Medical Humanities Scholarship

As a medical anthropologist, I study the culture of medicine as it affects patients, healthcare providers, and society at large. I am interested broadly in the problem of clinical uncertainty, and the complex social dynamics and moral problems that arise from it.  Medical practice often must balance precariously on the knife’s edge between offering healing and doing harm, because many of our most powerful therapeutic tools contain the potential for both.  Deciding what can be risked in the hope of helping cannot rely on scientific data alone, but is powerfully guided by social norms and moral values as well.  My research looks to understand how such difficult decisions are made and experienced by the patients, clinicians, and policy-makers faced with them. 

I have explored these issues in two areas of medicine where the balance between saving life and risking it can be uncertain: organ transplantation and pain management.  As an anthropologist, I am interested in comparing how different cultures respond to the problem of clinical uncertainty, and so have studied these issues in the U.S., Mexico, and Spain.

Organ Transplantation

My research on organ transplantation focuses primarily on the social and ethical questions raised by living organ donation.  I have conducted in-depth interviews with living kidney and liver donors in the U.S. to explore how they came to donate and what their post-donation experiences have been.  I have also carried out extensive fieldwork in Mexico to study the development of living donor kidney transplantation there, and its impact on families, the healthcare system, and national politics.  My work on transplantation appears in numerous journal articles and is published in my recent book Domesticating Organ Transplant: Familial Sacrifice and National Aspiration in Mexico.

Pain

Pain is the most common reason for seeking medical care in the U.S.  Yet the subjectivity of pain and the risks that accompany many pain medications often leave clinicians uncertain about how best to assess and treat it.  This uncertainty can produce frustration and even conflict with patients, making pain management a highly contentious area of both clinical practice and public policy.  Using shadow observations and in-depth interviews, I have been studying how clinicians and patients interact and make decisions around pain.  This ongoing research seeks to shed light on these difficult dynamics, and forms the basis of my second book project.

For more information, please see my faculty profile.

Publications

See publications in PubMed.

Contact

Contact Megan Crowley-Matoka, PhD, at 312-503-7962.

My work looks to understand the roles of fear and doubt in scientific and clinical medicine. I want to know the effect of anxiety on the decisions made by biomedical scientists, clinical professionals, health policy makers, and by patients. In short, how does healthcare think, and what should it do, about the things we all fear?

Furthering our understanding of how the anxious imagination affects medicine underpins my first book, A Condition of Doubt: The Meanings of Hypochondria (Oxford University Press, 2012), and is further developed in my current project on the emotion of horror in medicine.

Hypochondria Project Publications

A Condition of Doubt: The Meanings of Hypochondria. New York: Oxford University Press, 2012. 

• Awarded Kendrick Memorial Prize for best book of 2012, Society for Literature, Science, and the Arts.
• Listed in New York Daily News  “10 Best Books of 2012”
• Alexander Nazaryan, “Internal Affairs: On Hypochondria.” New Yorker “Page-Turner” Blog, August 3, 2012.
• Belling C. “Hypochondriac Hermeneutics: Medicine and the Anxiety of Interpretation.” Literature and Medicine.; 25 (2006): 376-401. PMID: 17649838.
• Belling C. “Overwhelming the Medium: Fiction and the Trauma of the 1918 Influenza Pandemic.” Literature and Medicine 28 (2009): 55-70. PMID: 20446644.
• Belling C. “Narrating Oncogenesis: The Problem of Telling When Cancer Begins.” Narrative 18 (2010): 229-247. Won 2010 Schachterle Essay award (SLSA)
• Belling C. “The Living Dead: Fiction, Horror, and Bioethics.”  Perspectives in Biology and Medicine, 53(2010): 439-451. PMID: 20639610.
• Belling C. “Depth Perception: Narrative, Metaphor, Medicine.” Genre 2011; 40(3): 239-261.

Current Scholarship

My work focuses on horror as a specific affective response by both patients and healthcare providers to the content of medicine: disease, suffering, deformity, and death. Initial findings have been that while the content of popular horror stories is extremely similar to the content of patients’ fears and the events of clinical experience, horror itself tends to be discounted or ignored in the medical literature and in medical education. Two levels of further analysis are now underway: qualitative study of practitioners’ own experience of horror in clinical contexts, and a theoretical study of the cultural and philosophical understanding of horror as a way to represent and respond to human experience.

The work has several implications, both for better understanding of patients’ needs and motivations, and for the ethical delivery of care.

• Clinical Setting: Offer a clearer understanding of the unspoken fears—regarding disease and medical interactions—that patients bring to healthcare and that can affect their decision making and adherence to treatment; present the implications of public health discourse’s use of horror tactics to influence population and patient behavior
• Undergraduate Medical Education: Forge an argument that horror needs to be attended to in training (the first manuscript ready for submission will be a study of anatomy lab as a training in the repression of horror in medical students)
• Continuing Education and Professional Development: Argue for the recognition of horror as a valid and normal response in clinicians, who should be trained that to acknowledge and analyze this reaction rather than suppress it is to deliver more ethical care and to facilitate self-care and reduce the risk of burnout

Questions I’m exploring include:

• What events or experiences in patient care provoke the emotional reaction of horror?
• What is horror? Is the reaction of horror morally or ethically weighted?
• How can we ensure that one's visceral (and by definition involuntary) horror reaction to a patient's physical state does not get in the way of one's compassionate connection with the person who is that patient?
• Are there ways to reflect on the experience of horror that might foster compassionate patient care rather than threaten it?

For more information, visit my faculty profile.

Publications

See publications on PubMed.

Contact

Contact Catherine Belling, PhD, at 312-503-3215.

My research incorporates my training in law, clinical ethics and medical humanities, and my background in theater.

Reproductive Ethics

Clinicians and patients across the spectrum of reproductive medicine deserve assistance with their ethical questions, and support in delivering and receiving high quality care. Since abortion is a legal procedure that almost one-third of American women (3 in 10) undergo, much of my current work focuses on the individual, professional, institutional, and social ethics of abortion care in the US. In 2017 Oxford University Press will publish my book on this topic, tentatively titled Scarlet A: The Ethics, Medicine, Law and Politics of Ordinary Abortion.

Medical Communication

In 2002, I created “medical improv,” a training method that adapts theatrical improv exercises and principles and applies them to medical skills such as communication, teamwork, and cognition in healthcare. I have taught Feinberg students this 10-hour medical improv course for 15 years. For four years, I have taught an International Train-the-Trainer workshop for clinicians and standardized patients who want to learn to teach my course. I currently am pursuing outcomes research on the method’s effectiveness. ​This work draws on my role as an adjunct faculty member at The Second City Training Center, and has been published in Academic Medicine and Annals of Internal Medicine.

For more information, please see my faculty profile.

Publications

See publications in PubMed.

Contact

Contact Katie L Watson, JD, at 312-503-1675.

I am a medical historian with a focus on women’s reproductive and sexual health. I am currently researching how surgeries develop and are taken up within medicine, specifically looking at the practice of episiotomy. I am interested in understanding the trajectory from first use to normalization and broader acceptance, and then eventually to challenging the value of this surgical procedure. I want to know what evidence led to its broad adoption in the field, and how, over time, new evidence shifted the field away from seeing the procedure as useful and necessary.

Historical perspective is deeply important to modern medical training for many reasons. For the clinician, it encourages critical thought and skepticism. This ability to challenge an accepted practice can lead to safer and more effective treatments. History can also add dimension to physicians’ understanding of an individual patient or population (e.g., their trust of health professionals, the rationale behind their health decisions).

For more information, please see my faculty profile.

Publications

See publications in PubMed.

Contact

Contact Sarah B. Rodriguez, PhD, at 312-503-2887.