Although humor is an integral part of human existence, its use in the doctorpatient relationship has not been studied extensively. Previous research has concluded that laughter between doctors and patients is asymmetrical, and that it serves to accentuate social distance. In a brief study of interactions between the author and two patients, abundant evidence of humor, with or without laughter, was found. This humor was varied and complex, and served to reinforce a sense of equality between physician and patient, to build a relationship between them, and to represent a sense of control and healing for the patient. Moreover, the humor did not detract from the patients’ perceptions of competent and professional medical care.
Knight has shown how the moral growth of medical students involves a spiritual journey. He may, however, present too sanguine a portrayal of the extent to which the medical education environment promotes this moral and spiritual growth. Medical school may indeed be more abusive than supportive. Admitting more women to medical school and teaching more humanities courses, while worthwhile, will not necessarily promote the goals that Knight appropriately advocates.
inThe longer I practice medicine, and the longer I teach medical students, the centrality of literature to my work becomes ever clearer. Every day in the office, I listen to patients' stories; I hear about their pain, suffering, hopes, dreams, loves, and losses. Through my patients' stories, just as through literature, I learn how and why people suffer, and how they heal. I learn how people's philosophies and experiences affect how they see the world and how they go about living in it. These topics were blatantly left out of my formal medical education. My own background in literature has helped me to analyze, as well as to elicit, my patients' stories.Without a sound and extensive knowledge of people and of human nature, a doctor operates in a vacuum. "Noncompliance" becomes an enigma, rather than the logical outgrowth of a person's life choices. Recommending tests and treatment becomes an adversarial activity rather than a discussion and negotiation connected with the patient's value system and life situation.Literature provides us with a more extensive exposure to a variety of people than we can assure through medical practice alone, especially for beginning doctors and students. Moreover, through literature, we see what parts of human interaction can give others strength, and which parts cause them harm. We see how people change, and why they don't. We see what threatens them and what nourishes them. By knowing literary characters, we enlarge our ability to know people in general and our patients in particular.Sometimes students become angry about particular stories, especially those dealing with issues like racism, sexism, or strong emotions. Instead 1Address correspondence to Harriet A. Squier, M.D., M.A.,
Just as the history of women in aUopathic medicine had been largely ignored in writings about the history of medicine until quite recently, so has the history of homeopathic women physicians been neglected in the history of homeopathy, despite the knowledge that many, if not the majority, of women physicians in the nineteenth century belonged to medical sects, x Although homeopathy was the main rival of aUopathic medicine in the mid to late nineteenth century, the literature about homeopathy is sparse compared to that of regular medicine. Only one-tenth of all nineteenth century physicians were sectarian. And since homeopathy ceased to be a serious rival to allopathy in the early twentieth century, and has left few obvious marks on current medical practice, it has slipped from the attention of medical historians. 2 Even though 17% of homeopathic physicians in 1900 were women, compared with 5-6% of regular physicians, histories of homeopathy typically fail to discuss women physicians in any substantive way. 3Because of the paucity of information about women homeopaths, two nineteenth century novels which depict main characters who are women homeopathic physicians will be used as a touchstone of discussion. While novels portray fictional characters and events, and thus may be unreliable as sources of factual historical information, these books do provide the twentieth century reader with suggestive glimpses of what life may have been like for women homeopaths of the 1880's. In addition, these novels raise many questions for the medical historian about homeopathy in general, and homeopathic women physicians in particular. 1Address corre~ndence to Harriet A. Squier, M.D., M.A.,
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