The day’s event on 4 May 2011 was organised by the RSM’s History of Medicine Section, whose president, Bloomsbury general practitioner Claire Elliott, made the opening address: “Does the history of medicine make us better doctors?” Elliott is also a clinical teaching fellow in primary care at UCL, and she would certainly respond in the affirmative. Her carefully selected, varied examples from fine arts, poetry, literature, and film illustrated why: the portrayal of doctors in art can lead to a greater appreciation of what doctors do; it can convey shared values and codes of conduct that may or may not have changed over centuries; it shows that the historical periods in which doctors work influences their work and their patients. The mainstays of a doctor’s activities are observation, listening, and integration; the basis of their work is academic rigour, scientific skills, understanding of relationships, and understanding the impact of illness. Elliott’s examples included the film/novel Middlemarch, paintings by John Singer Sargent, Picasso; A J Cronin’s The Citadel (book and film); and Atul Gawande’s book Better. In Elliott’s view, medical history as portrayed in art provides a sense of continuity as well as promoting an awareness of changes in medical practice and can thus help to orientate today’s doctors.
Brian Glasser, lecturer/film reviews editor at UCL Medical School, focused on the cinematic representation of medicine in biopics (combining fact and fiction, a real person’s life, society’s aspirational values—example: Dr Ehrlich’s Magic Bullet, documentaries (health information and education— Sicko, Titicut Follies, A Hospital Remembers, The English Surgeon), and fiction films. His examples illustrated that in some ways, nothing much has changed—surgeons, for example, still seem to work in pretty similar ways (1964’s Doctor in the House vs 1991’s The Doctor).
Retired consultant psychiatrist and BMJ columnist Theodore Dalrymple pondered the question, “What use is literature to medicine?” He tried to apply the methods of evidence based medicine, but this did not provide any answers, and there is no evidence that an interest in literature would make medical students better doctors (or even better people). Although literature provides viewpoints other than one’s own, the benefits are not measureable—on the other hand, some things don’t need to be measured to be known. A broad education gives life meaning, and so Dalrymple concluded that although there is no evidence that being cultured, well read, and good writers makes doctors better at their jobs, it is hard to imagine them not doing so.
Emily Mayhew from Imperial College London dissected the various means and meanings of representing facial trauma in war films and explained how historians are able to help film makers with the historical and medical detail, to ensure accuracy and help logical plot development. She chose three films to illustrate her point that facial disfigurement is introduced in different ways according to the subject or historical context. She also drew attention to the fact that while facial trauma is an iconic injury for the second world war, for the Afghanistan war this would be multiple amputation.
Retired chest physician and writer Dannie Abse provided a different approach by reciting from his varied, accomplished, and wonderful poetry, some funny, some rather terrifying. If the audience needed confirmation that poetry and medicine are not mutually exclusive, this was it.
Michael Clark, visiting lecturer in Film and Medicine at the Centre for the Humanities and Health at King’s College London focused on Jean-Paul Rappeneau’s 1995 film The Horseman on the Roof. One of the film’s major themes is the cholera outbreak in southern France in 1832. In spite of its medical theme, it is pretty much a doctor-free zone, with one exception. Cholera is clinically and accurately depicted, serves as a historical event as well as a metaphor and provides the narrative structure for the film.
Different approaches to the subject and different examples made for a lively and interesting day and provided me with a long list of films to watch and books to read.
Birte Twisselmann is a web editor at the BMJ.