Literature’s lessons for medical students

by Daniel Marchalik, MD, Director, Ambulatory Urologic Surgery
September 18, 2017

Many of my patients don’t know that, in addition to my medical degree, I also have a master’s degree in English literature. As an English major during my undergraduate studies, I had always wanted to study both literature and medicine.

These fields have a lot of overlap. When we first meet with patients and ask them to tell us about their medical conditions, we’re really asking them tell us their stories. What happened? What brings them to us today? What does their condition mean in the context of their lives?

The better we can understand and relate to these stories, the better doctors we become.

How the literature and medicine track works

I started the literature and medicine track at the Georgetown University School of Medicine in 2014 We began as an elective class, but the student response was so positive that the courses expanded it into its own program. It’s the country’s first dedicated literature and medicine track.

Students enrolled in the program work on special projects and meet once a month throughout their four years in medical school. At these meetings, we discuss works of fiction and how they can apply to our experience as physicians and medical students. In their third and fourth years, students have an additional meeting once a month with my colleague, Dr. Dennis Murphy, to discuss medical narratives – nonfiction writings that describe experiences in health care.

This program gives aspiring young doctors helpful tools to manage the greatest challenges in medical education: student burnout and their ability to remain connected to others.

Burnout

Burnout, or exhaustion caused by overwork and stress, is a serious problem among doctors and medical students alike. In a 2008 study, nearly 50 percent of medical students at seven U.S. medical schools reported feelings of burnout. And a 2012 study indicated that nearly 46 percent of doctors surveyed reported at least one of the symptoms of burnout, including:

  • Physical and/or mental exhaustion
  • Feelings of detachment or inability to connect with patients
  • Feelings of hopelessness or ineffectiveness

There are several ways to deal with burnout, including relying on a support system of friends and family members, as well as support from medical schools. And several studies have looked at involvement in the humanities—art, music and other ways of documenting the human experience—as ways to decrease burnout. For example, 62 percent of medical students reported in a 2013 study that a humanities journal could prevent burnout.

As of September 2017, we’re studying the literature and medicine track at Georgetown to see if our students’ experiences with avoiding burnout match what students at other institutions have reported. Based on the responses we’ve gotten so far, I expect we’re going to show that our program has had a substantial impact in this area of medical education for our students.

Cognitive empathy

Cognitive empathy, or recognizing and understanding the perspectives of other people, is another benefit of the literature and medicine track. Studying literature helps medical students understand other people by empathizing with characters and their struggles.

Studying literature helps medical students understand other people by empathizing with characters and their struggles. via @MedStarWHC

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A 2016 study found that reflective writing in medicine improves connections to colleagues and patients. Being able to put yourself in your patient’s shoes is one of the most important things a doctor needs to be able to do. This program helps medical students build these critical skills.

Learn more about the literature and medicine track and its goals.

Applying literature to the medical field

A lot of innovative, progressive thoughts and works are coming out of the literature and medicine track. One good example came about after we read Kazuo Ishiguro’s novel “Never Let Me Go.” This book deals with a frightening alternate future in which clones of humans are raised to have their organs harvested.

We had a powerful discussion about this book during class. Afterward, one of my students came up to me and said that he’d donated a kidney to his step-uncle, whom the student hardly knew. At the time, he hadn’t had any doubts about his choice, but he later felt conflicted after learning about the medical difficulties kidney donors may face later in life.

My student decided to write down and sort out his thoughts on the issue. He worked on the project for several months before submitting it to The Washington Post. It was the Post’s most-read article the week it was published and inspired many conversations on the subject of organ donation in the local and national media.

Other students have applied what we’ve discussed in various ways. One of my students started a column in The BMJ, formerly the British Medical Journal, a widely read publication for doctors worldwide. In this column, we discuss themes that go along with what we’ve talked about in the literature and medicine track, but we’re sharing these ideas with an international audience of medical leaders.

Another student completed a project tracing the writings of Charles Dickens, who wrote classics like “A Christmas Carol,” “A Tale of Two Cities,” “Oliver Twist” and others. This student’s project explored the idea that Dickens was one of the first Victorian public health advocates and that his writings were designed to bring about changes to health care in Victorian-era England.

Not only are the students coming away from our discussions with new ideas and perspectives, but I am too. I regularly co-author articles for The Lancet, another well-known medical journal. Many of these articles discuss ideas raised in our meetings in the literature and medicine track. Every time I meet with my students and discuss literary works, I consider how these works influence me and how they can apply to the greater medical community.

Hippocrates, the ancient Greek doctor who’s considered the father of modern medicine, once wrote: “Wherever the art of medicine is loved, there is also a love of humanity.” At its core, being a doctor involves caring for patients, understanding where they’re coming from, and applying our skills to serve their needs. The Literature and Medicine Track is an important step in that direction.

Category: Healthy Living     Tags: burnoutDaniel Marchalikempathymedical studentssymptoms of burnout