Medical Humanities最新文献

This article introduces 'sonic life writing' as a new methodological approach to sharing bodily knowledge about illness experience through non-lexical sound and music. Drawing on autoethnographic research conducted during treatment for HER2+breast cancer, I argue that sonic approaches can complement existing counter-narratives by offering non-lexical modes that bypass certain constraints of dominant cancer discourse, such as metaphors of warfare. The conceptual framework of 'corporeal acoustemology' extends Steven Feld's work on ways of knowing through sound into medical and corporeal territories, proposing that bodily processes and treatment experiences can be made audible through compositional practice. This methodology moves beyond data sonification to what I term 'artistic sonation'-qualitative sonic expression that captures the temporal, relational, emotional, and embodied dimensions of illness that can resist lexical representation. Three original compositions demonstrate this approach: TCH-P transforms chemotherapy experience into rhythmic testimony using South Indian konnakol vocal techniques; KRANKENHAUSFUNK and the extrinsic death receptor pathway reimagines hospital radio by broadcasting the cellular process of apoptosis through repurposed infusion pumps; and Anuvāram Jugalbandī explores the disrupted temporalities of illness and care through intercultural musical dialogue. Theoretically, the article proposes 'reparative listening' as a framework for engaging with sonic illness narratives, drawing on Eve Kosofsky Sedgwick's work on reparative reading and recent scholarship on acoustic justice. This approach creates conditions for witnessing experiences that fall outside conventional narrative structures while challenging the medical emphasis on visual over auditory engagement with bodies. This article and practice-based research positions music and sound not as therapeutic intervention but as testimonial practice and knowledge transmission, contributing to growing intersections between sound studies and health humanities. Sonic life writing offers new possibilities for sharing the complexities of illness experience while expanding our understanding of embodied ways of knowing in medical contexts.

Healthcare education is increasingly moving beyond the biomedical paradigm to incorporate medical humanities, highlighting a person-centred approach. Integrative medicine encompasses biomedical sciences as well as social and cultural factors to treat the whole person, focusing on optimal health and healing. These shifts are evident in the rise of competency-based frameworks that aim to integrate ethical values, cultural sensitivity and interdisciplinary knowledge. Despite these developments, limited research has examined how such frameworks differ across countries and health professions based on distinct academic traditions and conceptual emphases. To address this research gap, this study conducted a comparative analysis of seven national-level health professional competency frameworks for six countries: the UK, the USA, Canada, Australia, South Korea and China. Using Mayring's structured content analysis method, documents were analysed across four categories: competency domains, keyword mapping, structural features and sociocultural characteristics. To support interpretive depth, the Health Systems Science (HSS) framework was applied as a lens for understanding conceptual convergence and divergence in the person-centred approach. While all seven frameworks highlighted core areas such as communication, professionalism and patient-centred care, their structures and value orientations varied. The frameworks for the UK and Australia focused on moral accountability, while those for the USA and Canada emphasised functional and systems-based competencies. Frameworks for China and South Korea reflected traditional philosophies and professional identity formation. The HSS framework offered a valuable structure for aligning both topic-based domains and personal attributes across diverse educational systems, especially highlighting a person-centred approach to consolidate integrative medicine. The findings suggest that while each framework has distinct strengths, gaps remain-particularly in addressing social competencies, such as advocacy and cultural sensitivity. These areas warrant further integration, education and validation to support socially accountable and systems-oriented professional development.

In this epistolary paper, we draw on the work of an interdisciplinary, psychosocial study of the relationship between time and care, Waiting Times, to explore the significance of a book of letters as a waiting object. Words in Pain, a collection of letters by Olga Jacoby (1874-1913) to her doctor and family written in the shadow of her early death, was published posthumously in 1919 as the nation emerged from World War I and the Great Flu Pandemic; while a new edition was published in 2019 just before the COVID-19 pandemic forced the relationship between waiting, care, vulnerability and interdependence into consciousness. We argue that Jacoby's passionate reflections on her children and her imminent death show her working out how to live well in the face of a loss that is to come, while using her letters to take care of the future: a future that includes her children and the future generations to whom her letters have come down. We also explore how Jacoby's first editor in 1919, who published the book anonymously, perhaps to protect the identity of her well-known doctors, and her 2019 editors, who restored Jacoby's place in time, each performed an act of care, for both the past and the future. The act of writing and reading, but also that of editing, thus provides a container of time and care, while the letter becomes a waiting object that offers to reanimate a relationship to a future into which the writer knows she cannot endure.

Medical professionalism is a core component of medical education, yet it remains conceptually ambiguous and inconsistently articulated across institutions, cultures and training contexts. Although students are expected to demonstrate professionalism as part of professional identity formation, the meanings and expectations associated with professionalism are often implicit, variable and shaped by both formal curricula and the hidden curriculum. This qualitative study examined how medical students articulate and make sense of professionalism during undergraduate medical training using a discourse-informed analytical approach. All students (M1-M4) at a single US medical school were invited to participate, and recruitment concluded after 44 students volunteered. Data were collected through 20 individual semistructured interviews and four focus groups, and transcripts were analysed inductively to identify recurring ways professionalism was articulated in students' accounts. Analysis revealed three recurring ways professionalism circulated in student discourse: (1) definable and actionable, in which professionalism was described through observable behaviours such as punctuality, dress and communication; (2) inherently subjective, where professionalism was framed as situational, relational and shaped by cultural or interpersonal expectations; and (3) uncertain and confusing, characterised by difficulty articulating a coherent understanding and by the expansion of professionalism into broader expectations of self-presentation and image management. Across these accounts, students most often articulated professionalism in physician-centred terms, emphasising self-regulation, appearance, composure and evaluability, reflecting the institutional and assessment contexts of early medical training. This study demonstrates that medical students encounter professionalism through multiple coexisting ways of understanding that circulate within medical education and are variably taken up as students navigate professional expectations. By shifting analytical attention away from defining what professionalism should be and toward examining how professionalism is articulated and taken up in practice, a discourse-informed approach offers a productive framework for understanding professional identity formation in contemporary medical education.

Phobias unsettle not only the emotions but the cognitive and linguistic structures through which fear is experienced and expressed. This article examines how contemporary memoirs, Sarah Chihaya's Bibliophobia, Nicolette Heaton-Harris's Living with Emetophobia: Coping with Extreme Fear of Vomiting, Sara Benincasa's Agorafabulous! Dispatches from my bedroom and Russell Norris's Red Face: How I Learnt to Live with Social Anxiety, translate the somatic immediacy of panic into language. Drawing on Mary Helen Immordino-Yang's Emotion-Cognition Framework, which proposes that emotional and reflective systems are neurally interdependent, the study identifies integration nodes: moments in the text where sensory chaos and self-reflective commentary converge. These nodes mark the transformation of panic into narrative thought, showing how linguistic markers such as causal connectives, temporal shifts and ironic self-observation mediate between affective arousal and conceptual understanding.Through close reading and cognitive stylistic analysis, the article demonstrates that phobic memoirs enact, rather than merely describe, the process of cognitive-emotional regulation. Fragmented syntax and recursive phrasing reproduce the physiology of panic, while humour and irony re-establish agency by reframing fear as discourse. Across all four memoirs, phobia emerges not as a static pathology but as a dynamic linguistic event in which narrative enables emotional integration. The study argues that recognising these textual mechanisms can enrich clinical approaches to anxiety disorders by foregrounding narrative as a medium of adaptation and repair.

This article explores the historical and theoretical relationship between chiropractors and conspiracy theory belief. At the height of the COVID-19 pandemic, numerous journals published articles warning readers about chiropractic conspiracy theories targeting the mRNA vaccine, and for people to approach disproved medical practice with scepticism. COVID-19's persistent threats prevented further considerations of the anticonspiratorial roots of chiropractic and therefore some of the most significant explanations for some strands of chiropractic's steadfast commitment to the margins of standardised medical care. From its inception, chiropractic's architects have positioned it against mainstream medicine and under perpetual threat from legitimating medical institutions like the American Medical Association (AMA). This article recounts chiropractic's anticonspiratorial roots and its turbulent relationship with the AMA before considering some chiropractic conspiracy theories during the COVID-19 pandemic. Although conspiracy theories are common among chiropractic's founding text, the AMA bears some responsibility for the current state of chiropractic conspiracy theories. The purpose of this article is to inform policy makers, evidence-based chiropractors and researchers about the historical roots of conspiracy theories within chiropractic medicine and the ways that standardised medicine encouraged anticonspiratorial beliefs among chiropractors in its efforts to undermine 'alternative' medicine. Without careful consideration of these historical factors, critics risk misidentifying the motivating factors for chiropractic conspiracy theories and therefore risk perpetuating some harmful trends within some strands of chiropractic care. This analysis is especially relevant given the meteoric rise of the wellness industry and its influence on American politicians encouraging suspicion of standardised healthcare. While such developments demand their own specific analyses, this article's historical exploration of the connection between chiropractic and conspiracy theories will be relevant to those interested in better understanding the sordid history between standardised and alternative medicines and how the popular dismissal of alternative medicines as inherently untrustworthy or irrational risks intensifying the divide.

This article compares William Carlos Williams's short story 'The Use of Force' (1938) and Tess Gerritsen's novel The Surgeon (2001) to explore how biomedical care can slide into coercion and how clinical spaces oscillate between sanctuary and sacrilege. Building on Michel Foucault's formulation of clinical vision, together with Julia Kristeva's account of abjection and René Girard's sacrificial theory, I propose a three-strand analytic-power/knowledge, Gothic embodiment and parareligious affect-supplemented by an ecoGothic perspective that scales clinical violence from flesh to environment. Through close reading, the essay shows how Williams's intimate house call converts beneficent intention into brute force, while Gerritsen's medical thriller grotesquely weaponises medical expertise: the gaze that sees also dominates, and instruments of cure-tongue depressor, spoon, scalpel-become ritual implements that breach bodily borders. Attending to gendered vulnerability and trauma poetics, the analysis situates Gerritsen's femicidal surgeries within patriarchal control and foregrounds the counter-agency of Jane Rizzoli and Catherine Cordell. Placing a modernist vignette beside a 21st century medical thriller, the article maps both continuities and ruptures in the ontological, epistemic and ethical stakes of clinical authority, tracing how sacrificial logic, secular priesthood and toxic ecologies persist across periods. The contribution is twofold: to Gothic studies, by clarifying medicine's parasacral volatility and its ecological imaginaries; and to bioethics and the medical humanities, by articulating a normative claim that only practices disciplined by consent, narrative reciprocity and institutional accountability can sustain the secular covenant of care. Otherwise, curative ritual hardens into authorised brutality, and knowledge is purchased through a sacrificial economy in which cura collapses into cruelty. Such findings refine debates on clinical paternalism, narrative ethics and trauma representation in literature.

Since 2017, more than 600 000 Rohingya have sought refuge in Bangladesh, as Forcibly Displaced Myanmar Nationals (FDMN), in registered camps or improvised settlements in Cox's Bazar. Although humanitarian responses have significantly improved in the past decades, coordination gaps remain between health and non-health sectors (eg, little is known about the impacts of shelter or protection responses on refugee health). We thus aimed to explore FDMN perspectives on issues affecting their health to help inform health system responses to mass displacement in Cox's Bazar.We conducted photo-elicitation interviews with 39 FDMN in Kutupalong and Balukhali camps. Each participant-researcher pair photographed three to five images of participants' lived environment, then participants described each photograph and why chosen in interviews. We analysed data thematically.Participants reflected daily difficulties and indignities, due to open sewerage and limited potable water, alongside health and safety risks (eg, flimsy and insecure shelters, gas leaks), particularly for children, older people and those with special needs. Health services were reportedly basic and sometimes unfriendly. Participants advocated for health and safety improvements, providing photographic evidence of the risks they experienced daily.Photo-elicitation was valuable for visualising participants' daily lives and provided participants with a means to advocate for improvements in undignified and risky living conditions. Interviews enabled articulation of perceived effects on physical and mental health and recurrent themes of 'abandonment', with limited services and few pathways for change. Highlighting Rohingya experiences can help identify ways to improve living conditions, services and well-being.

The arts and humanities can direct attention to the health-threatening effects of adverse living and working conditions and the political and economic systems that spawn them. In pursuit of this goal, we presented 15 undergraduate health studies students and alumni with drawings by artist Georg Grosz that depicted the profound social inequalities of Weimar-era Germany and then had them explore the relevance of these drawings to the present-day Canadian scene. Students found the eight drawings which depicted topics of (1) Income and Wealth Inequality, Poverty and Food Insecurity; (2) Capitalism; (3) The Nature of Charity; and (4) Responses to the Polycrisis engaging and relevant, reporting discussion of these drawings reinforced their learning and were consistent with their own lived experiences. Several themes from the discussions emerged, such as Class Relations, Adverse Health Effects of Problematic Living and Working Conditions, the Nature of Charity and Barriers to Progress, which showed remarkable similarity with what is known about Grosz's motivations for these drawings. Regarding their potential for promoting health equity, students believed engaging with Grosz's drawings could provide means for mobilising healthcare and public health students and workers, as well as the public, to demand that governing authorities respond to these issues.

This is a craftivist (ie, craft-activist) methodological inquiry which uses zine-making to explore the experiences of a small group of National Health Service (NHS) foundation doctors in the south-west of England. Foundation doctors undertake a 2-year training programme, comprising rotating medical and surgical internships and advanced training, before receiving their full medical licence from the General Medical Council. Drawing on arts-based research (ABR) methodologies, the ethics of action research and a feminist new materialist ethico-onto-epistemology, this project is a collaborative inquiry that is attentive both to the need for praxis-oriented research with foundation doctors during the current NHS crisis and the role of method in producing particular forms of knowledge. Foundation doctors are reported to have high levels of burn-out and poor mental well-being, are facing increasing job insecurity with the rise of competition ratios for training posts, and in the past 2 years have initiated 14 strikes for better working conditions and pay. This project is the first example of craftivist ABR with foundation doctors and seeks to demonstrate the value of creativity as a form of praxis to communicate experiences differently and make a change.