There are, broadly speaking, two kinds of knowledge—analytic and intuitive, explicit and tacit. Analytic knowledge is arrived at by logical deductive thinking, and is a sequential thought process in which each step can be explained and defended. Intuitive knowledge, in contrast, is frequently alogical or nonrational, and often involves nonconscious mental processes. Though intuitive ways of knowing are essential to both scientific research and scientific medicine, the culture of medicine celebrates only the analytic, evidentiary kind of knowledge, while eschewing intuition (...) as being “nonscientific.” The popularity and prevalence of what is known as evidence-based medicine reflects this bias in favor of the analytic and the explicit. Though the evidence-based approach has contributed greatly to standardizing medical care, favoring treatments for which there is evidence of effectiveness, it has limitations. An overreliance on evidence-based medicine is problematic, because this approach leaves out important factors in the actual practice of clinical medicine such as diagnosis, nonverbal cures provided by patients, and the way the doctor–patient relationship bears on patient management and compliance, and because it is not appropriate for dealing with medical conditions that do not lend themselves to study by controlled clinical trials. (shrink)

This study compares two autobiographical descriptions of illness – the seventeenth-century John Donne's Devotions Upon Emergent Occasions and the twentieth-century Cornelius and Kathryn Ryan's A Private Battle . I begin by identifying the basic structure in both narratives as parallel to that of the case history, and then show how each individual's experience is shaped by the conditions of illness appropriate to their respective cultures. Lastly, I discuss the way in which both authors understand and represent sickness, as well as (...) their respective therapies, in terms of a particular metaphoric construct: for Donne, it is the analogy between illness of the body and illness of the soul; for Ryan it is the analogy between Ulness and war. The stance of each towards his illness is conditioned by this metaphoric model: Donne's is one of acceptance, of conforming to the will of God; Ryan's is one of resistance, of fighting heroically until the very end. Thus these metaphors are functional as well as aesthetic: they serve as figural modalities whereby the patient/author hopes to transcend his illness. Keywords: illness, patients, autobiography CiteULike Connotea Del.icio.us What's this? (shrink)

In this essay, the directors of an NEH Institute on “Medicine, Literature, and Culture” consider the lessons they learned by bringing humanities scholars to a teaching hospital for a month-long institute that mingled seminar discussions, outside speakers and clinical observations. In an exchange of letters, they discuss the productive tensions inherent in approaching medicine from multiple perspectives, and they argue the case for a broader conception of medical humanities that incorporates the methodologies of cultural studies.