In medical degree students, cinema and literature can contribute to exposing a series of transversal aspects of their training with little presence in the subject programs; in the same way, in citizenship, cinema and medicine can contribute to the formation of a critical awareness of the meaning and value of health.
The article published last July by the Journal of Medicine and Cinema presents the conceptual foundations of the optional subject Cinema, Literature and Medicine that since 2011 has been taught in the second year of medicine at the University of Oviedo, Asturias, Spain.
The text is included in the context of narrative medicine that seeks, through literature, a deeper understanding of the disease, the medical profession or the experiences of the patient.
The authors, doctors who work in various institutions in the region, take it for granted that two types of Medicine are conceived:
“to mute or technified in which the patient has little to contribute, and
“b) the narrative, based on dialogue, empathy and narrative understanding of each patient, which requires listening. The latter is the counterpoint of current biomedical-based techno-scientific medicine in which it depersonalizes the patient and even designates him with the name of his pathology. »
The reaction to the first conception provokes different manifestations of protest under the motto “I am not my disease”, “indicating that the patient does not bring his liver or kidney, or any other abnormally functioning structure, to the consultation, but everything goes with him, with his concerns and hopes, which forces us to consider not only the biological aspects but also the emotional and relational ones that make up the vital project of the patient”, according to the article.
Contributions of cinema to medicine
There are many publications that analyze the role of movies and television series. From them, a positive effect can be deduced that should be stimulated “because we live in an eminently visual culture (civilization of the image) and the historical knowledge of the majority of the population is specified or reinforced through audiovisual media”, the authors explain. .
Audiovisual language is a system of representation of the reality that surrounds people and gives meaning to the objects and practices of daily life, regulates social practices, modulates the behavior of the population and provides a sense of self and others’ identity.
The article summarizes the contribution of cinema to the teaching of medicine in the following concepts:
a) promotion of self-learning and critical and reflective attitude of the student;
b) acquisition of skills and abilities of the study plans;
c) exploration of the cultural and social dimension of the disease and the experience of becoming ill;
d) appropriation of symbols and meanings provided by film language;
e) incorporation of learned concepts into our life experiences;
f) approach of what has been learned to practical contexts, encouraging the attribution of meanings by the students, and
g) reconstruction of health events from human points of view.
Together with these facts, the authors emphasize that a film is a source of information that expresses the moment of its making, a reflection of the technical, political and social reality of that historical moment.
Literature and medicine are intimately linked not only to life, but also to death, which is a substantial part of literary production.
The authors value this supplementation for being an effective resource to learn about aspects ignored in the faculties: the patient in his miseries, concerns, life expectations, fear, anguish and fears.
In this sense, they refer to the fact that a third of the medical schools in the United States include literature courses within their undergraduate studies, highlighting that it is common to find them in Spanish schools.
The current rise of literature for the training of medical students and other Health Sciences degrees is due, to some extent, to the rise of narrative medicine and the weight of techno-scientific medicine that characterizes the biomedical model, forgetting the sick as a person. The article highlights that literature and the arts can help, not only to better understand the sick, but also to recover the comprehensive care that patients and their families demand.
Metaphors and eponyms, contributions to medicine
Bordallo Landa, González Rodríguez and Agustín Hidalgo, authors of the article, exemplify their points of view with medical descriptions originating from explanatory metaphors:
buffalo neck (characteristic of Cushing’s disease), rice-water diarrhea (typical of cholera), smell of wet straw (phenylketonuria), butterfly-wing image of some pneumonias or jellyfish head alluding to the tortuosity of the abdominal vessels typical of portal hypertension.
and continue; «the use of metaphors is more extensive and thus, for example, the term cancer is used as a metaphor for supposed moral punishments contained in expressions such as climate change is an environmental cancer, crime is a social cancer, school failure is an educational cancer or corruption is a political cancer».
Regarding eponyms, the article gives an account of some famous literary characters:
Achilles tendon, Morphine (alluding to the god Morpheus), Adam’s Apple, Mount of Venus, Head of Medusa, Hypnosis (alluding to Hypnos, god of sleep), or Atropine (referring to Atropos, one of the three Fates ).
The inspiring diseases
At the end of their reflections, the authors point out that reading can be useful at any time in the evolutionary process of the disease, with the exception, perhaps, of the most acute phase if it is accompanied by physical or emotional suffering that makes concentration difficult.
The accompaniment by books is possible because literature can inform, guide and tell stories related to the origin, evolution and outcome of many of the current prevalent diseases. In each of the phases of the disease, the individual will resort to reading with different objectives: to acquire knowledge, learn about other people’s experiences, obtain consolation, or simply entertain the passing of time. But perhaps the time where reading has provided (and provides) more company to the sick is in the slow progress of chronic diseases and convalescence; perhaps in these circumstances the spirit is more willing to share the stories that the books tell.
The images of patients reading in anti-tuberculosis sanatoriums or in the nursing homes that some classics of literature have recreated so much speak for themselves.
As examples of the relationship between illness and literary creation, the Asturian authors cite the cases of Cortazar or Bram Stoker, who during their childhood suffered long convalescences in which their love of reading arose. In this influence, when they refer to Tolkien, they remember that while the writer was recovering from his trench feverbegins to write the first lines of the saga of the Lord of the Rings.
It seems clear, in light of the preceding comments, that cinema and literature can contribute to exposing medical students to aspects of their training with little presence in the programs of undergraduate subjects.