VOL.10 NO. 2    THE MAGAZINE OF THE UNIVERSITY OF UTAH    FALL 2000

Our Bodies, Our Shelves

A visiting scholar program in literature and medicine brings together great books and medical minds.

by Theresa Desmond

In a windowless conference room at LDS Hospital, about 20 physicians gather on a winter evening to discuss Shakespeare’s Macbeth. The doctors consider the language of Macbeth’s soliloquies, the psychosomatic behavior of Lady Macbeth, and the question of Shakespeare’s familiarity with the medical practices of the time.

Jay Jacobsen, founder of the Visiting Literature Scholars Program, and Monnica Maillet, the most recent scholar.

At University Hospital, doctors, nurses, students, interested locals, and invited guests—members of Utah’s Hmong community, originating from southeast Asia—fill buffet plates before settling in to discuss The Spirit Catches You and You Fall Down (the Hmong description of epilepsy) by Anne Fadiman. The group views a portion of a documentary about the Hmong, then talks about the differences between traditional Hmong and recent Western medical practices.

In the cozy living room of a historic home now occupied by the Cancer Wellness House, a dozen women, all affected by cancer, take turns reading aloud passages from Charlotte Perkins Gilman’s The Yellow Wallpaper. An intense discussion follows, concerning the characters, narration, and author of this account of a century-old “rest cure” and its bleak implications, both within the fictional story and for its modern-day readers.

Far from Oprah’s madding crowds of readers, unique pockets of book lovers have assembled in little corners of the Salt Lake area. Their book selections may not make publishers drool, and their featured authors are sometimes dead, not on tour. But their conversations about literature and medicine, pursued through the U’s Visiting Literature Scholars Program, are always fascinating.
Reading about medicine usually implies delving into textbooks, journal articles, reference manuals, and maybe the occasional On Death and Dying-type study. But the growing field of literature and medicine proposes that health-care practitioners can benefit from literary works that deal, perhaps not overtly or scientifically, with medical issues. Confronting a new world through a piece of literature can lead to any number of questions: What does it mean to be called ‘sick’? What roles do doctors and patients assume based on prior experience and cultural background? Or, as Monica Maillet, the visiting scholar and facilitator for the above groups, likes to ask: “Why do you think that?”

The visiting scholars program, the brainchild of Jay Jacobson, professor of internal medicine at the U, has enabled scholars such as Maillet to prod doctors, medical students, and others with those questions. Jacobson, chief of the division of medical ethics at University and LDS hospitals, attended a literature-and-medicine program at Evanston Hospital in Illinois more than 10 years ago. He was immediately enthused by two results of the program: one, engagement—“I saw people talking about issues in medical ethics in a way they wouldn’t if those issues were presented in a didactic way”—and two, candor—“I saw doctors talk about some negative experiences and some emotional issues, something physicians don’t normally do.”

Returning to the U, Jacobson began the monthly reading group at LDS Hospital that still thrives today. With support from the Utah Humanities Council and the Tanner Humanities Center, he subsequently began to bring scholars to the U for a few days at a time. Gradually, the program became more ambitious, with monthly seminars at University Hospital, some original theatre, and, most recently, sponsorships of scholars for six-month visits. Cynthia Buckingham, executive director of the Utah Humanities Council, says it was this focus on a particular profession that interested the council. “Most doctors get their nuts-and-bolts training in medical school but need training in the moral and ethical issues that arise. How do I deal with a dying patient? It’s not simply a matter of prescribing the right dose.”

Jim Overall, professor emeritus of pediatrics and a reading-group participant, agrees. “The readings, plus the open and honest discussions among the 15 physicians attending the seminars, prompted considerable reflection on my own life as a physician—professional and personal values and priorities, the nature of my interaction with patients and physician colleagues, the human needs of patients and physicians, the gifts and shortcomings of the current health care system, and so on.”
For the most recent scholar visit, Jacobson, along with Maillet, the fourth of the scholars, pieced together funding from a number of interested parties: the office of the University’s Vice President for Diversity, the College of Humanities, the Honors Program, and the Utah Humanities Council. It was enough to guarantee the program only through Maillet’s six-month stay.

Maillet, who recei-ved her Ph.D. in theatre (English and classics) from Northwestern, says the literature-and-medicine field was initially conceived of to train medical students “to think more reflectively about what it might mean to confront different feelings and patients.” But that purpose, still the mainstay of the field, has expanded to serve other groups and needs, as evidenced by Maillet’s responsibilities as a scholar at the U. She facilitated four monthly reading groups: the LDS Hospital group, which chose to focus on poetry; the University Hospital group, which focused on health and cultural difference; a medical student group, which held several sessions on the theme of “difference”; and the group at the Cancer Wellness House. In addition, Maillet taught an undergraduate course through the Honors Program, was the keynote speaker at the Gender Equity Award luncheon, sponsored by the student chapter of the Utah American Medical Women’s Association, and made several presentations to classes and groups around the campus and community.

Just as it was for Maillet’s predecessors—Anne Hudson Jones, Joe Cady, and Suzanne Poiriet—the reading material was as varied as the groups. Though there are some canonical texts in the literature-and-medicine field—Maillet points to Tolstoy’s The Death of Ivan Ilych, Eliot’s Middlemarch, William Carlos Williams’ poetry, and Chekhov’s short stories as just a few—her groups at the U were open to all kinds of writing. The University Hospital group, focusing on cultural difference, read, among other works, The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing by Lori Arviso Alvord, M.D., and Elizabeth Van Pelt, and Woman Hollering Creek by Sandra Cisneros. The latter, whose title story deals with a pregnant woman in an abusive relationship and the medical visit that changes her life, led the group to ask questions about the intervention of health-care workers when abuse is suspected and how gender roles and assumptions of authority can affect health issues.

Perhaps most interesting was the small group at the Cancer Wellness House. Its program, “Healing Insights Through Literature,” was unusual, Maillet notes, in that it was primarily made up of patients, not practitioners. “There was a kind of connection between the readings and their lives that was quite moving at times,” she says. Without a pre-set reading list, participants worked together to find appropriate texts. For member Connie Homerstad, the goal was to read something that was not strictly informative. “As a cancer patient, I’ve already read a lot of cancer books. Great literature takes me away from the world of pain and cancer and all that junk we live in. It moves and transforms me.” For those re-examining beliefs during the diagnosis, treatment, or recovery phases of cancer, reading a book such as Two Old Women: An Alaska Legend of Betrayal, Courage, and Survival by Velma Wallis, a tale of elderly women cast out of their nomadic tribe to fight for their lives, can be an opportunity for poignant group reflections and private insights.

As Jacobson points out, for patient or practitioner, there is almost always something stimulating about the right mix of readers and material. “If issues arise through excellent books, people naturally talk about them.” And talking may be just the right balm.

—Theresa Desmond is editor of Continuum.

Copyright 2000 by The University of Utah Alumni Association