The Evolution of the Physician-Patient Relationship Background: In the influential novel Middlemarch , author George Eliot writes, “the medical profession as it might be was the finest in the world; presenting the most perfect interchange between science and art; offering the most direct alliance between intellectual conquest and the social good” (136). While medicine is often considered to be a discipline deeply rooted in science, many contributing factors to patient care lie in the artistic realm of the field, particularly the humanities. Therefore, researching the humanistic aspect of medicine is as important as investigating the science. My project serves to epitomize medical humanities exploratory research for other students by viewing medicine under a humanities-based lens and analyzing a critical part of patient care: the physician-patient relationship. Source: blogs.bmj.com/medical-humanities/ By: Devesh Malik Purpose: What does it mean to have a strong physician-patient relationship? Why is this dynamic important, and how does it develop? In this research project, I compiled archival and contemporary literary sources, written in the perspective of either the patient or the physician, to synthesize an evolutionary model of the physician-patient interaction; I aim to juxtapose past medical practice with that of the present to provide insight into how the patient experience has developed over time and why these changes have improved patient care. Source: ortholive.com Early 20th Century Medicine: Literary Text Directly Used in Research: A Young Doctor’s Notebook by Dr. Mikhail Bulgakov Other Useful Texts: The Immortal Life of Henrietta Lacks by Rebecca Skloot Hippocratic Writings (Chapter: “Epidemics”) by Hippocrates, edited by G.E.R Lloyd Notes on Hospitals by Florence Nightingale (founder of modern Nursing) Johns Hopkins University Medical Archives (Chesney Archives) New England Journal of Medicine, 1900’s editions ---------------------------------------------------------------------------------------------------------------------------------------------- In the last century, western medicine has evolved drastically; with new medical discoveries, inventions, and technologies, patient outcomes have improved tremendously. However, one characteristic of clinical medicine that is often overlooked is the interaction between patients and their doctors. When these relationships are presented in the occasional research paper, physicians are often praised for their humanistic mannerisms. Yet, archival records of the physician-patient relationship suggest that these interactions were not as commonly respectful as they are now. Mikhail Bulgakov was a physician and writer in the early 20th century. One of his books, A Young Doctor’s Notebook , is a written record of a few of his cases as a doctor in a rural town of Russia. These records not only contain information about the medical cases, but also an autobiographical recollection of his actions and thoughts before, during, and after helping the patients. This style of record-taking allows us to enter the mind of a early 1900’s rural doctor, and analyze how they interacted with and thought about their patients. Bedside manner is a term commonly used in modern clinical practice that refers to a doctor’s attitude and mannerisms towards their patient. In Dr. Bulgakov’s records, it was strongly suggested that this was not a concept practiced in the past, at least not in rural Russia. When a little girl was brought in by her mother and an old woman, Dr. Bulgakov was astonished to see the state the girl was in: “With every breath, hollows were being sucked in on her throat, her veins were swelling up and the colour of her face was changing from pinkish to a slightly violet hue.” (Bulgakov 33) Dr. Bulgakov was even more taken aback when he found out that the little girl was left untreated for five days, and rudely said to the mother, “‘What on earth were you thinking of?...The girl’s suffocating, her throat’s already blocked. You’ve been killing the girl for five days.’” (33-34) While it was clear from the descriptions in the record that the mother was frightened, Dr. Bulgakov seemed to only worry about informing her of her wrongdoings. Furthermore, after the old woman attempted to talk to Dr. Bulgakov, he said to her, “‘You shut up, woman, you’re being a nuisance.’” (33) In saying this, Dr. Bulgakov essentially dismissed the old woman’s input and worries. Modern medical practices show us that it is part of a physician’s responsibility to care for their patient first, yet still consider the emotions of the patient’s loved ones, especially with the family of pediatric patients. Furthermore, it is a doctor’s duty as a medical educator to properly and respectfully inform those who may not be medically literate; instead, Dr. Bulgakov looked at the uneducated old woman and thought, “‘It’d be a good thing if there were none of these old women in the world at all.’” (33) It is uncommon for laypeople to completely understand medical issues, thus it is unreasonable for Dr. Bulgakov, as a physician, to assume that anyone who is medically uneducated is not worth his energy, time, or respect. Source: amazon.com In medical ethics, there are four fundamental principles: autonomy, beneficence, nonmaleficence, and justice. In the case of this little girl and Dr. Bulgakov, there are no indications of anything against the latter three. Dr. Bulgakov’s efforts were clearly in favor of saving the girl, which supports the principle of beneficence. While the surgery required having “‘to cut her throat open lower down and insert a silver tube to give the girl a chance to breathe,’” (35) it is clear that this intervention was necessary for the sake of the patient’s recovery, and therefore aligns with the principle of nonmaleficence, or doing no unnecessary harm to the patient. Lastly, while the principle of justice may not be directly relevant to this individual case, it can be noted that Dr. Bulgakov chose to help the little girl and practice effective clinical care despite his resentful emotions towards the patient’s loved ones, which aligns with this bioethical concept. However, despite following these three principles, Dr. Bulgakov fundamentally neglected the first bioethical principle of autonomy, or the right to make one’s own personal medical decisions. As a pediatric patient, the little girl’s medical autonomy lies in the hands of her guardians. In the book, the mother blatantly refused intervention, saying, “‘I don’t consent!’” (35); nevertheless, Dr. Bulgakov ignored her judgement. Later, the mother is unethically coerced into providing consent by the feldsher (nurse), when he says, “‘What, are you mad? What do you mean, you don’t consent? You’re condemning the girl to die. Consent. Have you no pity?...Come on, hurry, hurry up and consent! Consent!’” (36) After berating the mother, she finally agreed to the surgery. Source: ollieburton.com In regards to establishing a strong physician-patient relationship, the principle of autonomy is arguably the most crucial. The other three are then important for following through with care and maintaining the depth, trust, and compassion that underlies all effective physician-patient relationships. In developing a strong relationship, it is the physician’s responsibility to acknowledge the patient’s perspective and consider it when reaching a mutually agreed upon solution, modernly known as shared decision-making. If this is not established early on in the interaction, the patient can quickly become detached from the physician, which can lead to their unwillingness to fully cooperate or share, thereby hindering the physician’s ability to care for them. Despite the relationship being shattered with the patient’s guardian and not the patient herself, this is still the essential piece missing in Dr. Bulgakov’s mannerism. His record of the surgery brought into sharp focus the immediate effect of a negative interaction when he wrote, “I felt acute regret about having entered the medical faculty and about having ended up in these backwoods. In angry despair I thrust the forceps somewhere towards the wound at random.” (38) If Dr. Bulgakov was to have a similar conflict with his patient directly, the emotional states of both the patient and Dr. Bulgakov could be affected, leading to immediate and possibly multiplicative repercussions in the patient’s treatment. It is important to consider the entire narrative when evaluating the situation. In the case of the young girl, diagnosed with diphtheritic croup, Dr. Bulgakov properly managed the crisis and saved the patient through a difficult surgery. It is remarkable that a patient so far along in their emergent illness was successfully treated in a rural setting lacking proper medical tools and operating rooms. Yet, it is still important to highlight the ethical mistakes made in the patient’s care, how they affected the physician-patient relationship, and how they could have had detrimental effects on current and future treatment. Modern Medicine: Literary Text Directly Used in Research: How Doctors Think by Jerome E. Groopman, MD Other Useful Texts: Deep Medicine by Eric Topol Being Mortal: Medicine and What Matters in the End by Atul Gawande The Two Kinds of Decay by Sarah Manguso Published Research (PubMed database) ---------------------------------------------------------------------------------------------------------------------------------------------- Since the early 20th century, the physician-patient experience has evolved via positive changes in medical practice, namely the increased attention to bedside manner. According to a paper published in 2008 regarding doctor-patient communication, “Nowadays complete, correct and comprehensible communication is a primary exigency for the physician, for the patient/person and for all the organizational levels of the sanitary system.” (Conti) It has become more common for physicians to emphasize effective communication with their patients and respect their autonomy by including them in their own personal care. This shows the positive improvements that have been made in the physician-patient dynamic, which have bettered modern patient care. Jerome E. Groopman is a practicing physician and author of the book How Doctors Think , which provides insight into the mind of contemporary doctors with an emphasis on the physician-patient relationship. Dr. Groopman focuses on the benefits of strong patient relationships through the stories of other physicians, but also highlights issues that still exist, such as personal biases and framing patients via quick, assumed diagnoses. In the book, Dr. Groopman introduces a powerful anecdote of a patient, Anne Dodge, who was told by many doctors that she had bulimia and anorexia nervosa. Despite claiming to follow her doctors’ recommendations for an increased diet, the physicians refused to believe her because her test results showed otherwise. Dr. Groopman discusses that, after being diagnosed with these two conditions, it was unfortunately commonplace for her doctors to view her under those diagnoses alone. However, Dr. Groopman emphasizes that “a self-aware physician knows that accepting the frame as given can be a serious error.” (22); it is critical for physicians to consider other possibilities, especially with patients like Anne. Fortunately, Anne decided to see a gastroenterologist, Dr. Myron Falchuk, who “began to question, and listen, and observe, and then to think differently about Anne’s case.” (Groopman 3) Dr. Falchuk made the conscious decision to believe his patient and consider other possible reasons for Anne’s presentation; in using a holistic approach, Dr. Falchuk developed a foundational, compassionate relationship with the patient built on trust in her narrative, which led to her correct diagnosis and saved her life. Source: amazon.com Source: priviahealth.com Dr. Groopman sheds light on two critical physician characteristics that help tremendously in creating a strong relationship with a patient: humility and collaboration. Humility, or the ability to recognize one’s own faults and mistakes, allows a physician to maintain an open mind and consider all possibilities, minimizing the chances of making hasty conclusions. This leads to stronger clinical intuition and an open, inclusive relationship with the patient. (20) Furthermore, Dr. Groopman writes that, “doctors desperately need patients and their families and friends to help them think. Without their help, physicians are denied key clues to what is really wrong.” (20) Collaborating with a patient and maintaining an equal relationship with them bolsters the physician’s capacity to treat them properly. After describing how to develop a strong relationship, Dr. Groopman discusses the traits necessary for maintaining it. For example, he clarifies that in order for a patient to effectively collaborate with their doctor, they have “to trust not only [their doctor’s] skill but also [their] sincerity and motivations’… without trust and a sense of mutual liking, Anne Dodge probably would have deflected Falchuk’s suggestions of more blood tests and an endoscopy.” (23) Without mutual trust, the relationship crumbles and the patient’s care is jeopardized. As a physician taking care of vulnerable individuals, it is their responsibility to provide the foundation of trust for the relationships to build on. Moreover, Dr. Groopman considers the communicative aspect of the interaction. He quotes Judy Hall, a social psychologist focused on researching the dialogue between doctors and patients, who said, “‘the communication piece is not separable from doing quality medicine. You need information to get at the diagnosis, and the best way to get that information is by establishing rapport with the patient.’” (Groopman 20). Hall highlights the importance of communication in maintaining the dynamic between the physician and the patient. Conclusion and Future Directions: “Medicine is, at its core, an uncertain science.” (Groopman 7) Therefore, it is crucial to investigate not just the academic foundation of the discipline but also the subjective aspects, such as the physician-patient relationship. From the paternalistic medical practices of the 1900’s to the respectful shared decision-making model of the 21st century, medicine as a humanistic practice has come a long way; the juxtaposition of these two systems underscores the positive changes that have been made in the field of clinical medicine and the impact that a strong physician-patient relationship can have on patient care. Nevertheless, the patient experience is not perfect. Contemporary issues in healthcare, such as shortened patient appointments due to systemic insurance restrictions, can make it difficult to cultivate these important physician-patient relationships. Furthermore, heavy amounts of paperwork can steal physicians’ time away from patients (Sanders), and computer-based healthcare systems can distract physicians during patient interactions. It was also shown that physicians tend to interrupt their patients and not engage in eye contact or have meaningful interactions because of computer use. (Rhoades) Time restraints during appointments could also be a confounding factor for this. Eric Topol, author of the book Deep Medicine , discusses the possibility of using artificial intelligence during patient appointments to eliminate the physicians’ computer-based responsibilities during interactions. This would greatly improve the patient experience and allow for stronger physician-patient relationships. Despite the great strides taken in bettering the physician-patient relationship, Dr. Groopman and Eric Topol show us that there is still more room to grow; future research and analyses of these often disregarded parts of medicine are required to provide more insight into improving the holistic treatment of patients. Citations: Bulgakov, Mikhail. A Young Doctor's Notebook . Alma Classics, 2012. Conti, A A, and G F Gensini. “Doctor-patient communication: a historical overview.” Minerva medica vol. 99,4 (2008): 411-5. Eliot, George. Middlemarch . IndyPublish.com, 2006. Groopman, Jerome E. How Doctors Think . Houghton Mifflin, 2007. Rhoades, D R et al. “Speaking and interruptions during primary care office visits.” Family medicine vol. 33,7 (2001): 528-32. Sanders, James H. “How Much Paperwork Is Too Much?” American Academy of Family Physicians (AAFP), Jan. 2005. About the Author Project Archives

The Evolution of the Physician-Patient Relationship: ARCHIVE Medical History: A Young Doctor's Notebook by Mikhail Bulgakov: "In this collection of short stories, drawing heavily from the author's own experiences as a medical graduate on the eve of the Russian Revolution, Bulgakov describes a young doctor's turbulent and often brutal introduction to his practice in the backward village of Muryovo." Source: amazon.com Source: amazon.com The Immortal Life of Henrietta Lacks by Rebecca Skloot: "A journalist named Rebecca Skloot recounts learning about an African American woman named Henrietta Lacks , who died in 1951 of cervical cancer, but whose cancerous cells became the first immortal human cell line, called HeLa . Rebecca explains that HeLa made possible some of the most important discoveries of the 21st century, but that we know little about the woman behind them." Source: litcharts.com Source: wikipedia.com Hippocratic Writings by Hippocrates, edited by G.E.R Lloyd: "This work is a sampling of the Hippocratic Corpus, a collection of ancient Greek medical works. At the beginning, and interspersed throughout, there are discussions on the philosophy of being a physician. There is a large section about how to treat limb fractures, and the section called The Nature of Man describes the physiological theories of the time. The book ends with a discussion of embryology and a brief anatomical description of the heart ." Source: amazon.com Source: amazon.com Notes on Hospitals by Florence Nightingale: "The founder of modern nursing expressed her revolutionary ideas of hospital reform in these two essays, published in 1859 and presented the previous year at the Social Science Congress. This report of her findings and suggestions had a profound effect on the medical community and reestablished the author as an international healthcare authority. Despite the advances in medical knowledge since Nightingale's era, her common-sense approach continues to form a solid foundation for nursing." Source: amazon.com Source: amazon.com Source: medicalarchives.jhmi.edu Johns Hopkins University Chesney Medical Archives: "The Johns Hopkins Chesney Archives is the official archival repository for Johns Hopkins Medicine, Nursing and Public Health. Dates of materials in the Chesney Archives range from the middle of the nineteenth century to the present. The Archives collects and preserves materials relating to the history of Johns Hopkins Medicine, Nursing, and Public Health and the individuals who have advanced teaching, research, and health care within these entities." Source: medicalarchives.jhmi.edu New England Journal of Medicine (early 1900's editions): "Published continuously for over 200 years, NEJM delivers high-quality, peer-reviewed research and interactive clinical content to physicians, educators, researchers, and the global medical community. Our mission is to publish the best research and information at the intersection of biomedical science and clinical practice and to present this information in understandable, clinically useful formats that inform health care practice and improve patient outcomes." Source: nejm.org Source: nejm.org Modern Medicine: How Doctors Think by Jerome E. Groopman: "How Doctors Think is a window into the mind of the physician and an insightful examination of the all-important relationship between doctors and their patients... Groopman explores the forces and thought processes behind the decisions doctors make. He pinpoints why doctors succeed and why they err. Most important, Groopman shows when and how doctors can avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact a person's health." Source: amazon.com Source: amazon.com Deep Medicine by Eric Topol: "The doctor-patient relationship - the heart of medicine - is broken: doctors are too distracted and overwhelmed to truly connect with their patients... In Deep Medicine , leading physician Eric Topol reveals how artificial intelligence can help. AI has the potential to transform everything doctors do, from notetaking and medical scans to diagnosis and treatment... By freeing physicians from the tasks that interfere with human connection, AI will create space for the real healing that takes place between a doctor who can listen and a patient who needs to be heard. " Source: amazon.com Source: amazon.com Being Mortal by Atul Gawande: "In Being Mortal , best-selling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending... In the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families." Source: amazon.com Source: amazon.com The Two Kinds of Decay by Sarah Manguso: "At twenty-one, just starting to comprehend the puzzles of adulthood, Sarah Manguso was faced with another: a wildly unpredictable disease that appeared suddenly and tore through her twenties, vanishing and then returning, paralyzing her for weeks at a time... In this captivating story, Manguso recalls her nine-year struggle: arduous blood cleansings, collapsed veins, multiple chest catheters, the deaths of friends and strangers, addiction, depression, and, worst of all for a writer, the trite metaphors that accompany prolonged illness." Source: amazon.com Source: amazon.com PubMed Database: "PubMed is a free resource supporting the search and retrieval of biomedical and life sciences literature with the aim of improving health- both globally and personally. The PubMed database contains more than 32 million citations and abstracts of biomedical literature. Citations in PubMed primarily stem from the biomedicine and health fields, and related disciplines such as life sciences, behavioral sciences, chemical sciences, and bioengineering." Source: pubmed.ncbi.nlm.nih.gov Source: pubmed.ncbi.nlm.nih.gov

Intersectionality of Religion & Medicine Archive Background Texts Part I: Ancient Medicine Part II: Development of Modern Medicine Part III: Modern Medicine Other Resources Anchor 5 Background Texts Medicine & Religion: A Historical Introduction by Gary B. Ferngren. "Medicine and Religion is the first book to comprehensively examine the relationship between medicine and religion in the Western tradition from ancient times to the modern era. Beginning with the earliest attempts to heal the body and account for the meaning of illness in the ancient Near East, historian Gary B. Ferngren describes how the polytheistic religions of ancient Mesopotamia, Egypt, Greece, and Rome and the monotheistic faiths of Judaism, Christianity, and Islam have complemented medicine in the ancient, medieval, and modern periods" Source: amazon.com Essential Readings in Medicine & Religion by Gary B. Ferngren. "Gary B. Ferngren and Ekaterina N. Lomperis have gathered a rich collection of annotated primary sources that illustrate the intersection of medicine and religion. Intended as a companion volume to Ferngren’s classic Medicine and Religion, which traces the history of the relationship of medicine to religion in the Western world from the earliest ancient Near Eastern societies to the twenty-first century, this useful and extensive sourcebook places each key document in historical context. Drawing from more than 160 texts, the book explores a number of themes, including concepts of health, the causes and cure of disease, medical ethics, theodicy, beneficence, religious healing, consolation, and death and dying. Each chapter begins with an introduction that furnishes a basic historical setting for the period covered. Modern translations, some of which have been made especially for this volume, are used whenever possible. The texts are numbered sequentially within each chapter and preceded by a short introduction to both the author and the subject." Source: amazon.com Anchor 1 Part I: Ancient Medicine The Soul of Medicine: Spiritual Perspectives and Clinical Practice by John R. Peteet and Michael n D'ambra. "The Soul of Medicine explores the role and influence of spirituality in clinical practice, professionalism, and medical education. The contributors to this volume approach this topic from their own spiritual perspectives—Jewish, Christian, Muslim, Buddhist, Hindu, New Age / Eclectic, secular, Jehovah’s Witnesses, and Christian Scientist. Their thought-provoking essays provide rich insights not only into the needs of patients with various world views but also into how spirituality influences the practice of medicine." Source: amazon.com Anecdotes and Antidotes: A Medieval Arabic History of Physicians by Ibn Abi Usaybi'ah. "Anecdotes and Antidotes is an abridged version of this world history of medicine. It comprises 103 biographies of physicians and philosophers, organized geographically and chronologically, from the 4th century BC to the 13th century, and includes seminal Muslim, Christian and Jewish figures. It contains vital medical and historical information, as well as revealing the cultural values, interests and concerns of the literary and intellectual elite of the time." The Medieval Islamic Hospital: Medicine, Religion, and Charity by Ahmed Ragab. "The first monograph on the history of Islamic hospitals, this volume focuses on the under-examined Egyptian and Levantine institutions of the twelfth to fourteenth centuries. By the twelfth century, hospitals serving the sick and the poor could be found in nearly every Islamic city. Ahmed Ragab traces the varying origins and development of these institutions, locating them in their urban environments and linking them to charity networks and patrons' political projects. Following the paths of patients inside hospital wards, he investigates who they were and what kinds of experiences they had. The Medieval Islamic Hospital explores the medical networks surrounding early hospitals and sheds light on the particular brand of practice-oriented medicine they helped to develop. Providing a detailed picture of the effect of religion on medieval medicine, it will be essential reading for those interested in history of medicine, history of Islamic sciences, or history of the Mediterranean." Source: amazon.com Source: amazon.com Medicine, Religion and Gender in Medieval Culture by Naoë Kukita Yoshikawa. "Current preoccupations with the body have led to a growing interest in the intersections between religion, literature and the history of medicine, and, more specifically, how they converge within a given culture. This collection of essays explores the ways in which aspects of medieval culture were predicated upon an interaction between medical and religious discourses, particularly those inflected by contemporary gendered ideologies. The essays interrogate this convergence broadly in a number of different ways: textually, conceptually, historically, socially and culturally. They argue for an inextricable relationship between the physical and spiritual in accounts of health, illness and disability, and demonstrate how medical, religious and gender discourses were integrated in medieval culture." Source: amazon.com Anchor 2 Part II: Development of Modern Medicine Companion Encyclopedia of the History of Medicine by W. F. Bynum and Roy Porter. "This is a comprehensive reference work which surveys all aspects of the history of medicine, both clinical and social, and reflects the complementary approaches to the discipline. The editors have assembled an international team of scholars to provide detailed and informative factual surveys with contemporary interpretations and historiographical debate." Source: amazon.com Secret Doctors: Ethnomedicine of African Americans by Wonda L. Fontenot. "Based on an ethnographic study of the traditional medicine of African Americans in the rural southern United States, this work concentrates on the original Louisiana Territory, with its Native and African American indigenous traditions, and the French migration and Black Haitian freed and enslaved population influx during the 1700s and 1800s. Fontenot finds strong ties between rural Louisiana practices and Haitian and West African medicine. The ethnographer, a native of the region where she did her research, is respected among local practicing secret doctors and is able to give a unique insider's view. Aside from documenting a rare treasure of our American cultural diversity, this study has a wider purpose in the field of health practices and policy. The high cost of Western medicine, lack of access to quality care, and the patient-doctor ratio are areas of major national concern, and rural residents and people of color are recognized to be the most at-risk populations. The alternative health-care system presented here can strengthen mainstream medicine's understanding of such patient populations while preserving valuable knowledge of healing plants and culturally sensitive therapies." Source: amazon.com Prescribing Faith: Medicine, Media, and Religion in American Culture by Claire Hoertz Badaracco. "The healing powers of medicine and prayer are often media headlines. Not explored is how media itself has shaped popular ideas about religion and health. Prescribing Faith traces the confluence of medicine, media and religion from mid-nineteenth century American culture to the present day. Badaracco examines how media portrays the relationship between religious faith and medicine, showing that the relationship is one fraught with conflict of interest, controversy, and paradox. Prescribing Faith offers valuable insight into deconstructing religion and medicine as shaped by today's media." Source: amazon.com Melancholy and the Care of the Soul: Religion, Moral Philosophy and Madness in Early Modern England by Jeremy Schmidt. "Melancholy is rightly taken to be a central topic of concern in early modern culture, and it continues to generate scholarly interest among historians of medicine, literature, psychiatry and religion. This book considerably furthers our understanding of the issue by examining the extensive discussions of melancholy in seventeenth- and eighteenth-century religious and moral philosophical publications, many of which have received only scant attention from modern scholars." Source: amazon.com Anchor 3 Part III: Modern Medicine Medicine Woman: Reclaiming the Soul of Healing by Lucy H. Pearce. "Medicine Woman voices a deep yearning for a broader vision of what it means to be human than our current paradigm allows for, calling on an ancient archetype of healing, Medicine Woman, to re-vision how we can navigate sickness and harness its transformational powers in order to heal. Packed with dozens of healing arts exercises and hundreds of medicine questions to help integrate body and mind in the healing process." Source: amazon.com The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman. "Through miscommunications about medical dosages and parental refusal to give certain medicines due to mistrust, misunderstandings, and behavioral side effects, and the inability of the doctors to develop more empathy with the traditional Hmong lifestyle or try to learn more about the Hmong culture, Lia's condition worsens. The dichotomy between the Hmong's perceived spiritual factors and the Americans' perceived scientific factors comprises the overall theme of the book." Spirituality, Healing and Medicine: Return to the Silence by David Aldridge "In Spirituality, Healing and Medicine he evaluates the existing literature from across the disciplines to ascertain just how effective and influential spiritual healing may be on the patient's physical and psychological well-being. He encourages us to redefine treatment strategies and the ways in which we understand health, and argues that the spiritual elements of experience help the patient to find purpose, meaning and hope in the face of sickness. It is in the understanding of suffering and the need for deliverance from it, he suggests, that the traditions and aims of medicine and spirituality meet." Source: amazon.com Source: amazon.com Handbook of Religion and Mental Health by David H. RosmarinHarold G. Koenig. "The book describes how religious beliefs and practices relate to mental health and influence mental health care. It presents research on the association between religion and personality, coping behavior, anxiety, depression, psychoses, and successes in psychotherapy and includes discussions on specific religions and their perspectives on mental health." Source: amazon.com Anchor 4 General Resources and Archives National Library of Medicine Islamic Medical Manuscripts at the National Library of Medicine Medieval Manuscripts in the National Library of Medicine Archives and Special Collections University of Pittsburgh Library Catalogue Antiquity Database

The Intersectionality of Religion and Medicine in the Health Humanities Purpose This research focuses on determining the intersectionality of religion and medicine/health throughout the years. The two have impacted each other greatly, contributing to new findings in the field of medicine and the founding of new religious sects. While originally very religious, medicine has become more secular as the years have passed. This research begins with Ancient Medicine and continues through to modern-day practices, tracing the influences of religion on medicine and its applications in the field of health. The Cult of Asclepius during the Plague of Athens Source: Robert Thom Ancient Medicine 450 B.C.E. to 1600 C.E. Overview of Various Religious Practices in Medicine: The groups/religions focused on during this preliminary research included the Ancient Near East (Mesopotamia, Egypt, Israel), the Greeks, the Romans, Christianity (Early and Middle Ages), and Islam. Hinduism, Buddhism, ancient Chinese medicinal practices, and folk medicine were also studied, although not as in-depth. A common thread among these groups included: Botany as a cure/treatment to ailments (all groups) The idea of possession by demons/evil spirits (Greeks, Romans, Hinduism, Christianity) Priest and Physician as separate entities (Ancient Near East, Greek) Magic's use for healing (Greeks, Romans, Early Christianity, Islam (Sufi)). Suffering as a way to repent (Ancient Near East, Greeks, Romans, Hinduism, Christianity, Islam) Development of Hospitals (Christianity, Islam, Buddhism) God treats through the Physician (Judaism, Islam) Healing via Prayer (Buddhism, Christianity, Islam, Chinese Medicine) Major Influences in Ancient Medicine: Hippocrates (460 BCE - 370 BCE) is often coined as the Father of Medicine. He laid the groundwork for the future of medicine, through his work on the human body and by defining the 4 humours (blood, yellow bile, black bile, and mucus). He also identified the limitations of medicine, claiming “What is not healed with medicine, is healed with the knife; what the knife does not heal, is healed with the cautery, and what the cautery does not heal must be considered incurable.” Because his ideas were flexible, they were easily utilized by monotheistic religions. Galen (129 CE - 216 CE) further developed humoral pathology and is often considered the last great physician of antiquity. Islam received the work of Hippocrates and Galen warmly. They used it in their treatments, removing the polytheistic elements to fit their religious barriers. In addition, because the act of dissection was seen as inappropriate in Islam, they based their knowledge solely on that of Galen. Asclepius is seen as the patron god of medicine, being of Greek origin. As the chief healing god, he garnered a following, naming themselves the Cult of Asclepius, who built temples in his honor and treated patients. Beginning in the 4th century, Christians began to believe in Asclepius. Historical Events: During this time, several important events occurred which shaped the lens through which religion and medicine were viewed. Development of the Hospital - while not considered a fully-fledged institution, the first hospital was founded in the 4th century in Rome by a wealthy widow named Fabiola Rule of St Benedict (516) - ordered no restrictions upon the care for the sick 4th Lateran Council (1215) - Canon 22 pronounced confession as the ideal healing method, prioritizing priests at bedside before physicians (healing the soul is more important than healing the body) The Emergence of Hospitals: Starting as early as the 4th century, hospitals began to emerge. Being tied to religion heavily in the beginning, these institutions were linked with churches, monasteries, and mosques. The Bīmāristān changed this narrative, being not only for the sick but also for education. The first of these Islamic Hospitals was built in 872 in Egypt as part of the royal complex. While still having religious undertones, treatments at Bīmāristāns were based largely on the teachings of Galen, and the teaching of future practitioners was prioritized. Gender as an Additional Component: Until the Middle Ages, women were still given privileges within the medicinal world. There was, and remains, a gender-specific issue of authority and power. The relationship between religion and healing was examined through the lens of the Virgin Mary and the comfort she provided to ill or pregnant women. Women were often blamed for birth defects, which were seen as a punishment from God because of their moral failings. The Trotula texts were published for women's illnesses in the 12th century. Seeing as women were underrepresented in medicine, both as physicians and patients, this was essential to furthering the level of care they received. One person of note is Hildegard of Bingen, who in the 12th century became the first woman to be recognized as a doctor of the Church in Catholicism. Her views aligned with humoral medicine and melancholia (mood disorders). Suggested Readings Medicine and Religion: A Historical Introduction Essential Readings in Medicine and Religion: Chapter Anecdotes and Antidotes: A Medieval Arabic History of Physicians Medieval Islamic Hospital Medicine, Religion and Gender in Medieval Culture Soul of Medicine Companion Encyclopedia of the History of Medicine Floorplan of a bismaristan in 10th century (ancient Islamic Hospital) Source: AramcoWorld Newsletter March/April 2017 Floorplan of St. Giles Hospital in 13th century (medieval European Hospital) Source: C. Rawcliffe, Medicine for the Soul: The Life, Death and Resurrection of an English Medieval Hospital. St Giles's, Norwich, c. 1249-1550 (Stroud, 1999), p. 62 Development of Modern Medicine 1600 to 1950 Mood Disorders: Just preceding this era, Burton published The Anatomy of Melancholy , which focused on mood disorders under the term melancholia. This concept led to copious discourse during the 17th century and transformed how human thought and emotion were seen. By separating religious melancholy from the affliction of the conscience, a more therapeutic approach was founded that did not abandon the care of the soul. Some treated religious melancholy as a disease, others as a religious obstacle that could be cured through "rest and health in God." An interesting finding was that women were more likely to seek out help for melancholy, highlighting it as something that afflicted women more. Ethnomedicine: Ethnomedicine of various groups was studied during the course of this research. A major focus was that of African Americans and their utilization of Secret doctors, whom they viewed as safe options for care. This is not surprising, seeing as there is a mistrust of mainstream caregivers. Through the work of Secret Doctors, black folk medicine was given the chance to survive and prosper, allowing for the treatment of many. Secret Doctors believed in oral histories, herbal remedies, prayer, amulets, and often were familial affairs, with parents training their children in the art of healing. Secret Doctors also provided care of mental health, treating through divination. While many cultures excluded women from the field of Medicine, the ethnomedicine of Secret Doctors allowed them to be seen as strong and positive healers. Development of Additional Religious Approaches: As religion and medicine interacted more, additional groups arose. A prominent example of this is Christian Science, which focused on the therapeutic power of prayer and preventative medicine. Christian Scientists were found to be satisfied (more than 50%) with their lives and their incorporation of religion. Suggested Readings Companion Encyclopedia of the History of Medicine Melancholy and the Care of the Soul: Religion, Moral Philosophy and Madness in Early Modern England (The History of Medicine in Context) Secret Doctors: Ethnomedicine of African Americans Prescribing Faith: Medicine, Media, and Religion in American Culture Source: Secret Doctors: Ethnomedicine of African Americans Modern Medicine 1950 to 2021 Cultural Competency: Defined as the "ability to understand, appreciate and interact with people from cultures or belief systems different from one's own,", cultural competency became a concern within modern medicine in the last 50 years. Although Westernized medicine is largely secular, the same cannot be assumed for other regions of the world. A prime example is the Hmong people, who utilize their cultural techniques for the practice of healing. The Spirit Catches You and You Fall Down is centered around the care of a young Hmong girl, Lia, with epilepsy who received treatment via Westernized medicine. However, her physicians did not understand their limitations, such as language barrier, cultural differences, and lack of understanding. Because of this, Lia's care was affected. Ultimately, with more cultural competency and understanding of the intersectionality of religion and health in various environments, changes can be made in the medical field. The Treatment of Women: Women, even in the modern era, are often treated incorrectly. Whether it be claims of them 'faking' their symptoms or overreacting, modern medicine does not place women on an equal plane with their male counterparts. However, women have decided that they wish to reclaim their healing and advocate for their health. Noteworthy quotes from Medicine Woman: Reclaiming the Soul of Healing include: "For many women, diagnosis, and the path that leads to it, is a deeply problematic part of Western medicine" “But their greater suffering does not eliminate mine. I am not imagining it. Something is most definitely not right within me.” "The current medical system simply does not allow for the full humanity of either patient or doctor. And the mental illness brought on by stress and anxiety is not just occurring in patients, it is running at its highest level ever amongst doctors and nurses too. Western medicine is on life support." Religion, Spirituality, and Mental Health: From the publication of Burton's Anatomy of Melancholy , the idea of mood disorders was seen as conventional. Spirituality is considered as the "refining of human consciousness in reaching the truth" and as a unification of Eastern and Western ideas. In religion, spirituality can be seen through yin and yang (Chinese medicine), the cross (Christianity), and the 'middle way' (Buddhism). Religion and spirituality influence people in a powerful manner. There is a healing power of prayer in clinical settings and religion can be seen as a buffer against disease. Prayer can also be seen through a therapeutic lens. Religion provides life with meaning and provides people with a social network and community. Through this, religion has a positive effect on coping and provides people with solutions (both emotional and spiritual). In fact, there is an inverse relationship between depression and religion. Overall, while those with strong belongings to religious groups have better mental health, they remain hesitant to reach out when they need help, often believing it to be embarrassing and that their community will support them just as much as a mental health professional. A Secular Perspective: As modern medicine takes the forefront, a secular perspective arrives as well. This change shifts the patient-physician relationship, making it less interactive. It gives way to a greater application of spirituality rather than religion and separates the physician from the religious perspective. Instead, in cases where needed, a chaplain or member of the clergy will help the physician. This keeps the physician from blurring the lines if they incorporate spirituality into their medical care. Additionally, pastoral care becomes more prominent. Medicine in the U.S. has become more cynical with a drive for efficacy. Suggested Readings The Spirit Catches You and You Fall Down Medicine Woman: Reclaiming the Soul of Healing Prescribing Faith: Medicine, Media, and Religion in American Culture Soul of Medicine Spirituality, Healing and Medicine: Return to the Silence Handbook of Religion, and Mental Health Source: The Institute for Family Studies View Archive Contact the Researcher Aliana Rao

Resources All citations for Harmony's Research are listed below! Go to Research References Purchase and Website Links are also included with each cited source, other than the unknown author Appendix A research study questions. That source can be found with a general google search but has no direct link from the British Medical Journal. Alda, A. (2018). If I Understood You, Would I Have This Look on My Face?: My Adventures in the Art and Science of Relating and Communication. Random House. Amatriain, X. (2020, February 27). NLP & Healthcare: Understanding the Language of Medicine. Curai Health Tech. https://medium.com/curai-tech/nlp-healthcare-understanding-the-language-of-medicine-e9917bbf49e7 Appendix A: Patient Semi-Structured Interview Questions. (2017). British Medical Journal. Baile, W. (n.d.). • Breaking Bad News • Addressing Emotions • Discussing Medical Errors • Cultural Competence • Challenging Emotional Conversations with Patients & Families • Effective Communication in Supervision The Complete Guide to Communication Skills in Clinical Practice. In MD Anderson I*CARE (pp. 1–45). Retrieved May 4, 2022, from https://www.mdanderson.org/documents/education-training/icare/pocketguide-texttabscombined-oct2014final.pdf Bickmore, T., & Giorgino, T. (2006). Health Dialog Systems for Patients and Consumers. Journal of Biomedical Informatics, 39(5), 556–571. https://doi.org/10.1016/j.jbi.2005.12.004 Bulger, J., Handley, M., & Nickel, W. (2016, August 31). Choosing Wisely®. Edhub.ama-Assn.org; AMA Steps Forward. https://edhub.ama-assn.org/steps-forward/module/2702596 Casassa, C. (2017, October 17). Just Go With It: My First Patient Interview. The Doctor Weighs In. https://thedoctorweighsin.com/first-patient/ Cassell, E. J. (1985). Talking with patients: Clinical Techniques (Vol. 2). MIT Press. Cassell, E. J. (1987). Talking with Patients: Theory of Doctor Patient Communication (Vol. 1). MIT Press. Clark, H. H. (1968). On the use and meaning of prepositions. Journal of Verbal Learning and Verbal Behavior, 7(2), 421–431. https://doi.org/10.1016/s0022-5371(68)80027-1 Cole, S. A., & Bird, J. (2000). The Medical Interview: The Three-Function Approach. Mosby. Gilligan, T., Coyle, N., Frankel, R. M., Berry, D. L., Bohlke, K., Epstein, R. M., Finlay, E., Jackson, V. A., Lathan, C. S., Loprinzi, C. L., Nguyen, L. H., Seigel, C., & Baile, W. F. (2017). Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline. Journal of Clinical Oncology, 35(31), 3618–3632. https://doi.org/10.1200/jco.2017.75.2311 Groves, J. E. (1978). Taking Care of the Hateful Patient. New England Journal of Medicine, 298(16), 883–887. https://doi.org/10.1056/nejm197804202981605 Hashim M. J. (2017). Patient-Centered Communication: Basic Skills. American family physician, 95(1), 29–34. King, A., & Hoppe, R. B. (2013). “Best Practice” for Patient-Centered Communication: A Narrative Review. Journal of Graduate Medical Education, 5(3), 385–393. https://doi.org/10.4300/jgme-d-13-00072.1 Knops, K., & Lamba, S. (2010). Clinical Application of ASCEND: A Pathway to Higher Ground for Communication. Journal of Palliative Medicine, 13(7), 825–830. https://doi.org/10.1089/jpm.2010.0023 Lauster, C. D., & Sneha Baxi Srivastava. (2017). Fundamental Skills for Patient Care in Pharmacy Practice (pp. 1–36). Jones & Bartlett Learning. https://samples.jbpub.com/9781449652722/9781449645106_CH01_001_036.pdf (Original work published 2014) Lipkin, M., Kaplan, C., Clark, W., & Novack, D. H. (1995). Teaching Medical Interviewing: The Lipkin Model. The Medical Interview, 422–435. https://doi.org/10.1007/978-1-4612-2488-4_36 Manguso, S. (2012). The Two Kinds of Decay. Granta. Miliard, M. (2017, May 18). EHR Natural Language Processing Isn’t Perfect, but It’s Really Useful. Healthcare IT News. https://www.healthcareitnews.com/news/ehr-natural-language-processing-isnt-perfect-its-really-useful Miliard, M. (2018, June 8). How Mercy is Using NLP with its Epic EHR to Improve Analytics for Cardiac Care. Healthcare IT News. https://www.healthcareitnews.com/news/how-mercy-using-nlp-its-epic-ehr-improve-analytics-cardiac-care Mityul, M. I., Gilcrease-Garcia, B., Searleman, A., Demertzis, J. L., & Gunn, A. J. (2018). Interpretive Differences Between Patients and Radiologists Regarding the Diagnostic Confidence Associated With Commonly Used Phrases in the Radiology Report. American Journal of Roentgenology, 210(1), 123–126. https://doi.org/10.2214/ajr.17.18448 OZER, M. N. (1977). The Interactive Assessment: A Means for Enhancing Development. The Journal of Creative Behavior, 11(1), 67–72. https://doi.org/10.1002/j.2162-6057.1977.tb00587.x Panicek, D. M., & Hricak, H. (2016). How Sure Are You, Doctor? A Standardized Lexicon to Describe the Radiologist’s Level of Certainty. American Journal of Roentgenology, 207(1), 2–3. https://doi.org/10.2214/ajr.15.15895 Prakash B. (2010). Patient satisfaction. Journal of cutaneous and aesthetic surgery, 3(3), 151–155. https://doi.org/10.4103/0974-2077.74491 Rosenkrantz, A. B. (2017). Differences in Perceptions Among Radiologists, Referring Physicians, and Patients Regarding Language for Incidental Findings Reporting. American Journal of Roentgenology, 208(1), 140–143. https://doi.org/10.2214/ajr.16.16633 Roter, D., & Frankel, R. (1992). Quantitative and Qualitative Approaches to the Evaluation of the Medical Dialogue. Social Science & Medicine, 34(10), 1097–1103. https://doi.org/10.1016/0277-9536(92)90283-v Schön, D. A. (2017). The Reflective Practitioner: How Professionals Think in Action. Taylor And Francis. Scripts to Help Your Practice Collect Patient Payment at the Time of Service. (2017). American Medical Association. https://edhub.ama-assn.org/ Stanford Medicine. (2018). GET SMART: How to Talk to Your Patients About Antibiotics [Online Infographic]. In Stanford Medicine: Stanford Antimicrobial Safety & Sustainability Program. https://med.stanford.edu/cme/learning-opportunities/antimicrobialstewardship.html Stanford Medicine. (2020). Serious Illness Conversation Guide [Online PDF]. Ariadne Labs. https://med.stanford.edu/advancecareplanning/resources.html Staples, S. (2015). Examining the linguistic needs of internationally educated nurses: A corpus-based study of lexico-grammatical features in nurse–patient interactions. English for Specific Purposes, 37, 122–136. https://doi.org/10.1016/j.esp.2014.09.002 Tayal, S., Michelson, K., & Tayal, N. (2016, August 31). Empathetic Listening. Edhub.ama-Assn.org; American Medical Association. https://edhub.ama-assn.org/steps-forward/module/2702561 The American College of Obstetricians and Gynecologists s. (2011, May). Effective Patient–Physician Communication. Www.acog.org . https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/02/effective-patient-physician-communication The Apache Software Foundation. (2017). Documentation - Apache OpenNLP. Opennlp.apache.org. https://opennlp.apache.org/docs/ The Apache Software Foundation. (n.d.). Apache cTAKESTM - clinical Text Analysis Knowledge Extraction System. Ctakes.apache.org. Retrieved May 4, 2022, from https://ctakes.apache.org/ Top 12 Use Cases of Natural Language Processing in Healthcare. (2019, June 7). Maruti Techlabs. https://marutitech.com/use-cases-of-natural-language-processing-in-healthcare/ Vidant Health. (n.d.). Conversation Scripts for Providers. Vidant Health. Retrieved May 4, 2022, from https://www.vidanthealth.com/patients-and-families/advance-care-planning/conversation-scripts-for-providers/#one-year-later White, M. K., & Keller, V. F. (2000). Difficult Clinician-Patient Communication. 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The Concept of the Self in Medicine Purpose Undeniably, the most important thing to a person is their sense of self, which refers to who we are and what makes us this way. It consists of our beliefs, our passions, and our personalities, among other factors that are more external, such as where we live. One place that this seems to take a backseat, however, is in the case of medical treatment. Suddenly we are nothing but a name on a chart that is made up of the sum of our illnesses, our individuality and who we are, now left undefined. More often than not, the only version of the self that is cared for by doctors is our physiological make-up, and this is where we reach a fundamental problem in our ways of biomedicine; doctors don’t care enough about their patients on an individualized, empathetical level. My research revolved around ethics and the personal narratives of patients and doctors, to analyze the patient-doctor relationship, and the concept of the self in medicine. The Project My research was targeted towards crafting a course that could be used to teach undergraduate pre-med students, or students going into another aspect of medicine, about the humanitarian sphere of medicine. Course Syllabus When it comes to being the carrier of a disease, we exchange our label of person for another p-word: patient. The purpose of this course is to examine the various relationships in medicine, revolving around patients, doctors, and humanity as a whole. Medicine has become an environment where individuality has been broken down, the self stripped away, in an effort to make treatment more efficient. However, it has become counterproductive; though more patients are able to be seen daily, a lack of empathy and understanding is leaving treatment subpar, the ever-important relationship between patients and their doctors dwindling down to nothing. This course will examine the place of the self in medicine, both the good and the bad, as well as researching the concept of ethics and doctoral responsibility. To do so, multiple articles, patient/doctor narratives, and other forms of prose will be closely analyzed to determine whether the importance of personage should be reevaluated in the medical sphere. COURSE OBJECTIVES To examine personal narratives of patients and doctors, as well as researchers, to determine the importance of the self in Western medicine. In turn, throughout the course, students will develop their own concept of the level of self that is permissible. Allow students to actively interact with the humanitarian sphere of medicine and treatment through assignments targeted towards critically thinking about the self in medicine. Examining the past and present of ethics in medicine, utilizing current events to jumpstart the discussion of a possible reevaluation. Cultivate research and writing skills through multiple discussion board posts and other writing assignments. Encourage a relationship between patient narratives and their medicinal qualities, bridging the gap between the humanitarian and scientific sides of Western medicine. ORGANIZATION OF COURSE CONTENT This course is organized thematically, with the various articles and texts being arranged into four categories: “The Self in Medicine,” “Ethics in Medicine,” “The Self as a Hinderance,” and “The Self as Healing.” Each category is also broken up into weekly subcategories pertaining to that specific concept. REQUIRED TEXTS Atul Gawande, Being Mortal: Medicine and What Matters in the End (Picador, paperback reprint edition, 2017) ISBN-13: 9781250076229 G.E. R Lloyd, ed. Hippocratic Writings (Penguin, Revised Ed., 1984) ISBN 978-0140444513 Audre Lorde, The Cancer Journals: Special Edition (Aunt Lute Books, 2nd edition, 1997) ISBN-13 : 978-1879960510 Kathy Charmaz, Good Days, Bad Days: The Self and Chronic Illness in Time (Rutgers University Press, Reissue edition, 1993) ISBN-13 : 978-0813519678 Paul Kalanithi, When Breath Becomes Air (Random House, 1st edition, 2016) ISBN-13 : 978-0812988406 *Links to additional readings can be found on our course site GRADING POLICY Weekly Discussion Board post and replies 10% Participation 10% Additional Assignments 20% Midterm Paper 25% Midterm Revision 5% Final Paper 30% Grading Scale A+ = 97-100% A = 94-96% A- = 90-93% B+ = 85-89% B = 80-84% C+ = 75-79% C = 70-74% D+ = 65-69% D = 60-64% F = 59% and Below CLASS POLICIES Attend all classes fully prepared to discuss the readings assigned for the day. If you must be absent, it is your responsibility to turn in any assignments due that day, and for getting the notes you missed from a fellow student. Perform close readings of the texts, including annotations and notes, so that you are prepared to speak in class. Complete Discussion Boards posts (250-500 words) by class time. Late posts, without good reason, will not be counted. Respond to two other students by the end of the week (minimum 100 words) Writing Assignments (details provided separately) should be completed by midnight on the day that they are due. Assignment guidelines will be found in our class site ATTENDANCE POLICY This course has an attendance requirement, in keeping with Departmental/Literature Program norms and guidelines. There is no distinction between “excused” and “unexcused” absences: whether you notify me beforehand or not; whether it is due to illness, or unforeseen emergency, or family responsibilities; or simply because you are too tired; or because of athletic events, you have to accept the consequences of your absence. For each absence without make-up work, after the fourth, however, your final grade will be lowered by a third (e.g., from B to B- to C+, and so on). I will take attendance almost every class session. SCHEDULE Section One: The Self in Medicine Week One - Where it Began: Reading the Original Medical Records Part I Read: Psychology Today – “What is the Self?” Hippocratic Writings – Epidemics Book I Week Two - Where it Began: Reading the Original Medical Records Part II Read: Hippocratic Writings – Epidemics Book III Assignment: Discussion Post One + Responses Week Three - Personage VS Patientage: What we give up to Receive Treatment Read: NCBI – “Identity and Psychological Ownership in Chronic Illness and Disease State” My Heart Sisters – “The Loss of the ‘Self’ in Chronic Illness is What Really Hurts” The Mighty – “When you fear You’ve lost Yourself to your Chronic Illness” Assignment: Discussion Post Two + Responses Section Two: Ethics in Medicine Week Four – What are the Ethics of Medicine? Read: Hippocratic Writings – The Oath AAPS – “Various Physician Oaths” Journal of the Royal Society of Medicine – “’First do no Harm’ – A Clear Line in Law and Medical Ethics" Assignment: Assignment One – Bioethics and Medicine Week Five – Ethics in Medical Research Read: Smithsonian Magazine – “In need of Cadavers, 19th-Century Medical Students Raided Baltimore’s Graves” History – “Tuskegee Experiment: The Infamous Syphilis Study” Assignment: Discussion Post Three + Responses Week Six – The History of Surgery Read: The Yale Journal of Medicine – “Body Snatching: A Grave Medical Problem” Assignment: Assignment Two – Virtual Museum Tours Week Seven – When Ethics Become Complicated: COVID-19 Read: The New England Journal of Medicine – “Facing Covid-19 in Italy – Ethics, Logistics, and Therapeutics on the Epidemics” NPR – “US Hospitals Prepare Guidelines for who gets Care Amid Corona Virus Surge” BMC Critical Care – “…the Italian Perspective During the COVID-19 Epidemic” Minnesota Department of Health – “Ethical Framework to Allocate Remdesivir in the COVID-19 Pandemic” Week Eight – Midterm Assignment: Midterm Paper Section Three: The Self as a Hinderance Week Nine – Doctors are People Too Reading: The Atlantic – “Doctor’s Tell all – and it’s Bad” NCBI – “Culture of Blame – An Ongoing Burden for Doctors and Patient Safety” Assignment: Discussion Post Four + Responses Week Ten – When Treatment Becomes Harm Reading: Being Mortal The Cancer Journals AP News – “When to give up: Treatment or Comfort for Late-Stage Cancer?” Assignment: Discussion Post Five + Responses Section Four: The Self as Healing Week Eleven – Doctors and the Concept of Empathy Read: frontiers in Behavioral Neuroscience – “Why Empathy has a Beneficial Impact on Others in Medicine: Unifying Theories” Patient EngagementHIT – “Understanding Physician Empathy, how it Impacts Patient Care” NCBI – “What is Clinical Empathy?” Assignment: Discussion Post Six + Responses Week Twelve – The People Behind the Patients Read: Good Days, Bad Days: The Self and Chronic Illness in Time When Breath Becomes Air Journal of Clinical Nursing – "Seeing the Person Behind the Patient: Enhancing the care of Older People Using a Biographical Approach" DUKE Center for Personalized Healthcare – "The Importance of Physician-Patient Relationships Communication and Trust in Health Care" AMA Journal of Ethic – "They Are People First, Then Patients" NCBI – "Knowing the Patient as an Individual" Cambridge University Press – "The secret is out: Patients are People with Feelings that matter" Week Thirteen – Wrapping Up Assignment: Final Paper Click here for Assignment Guidelines Click here to go to the Archive for additional readings Archive