to explore the future of medical anthropology.

Aside from established departments, a smattering of medical humanities-oriented courses also exist in the College’s General Education program.

Thornber has taught two: Gen Ed 1078: “Disease, Illness, and Health through Literature” and Gen Ed 1144: “Mental Health and Mental Illness through Literature and the Arts.”

“For many of the students, they said it made them feel less lonely,” Thornber said, and “made them feel better connected to their friends, their family members, particularly family members who they’ve watched suffer from serious illness.”

A Lack of ‘Faculty Strength’

The state of medical humanities at HMS stands in stark comparison to other science and medicine departments at the school.

HMS is the only school in North America to have created a substantial medical social science requirement with PWY120: “Essentials of the Profession: Evidence, Ethics, Policy and Social Medicine.”

“HMS did that because we have this very large social science faculty that was able to make the case that these are things that all medical students must learn, even if it’s not required by the national accrediting agencies,” Jones said.

While he hopes for greater medical humanities programming at Harvard, Jones acknowledges that there hasn’t always been significant demand among students.

“Have I met an undergraduate who came to me and complained vociferously that what Harvard really lacks is a medical humanities program or medicine and society program?” Jones said. “I don’t think so.”

Though some members of Harvard’s faculty are eager to see the medical humanities gain a more formalized space within the University’s curriculum, the field has seen a number of roadblocks in expansion.

Last year, a draft report from the Faculty of Arts and Sciences’ strategic planning committee proposed the creation of a new secondary field in “Integrated Humanities,” which would include a track in the medical humanities.

But the recommendation was ultimately omitted from the committee’s final report.

Still, in Kelly’s discussions with faculty since, “several mentioned the medical humanities as an area in which they would like to see growth for our division,” he wrote.

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The medical humanities have not “moved forward” because the school lacks the core faculty — and the funding — to do so, according to Jones.

“A new hire at the Medical School more or less requires a $6 million gift,” Jones said. “So until someone gives $6 million to endow a professor of literature and medicine, we’re not going to have a professor of literature and medicine.”

Like HMS, a lack of faculty has made attempts to formalize a medical humanities program unsuccessful at the undergraduate level.

“There’s really no one in philosophy who works on medical ethics or bioethics,” Jones said. “There’s no one in English literature who self-identifies as doing medical humanities.”

The expansion of the program would be propelled by sustained interest by deans across departments — a movement that has not yet arrived at the FAS, he said.

Former Arts and Humanities Dean Robin E. Kelsey cited the interdisciplinary nature of the field as a complicating factor in faculty searches.

“Because hiring is ordinarily done department by department, it can be difficult for the FAS to develop faculty strength in interdisciplinary areas, such as the medical humanities,” Kelsey wrote.

“Personally, I think we need better mechanisms for doing that,” he added.

‘Softer Aspects of Human Experience’

Despite a potential lack of formalized curricula, academics are not the only way for interested students to pursue the medical humanities.

While an undergraduate, Ashe found that the best resources to explore the intersection between the sciences and the humanities were “the Stacks and my peers.”

At the College, the Harvard Undergraduate Premedical Society also runs a literary magazine, “Prescriptions,” that “aims to create a space at the intersection of medicine and the humanities,” according to an email promoting the magazine.

Mira H. Jiang ’26, the Editor-in-Chief of Prescriptions, said she joined the magazine during her freshman year to combine her passions in medicine and creative writing.

Jiang said though Harvard lacks formal structures for studying the medical humanities, there is certainly interest from students.

“There’s a lot of interest in this field, but it’s not very immediately accessible, I feel like, on an undergraduate level,” Jiang said.

Some students have assembled their own makeshift medical humanities curricula through a combination of various fields.

Zhixiao Yip ’27, who double concentrates in Comparative Literature and Molecular and Cellular Biology, said Harvard provides students with plenty of resources to adapt their academics around the medical humanities.

Still, students may be hesitant to embrace such resources due to stereotypes surrounding either the humanities or sciences, she said.

“I wish sometimes we could better improve on the connotations that, for example, studying the humanities connotes or studying the sciences connote,” Yip said.

“These are both scholarly paths that people work very, very hard to pursue, and I think standing at the intersection makes you realize just how much work people are doing on either side of these fields,” Yip added.

Though some may see medicine and humanities as being on opposite sides of the spectrum, Ashe said she hopes the humanities can bring “the softer aspects of human experience” to medicine.

“The science and the humanities can balance one another out — as long as the humanities are, in some level, emphasized a bit more than they are currently,” she said.

—Staff writer Veronica H. Paulus can be reached at veronica.paulus@thecrimson.com. Follow her on X @VeronicaHPaulus.

—Staff writer Akshaya Ravi can be reached at akshaya.ravi@thecrimson.com. Follow her on X @akshayaravi22.