Introduction to Medical Humanities: Medicine and the Italian Artistic Heritage PDF
Preview Introduction to Medical Humanities: Medicine and the Italian Artistic Heritage
Renzo Pegoraro Luciana Caenazzo Lucia Mariani Editors Introduction to Medical Humanities Medicine and the Italian Artistic Heritage Introduction to Medical Humanities (cid:129) (cid:129) Renzo Pegoraro Luciana Caenazzo Lucia Mariani Editors Introduction to Medical Humanities Medicine and the Italian Artistic Heritage Editors RenzoPegoraro LucianaCaenazzo PontificalAcademyforLife DeptMolecularMedicine Roma,Italy UniversityofPadua Padova,Italy LuciaMariani FondazioneLanza Padova,Italy ISBN978-3-031-04918-7 ISBN978-3-031-04919-4 (eBook) https://doi.org/10.1007/978-3-031-04919-4 ©SpringerNatureSwitzerlandAG2022 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthe materialisconcerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation, broadcasting,reproductiononmicrofilmsorinanyotherphysicalway,andtransmissionorinformation storageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology nowknownorhereafterdeveloped. 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ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Introduction A Course in Medical Humanities in Padua Medical Humanities “Medicalhumanities”isanuntranslatableandoftenmisconstruedterm,borninthe UnitedStatesinthe1960s,alongwithbioethics,inthecontextofwhatisknownas the“contemporarycrisisinmedicine.” Since the dawn of “laboratory medicine” in the late nineteenth century, physi- ciansgraduallyshiftedtheirfocusfromthe“patient”tothe“disease”asthecentral entityoftheirstudyandpractice.Sincethen,clinicalinteractions,dialoguewiththe patient,anddiagnosishavebeendeeplymodifiedtothepointthattheindividuality ofpatientrisksbeingcompletelyreducedtotheinstrumentaldatacontainedintheir medicalrecords.Technology,now,isbetweenthedoctorandthepatient,changing medicineintoasciencethatseemsunabletocontemplatethefundamental“individ- uality”ofpathologicalphenomena.Thecrisisofmedicinepartiallyderivedfromthe dramatic change in the “medical gaze” toward patients and diseases. Laboratory medicine, moreover, requires enormous economic costs for its instruments and procedureswhichbothindustrializedanddevelopingcountriesareevenmoreunable to sustain. The unequal distribution of healthcare determined by economic con- straints favors a perception of medicine as a science which contributes to social inequality. “Medical humanities” might represent a crucial instrument for creating a new relationship between doctors and patients. It encompasses the idea of offering cultural and cognitive tools to health practitioners, allowing them to establish a better, “more human,” and trusting relationship with patients and their illness. The effort of “re-humanizing” medical education and practice emphasizes the concepts of human vulnerability, individual autonomy, empathy, and responsibility for the other as part of the basic identity of human beings. The early supporters of the movementwerehospitalchaplainsandministersinmedicaleducation.Theyfocused v vi Introduction on “rehumanizing” medical education and practice by putting humanities courses intothemedicalcurriculum. AsdescribedintheNewYorkUniversitySchoolofMedicinewebsite,theterm “medical humanities” concerns the relationship between humanities (literature, philosophy,ethics,history,andreligion),arts(literature,painting,sculpture,theatre, and cinema),social sciences (anthropology, psychology, and sociology), and med- icine. Literature, for example, might prepare health practitioners to deal with the “narrative” aspects of health and disease. Asick man becomes a “patient” through offeringa“story”tothedoctor,whoneedstobeabletounderstandallofitsexplicit and implicit features. Philosophy, ethics, history, and religion are essential to understand the moral and aesthetic values involved in the perception of health and illness, as well as in any decision that might be undertaken, by both patients and doctors, to improve health or fight diseases. Humanities and arts, in sum, provide important information about the human condition, its sufferings, and our responsi- bility towards each other. Jointly, they offer a historical perspective on medical practice.Thefocusonliteratureandartsaimsatdevelopingandconsolidatingskills, suchasobservation,analysis,empathy,andself-examination,whichareessentialin medicalpractice.Socialscienceshelpustounderstandhowbioscienceandmedicine movewithindifferentsocialandculturalcontextsandhowcultureinteractswiththe individual’sexperienceofillnessandthewaysinwhichmedicineispracticed.The social perspective is essential to understand that patients’ and doctors’ beliefs and decisionsabouthealthanddiseasearedeeplyinfluencedbyeconomicconstraintsas wellassocialstatus. At a time when medicine demonstrates an increasing and almost exclusive reliance on scientific and technological progress, it is necessary to restore and promote the important relationship that always existed between medicine and the arts. It is crucial that medical schools teach future physicians how to deal with suffering. A medical curriculum, based uniquely on sciences, does not prepare studentstodealwiththerealperson,apersonwithconcreteproblems.Itispossible tosaythatacurriculumbasedonlyon“hardsciences”mightexcludetheteachingof authenticmedicalproblems,whichinturnarecrucialforanamnesis,diagnosis,and therapy. Tofacepresentandfuturemedicalissues,itisessentialtoregaintherelationship, lost and neglected over the last centuries, that exists between the human condition and spirituality, between charity and suffering, between life and death. Reading medicine from the perspective of social sciences gives health professionals an advantagetoestablishthatsubstantial,andnotjustformal,therapeuticalliancethat allowsthemtoreallyidentify,casebycase,themostappropriatetherapeuticchoices. Scientific and technological progress, social changes, the increasing levels of competenceachievedbymanypatients,andastrongerperceptionoftheirroleinthe processofdiagnosisandtreatmentrequireanewprofileforboththephysicianand thehealthprofessional.Whatitisneededisanew,or“older,”kindofdoctorableto rootandcultivatetheirscientificexpertiseonthedimensionofserviceastradition- allyascribedtotheirprofession. Introduction vii Health and disease are not simply biological phenomena determined by quanti- tative andanatomicalparameters, butthey arealso complex cultural objects which can be fully understood only in their socio-historical context. The humanities undoubtedlyofferphysicianstheinstrumentstofunctionwithintheirownperception ofpatientsanddiseases,aswellaspatients’ideas,beliefs,andexpectations,which dramaticallyaffectthetherapeuticpathway. The Book The book proposes an integrated and interdisciplinary approach to analyze and interpret the human experience of illness, disability, healthcare, and medical inter- ventioninordertotrytotakehealthcarepracticebacktoitsoriginalpurpose:“bea medicinefortheperson.” Italianandinternationalexpertsinpainting,sculpture,literature,cinema,forensic science,psychiatry,bioethics,andhistoryofmedicineofferedtheirqualifiedobser- vations, proposing a “humanistic” reflection on illness, medicine, and the role of physicians and nurses. All contributions were intended to overcome a reductive conception of treatment practices that explain illness only according to bio-molecularreactions.Thehumanitieshavealwaysofferedafundamentalcontri- butiontotheaspirationofgainingamorecompletepictureofillness,andimproving medicalcareandourassistancetothesick.Insteadoffindingaclinicalexplanation, the humanities offer a deeper understanding of the human side of illness, both personal and social, encouraging a greater empathic understanding of self, the other,andtheoveralltherapeuticprocess. AfterthefirsttwochaptersbySandroSpinsantiandMarioPicozzi,whichwecan consider as introductory, this publication presents chapters offering different per- spectivesinmedicalhumanities. In their chapters, Anna Borovecki and Luciana Caenazzo analyze the path of bioethics in the countries of the Mediterranean basin, while Fabio Zampieri and Alberto Zanatta draw a profile of the history of medicine through the analysis of medical liability in situations that occurred in the Medical School at Padua University. To reopen the dialogue between medicine, ethics, and the humanities, Paolo Cattorini proposes a narrative approach emphasizing the role of cinema as an educational tool to test the general theories and deepen the moral awareness of individuals,particularlyhealthcareprofessionals. Another important aspect in medical humanities is represented by narrative medicine, which has been well analyzed by Lucia Galvagni through sick persons’ perspectives, and exemplified by Pamela Tozzo and co-authors through the Grac- chusstory,andbyHubZwartinhischapteronanewinterpretationofDanBrown’s Inferno. viii Introduction Gabriele Righetto explores the aspects of architecture and Giovanna Baldissin MolliexploresthoseofsculpturewhileGiovanniSegusoexpressesinpoetryallthe emotionsrelatedtohisnativeland. Sefik Görkey, using tracking shot of some beautiful Italian frescoes, both reli- gious and secular, analyzes this kind of art from the medical point of view. Some religious scenes offer us enormous information on different diseases and their symptoms,betheyrealisticortotallyimaginative. Throughthesuggestionsofferedbythebook’schapters,youngmedicalstudents, physicians,andhealthpractitionerscaninitiateapersonalreflectiveitineraryonthe theme of pain and suffering. They can learn through the patient’s subjectivity to recognizethefundamentalquestionsoflifeanddeath,rightorwrong,goodorevil, andfindempathyastheguidingstaroftheirprofession. UniversityofPadua,Padova,Italy LucianaCaenazzo FondazioneLanza,Padova,Italy LuciaMariani PontificalAcademyforLife,Rome,Italy RenzoPegoraro Contents 1 TheMedicalHumanities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 SandroSpinsanti 1 “Humanitas”andItsVariants:AFamilyofMeanings. . . . . . . .. 1 2 The“MedicalHumanities”inPractice. . . . . . . . . . . . . . . . . . . . . 10 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 2 ClinicalEthicsintheContextofMedicalHumanities. . . . . . . . . . . 17 MarioPicozziandFedericoNicoli 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 17 2 TheCrisisinMedicineandinBioethics. . . . . . . . . . . . . . . . . . . 18 3 MedicalHumanitiesandtheConceptofAcknowledgment. . . . . . 20 4 ClinicalEthicsConsultation:APossibleCommonPoint. . . . . . . . 23 5 WhatKindofSpecificTraining?AnItalianExperience. . . . . . . . 25 6 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Bibliography. .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. 28 3 Perspectiveson“MediterraneanBioethics”. . . . . . . . . . . . . . . . . . . 31 LucianaCaenazzoandAnaBorovecki 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 31 2 Whya“MediterraneanBioethics”?. . . . . . . . . . . . . . . . . . . . . . . 33 3 TheFuturePerspectiveon“MediterraneanBioethics”. . . . . . . .. 35 Bibliography. .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. 36 4 MedicalLiability:TwoHistoricalCasesfromPadua. . . . . . . . . .. 39 AlbertoZanattaandFabioZampieri 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 39 2 CaseI:TheDoctor-PatientRelationshipbetween“Ethics”and “Cunning”–GabrieleZerbi. . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 3 CaseII:TheCynicalDoctor–AlessandroKnipsMacoppe. . . . . . 48 4 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 ix x Contents 5 MedicalIssuesinItalianFrescoes. . . . . . . . . . . . . . . . . . . . . . . . . . 61 ŞefikGörkey 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 61 2 (Medical)HumanityThroughItalianFrescoes. . . . . . . . . . . . . . . 63 3 AnatomicalKnowledgeandItalianFrescoes. . . . . . . . . . . . . . . . 64 4 MedicalDiagnosisThroughItalianFrescoes. . . . . . . . . . . . . . . . 65 5 DisabilityThroughItalianFrescoes. . . . . . . . . . . . . . . . . . . . . . . 66 6 EpidemicsThroughItalianFrescoes. . . . . . . . . . . . . . . . . . . . . . 67 Bibliography. .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. 68 6 TheSculptedBody:InterferencesBetweenBeautyandAnatomy.. 69 GiovannaBaldissinMolli 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 69 2 BodyRepresentations:TheExperienceoftheSacred. . . . . . . . . . 72 3 AnatomicalKnowledge:DissectionandRelics. . . . . . . . . . . . . . 75 4 TheDrawing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 5 Michelangelo’sLegacy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 6 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Bibliography. .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. 87 7 ClinicalNarratives:StoriesandEthicsinHealthcare. . . . . . . . . . . 91 LuciaGalvagni 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 91 2 NarrativesandMetaphorsofHealthandDisease,Illness,andCare 92 3 BetweenMedicineBasedonScientificEvidenceandMedicineThat ListenstoStories:TheReturnoftheHumanitiesinClinicalPractice 94 4 StoriesBetweenMoralImaginationandNarrativeIdentity. . . . .. 97 5 StoriesofPatientsandCarers. . . . . . . . . . . . . . . . . . . . . . . . . . . 98 6 ForaPhenomenologyofIllness. . . . . . . . . . . . . . . . . . . . . . . . . 101 7 CareAmongMoralLife,ExistentialDynamics,andInstitutional Realities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 8 ViralPandemicsandtheAdventofNeo-Renaissance:ALacanian ReadingofDanBrown’sInferno. . . . . . . . . . . . . . . . . . . . . . . . . . . 107 HubZwart 1 Introduction. .. . . .. . . .. . . .. . . . .. . . .. . . .. . . .. . . .. . . .. 107 2 PlotSummary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 3 ConceptualFrameworkandDesign:TheFourDiscourses. . . . . . 112 4 First“Therapy”:AwakeningtheUnworldlyExpert(theMutual ExposureofPastandPresent). . . . . . . . . . . . . . . . . . . . . . . . . . . 117 5 Second“Therapy”:ACravingProdigyandtheMathemeofDesire 119 6 Third“Therapy”:BertrandZobrist–PsychopathorTherapist?. . . 122 7 Fourth“Therapy”:ThePolicyofDenial. . . . . . . . . . . . . . . . . . . 125 8 Resume:Inferno’sBasicStructureinTermsoftheFourDiscourses 127 9 TheObjectaas“Actor”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 10 ImplicationsforVirology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Bibliography. .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. . . . .. 135
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