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MEDICAL HUMANITIES

Medical Humanities

From the outset Dean Cecil Lewis was determined that medical students should enjoy the broadest possible education, stating in the University of Auckland Gazette in 1967 that:

The nature of our curriculum must not be taken as an indication that we are moving towards science to the detriment of the essential humanity of medicine.’

Students responded well to this approach, as Innes Asher – one of the 1968 entrants – recalled in a 2017 interview.

This was endorsed by Steve Culpan in his prize-winning essay on his experiences as a foundation student, when he wrote:

From the start of planning, the emphasis was on a continual liberal diverse education. A background in psychology was considered essential, with less accent being placed on an exhaustive didactic exposition of anatomy.

Some staff were just as enthusiastic about incorporating medical humanities into the curriculum. Sir John Scott, a member of staff in the Auckland Medical School from 1970, had studied English before switching to medicine. In his contribution to In the Beginning: A history of the Medical Unit at Auckland Hospital and the formative years of the Department of Medicine, The University of Auckland (2013), Scott made reference to an informal course in medical humanities around 1972 and lamented the fact that this had been crowded out of the curriculum by the rapid expansion of biochemistry and pharmacology. He also paid tribute to Cecil Lewis’s vision:

He had his own lectures in which he introduced a form of humanities, which was squeezed out as the curriculum got busier and busier. To indicate the sort of thing that happened in those days, my wife had done Honours in English at Victoria with James K Baxter. One night before this room – this was a bedroom in those days but it was full and that room was full – and James K Baxter silenced a bunch of 40 medical students, giving an allegory of his life in poetry. We did not have a tape-recorder, nobody recorded it. He was dead a month later. Black mark on me. But that was the sort of thing we could do.

JK Baxter (1926-72), one of New Zealand’s most prolific and influential poets, died in October 1972 of a heart attack.

Sir Richard Faull, a senior lecturer in anatomy from 1975, also commented on Lewis’s commitment to linking the humanities and medicine in a 2017 interview:

To my mind the diversity of the University is critical and the Humanities underpin the whole University. And medicine, art and the humanities go together hand-in-hand. It was always hoped that that would happen. I think there’s probably room for further development though.

Medical humanities was formally introduced to the curriculum by Garth Cooper, a 1979 Auckland medical graduate who had returned to his alma mater in 1993 after a stellar career in experimental therapeutics in the UK and America. Appointed to an associate professorship in the Department of Medicine and the School of Biological Sciences, in 1994 Cooper negotiated a six-lecture slot in the first-year physico-chemistry teaching schedule for medical history. The following year he invited colleagues including Dr Linda Bryder (History), Professor John Carman (Anatomy), Dr Peter Davis (Community Health), Dr Derek Dow (General Practice), Mrs Marion Heap (Molecular Medicine) and Dr Will Richardson (Classics and Ancient History) to deliver individual lectures. From 1996 to 1999 Dr Dow assumed sole responsibility for this course.

In 2000, after extensive discussion by an Inter Faculty Committee (Medicine, Arts and Law), the medical history lectures were replaced by a one-semester medical humanities elective programme for second-year students, with courses taught by staff from the disciplines of Anthropology, Classics, English, History, Law, Politics and Sociology. When he was interviewed in 2014, foundation professor of psychiatry John Werry showed his affinity with the views of Cecil Lewis, when he commented on the alleged resistance to the concept.

By 2018 the programme had evolved further, with students now required to select 3 topics from: Ethical Issues in Contemporary Medicine, Concepts of Disease in the History of Medicine, Medicine and Performance, The Student Teacher, Musicians and Health, Medicine in Classical Thought, Spirituality in Health Care, Medicine and the Philosophy of Science, Comparative Literature, Medicine in the Visual Arts, Medicine and the Law. 

Ceil Lewis would have been proud of this evolution.

 

Portrait of James K Baxter by Joseph Alach, 1973.

Dr Val Grant (left), the daughter of a Methodist minister, taught psychology at the University of Auckland for more than 34 years and coordinated the Medical Humanities programme from its inception in 2000 until 2010.

Associate Professor Phillipa Malpas (right), a philosopher by training who has a particular interest in medical ethics, has taught in, and also coordinated, MBChB 311: Medical Humanities since 2009.

The Dean’s Lectures

Writing about `Undergraduate Education’ in the September 1967 issue of the New Zealand Medical Journal, Dean Cecil Lewis promoted the concept of dean’s lectures, open to all students, on a wide range of topics. He attributed the birth of this idea to the University of Western Australia – where he had taught prior to his appointment to Auckland – noting it had also been recently adopted in an American university.

Lewis’s vision was implemented in part thanks to the generosity of David Nathan, one of Auckland’s earliest businessmen, who died in August 1886. Nathan’s 1885 will bequeathed `the sum of two hundred pounds to the Treasurer and trustees of the Auckland Hospital upon trust to invest the same and apply the interest thereof towards the expense of medical lectures to be given at the Auckland Hospital or in connexion therewith for the instruction of medical students and until such lectures are given upon trust to accumulate by adding the interest to principal which interest when added shall form part of the capital fund.’ The money lay dormant until the 1960s, at which point Lewis utilised it for his new scheme.

The Dean’s choice of lecturers was wide-ranging. In 1972, for example, they included the disciples of Hare Krishna, two future Prime Ministers (David Lange and Robert Muldoon), Tuhoe activist Tame Iti, student protestor and future mayor Tim Shadbolt, and Major Thelma Smith of the Salvation Army.

When Lewis returned to Auckland for the School’s 25th anniversary in 1993 he gave a Dean’s Lecture, sparking the comment that `we haven’t had a lecture like that since Cecil Lewis left Auckland.’

Perhaps the most exotic of all was the brain child of Rex Hunton, lecturer in community health. Through his work as a clinical physician Rex got to know a group of Hells Angels and invited them to give a Dean’s Lecture. The story is best told in the words of his wife Valerie. 

Tame Iti (left) addressed the issue of `Pakeha, Friend or Foe? Tim Shadbolt (right) spoke on `Bullshit and Jellybeans’, taken from the title of his controversial 1971 book.

Rex Hunton on stage with the Hells Angels.

Auckland graduates as creative writers

Links between medicine and literature date back to Greek mythology, with Apollo recognised as the god of both poetry and healing. This connection has carried on through the centuries, with numerous doctors combining professional lives with contributions to fiction as novelists (Robin Cook, Conan Doyle, Somerset Maugham et al), poetry (Havelock Ellis, John Keats, Oliver Wendell Holmes etc) and drama (Anton Chekhov, Jonathan Miller et al).

Until relatively recently only a handful of New Zealand-trained doctors fitted this pattern. Robert Briffault, who graduated in 1901, abandoned medicine and his homeland after service at Gallipoli and later became a writer of fiction. Merton Hodge moved to Britain soon after graduating in 1929 and established a reputation as a playwright with The Wind and the Rain (1931), a tale of three medical undergraduates sharing lodgings in Edinburgh.

Since its inception in 1968, and more particularly over the past two decades, Auckland Medical School graduates have produced a significant volume of fiction and, in some instances, non-fiction works.

Several have made a name for themselves as poets, the best-known being Papakura-born Glenn Colquhoun who graduated MB ChB in 1997. Three years later he won the Montana Book Award for the best first book of poetry, following up in 2003 with the main Poetry and Reader’s Choice Awards for Playing God. In 2005 Colquhoun was recognised as a distinguished alumnus of his alma mater.

One of his works from this period – `A Medical Education’ – was dedicated to one of his clinical teachers, Hamilton physician Peter Rothwell; other poems have such evocative titles as `Today I do not want to be a doctor’ and `When I am in doubt (a poem for surgeons)’. Colquhoun also pens children’s stories, and explores in prose and verse the relationships between Māori and Pakeha literature.

In 2009 Colquhoun was granted a Fulbright Scholarship to visit medical humanities centres at Harvard, Columbia and Pennsylvania State Universities, with the aim of helping to set up programmes in Auckland. He currently (2019) practises as a GP in Palmerston North.

The poetic careers of two earlier graduates had a much longer gestation than Colquhoun’s meteoric rise. Robynanne Milford, a member of the second intake who graduated in 1975 and became a Christchurch GP, published her first volume of poetry, Songcatcher in 2009 and has followed this with Grieve Hopefully (2012), Aspiring Light (2015), and Finding Voice: Women on the Dunstan 1860-1900 (2018).

One of Milford’s near-contemporaries, South Auckland GP Greg Judkins (MA ChB 1976), revealed in a 2016 interview that he had dabbled in poetry for most of his life, adding that:

Being a GP is a great source of inspiration and material and characters and scenarios – it’s just given to you on a plate! It’s all just there waiting to be written about. You get all these insights into human nature, all the tragedies of peoples’ lives, you get this window into it all.

From around 2010 Judkins became more interested in the short story genre, and took out the runner up prize in the University of Auckland Alumni Relations Short Story Competition in 2014 with Makalofi, a tale of a 72-year-old Tongan woman and her relationship with her medical practitioner. In 2016 the Royal New Zealand College of General Practitioners established The Greg Judkins Prize for Reflective Poetry `in honour of Dr Greg Judkins, who for more than 30 years has encouraged registrars to use poetry as a medium to reflect on their practise.’

One of Auckland’s doctor-poets has also made a name for herself as a dramatist. Renee Liang MB ChB 1997, the daughter and grand-daughter of medical men, works as a paediatrician and has also been the Asia leader for Growing up in New Zealand, the longitudinal study established in 2005.

In addition to her medical work, Liang gained a Master of Creative Writing and a Post Graduate Diploma in Arts (Theatre Writing) from her alma mater and has published four books of poetry and several plays. In 2010 she was named as one of 6 Sir Peter Blake Emerging Leaders for her work in helping to define and break down barriers in New Zealand’s cultural landscape through her efforts in the arts, science and medicine.

Hopeful that Renee would choose an occupation other than medicine, her grandfather gave her a name which translated to `literary blossom’. Over the past two decades she has more than lived up to his hopes while still maintaining her medical career.

This poetic tradition established over the half century of the FMHS’s existence, seems set to continue. In 2017 Tanisha Jowsey, lecturer in the Centre for Medical and Health Science Education, edited Medicine Reflections, which contained 102 `original reflective works’, by a total of 64 students. In a prologue to the collection Glenn Colquhoun, a doyen of Auckland medical poets, explained how he found an echo of his younger self in the volume:
I have read it and it makes me want to smile. It makes me recognize my own desire to write as a young man. It makes me want to say well done. And thank you. To those of you who have contributed, there you are, bright and shining, part of a tradition that stretches all the way back to Hippocrates and St Luke through to Keats and Chekhov and Williams Carlos Williams. You practice medicine and you write.

Glenn Colquhoun.

Robynanne Milford as a 4th year student in 1972.

Greg Judkins, 2016.

Renee Liang in her role as a doctor.