Both patients and providers are crying out for health care to become more humane....This project can help to restore the heart and soul of health care that so many of us believe has been weakened. (Physician)

IMAGINE doctors, nurses, receptionists, trustees, administrators, lab techs, PAs, with books in hand, sitting in a hospital conference room, talking about what they have read and reflecting together on what it means to them-as people, and as professionals engaged in the enterprise of health care. Since 2003 more than 2000 health care professionals in 52 hospitals in 8 states did just this.

And what difference does it make? A hospital vice-president describes it this way: It is difficult to articulate how this relatively simple concept of bringing people together to share in art has made a lasting and transformational impact to our small rural hospital and surrounding communities. To quote Henry David Thoreau, "Could a greater miracle take place than for us to look through each other's eyes for an instant?"

Created by the Maine Humanities Council, Literature & Medicine: Humanities at the Heart of Health Care® is a national award-winning, hospital-based, scholar-led humanities reading and discussion program for health care professionals that benefits both them and their patients. The Maine Hospital Association has cited it as a patient-quality initiative.

The program encourages participants to connect the worlds of science and lived experience, giving them the opportunity to reflect on their professional roles and relationships through plays, short stories, poetry, fiction and personal narratives in a setting where they can share their reflections with colleagues. It has a significant effect on the way participants understand their work, and their relationships with patients and with each other. It is also an innovative and cost-effective way to improve patient care:

The reflection and conversation that takes place in the process greatly enhances the level of cooperation, collaboration and esprit de corps within our hospital family and our community at large. This impetus in turn greatly improves the quality of care we provide to our patients and their families. (Hospital administrator)

OUTCOMES

• better and more satisfying communications with patients and colleagues
• greater understanding that institutional hierarchies impede communication
• greater understanding that varied cultural and socio-economic perspectives and family history affect patient health and patient care, and
• greater satisfaction with their work, leading to less burn-out.

• My expectations for increased communications, better understanding of health care issues, need to change, creative ideas for improving care were exceeded. The participants expressed gratitude and awe for what the seminar brought to them and how the concepts discussed changed their behavior and way of thinking about others/ patients.
• My goals were to promote interdisciplinary communication and teamwork at the medical center and to expand the professional practice of the participants. I feel it was a wonderful group and accomplished these objectives.
• This is the best team building activity we've ever done.
• These discussions have significantly reordered how I think about medicine.
• The seminars helped foster communication across the hierarchy of medical culture, which was great and much needed.
• Surgeons commune with nurses from our long-term care facility; secretaries speak with equal voice to administrators; laboratory technicians give their viewpoint to obstetricians. In short, [Literature & Medicine] has greatly improved communications among participating employees, and has also improved communications with patients.

Background and Purpose

Health care professionals can no longer rely on what they know from their own lives to understand their patients, who may be of a different religious, socio-economic or cultural backgrounds. Literature, however, offers vicarious experiences of worlds outside that of the reader, supplying full-bodied accounts of illness, death and human relationships in all places and among all peoples. This is why the field of medical humanities is growing nationally, and why the integration of literature into medical education is becoming commonplace. Literature & Medicine is, therefore, part of a larger effort, but it is also unique as the only program of its kind that links hospitals on a statewide-and now national-basis and involves a heterogeneous mix of veteran health care providers.

Getting Involved

If you are interested in starting a Literature & Medicine program in your area, please contact either Lizz Sinclair or Victoria Bonebakker. We would be happy to talk with you.