Reflections on Literature & Medicine at the Veteran Administration Hospital
Rosalia Scalia, Veteran Administration Maryland Health Care System is this week’s contributing author.
The Veteran Administration Maryland Health Care System (VAMHCS) opened its Literature & Medicine program January 2010 with participants from a cross-section of hospital staff representing various backgrounds and training. Armed with a syllabus full of reading assignments including poetry, drama, plays, essays, non-fiction, and photography the group met monthly for six months and discussed the selected readings, reflecting on their different perspectives, honed by their professional training.
No subject was taboo. The group explored everything from hierarchical institutional systems that limit interactions between patients, staff and doctors; cultural and language barriers; socio-economic, class and gender issues that impeded communication, issues that can result in misunderstandings, misdiagnosis, and mistakes, despite best intentions. For instance, one story we read was about a homeless man, drunk and shabbily dressed, who is a chronic visitor to an ER and is treated with disdain by staff Later, the same health care providers feel guilt and shame when an ambulance brings him back to the ER, this time as a John Doe found frozen in a nearby park. His humanity, invisible when he was alive, became apparent to the staff after his death.
Spurred by the readings, which included the Pat Barker novel Regeneration; Anne Faidman’s award winning book, The Spirit Catches You and You Fall Down, which chronicles inter-cultural miscommunication between doctors, nurses, a medical system and the family of an epileptic Hmong child; Echoes of War, an anthology of works by literary giants such as Carver, Dubus, O’Connor, and others; and various handouts, the group discussed trauma, anger, family, class, disability, cultural diversity, and body image. They questioned their relationships, roles, recalled milestone experiences in their careers, doubts and certainties, and grew comfortable enough with each other to share them. Many reported that the program helped them remember why they had been drawn to the health care field and it helped them return to their posts with a wider understanding and a greater compassion, rather than the routine of viewing patients as a set of symptoms or as a disease state.
Because of the Veteran Administration’s (VA) mission to serve veterans, many of the literary selections focused on issues unique to hospitals for soldiers with the hope that the works would provide health care professionals serving them with new or deeper insights into trauma’s impact on their patients. Also unique at VA medical centers, many of the health care providers themselves are veterans who have served overseas, prompting lively discourse that included the patients’ perspectives. Consequently, the program encouraged participants to gain a better understanding of how combat and military experiences have shaped their patients, including a deeper knowledge of all that they had been forced to carry and inadvertently lost as a result of their service, concluding with how what they lost often became burdens they carried after their duty had ended.
When the Literature & Medicine program ended in June, participants lingered, reluctant to leave at the end of it. In short, without realizing it, participants bonded, learned more about each other as professionals and as people, becoming a veritable palliative care team for the entire institution by fostering increased patient safety and communications. The program is being touted as an innovative way to improve patient care because it encouraged participants to connect the dots, bridging the worlds of science and life experience and through the use of literature, and exploring the dire consequences when the world disconnects.
Organized by Christina LaGana, PhD, the associate chief for education and academic affairs, supported by grants from National Endowment for the Humanities and the Maryland Humanities Council, the Literature & Medicine program at the VAMHCS will expand to the Perry Point facility in the coming year.
By Rosalia Scalia, VA Maryland Health Care System.
Tags: Literature & Medicine