Summer Reading

Summer Reading
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In the summer of 1962 I had just graduated from Queens College and was living at home with my parents in Far Rockaway, a suburban town in New York City located on the Atlantic Ocean. In the fall I would start N.Y.U. medical school. My four college years had been filled with excitement, a development of the joy of learning and greatly expanded intellectual horizons. The premedical science curriculum consumed much of my course load. However, there were other very enjoyable liberal arts requirements, including literature, art, music, social science, foreign language. I also took all my available electives in comparative literature. I was drawn to art and literature with increasing intensity, despite the concentration in chemistry and biology. I took all my available elective courses in comparative literature. In my junior year, I had even considered switching from pre-med to a major in English. However, over time medicine won out.

As I awaited the start of medical school, I was filled with both excitement and anxiety. Medicine was the beginning of a new life. But I also recognized the intense commitment required in mastering this new field of study. Would I have to give up my newfound love of art and literature? Would I be unidimensional; would I turn into a one-trick pony, a medical philistine? Could I work both sides of my brain? Could I live, at least in part, in two worlds? The angst mounted as the summer progressed.

That summer, as usual, was spent working at a temporary job. My family had minimal means; summer work was a necessity. This was the second summer that I worked through the night, sorting mail at the local post office. It was a demanding job that started at midnight and finished at 8:30 the following morning. I found myself twelve hours out of phase with my friends, my family and my fiancée. I would return home in the early hours of the morning and take a brief nap. Thereafter, in the afternoon while everyone worked, I'd journey one block to the Far Rockaway beach, armed with a sandwich and lots of water to drink and many books. All afternoon was spent reading intensely. Classics flew by before my eyes: Mann, Homer, Camus, Tolstoy, Cervantes, Proust, Melville and on and on. It was as if in these two months I could satisfy literary needs for years to come. The books were consumed at rapid rate. I was totally focused, impervious to sun and surf, and without external distraction. This was great learning, an attempt to assuage anxiety, an obsession.

The summer went by quite quickly and the first year of medical school began. Enter the world of biochemistry, anatomy, and the other preclinical sciences. It was, as expected, all consuming, with little chance for much else. My summer anxiety was soon realized and my library closed to all but medical texts and journals. Fortunately this was not permanent. After medical school and further training I began a faculty life that continues to the present. There has been adequate time, more than adequate time, to pursue seriously other activities outside medicine. As time commitments eased a bit, I returned to nonmedical reading. Writing prose and poetry as well as painting soon followed and became important parts of my life. For me the union of art, literature and medicine has been symbiotic. I have no doubt that the arts have made me a better doctor, and that medicine has also fueled many of my creative impulses. This situation is by no means unique. There are growing numbers of fine physician-authors and artists to emulate.

Over time, there has been increasing awareness of the need for integrating humanities and humanistic issues into the course of medical training in medical school and house staff programs. At Yale an elective is offered to medical students early in their training at the Yale British Art Center. In this elective, students are asked to observe works of art and then answer specific questions concerning the art. This has led to documented enhanced awareness and perception. This same model has been followed in a number of other institutions and a number of other venues outside medicine. Training of the eye to see all that is present, such an important aspect of medicine, can be facilitated greatly by involvement in the arts. The more intense the developed observational skills, the greater will be both sensitivity and empathy. In many medical institutions, including our own, there are also opportunities for students and trainees to take part in writing workshops. Resident trainees write about their experiences and in so doing grow both professionally and personally. I've had the opportunity to evaluate poems written by students both at Yale and University College of London as part of an annual competition. The quality and depth of these observations have been remarkable. At Yale there is also a yearlong Humanities in Medicine lecture series as well as a student poetry magazine called "Murmurs". For the past ten years I have been running a monthly humanities seminar for our cardiology trainees.

The incorporation of humanities and arts into the study of medicine and training of physicians is a major step forward. The educational expansion enhances humaneness, promotes understanding and empathy and helps focus on the need to listen, to look, to hear and to understand the patients we care for. This is increasingly relevant in an era of data-driven medicine where physicians often know more about the patient's laboratory work than about the patient. At whatever level of education and training, such activities will strengthen physician skills and promote the role of healer. They help focus medicine back to the patient, the individual. These are not elective activities; these are imperatives. Future generations of medical students should not feel the need for summer reading in preparation for an obligatory liberal arts withdrawal. Medical education requires training in science and humanities together, proceeding hand in hand.

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