Humanities are a helpful tool when facing difficulties with patients: interview with Isabel Fernandes

isabelfernandes
Isabel Fernandes

We host the interview with Isabel Fernandes, Full Professor at the Department of English Studies of the University of Lisbon, former director of the Centro de Estudos Anglísticos until 2014, and present scientific coordinator of the Narrative & Medicine Project.

Q. When was your first encounter with Medical Humanities?

IF. I went to a conference in Canada – the conference on Narrative Matters in 2008. Rita Charon was there and her lecture on close reading in medical education impressed me a lot. Coming back to Portugal I thought it was possible to start from there, and I involved a doctor, a friend of mine who is also a philosopher. He was enthusiastic, and we tried to gather people around us.

Q. What is close reading? [1]

IF. It is a method which was adopted from the 1920s in USA and UK. It was inspired by people like I.A Richards and TS Elliot; they want to redirect the attention of students and teachers not only to the events of the story but to the language itself, the rhetorical and narrative devices, ambivalence, etc. Close reading is extremely useful when you try to educate people. There is a particular attention to the use of language.

Q. With whom do you practice close reading in health care?

IF. Doctors, future doctors, nurses, psychotherapists, volunteers. Therefore, step by step, we aimed and achieved to have an interdisciplinary semester course here at the University in Lisbon. It is organized in six modules of 8 hours each. Faculty staff come from Literature, Cinema Studies, Ethics, Philosophy, Medicine, Sociology, Nursing and Psychology: each teacher has to decline Narrative Medicine according to his or her background. There is also a lot of practical work. Therefore, we have modules in: Narrative and Literature, Narrative and Communication, Narrative Medicine and Sociology, Narrative Nursing, Narrative Ethics, which deals with the responsibility of the doctor. This year we decided to have one common literary text to be addressed from different perspectives; it is an excerpt of a diary by a Portuguese 20th century physician, Miguel Torga – pseudonym of Adolfo Correia da Rocha, renowned Portuguese poet and writer (“May the sun come, it’s a new day; In the pure land of fantasy; That our darkness enlightened”). As a writer, in his diary he speaks about his anxiety as a possible patient. The course was started in 2012 and runs regularly: the best of this course is that people volunteered, they came without any “prescription” to come; we had a hospital manager, handling hospital organization, and then, reading groups with doctor and nurses in that same hospital. We have also many retired doctors, who want and have the time to rethink their professional experience. We also attracted people from Brazil: humanization of care, together with providing effective care is one of the biggest priorities in Brazil.

Q. You teach Humanities and come from a Humanistic background. How do you find your students?

IF. They think that in their medical studies they had too much scientific and theoretical stuff and technology, six full years, so this is why they are eager for a different approach, especially when they start practicing. The paradigm is a very hard scientific paradigm: it tends to overlook aspects which might be immediately useful to them, as the intersubjective relationship between doctor and patient. However, young doctors are sceptical: they don’t have enough experience with the patients, and that’s why they come to us, since young doctors are very much puzzled by the requests from patients they are faced with, and they want to have some help concerning possible behaviours. We are also intent in showing that Narrative Medicine methods can also contribute to prevent burn out among health care professionals.

 

[1] “In literary criticism, the term close reading describes the careful, sustained interpretation of a brief passage of a text. A close reading emphasizes the single and the particular over the general, effected by close attention to individual words, the syntax, and the order in which the sentences unfolds ideas, as the reader scans the line of text. Nella critica letteraria, il termine close reading descrive l’attenta e prolungata interpretazione di un breve passaggio di testo. Il close reading predilige il singolo e il particolare sopra il generale, risultato di una stretta attenzione alle singole parole, alla sintassi, all’ordine in cui le sentenze rendono le idee, così come il lettore esamina la linea di testo.” open Wiki

Maria Giulia Marini

Epidemiologist and counselor in transactional analysis, thirty years of professional life in health care. I have a classic humanistic background, including the knowledge of Ancient Greek and Latin, which opened me to study languages and arts, becoming an Art Coach. I followed afterward scientific academic studies, in clinical pharmacology with an academic specialization in Epidemiology (University of Milan and Pavia). Past international experiences at the Harvard Medical School and in a pharma company at Mainz in Germany. Currently Director of Innovation in the Health Care Area of Fondazione ISTUD a center for educational and social and health care research. I'm serving as president of EUNAMES- European Narrative Medicine Society, on the board of Italian Society of Narrative Medicine, a tenured professor of Narrative Medicine at La Sapienza, Roma, and teaching narrative medicine in other universities and institutions at a national and international level. In 2016 I was a referee for the World Health Organization- Europen for “Narrative Method of Research in Public Health.” Writer of the books; “Narrative medicine: Bridging the gap between Evidence-Based care and Medical Humanities,” and "Languages of care in Narrative Medicine" edited with Springer, and since 2021 main editor for Springer of the new series "New Paradigms in Health Care."

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