“Why Literature And Medicine?” By Larry R. Churchill: Summary and Critique

Introduction: “Why Literature And Medicine?” By Larry R. Churchill

“Why Literature and Medicine?” by Larry R. Churchill first appeared in Literature and Medicine in 1982 (Vol. 1, pp. 35-36), published by Johns Hopkins University Press. Churchill argues for the integration of literature into medical education, emphasizing that literature fosters deeper insight into the human condition—something that purely scientific training often neglects. He critiques the longstanding division between the sciences and humanities, noting that medical students respond more profoundly to narratives like John Berger’s A Fortunate Man than to sociological models of illness (Churchill, 1982). This, he suggests, is because literature has the unique capacity to engage imagination and empathy, enabling physicians to better understand their patients’ lived experiences. Churchill asserts that medical education risks alienating students from the human aspects of their profession, as “too frequently the well-trained professional is not well educated” (p. 36). He highlights literature’s ability to offer “thick descriptions” of human suffering and ethical dilemmas, referencing James Dickey’s poem Diabetes as an example of how literature conveys the patient’s perspective more powerfully than clinical descriptions of noncompliance (p. 36). Ultimately, Churchill argues that literature does not merely supplement medical training but is essential to it, as it provides “the space to imagine how it might be otherwise” and cultivates the moral and perceptual skills necessary for compassionate care (p. 36). His essay remains a foundational work in the interdisciplinary field of literature and medicine, reinforcing the idea that storytelling is integral to ethical medical practice.

Summary of “Why Literature And Medicine?” By Larry R. Churchill

Theoretical Terms/Concepts in “Why Literature And Medicine?” By Larry R. Churchill

Term/Concept	Definition/Explanation	Reference from Churchill (1982)
Academic Bifurcation	The division between sciences and humanities, leading to a separation between technical knowledge and humanistic understanding.	“The typical academic bifurcations of sciences and humanities (hard data and soft; knowledge and opinion; fact and value; cognitive and affective) have dominated our ways of thinking and perceiving” (p. 35).
Human Condition	The broad range of emotional, psychological, and existential challenges faced by humans, including suffering, alienation, chronic illness, and death.	“Suffering, depression, alienation, chronic disease, disability, and death are non-technical-solution problems—problems of the human condition” (p. 35).
Alienation in Medical Education	The sense of detachment medical students experience from the human realities of medicine due to an overemphasis on scientific and technical knowledge.	“Too frequently the well-trained professional is not well educated; too frequently the professional is uprooted from any real appreciation of the human condition” (p. 36).
Scientism	The belief that scientific knowledge is the only valid form of knowledge, often leading to the marginalization of humanities in medical education.	“Beyond recognizing false bifurcations and the idolatry of scientism, literature can provide what Clifford Geertz calls ‘thick descriptions’ of our human situation” (p. 36).
Thick Description	A concept from Clifford Geertz referring to detailed, nuanced accounts of human behavior and experience that capture deeper meaning and context.	“Literature can provide what Clifford Geertz calls ‘thick descriptions’ of our human situation, and the space to imagine how it might be otherwise” (p. 36).
Imagination in Medicine	The role of literature in fostering empathy and allowing medical professionals to see from a patient’s perspective.	“Imagination frees us from the immediate and allows the unusual, the other, to appear” (p. 36).
Narrative Power	The idea that storytelling is a compelling way to understand and convey human experiences, particularly in ethical and medical contexts.	“Narrative has the power to show us, rather than tell us about, the profound mystery of medical encounters” (p. 36).
Moral Decision-Making through Stories	The argument that ethics in medicine is shaped more by compelling narratives than abstract principles.	“Our sense of morality in medicine is ultimately grounded in the persuasive power of stories of helping and healing, not in the clarity of our thinking about principles” (p. 36).
Empathy through Literature	The ability of literature to help medical professionals understand the lived experiences of patients.	“Literature evokes and stimulates the imagination, permitting us to change places with the patient and dwell in his or her ambience” (p. 36).
Natural Integration of Literature and Medicine	The argument that literature and medicine are inherently connected, rather than artificially linked.	“Far from being artificial, the conjoining of literature and medicine is natural and even essential” (p. 36).

Contribution of “Why Literature And Medicine?” By Larry R. Churchill to Literary Theory/Theories

• Narrative Theory and the Power of Storytelling
  • Churchill emphasizes the importance of narrative in understanding human experiences, particularly in medicine. He argues that “narrative has the power to show us, rather than tell us about, the profound mystery of medical encounters” (Churchill, 1982, p. 36).
  • His argument aligns with Narrative Theory, which suggests that stories shape human perception and meaning-making, particularly in ethical and medical contexts.
  • He supports the idea that moral and ethical decisions in medicine are better understood through stories rather than abstract principles: “Our sense of morality in medicine is ultimately grounded in the persuasive power of stories of helping and healing, not in the clarity of our thinking about principles” (p. 36).
• Reader-Response Theory and Empathy in Literature
  • Churchill’s discussion of how medical students respond more profoundly to literature than theoretical texts aligns with Reader-Response Theory, which argues that meaning is shaped by the reader’s engagement with a text.
  • He suggests that literature’s power lies in its ability to evoke empathy and personal reflection: “Literature evokes and stimulates the imagination, permitting us to change places with the patient and dwell in his or her ambience” (p. 36).
  • This reinforces the idea that meaning is not fixed in a text but is actively constructed by the reader’s experience and emotions.
• Hermeneutics and “Thick Description”
  • Churchill references Clifford Geertz’s concept of “thick descriptions,” which is rooted in hermeneutics—the study of interpretation, especially in human sciences (p. 36).
  • He argues that literature allows for a deep, context-rich understanding of human suffering that is often missing from clinical descriptions.
  • This contribution aligns with hermeneutic literary theory, which emphasizes deep, interpretive engagement with texts to uncover meaning beyond surface-level analysis.
• Medical Humanities and Interdisciplinary Literary Studies
  • Churchill’s essay serves as a foundational text in the field of Medical Humanities, advocating for the integration of literature into medical education.
  • His argument that “far from being artificial, the conjoining of literature and medicine is natural and even essential” (p. 36) supports interdisciplinary literary studies, where literature is examined in conjunction with fields like ethics, philosophy, and healthcare.
  • This contribution highlights the role of literature as a bridge between scientific knowledge and humanistic understanding.
• Ethical Criticism and the Role of Literature in Moral Decision-Making
  • Ethical criticism explores how literature influences moral reasoning and ethical dilemmas.
  • Churchill asserts that literature plays a crucial role in shaping medical ethics, arguing that “the power to see clearly and from diverse perspectives is the sine qua non for choice and decision” (p. 36).
  • His emphasis on storytelling as a moral guide reflects the broader argument within ethical criticism that literature is essential for cultivating ethical awareness.

Examples of Critiques Through “Why Literature And Medicine?” By Larry R. Churchill

Literary Work	Churchill’s Perspective and Critique	Reference from Churchill (1982)
John Berger’s A Fortunate Man (1967)	Churchill praises this work for its ability to engage medical students deeply, providing a compelling humanistic perspective on medicine. He contrasts its impact with abstract sociological definitions, stating that freshman medical students are “more profoundly affected by reading John Berger’s A Fortunate Man than Talcott Parsons’s definition of the sick role” (p. 35). This highlights the importance of narrative over theoretical frameworks in medical education.	“Perhaps freshman medical students know something that professionals have forgotten” (p. 35).
James Dickey’s poem Diabetes	Churchill argues that this poem conveys the patient’s perspective on illness more effectively than clinical descriptions of noncompliance. He states that it is “worth a thousand sociological descriptions of ‘noncompliance,'” as it allows readers to experience the emotional and sensory struggles of a diabetic patient (p. 36).	“Literature evokes and stimulates the imagination, permitting us to change places with the patient and dwell in his or her ambience” (p. 36).
The Parable of the Good Samaritan (Biblical Narrative)	Churchill uses this parable to illustrate the power of storytelling in ethical reasoning, comparing it to the principle of beneficence in medical ethics. He argues that “The parable of the Good Samaritan is to the principle of beneficence as Fort Knox is to a quarter,” suggesting that narratives have a stronger persuasive power in shaping moral understanding than abstract principles (p. 36).	“It is the narrative power of the parable that makes it compelling—that is, the knitting together of events, motives, and actions that together form a story” (p. 36).
Clifford Geertz’s Concept of “Thick Description” (Applied to Literature)	While not a literary work per se, Churchill engages with Geertz’s anthropological theory of “thick description” to argue that literature provides rich, contextually nuanced insights into human suffering. He suggests that literature can “provide what Clifford Geertz calls ‘thick descriptions’ of our human situation,” allowing deeper engagement with the lived experiences of patients (p. 36).	“Beyond recognizing false bifurcations and the idolatry of scientism, literature can provide what Clifford Geertz calls ‘thick descriptions’ of our human situation, and the space to imagine how it might be otherwise” (p. 36).

Criticism Against “Why Literature And Medicine?” By Larry R. Churchill

• Overemphasis on Narrative at the Expense of Scientific Rigor
  • Some critics argue that Churchill romanticizes the role of literature in medicine, potentially downplaying the necessity of empirical, evidence-based knowledge in clinical practice.
  • His assertion that medical students are “more profoundly affected” by A Fortunate Man than by sociological theories (Churchill, 1982, p. 35) may overlook the importance of understanding broader systemic and theoretical medical frameworks.
• Lack of Concrete Methodology for Integrating Literature into Medical Training
  • While Churchill advocates for the inclusion of literature in medical education, he does not provide a clear framework or practical methodology for its implementation.
  • His argument remains largely philosophical, leaving unanswered questions about how medical curricula should balance literary and scientific training.
• Potential Subjectivity and Variability in Literary Interpretation
  • Reader-response theory suggests that different readers extract different meanings from the same text, making literature an inconsistent tool for medical education.
  • What one student finds illuminating, another may find unhelpful or irrelevant, raising concerns about the reliability of literature as a pedagogical tool in medical training.
• Ethical and Cultural Biases in Literary Selections
  • Churchill assumes that certain literary works (e.g., A Fortunate Man, Diabetes) universally resonate with medical students, but literature is culturally and contextually dependent.
  • His argument does not account for how diverse student backgrounds might influence their engagement with Western literary traditions and medical narratives.
• Failure to Address the Limitations of Literature in Addressing Structural Issues in Medicine
  • Churchill focuses on literature’s ability to enhance empathy and moral reasoning but does not fully address how systemic medical issues (e.g., disparities in healthcare access, institutional biases) require more than narrative understanding.
  • While literature can enrich medical ethics, it alone does not equip physicians with the tools to solve structural inequalities in healthcare.

Representative Quotations from “Why Literature And Medicine?” By Larry R. Churchill with Explanation

Quotation	Explanation
“Freshman medical students are more profoundly affected by reading John Berger’s A Fortunate Man than Talcott Parsons’s definition of the sick role.” (p. 35)	Churchill argues that narratives resonate more deeply with medical students than abstract sociological theories. This highlights the power of storytelling in shaping human understanding of medicine.
“The typical academic bifurcations of sciences and humanities (hard data and soft; knowledge and opinion; fact and value; cognitive and affective) have dominated our ways of thinking and perceiving.” (p. 35)	He critiques the rigid separation between science and the humanities, which limits a holistic approach to medical education.
“Suffering, depression, alienation, chronic disease, disability, and death are non-technical-solution problems—problems of the human condition.” (p. 35)	Churchill emphasizes that many medical issues cannot be solved solely by scientific advancements but require emotional and humanistic understanding.
“Too frequently the well-trained professional is not well educated; too frequently the professional is uprooted from any real appreciation of the human condition—both that of patients and his or her own.” (p. 36)	He criticizes medical education for producing technically skilled but emotionally disconnected professionals.
“Perhaps Literature and Medicine can remind us of what freshman medical students still know but which professionalization teaches us to forget.” (p. 36)	He suggests that literature can help medical professionals retain their initial empathy and humanistic perspective.
“Literature can provide what Clifford Geertz calls ‘thick descriptions’ of our human situation, and the space to imagine how it might be otherwise.” (p. 36)	Churchill references Geertz’s concept of “thick description” to show how literature provides rich, nuanced insights into human experiences.
“Imagination frees us from the immediate and allows the unusual, the other, to appear.” (p. 36)	He asserts that literature stimulates the imagination, enabling doctors to empathize with patients’ experiences.
“James Dickey’s poem Diabetes is worth a thousand sociological descriptions of ‘noncompliance,’ precisely because it allows us to see what the diabetic sees at breakfast and what it means to long for the forbidden beer at a campsite.” (p. 36)	Churchill uses this example to show that literature can communicate lived experiences of illness more effectively than clinical descriptions.
“The parable of the Good Samaritan is to the principle of beneficence as Fort Knox is to a quarter.” (p. 36)	He argues that stories, rather than abstract ethical principles, have a more profound impact on moral reasoning in medicine.
“Far from being artificial, the conjoining of literature and medicine is natural and even essential.” (p. 36)	Churchill concludes that literature is not just a supplementary tool in medicine but a fundamental aspect of understanding and practicing compassionate care.

Suggested Readings: “Why Literature And Medicine?” By Larry R. Churchill

1. Churchill, Larry R. “Why literature and medicine?.” Literature and Medicine 1.1 (1982): 35-36.
2. Rousseau, G. S. “Literature and Medicine: The State of the Field.” Isis, vol. 72, no. 3, 1981, pp. 406–24. JSTOR, http://www.jstor.org/stable/230258. Accessed 21 Feb. 2025.
3. Greenhalgh, Trisha, and Brian Hurwitz. “Narrative Based Medicine: Why Study Narrative?” BMJ: British Medical Journal, vol. 318, no. 7175, 1999, pp. 48–50. JSTOR, http://www.jstor.org/stable/25181430. Accessed 21 Feb. 2025.
4. HALLER, JOHN S. “POSTMODERNIST MEDICINE.” Shadow Medicine: The Placebo in Conventional and Alternative Therapies, Columbia University Press, 2014, pp. 31–60. JSTOR, http://www.jstor.org/stable/10.7312/hall16904.7. Accessed 21 Feb. 2025.