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Health Humanities: now and future | King’s College London, June 26th-27th

The conference of the Consortium for Humanities Centers and Institutes (CHCI) was devoted to the future of Health Humanities. A marathon that has focused on “the discourse on the method”, dialoguing on comparison, encounter, and clash between scientific and humanistic research: two worlds, apparently distant, that need to be made for a mutually enriching dialogue to improve healthcare paths.

Talking about “schism” – among other things, the meeting was just one day after the declaration of the victory of the “to leave” side of Brexit – speakers addressed the theme of the division pervading the editorial standards of publications in scientifc and Medical Humanities field. The latter, if we don’t educate the scientific community, will probably become essays, or best-seller fiction profiting on illness narratives. However, we must try to write so that clinicians, the carers and health policy makers to grasp the depth and power of narrative tools. A bit of cunning is necessary: including a “meaningless” but validated questionnaire, we can accomplish certain habits of the referees, keeping them in a comfort-zone. Speakers confirmed the paucity of the sense given by close-ended questions or by scales from 1 to 10 to evaluate “happiness” and “unhappiness”, if we don’t wonder about what might be conditions leading to happiness or unhappiness. Rhetoric the mentioning that every social and national context has its specificity: a 6 collected in Italy can be quite different from a 6 collected in Greece.

As for perception of diversity among countries, the World Health Organization presented the working group called “Cultural context for health”: the theme of understanding cultural contexts to ensure effective care is fundamental to guarantee quality of care. WHO refers to the UNESCO definition of “culture”: it is “that complex whole which includes knowledge, beliefs, arts, morals, laws, customs, and any other capabilities and habits acquired by [a human] as a member of society”.

In 2015, a Lancet commission indicated that the lack of understanding of culture was the key-reason for not providing adequate medical care. Narrative methodologies enter this context, much more effective in defining organizational and individual cultures: then comes the need for WHO to include, among its tools used for the orientation of social and health policies, a work on the guidelines for “Narrative method in public health” – for which Maria Giulia Marini, Director of the Health and Wellbeing Area of ISTUD Foundation, has been chosen as referee, given continuing English publications on Narrative Medicine.

The openness of WHO – born with a clinical orientation – to a narrative world for a better listening to the needs of citizens, patients, families, carers, and people in general, it’s an extraordinary event since we all believe that Narrative methods are one of the keys to produce health.

Among the presentations, there was the interesting work of the University of Exeter on the issue of patients’ “eternal” time perception: in a world at risk to throw away of the dream of the WHO definition of health (“a complete state of psycho-physical-social wellbeing, and not just the absence of disease”), patients are forced into a prolonged waiting, a “frozen time”, to receive replies by healthcare providers. “Frozen time” is a definition able to cross not only the disease, but the whole contemporary society. As if there were an amplified “Waiting for Godot”, concerning precariousness, economy, state and human relations. Seeking a balance for all between patience and impatience is the challenge we must address.

Another brilliant presentation was that of the University of North Carolina: the oversimplification of empathy. Trivial “recipes” to standard questions on empathy were admirably debated, denouncing the excessive bureaucratisation and commercialization of oversimplified courses on this skill. Too often empathy is treated and taught in a “pathetic” and excessively compassionate way, forgetting another innate and natural human quality: in addition to crying, the ability to smile and laugh.

More lightness, light, and joy might – and should – be present in care settings, waiting rooms, academies, healthcare institutions, and social networks. Humour, smile, a gentle joke – without falling into an offensive cynicism, but returning to the ability to laugh: people hating laughter – as Umberto Eco wrote in “The Name of the Rose” – become murderers in order to live in tragedy, erasing human comedy. Comedy is a universal skill, therefore, despite secessions, schisms and heaviness of judgement, the dream is learning how to minimize situations full of tension, anger, pain and sadness, even in saddest care settings. No longer a hospital as suffering, but as a place of peace and serenity.

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Epidemiologist and counselor – 30 years of professional life in health care. Classic humanistic background, including the study of Latin and ancient Greek, followed by scientific academic studies, chemistry and pharmacology. First years of career, in private international environment. I worked in medical research, moved to health care organization, getting academic specialization in Epidemiology. Later, in consultancy and health care education. Counselor with transactional analysis orientation. Currently, director of Innovation in Health Care Area of Fondazione ISTUD, an independent not for profit Italian Business School with an humanistic approach acknowledged by the Italian Ministry of Researech.. Active member of the board of Italian Society of Narrative Medicine, tenured professor of Narrative Medicine at Hunimed, Milan, and in 2016, referee for World Health Organization for “Narrative Method in Public Health.” Writer of the book; “Narrative medicine: Bridging the gap between Evidence Based care and Medical Humanities,” edited with Springer and of international publications on narrative medicine in scientific journals. Last book “The Languages of care in narrative medicine: words, space and sounds in the healthcare ecosystem”. Lecturer in different international contexts from Academy to Public and Private Foundations.

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