Developing Disability-Focused Pre-Health and Health Professions Curricula.

People with disabilities (PWD) comprise a significant part of the population yet experience some of the most profound health disparities. Among the greatest barriers to quality care are inadequate health professions education related to caring for PWD. Drawing upon the expertise of health professions educators in medicine, public health, nursing, social work, and physician assistant programs, this forum showcases innovative methods for teaching core disability skills and concepts grounded in disability studies and the health humanities. Each of the essays offers practical guidance for developing curricular interventions appropriate for students at various levels of training and familiarity with disability to be implemented in classroom discussions, case-based learning, lectures, panels, and clinical simulations across the full spectrum of pre-health and health professions education.

Centering Patients, Revealing Structures: The Health Humanities Portrait Approach.

This paper introduces an innovative curricular approach-the Health Humanities Portrait Approach (Portrait Approach)-and its pedagogical tool-the Health Humanities Portrait (HHP). Both enable health professions learners to examine pressing social issues that shape, and are shaped by, experiences of health and illness. The Portrait Approach is grounded in a set of "critical portraiture" principles that foster humanities-driven analytical skills. The HHP's architecture is distinctively framed around a pressing social theme and utilizes a first-person narrative and scholarship to explore how the dimensions of the personal and the structural are mutually constituted. We argue that when creator-educators adopt the Portrait Approach and its critical portraiture principles to design and teach the HHP, they enable learners to become proficient in synthesizing and analyzing-with both depth and breadth-the human and social dimensions of patients' lives. This inventive curricular intervention provides a needed contribution to health professions education in that it utilizes health humanities methodologies to elucidate the multiple aspects of health, illness, disability, and healthcare.

Critical Healing: Queering Diagnosis and Public Health through the Health Humanities.

This introduction provides an overview to a special issue on Critical Healing, which draws on queer theory, disability studies, postcolonial theory, and literary studies to theorize productive engagements between the clinical and cultural aspects of biomedical knowledge and practice. The essays in this issue historicize and theorize diagnosis, particularly diagnosis that impacts trans health and sexuality, homosexuality, and HIV/AIDS transmission. The essays also address racialization, disability, and colonialism through discussions of fiction, film, theoretical memoir, and comics, as well as biomedical discourse and knowledge.

The Almost Right Word: The Move From Medical to Health Humanities.

Since the emergence of the field in the 1970s, several trends have begun to challenge the original assumptions, claims, and practices of what became known as the medical humanities. In this article, the authors make the case for the health humanities as a more encompassing label because it captures recent theoretical and pedagogical developments in higher education such as the shift from rigid disciplinary boundaries to multi- and interdisciplinary inquiry, which has transformed humanities curricula in health professions. Calling the area of study health humanities also underscores the crucial distinction between medicine and health. Following a brief history of the field and the rationales that brought humanities disciplines to medical education in the first place-the "why" of the medical humanities-the authors turn to the "why" of the health humanities, using disability studies to illuminate those methodologies and materials that represent the distinction between the two. In addition, the authors make note of how humanities inquiry has now expanded across the landscape of other health professions curricula; how there is both awareness and evidence that medicine is only a minor determinant of health in human populations alongside social and cultural factors; and finally, how the current movement in health professions education is towards interdisciplinary and interprofessional learning experiences for students.

From Silence into Language: Questioning the Power of Physician Illness Narratives.

Physicians' narratives of their own experiences of illness can be a kind of empathic bridge across the divide between a professional healer and a sick patient. This essay considers ways in which physicians' narratives of their own and family members' experiences of cancer shape encounters with patients and patients' experiences of illness. It analyzes ethical dimensions of physicians' narratives (such as those by Atul Gawande, Siddhartha Mukherjee, and Paul Kalanithi) and of reflective writing in medical education. It also compares illness narratives written by physicians-turned-patients to those written by patients without medical training in order to explore questions of who ultimately benefits from these narratives and whether these narratives can engender greater empathy between clinicians and patients.

Who speaks for whom? Health humanities and the ethics of representation.

The medical or health humanities are in essence a form of advocacy, a means of addressing a problem of underrepresentation. They focus on suffering, rather than pathology, and on sociocultural understandings of illness and disability, rather than a narrow biomedical perspective. The health humanities thus analyse and attempt to recalibrate the power imbalance in healthcare. This article reviews health humanities scholarship that addresses underrepresentation through the analysis of illness and disability narratives. It examines the ethics of representation by exploring how literary representation functions, its aesthetic as well as political dimensions, and how it operates as a relay mechanism for power. The mechanism of representation is further explored through a reading of Eli Clare's narrative Exile and Pride. Donna Haraway's notion of articulations is proposed as a tool for a more ethical approach to representation. The article suggests that transparency about the power health humanities scholars stand to gain through representation may contribute to a more ethical health humanities practice.

Distance learning: empathy and culture in Junot Diaz's "Wildwood".

This essay discusses critical approaches to culture, difference, and empathy in health care education through a reading of Junot Diaz's "Wildwood" chapter from the 2007 novel The Brief Wondrous Life of Oscar Wao. I begin with an analysis of the way that Diaz's narrative invites readers to imagine and explore the experiences of others with subtlety and complexity. My reading of "Wildwood" illuminates its double-edged injunction to try to imagine another's perspective while recognizing the limits to-or even the impossibility of-that exercise. I draw on post-colonial theory and feminist science studies to illuminate a text that is created and interpreted in a post-colonial context-the Dominican diaspora in the United States. The essay offers a model of historical and critical analysis that health care educators can use to frame the concept of empathy in the classroom and the clinic.

Reflection in/and writing: pedagogy and practice in medical education.

During the past decade, "reflection" and "reflective writing" have become familiar terms and practices in medical education. The authors of this article argue that the use of the terms requires more thoughtfulness and precision, particularly because medical educators ask students to do so much reflection and reflective writing. First, the authors discuss John Dewey's thoughts on the elements of reflection. Then the authors turn the discussion to composition studies in an effort to form a more robust conception of reflective writing. In particular, they examine what the discipline of composition studies refers to as the writing process. Next, they offer two approaches to teaching composition: the expressivist orientation and the critical/cultural studies orientation. The authors examine the vigorous debate over how to respond to reflective writing, and, finally, they offer a set of recommendations for incorporating reflection and reflective writing into the medical curriculum.

Language, identity, and belonging: deaf cultural and narrative perspectives.

By acquiring an understanding of the cultural meaning of deafness and acting as a bridge to resources and opportunities, clinicians may better serve children and parents.

Sympathy, disability, and the nurse: female power in Edith Wharton's The Fruit of the Tree.

The nursing profession's emphasis on empathy as essential to nursing care may undermine nurses' power as a collective and detract from perceptions of nurses' analytical skills and expertise. The practice of empathy may also obscure and even compound patients' suffering when it does not fully account for their subjectivity. This essay examines the relation of empathy to women's agency and explores the role empathy plays in obscuring rather than empowering the suffering other, particularly people who are disabled, through a close reading of Edith Wharton's 1907 novel, The Fruit of the Tree, and through discussions of empathy and sympathy from literary and disability studies.

Telling stories about illness and disability: the limits and lessons of narrative.

Autobiographical narratives of illness and disability are influential in popular and medical discourses of illness and disability, in part because these narratives represent illness and disability within a sociocultural context, intersecting with other categories of difference. Clinicians can benefit patients through a critical understanding of the formal and social conventions that shape illness and disability narratives and the effect these conventions can have on the lived experience of illness and disability. I analyze the 2003 edition of Lucy Grealy's Autobiography of a Face to illustrate these socio-narrative conventions, especially in light of an afterword that significantly revises the ending to Grealy's narrative. I explore the parallels between narrative conventions-such as the "recovery narrative"-and caregivers' expectations that shape the role of the "good patient," as well as the resistance to conventions of closure, represented by the "renegotiated ending."

Disability and narrative: new directions for medicine and the medical humanities.

People with disabilities are a large minority that disproportionately seeks medical care. However, disability is relatively neglected in medical education and practice, and disabled people experience troubling differences and even disparities in healthcare. Practitioners can help improve healthcare for disabled people through disability studies, a multi-disciplinary field of enquiry that draws on the experiences and perspectives of people with disabilities to address discrimination. This article outlines a disability studies perspective on healthcare, specifically the rejection of the medicalisation of disability and difference in favour of an understanding of disability that focuses on social factors that disable, such as stigmatisation and a lack of accommodation. The 'social model' of disability can be expanded to chronic illness and to the broader work of the medial humanities. The author argues that narrative, particularly first-person accounts, provide a critical resource by representing the point of view of people with disabilities and by offering a means of examining the social context and social determinants of disability. The author examines specific conventions of narrative, the dominant plotlines such as the triumph over adversity, that predetermine experiences of disability and illness. Through disability studies and critical examinations of narrative informed by disability studies, practitioners can provide better care for patients with disabilities and work as allies towards more equitable relations in the clinic.

Expanding clinical empathy: an activist perspective.

BACKGROUND: Discussions of empathy in health care offer important ways of enabling communication and interpersonal connection that are therapeutic for the patient and satisfying for the physician. While the best of these discussions offer valuable insights into the patient-physician relationship, many of them lack an action component for alleviating the patient's suffering and emphasize the physician's experience of empathy rather than the patient's experience of illness. METHODS: By examining educational methods, such as reflective writing exercises and the study of literary texts, and by analyzing theoretical approaches to empathy and suggestions for clinical practice, this article considers how to mindfully keep the focus on what the patient is going through. CONCLUSION: Clinical empathy can be improved by strategies that address (1) the patient's authority in providing first-person accounts of illness and disability, (2) expanding the concept of empathy to include an action component geared toward relieving patients' suffering, and (3) the potential value of extending empathy to include the social context of illness.

Class and ethnicity in the global market for organs: the case of Korean cinema.

While organ transplantation has been established in the medical imagination since the 1960s, this technology is currently undergoing a popular re-imagination in the era of global capitalism. As transplantation procedures have become routine in medical centers in non-Western and developing nations and as organ sales and transplant tourism become increasingly common, organs that function as a material resource increasingly derive from subaltern bodies. This essay explores this development as represented in Korean filmmaker Park Chan-wook's 2002 Sympathy for Mr. Vengeance, focusing on the ethnic and class characteristics of the global market in organs and possible modes of counter-logic to transplant technologies and related ethical discourses.