"This will keep me happy for weeks": care objects, affect and graphic medicine.

Looking beyond anthropocentric care relationships reveals nuanced levels of interdependence among human and non-human entities. Attention to these heterogeneous inter-relationships illuminates the subtle and visceral affective intensities among diverse participants, including humans, objects and the environment, among others. The interdisciplinary field of graphic medicine foregrounds these entanglements through comic affordances, challenging the predominant notion that care belongs only at the scale of human beings. This article analyses selected sections from graphic medical narratives such as Brian Fies's Mom's Cancer, Sarah Leavitt's Tangles and Joyce Farmer's Special Exits to illustrate how objects become a source of care for humans during illness, thus becoming care objects. Furthermore, using the affordances of comics, this essay examines, how the selected sections of the abovementioned graphic narratives portray the often unnoticed/overlooked affective entanglement between the sufferers and objects. In doing so, this article underscores the inter-relatedness between humans and non-human entities within the context of caregiving.

Disruption, transformation and silos: medical humanities and the management gurus.

To disrupt, to transform and to break through silos are common sense aims for the medical humanities and other interdisciplinary endeavours. These keywords arise because of the influence upon the academy of management and business gurus, reputed experts who arose in response to the economic crises of the 1980s. Despite the noted analytic deficiencies in the concept of disruption, and its association with product innovation, the term has been extended to academic research, where it connotes radical novelty in research practice, typically accompanied by profound organisational and managerial change. 'Disruption' has become wedded to the word 'transformation' as national funders seek to support more radically innovative research that will maintain Western economic hegemony. A distorted version of Kuhn's model of scientific revolutions underpins the discourse of transformation, which fits humanities research to a template in which revolutionary, transformative shifts can be instrumentally favoured by funders, at the expense of inferior 'incremental' progress. Disruptive and transformative research are, according to funders, more readily produced in organisations that have broken through silos between disciplines. The silo metaphor misleadingly models academic disciplines as if they were essentially unitary entities, akin to the functionally specialised units of a business organisation. The discourse of silos arises from the guru doctrine of the learning organisation. This theory supposes that the organisation-including the university-is literally a living organism, and thereby susceptible to corporate sickness, mortality, infection and disability. Medical humanity researchers should be aware of, and reject, this vitalist metaphysic in which the optimal organisation is a culturally homogeneous supra-personal organism whose immense capacities are harnessed by visionary leaders. Moreover, a new vocabulary should be developed for research evaluation, superseding the supposed hierarchical opposition between transformative and incremental research.

Federal field nurses and Indigenous births.

Beginning in 1924, the US Office of Indian Affairs sent public health or 'field' nurses to Native nations to provide preventative healthcare and education. The field nurse programme began under the US policy of assimilating Native Americans. To that end, field nurses championed 'modern' institutionalised medicine and opposed Indigenous health traditions. They taught an ethnocentric form of health education to Native mothers, and their work was complicit in the genocidal policy of removing Native children to federal boarding schools. However, Indigenous women resisted many of the interventions of the field nurse programme. They also exercised medical pluralism and sought other field nurse services relating to childbirth, prenatal and postpartum health, sometimes in defiance of the nursing programme's professional boundaries. The history of the field nurse programme reveals the ways in which professionalised public health nursing served settler colonial policy, yet it also showcases Native women's self-determination as pregnant patients and as nurses themselves.

Prognostication: A fading Hippocratic art?

Over the past 75 years modern medicine has advanced in its ability to diagnose and treat many diseases. However, the medical profession's ability to prognosticate the course and outcome of an illness has not satisfied the needs of many patients. Physicians must not lose the ability, or desire, to consider the whole person in relation to a patient's disease. We need to ask ourselves what person has the disease, not what disease the person has. Here I endeavor to demonstrate why Hippocrates valued prognostication highly, how its importance may have faded from the consciousness of current medical practice, and how modern technology is attempting to reinvent or revise it.

'You come as a human being ': exploring sense of equality in arts interventions through an ethnographic study of Shared Reading.

Research shows that the arts hold a particular potential for promoting health, well-being and social inclusion for vulnerable people. However, the use and consumption of the arts tend to be socially skewed in favour of people with high cultural, social and economic capital. While extensive research has been conducted on how to create equal access to arts activities for vulnerable groups, little research has investigated how to ensure meaningful engagement with the arts by this group. Shared Reading (SR) has had considerable success in engaging vulnerable groups in collective literary practices, and research suggests that this may partly be due to the unique forms of social and literary engagement that the concept fosters. These forms of engagement, we suggest, lay the foundation for a sense of equality among participants that may promote social connectedness and well-being. On this basis, the present study aims to investigate whether and how a sense of equality may play a role in SR practices. The study found that SR promotes a sense of equality by creating a space where social interaction and relatedness does not hinge on social roles, but rather on lived experiences-and vulnerabilities inherent to these-conveyed through literary texts and shared among participants. However, to promote a sense of equality in SR, meaningful engagement for all participants must be ensured, making facilitation an essential element of SR practices and an important focus in arts interventions in general. We conclude that SR, and arts interventions more generally, may be a promising way to promote a sense of equality, but further research is needed on the specific qualities of and potential contexts for the promotion of a sense of equality.

Between medicine, humanities and the law: compiling a living archive of assisted dying.

Stories about personal experiences of assisted dying, a term comprising both instances when a lethal substance is administered by a physician or by the patient themselves, are frequently cited in law-making processes. These experiences of healthcare systems and the laws governing end-of-life procedures thereby interactively influence the future of medicine at the deathbed. With more countries legalising some form of assisted dying or opening political debate about the issue, addressing how these personal stories shape public opinions and social institutions is timely. In this current controversy, we question how medical humanities researchers are to make sense of the role of these stories in law-making, and critically reflect on a digital archive that seeks to make these interconnections visible. At the methodological level, the reciprocal interactions in assisted dying between medicine, law and the arts urges us to reconsider the conceptual foundations of interdisciplinary research in the medical humanities.

Rethinking empathy: professional work with persons with PIMD.

This article combines ethnographic interpretations with analyses of the conceptual history of empathy. Moving beyond the more common notions, which often rely in psychological theories and terminologies, the conceptual-historical analyses trace its roots to 18th and 19th century notions of 'Einfühlung'. As the ethnographic work follows the professional work with two young women with profound intellectual and multiple disabilities, the article makes a fivefold argument. First, we argue that empathy is often considered a matter of individual cognition but should be rethought as an embodied process of feeling-into. Second, we argue that this process is characterised by incompleteness-and hence must acknowledge that empathy is always partial, always on the way to understanding. Third, we argue that this incompleteness forces us to think about the underlying 'connecting force', and that the conceptual history suggests that we should think about this force as a form of love. Fourth, we suggest that this 'love' is highly embodied, and that this suggests that theoretical notions of empathy should relate to notions of kinship. Fifth, we suggest that the combination of this love (affection, appreciation), embodied kinship and incompleteness suggests a final rethinking, namely the notion of empathy as a form of longing.

Towards a transformative health humanities approach in teaching the Sustainable Development Goals (SDGs).

The adoption of the United Nations' Sustainable Development Goals (SDGs) marks a significant shift in global political agendas, emphasising sustainability in various fields, including health. To engage meaningfully with sustainability, a transformative educational approach is essential. Lange's concept of transformative learning encompasses three levels: personal and cognitive change (micro level), changes in our interactions with others and the environment (meso level) and societal changes (macro level). This paper posits that applying health humanities approaches, particularly narrative medicine, can enhance transformative education at these three levels, leading to a powerful, transformative health humanities framework for teaching sustainability and the SDGs. This interdisciplinary method, which includes reflective self-assessment, exploration of different relational perspectives and social reality comprehension, facilitates transformative learning. However, implementing this transformative strategy requires a critical reassessment of some core principles and methods within the existing health humanities paradigm.

Staff disability data in UK higher education: Evidence from EDI reports.

OBJECTIVES: To explore how higher education institutions (HEIs) make transparent the data they collect on staff disability, and how this relates to existing equality, diversity and inclusion (EDI) charters. DESIGN: Descriptive cross-sector quantitative study based on UK HEIs. SETTING: Higher education sector in the UK. PARTICIPANTS: 162 HEIs across the UK with information extracted from the Higher Education Statistics Agency (HESA), each institution's website and Advance HE. PRIMARY AND SECONDARY OUTCOME MEASURES: Availability of a publicly available EDI report. Type of information on staff disability identified within the EDI report and level of detail, the latter derived from the number of different types of information provided in the report. Athena SWAN and Disability Confident award level for each HEI were used as a proxy for the sector's commitment to EDI. RESULTS: Under a quarter of HEIs do not have an open EDI report online. The majority of Athena SWAN award holders make their EDI reports publicly available, which is similar by Disability Confident status. Russell Group universities are more likely to have a publicly available report. Regionally, EDI report availability is lowest in London. The level of detail with regards to staff disability varies, with more than half of institutions providing 'little detail' and just under a third 'some detail'. Athena SWAN award holders and Disability Confident members are twice as likely to provide 'some detail' than those which do not hold an award. CONCLUSIONS: Challenges remain to obtain a clear picture of staff with disabilities within higher education. The lack of both uniformity and transparency in EDI reporting with respect to disability hinders the ability to quantify staff with disabilities within higher education, develop meaningful interventions and address inequities more widely.

It's "Classical Advice!" Why Medical Education Should Go Beyond Science.

This article is a reflection on a new (but ancient) definition of medicine, which considers doctors and patients alike from their complex human experiences. It explores the doctor-patient relationship as well as the practice of medicine itself through an historical lens, by examining some of the scholarship of Galen of Pergamum, the ancient Greek doctor and philosopher of the second century CE. The intention is not to give a new, definite answer, but to use an example from the past to look at the matter from a different, perhaps unusual, perspective.

A podcast to teach medical humanities at medical school: a text-mining study of students' lived experience.

The teaching of medical humanities is increasingly being integrated into medical school curricula. We developed a podcast called Le Serment d'Augusta (Augusta's Oath), consisting of six episodes tackling hot topics in the modern world of healthcare related to the patient-doctor relationship, professionalism, and ethics. This podcast aimed to provide scientific content in an entertaining way, while promoting debate among medical students. The Le Serment d'Augusta podcast was proposed as one of the various optional modules included in the second- to fifth-year curriculum at the School of Medicine of Sorbonne University (Paris). We asked students to report their lived experience of listening to the podcast. We then used a text-mining approach focusing on two main aspects: i) students' perspective of the use of this educational podcast to learn about medical humanities; ii) self-reported change in their perception of and knowledge about core elements of healthcare after listening to the podcast. 478 students were included. Students were grateful for the opportunity to participate in this teaching module. They greatly enjoyed this kind of learning tool and reported that it gave them autonomy in learning. They appreciated the content as well as the format, highlighting that the topics were related to the very essence of medical practice and that the numerous testimonies were of great added value. Listening to the podcast resulted in knowledge acquisition and significant change of perspective. These findings further support the use of podcasts in medical education, especially to teach medical humanities, and their implementation in the curriculum.

Revitalizing neurology practice: integrating health humanities, neurobiology, and digital innovation / Revitalizando a prática em neurologia: integrando as humanidades em saúde, neurobiologia e inovação digital

Rapid changes in medical education are being fueled by advancements in science, technology, and societal structures. However, the traditional medical curriculum often struggles to keep pace with the evolving demands of medical practice in light of these advancements. Neurology presents distinctive challenges in modern medicine, requiring innovative solutions to improve patient care and support the well-being of healthcare providers. This essay delves into the intricate issues encountered by neurologists, such as the diminishing interpersonal connections in the medical field and the prevalent issue of burnout among professionals, exacerbated by outdated educational programs. This research advocates for a comprehensive approach to enhancing neurology practice through the perspectives of Medical Humanities (MH) and neurobiology, within the evolving realm of Neurohumanities. By integrating stateof-the-art neurobiological findings, MH/Neurohumanities, and a focus on empathy, the article proposes practical strategies to rejuvenate clinical practice and bolster the resilience of neurology practitioners. Furthermore, it underscores the untapped potential of artificial intelligence and machine learning while examining how the digital ecosystem could revolutionize neurology medical education. Grounded in evidence-based research and practical insights, this article offers valuable guidance for navigating the complexities of contemporary neurology practice and cultivating a workforce of healthcare professionals who possess both technological acumen and compassion.

Mudanças rápidas na educação médica estão sendo impulsionadas pelos avanços na ciência, tecnologia e estruturas sociais. No entanto, o currículo médico tradicional frequentemente luta para acompanhar as exigências em constante evolução da prática médica diante desses avanços. A neurologia apresenta desafios distintos na medicina moderna, exigindo soluções inovadoras para melhorar o cuidado ao paciente e apoiar o bemestar dos profissionais de saúde. Este ensaio explora as questões complexas enfrentadas pelos neurologistas, como a diminuição das conexões interpessoais no campo médico e o problema prevalente do esgotamento entre os profissionais, exacerbado por programas educacionais desatualizados. Esta pesquisa defende uma abordagem abrangente para aprimorar a prática da neurologia por meio das perspectivas das Humanidades Médicas (HM) e da neurobiologia, dentro do campo em evolução das Neuro- Humanidades. Ao integrar descobertas neurobiológicas de ponta, HM/Neuro-Humanidades e um foco na empatia, o artigo propõe estratégias práticas para rejuvenescer a prática clínica e fortalecer a resiliência dos profissionais de neurologia. Além disso, destaca o potencial inexplorado da inteligência artificial e da aprendizagem de máquina ao examinar como o ecossistema digital poderia revolucionar a educação médica em neurologia. Fundamentado em pesquisas baseadas em evidências e insights práticos, este artigo oferece orientações valiosas para navegar pelas complexidades da prática contemporânea da neurologia e cultivar uma força de trabalho de profissionais de saúde que possuam tanto acuidade tecnológica quanto compaixão.

Integrating neuroscience and humanities in healthcare evolution: a multidisciplinary perspective / Integração das neurociências e das ciências humanas na evolução dos cuidados de saúde: uma perspetiva multidisciplinar

The trajectory of healthcare has evolved from ancient holistic practices to the present biomedical model, reflecting the dynamic interplay between scientific progress, technological advancements, and the integration of humanistic values. While biomedical advancements have revolutionized medical treatments, there is an emerging recognition of the importance of integrating neuroscience and humanities to foster holistic patient care and understanding. This paper aims to explore the historical development of medicine, emphasizing the convergence of neuroscience, psychiatry, and neurology within the biomedical framework. Additionally, it investigates the resurgence of humanities in healthcare and its role in promoting patientcentered care. Through a comprehensive review of literature, this study traces the historical roots of medicine and examines the interdisciplinary intersections of neuroscience, psychiatry, neurology, and medical humanities. The exploration reveals the significant contributions of interdisciplinary approaches in enhancing patient-centered care, fostering a comprehensive understanding of health and well-being, and shaping modern healthcare practices. The integration of neuroscience and humanities offers valuable insights into the complexities of human health, bridging legacy practices with innovative approaches. Embracing this interdisciplinary perspective is crucial for promoting holistic healthcare, emphasizing patient-centered care, and enriching the understanding of health and well-being in contemporary healthcare settings.

A trajetória dos cuidados de saúde evoluiu das antigas práticas holísticas para o atual modelo biomédico, reflectindo a interação dinâmica entre o progresso científico, os avanços tecnológicos e a integração de valores humanísticos. Embora os avanços biomédicos tenham revolucionado os tratamentos médicos, há um reconhecimento emergente da importância de integrar as neurociências e as humanidades para promover a compreensão e os cuidados holísticos dos doentes. Este artigo tem como objetivo explorar o desenvolvimento histórico da medicina, salientando a convergência da neurociência, da psiquiatria e da neurologia no quadro biomédico. Além disso, investiga o ressurgimento das humanidades nos cuidados de saúde e o seu papel na promoção de cuidados centrados no doente. Através de uma revisão exaustiva da literatura, este estudo traça as raízes históricas da medicina e examina as intersecções interdisciplinares da neurociência, psiquiatria, neurologia e humanidades médicas. A exploração revela os contributos significativos das abordagens interdisciplinares para melhorar os cuidados centrados no doente, promover uma compreensão abrangente da saúde e do bem-estar e moldar as práticas modernas de cuidados de saúde. A integração das neurociências e das humanidades oferece conhecimentos valiosos sobre as complexidades da saúde humana, fazendo a ponte entre práticas antigas e abordagens inovadoras. A adoção desta perspetiva interdisciplinar é crucial para promover cuidados de saúde holísticos, enfatizando os cuidados centrados no doente e enriquecendo a compreensão da saúde e do bem-estar nos contextos de cuidados de saúde contemporâneos.

'What's a D and C between friends?' Space, intimacy and the medicalisation of unmotherhood in modernist literature.

This essay theorises what 'unmotherhood'-or, living outside of motherhood-means within the specific context of 'the modern'. Unmotherhood is an actively constructed state; it is explored through the parameters of agentive choice, social pressure and state control; and at the turn-of-the-20th-century novels articulate this state through specific vocabularies of contemporaneous phenomena of modernity. I look to four novels representative of four forms of unmotherhood: Tess Slesinger's The Unpossessed depicts a somewhat voluntary abortion; H.D.'s Asphodel (and its sister novel Bid Me to Live) are fictional representations of the author's own stillbirth; Jean Rhys's Good Morning, Midnight depicts a woman's life in the wake of her newborn son's death and Nella Larsen's Quicksand is a narrative dependent on the protagonist's refusal to marry because of her equation of marriage with conception. Reading these narratives together affords us the opportunity to consider what 'unmotherhood' means as a constructed state in and of itself, beyond the presumed negative, passive state of the 'not' or the 'not yet'. Through this analysis, I define 'unmotherhood' as: (1) a state mediated through medical knowledge, objects, spaces and authority figures; (2) an experience narrated through vocabularies pulled from phenomena closely associated with 20th-century modernity and (3) a role dynamically shaped through compulsory heterosexuality embedded in familial relationships. In these three ways, my analysis of the selected novels defines unmotherhood as a permanent, transient, chosen, enforced and-contradictory as it all may be-a legible and definable experience.

An alternative theoretical approach to develop a new conception about pain in people with dementia.

The theoretical approach presented in this paper describes a novel experimental-theoretical methodology to conceptualise pain in people with dementia. Existing procedures for assessment of pain rely on subjective self-report using pain questionnaires and rating scales that have proven to be highly problematic where a person has dementia. Consequently, pain in people with dementia can be undetected and/or undertreated. To address that, we have developed an alternative experimental approach that builds on theoretical and methodological precedents from the arts, humanities and social sciences, for instance, visual thinking strategies, creative thinking or two-step flow of communication. Based on this approach, we designed an experimental workshop setting to ingrate these methodologies to explore pain and its expression in people with dementia. This had led to a new definition of pain as an interruption of the socially mediated process of bodily meaning-making. Furthermore, our experimental methodology could equally well be applied as a training method, where professional staff can intervene into existing implicit meanings and understandings of medical issues. These results emphasise that the future of pain research needs to consider the relational aspects of pain more seriously.

#Headlesspreggos: challenging visual imaginaries of pregnancy and reproduction.

Amid new abortion restrictions in the USA, scientific advances in genetic technologies and investigations of COVID-19 vaccinations in pregnancy, news stories about reproduction abound, often accompanied by images of what journalist Josie Glausiusz has called the "headless, legless, pregnancy bump". These images of disembodied pregnant torsos at once improve search engine optimisation for news organisations while perpetuating the view of the 'bump' as the quintessential visual representation of pregnancy.The images that accompany news articles convey meaning beyond what is included in the text and work to reinforce stereotypes about race, gender and age. In the so-called obesity epidemic, for example, psychotherapist and fat activist Charlotte Cooper documented how images of fat people with their heads cropped out view had become a visual symbol of abjection-'the headless fatty'-without a face or agency to speak of. The use of 'headless preggos' similarly divorces pregnant people from the embodied experience of their pregnancies, reducing them to a single body part.In this article, we chronicle our experiences tracking images of headless preggos via Twitter, arguing that their use works to erase pregnant people's autonomy and to construct the fetus as the central concern in reproductive interventions. We begin by tracing the evolution of visual representations of pregnancy including the increasing focus on the fetus and 'bump'. We then provide a description of our experience with the Twitter account, including our exchanges with academics, journalists and others that highlight how the continued reliance on headless preggos obscures the experiences of pregnant people by focusing all attention on the fetus, as well as how the same images might be thoughtfully deployed. We conclude by offering suggestions for those creating and selecting images that might result in more robust, creative visual representations of pregnancy and reproduction.

What can art history offer medical humanities?

This article charts the emergence of visual medical humanities as a space of academic research, creative practice and lively critical debate, with a focus on how art historical scholarship has influenced the field's formation. Concentrating on developments over the past decade, it offers an overview of current scholarship while highlighting opportunities and challenges for the future. We begin with a survey of medical and health humanities handbooks and readers, noting that their engagement with art and visual culture is predominately limited to the contexts of therapy, clinical pedagogy and medical history. The main part of the article explores art historical scholarship in relation to three areas of significance for the medical humanities. First, we address art historical research that engages with medical history, identifying major topoi including the anatomical body, the doctor-patient encounter and the close relationship between clinical and artistic vision; we argue that this work has tended to presume, rather than explicitly articulate, its relationship to medical humanities and recommend that art historians wishing to engage more deeply with the medical humanities need to clearly communicate what their work brings to wider debates in the field. Second, we explore contemporary arts practices that mobilise health-related experiences, forms of care and practical activism: medical humanities, we argue, has much to gain from a critical engagement with contemporary (as well as historical) art. Third, we review three art history-led projects that are redefining the field and promoting new models for collaborative 'entanglement' across disciplines: Art HX: Visual and Medical Legacies of British Colonialism; Visualizing the Virus; and Confabulations: Art Practice, Art History, Critical Medical Humanities By arguing for the vital importance of attending to the critical complexities of art and visual culture, this article aims to enrich existing debates and provoke a new wave of visually engaged medical humanities scholarship.

From the womb to the world: a study of pregnancy narratives by celebrity moms in India.

This article examines how celebrity moms in India are self-constructing their public persona through their pregnancy narratives. As a form of personal narrative, pregnancy narratives provide important insights into the unnarrated private world of pregnancy and its nuanced experiences. Although pregnancy and motherhood are glorified in India, it is subjected to a regime of cultural control thereby influencing women's disclosure of pregnancy behaviour and their narrative freedom. Despite being a life-altering event for women, pregnancy experiences and their narrativisation in India have largely been confined to the domestic spaces. However, some recent developments suggest the modernisation of maternity in India and point towards the emergence of a new cultural phenomenon as celebrity mothers through their pregnancy narratives are questioning the traditional beliefs and scientific practices which restrict women and their narrative freedom during pregnancy and childbirth. They are also documenting their obstetric violence, postpartum changes and the alternative means adopted by them to give birth. Through a narrative analysis of Kareena Kapoor's Pregnancy Bible (2021), Tahira Kashyap's The 7 Sins of Being a Mother (2021) and Kalki Koechlin's The Elephant in the Womb (2021), this article examines how modern maternity is being constructed in India and how it is entering popular discourse through personal narratives. In the process, it investigates how these celebrity mothers, to make themselves more acceptable, subvert the existing discourse of maternity and modernise it while retaining its necessary traditionalism. Most importantly, the article develops an understanding of the role of these narratives in encouraging the performance of maternity beyond the domestic setup.