Summary

This monograph is an important contribution—along with the Health Humanities Reader (2014)—to the burgeoning field of health humanities, a new academic field and the presumed replacement for (and expansion of) medical humanities. While the medical humanities included philosophy, literature, religion, and history, health humanities includes many more disciplines, and the creative arts.
This book is dense with theory and abstraction, but it imaginatively and intelligently promotes the notion that health is a larger and more useful concept than disease, which dominates and limits standard medicine. 

Five authors are listed for the book as a whole; none are attributed specifically to any of the eight chapters.
 
The first chapter “Health Humanities” promotes health humanities as an expansion of medical humanities to include more people (including unpaid caregivers and patients), social and national well-being, and the arts, such as dance, music, and visual art. We need to consider wider ranges of meaning, agency, and patients’ varying life stories. Unpaid caregivers have been neglected, even though “the majority of healthcare as it is practiced, is nonmedical” (p. 13). Medicine per se has been too science-based and too disease oriented, but critical theory and the arts can be “enabler[s] of health and well-being” (p. 19) with many applications to hospitals, clinics, homes, and neighborhoods.

“Anthropology and the Study of Culture” describes a wide range of inquiry, both worldwide and throughout human time, including rituals, conceptions of disease, health, death, and impacts for patients. Some cultures believe in spirit possession. The Chinese have worked with qi (life energy) for millennia. Cultural studies look at popular media, spiritual perspectives, also local and subcultural values.
 
“Applied Literature” discusses pathographies, including mental illness (for example, self-harm); it reviews concepts from Rita Charon and describes how reading groups can promote well-being. Literature expands our understanding of humans well beyond the biomedical gaze. Closely related, “Narrative and Applied Linguistics” reviews notions from Osler, Barthes, Bruner, Propp, Frank, and others. Patients want, beyond technical expertise, healthcare personnel who will help them co-create an enabling narrative. New techniques in linguistics include analysis of a corpus of usage, for example, teen language, thereby gaining approaches to young patients who cut themselves.

At 23 pages, the longest chapter is “Performing Arts and the Aesthetics of Health.” It posits that all arts are uniquely human because they are relational, aesthetic, and temporal (with time in a kairos sense, not just chronos). The arts fit into health practices, which also share the same three qualities. The arts promote coherence, agency, communication, expression, and social wellbeing, traits that are described specifically in music, dance, and drama. Similarly, the next chapter “Visual Art and Transformation,” promotes this particular art, whether elitist or popular, as communicative and transformative. The making of art can be healing. 

“Practice Based Evidence: Delivering Humanities into Healthcare” argues against Evidence Based Practice and its limitations. Instead of Randomized Controlled Trials, smaller, more qualitative studies may be more accurate and useful. Practice Based Evidence (and feminist and postmodern approaches) all create wider and deeper notions of validity.

“Creative Practice as Mutual Recovery” suggests that caregivers, whether professional or lay, also find healing as they deliver care.

In “Concluding Remarks” we read, again, that  “the majority of health care and the generation of health and well-being is non-medical” (p. 153). Medicine and medical humanities are “too narrow a bandwidth,” but health humanities can support all caregivers, various institutions (including schools), self-care, and complementary medicine.   

Commentary

This monograph presents health humanities, a new field in the past decade and the presumptive replacement for medical humanities (itself new in the 1980s), which provided an important voice in the improvement of medical care.

The new field of Health humanities subsumes many of the advantages of medical humanities, but it increases the interdisciplinary range, includes the arts, and welcomes new theoretical approaches. Further, it expands realms of delivery to include community care, schools, and prisons, and it involves more people (beyond nurses and doctors) to include all hospital personnel (even cleaners and diet personnel) and, as well, nonpaid caregivers at home.

This book promotes health, not disease, a balance between giver and receiver, not paternalism, and agency, not “autonomy.” It suggests that healthcare became narrowed in the 20th century by positivism, reductive science, Evidence Based Medicine, economics, and public policy. We should keep all the benefits of modern care but also expand our understanding to include other resources, such as the arts, and other intellectual traditions, such as feminist and postmodern inquiry.

The dominance of the pharmaceutical industry in research and delivery of medicine has meant less emphasis on preventive healthcare, often a more efficient and economic path. The book is critical of paternalistic medicine and a sub rosa ideology of elitism and power relations in, at times, a straw-man rhetoric. Health humanities itself also has various ideologies inherent in it. Caregivers, scholars, and thinkers will need to sort out which ideologies serve healthcare best. 

Although inclusive of cleaning and catering staffs, the book has scant mention of clergy—whether hospital chaplains or visiting ministers, priest, rabbis, imams, etc.—or of religion and spirituality in general.

Of the six authors, five are British and one American; they have done ambitious scholarship, drawing on published research worldwide: the 24-page reference section lists over 500 citations from many disciplines. This is an important and valuable book.  

Publisher

Palgrave Macmillan

Place Published

New York and Houndmills

Edition

2015

Page Count

194