Using Literature and Photography to Teach Social Justice and Encourage Activism for Public Health Martin Donohoe
Medicine and Public Health • Schism between the fields • Witnessed victims vs. “statistical” victims • Medical ethics / public health ethics • Activism
Harvey Cushing “A physician is obligated to consider more than a diseased organ, more even than the whole man. He must view the man in his world.”
Martin Luther King “Injustice anywhere is a threat to justice everywhere”
Important Historical Figures in Medicine/Public Health and Social Justice Dr. Thomas Hodgkin (abolitionist and opponent of British oppression of native populations in South Africa and New Zealand) Nurse Margaret Sanger (founder of the family planning movement in the US) Dr. Albert Schweitzer (won Nobel Peace Prize in part for developing a missionary hospital for the poor in Gabon, Africa)
Important Historical Figures in Medicine/Public Health and Social Justice Florence Nightingale (feminist, founder of the modern nursing profession, and advocate for hygienic hospitals) Dr. Salvador Allende (assassinated president of Chile and promoter of better living conditions for the poor and working classes). *The quiet and unknown*
Important Historical Figures in Medicine/Public Health and Social Justice • Charles Dickens • Anton Chekhov • Upton Sinclair • George Orwell • William Carlos Williams
Rudolph Virchow • Founder of modern pathology • Thrombosis, pulmonary embolism, leukocytosis, leukemia • Member of state and local government for over 30 years • Founded journal Medical Reform
Rudolph Virchow • Argued that many diseases result from “the unequal distribution of civilization’s advantages” • Advocated public provision of medical care for the indigent • Promoted universal education
Rudolph Virchow • Worked to outlaw child labor • Improved water distribution and sewage system • Enhanced food inspection process • Published study of skull volumes to dispute myth of larger Aryan brains
Rudolph Virchow • Passed hygiene standards for public schools • Set new standards of training for nurses • Improved local hospital system
Rudolph Virchow “Doctors are natural attorneys for the poor … If medicine is to really accomplish its great task, it must intervene in political and social life…”
The Role of Literature • Vicarious experience • Explore diverse philosophies • Promotes empathy, critical thinking, flexibility, non-dogmatism, self-knowledge • Encourages creative thinking • Allows for group discussion/debate
Why Use Literature • Encourage appreciation of non-medical literature • Develop reading, analytical, speaking and writing skills • Promote ethical thinking (narrative ethics) • Identification with doctor authors (e.g., Keats, Chekhov, Maugham, Williams)
Why Study Literature? “Why live? Life without literature is reduced to penury. It expands you in every way. It illuminates what you’re doing. It shows you possibilities you haven’t thought of. It enables you to live the lives of other people…It broadens you, it makes you more human. It makes life more enjoyable.” M.H. Abrams
Nurse Margaret Sanger Books have been to me what gold is to the miser, what new fields are to the explorer.
Readings • Oliver St John Gogarty • Keats • Chekhov • Maugham • WC Williams
Stigmatization John Updike “From the Journal of a Leper.” Am J Dermatopathol 1982;4(2):137-42
Homelessness Doris Lessing “An Old Woman and Her Cat” From the Doris Lessing Reader (New York: Knopf, 1988)
Race and Access to Care Ernest J Gaines “The Sky is Gray” in Gray, Marion Secundy, ed. Trials,Tribulations, and Celebrations: African American Perspectives on Health, Illness, Aging and Loss. Yarmouth, Maine: Intercultural Press, 1992
Poverty • Orwell, George. How the Poor Die. In Sonia Orwell and Ian Angus, eds. The Collected Essays, Journalism and Letter of George Orwell, IV; In Front of Your Nose, 1945-1950. New York: Harcourt, Brace and World, Inc: pp.223-233. • Eighner, Lars. Phlebitis: At the Public Hospital. In Travels with Lizbeth. New York: St. Martin’s Press, 1993.
Domestic Violence Michael LaCombe “Playing God” In LaCombe M, ed. On Being a Doctor. Philadelphia: American College of Physicians, 1994
Human Subject Experimentation / Human Rights Abuses Shusaku Endo The Sea and Poison (New York: Taplinger Publishing Co., 1972)
Conflicting Responsibilities of Physicians Pearl S. Buck “The Enemy” In Far and Near: Stories of Japan, China, and America (New York: The John Day Company, 1934)
Christopher ColumbusUpon meeting the Arawaks of the Bahamas They…brought us…many…things…They willingly traded everything they owned…They do not bear arms…They would make fine servants…With fifty men we could subjugate them all and make them do whatever we want.
Josef Stalin The death of one man is a tragedy. The death of millions is a statistic.
Horace Odes (III.2.13) Dulce et decorum est pro patria mori It is sweet and fitting to die for one’s country
"Dulce Et Decorum Est"Wilfred Owen, 1917-18 … In all my dreams, before my helpless sight, He plunges at me, guttering, choking, drowning. If in some smothering dreams you too could pace Behind the wagon that we flung him in, And watch the white eyes writhing in his face, His hanging face, like a devil's sick of sin;
"Dulce Et Decorum Est"Wilfred Owen If you could hear, at every jolt, the blood Come gargling from the froth-corrupted lungs, Obscene as cancer, bitter as the cud Of vile, incurable sores on innocent tongues,- My friend, you would not tell with such high zest To children ardent for some desperate glory, The old Lie: Dulce et decorum est Pro patria mori.
Dwight D. Eisenhower Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and not clothed.
“Mother’s Day Proclamation, 1870”Julia Ward Howe Arise then...women of this day!Arise, all women who have hearts!… Say firmly:"We will not have questions answered by irrelevant agencies,Our husbands will not come to us, reeking with carnage,For caresses and applause.
“Mother’s Day Proclamation, 1870”Julia Ward Howe Our sons shall not be taken from us to unlearnAll that we have been able to teach them of charity, mercy and patience.”… From the bosom of a devastated Earth a voice goes up withOur own. It says: "Disarm! Disarm!
“Mother’s Day Proclamation, 1870”Julia Ward Howe Let women … …promote the alliance of the different nationalities,The amicable settlement of international questions,The great and general interests of peace.