The COVID-19 pandemic challenges us to rethink of the role of health humanities and its relationship to medicine. How medicine regards health humanities has evolved from a desirable hobby or pastime into a complementary practice to improve core medical skills. As the pandemic revolves, evolves, and resolves, there is a need for health humanities to provide a moral and social conscience for medicine, especially around issues of health inequities, given the difficulties that bioethics now has in performing this role. It is an advantage to be positioned outside medicine in performing this very necessary task, which has been so illuminated by the experiences of the pandemic. Narratives, in all forms, continue to inspire action: a gift (koha) from health humanities, which cares for both those who receive and give.
E huri tō aroaro ki te rā, tukuna tō ataarangi ti muri i a koe [Turn and face the sun and let your shadow fall behind you]. – Alsop and Kupenga (2016, p. 132)
Early on in the pandemic, I learnt of a fascinating and extremely farsighted article written by Dr Aisha Ahmad, a professor of political science at the University of Toronto, who grew up in war zones and who now specialises in international relations and international security (CBC Radio, 2020). She likened living through a pandemic as to living through a warzone and wrote: “...it almost feels like an assault on the person yourself, on your own personal identity, but you have yet to breathe into this new world and create new parts of who you can be under these conditions, new ways to be happy.” It is interesting, and maybe even paradoxical and ironic, that Aisha Ahmed asks us to breathe into the new normality, given that it has been a virus that took our breath away being the base cause for this very changed world.
Breathing is literally the stuff of life. Usually we take it completely for granted. It is not until it is impaired that we notice it, a fact noted by Havi Carel (2014) in her part-personal illness narrative (of a rare lung disease), part-phenomenological analysis:
The healthy body is transparent, taken for granted. We do not stop to consider any of its functions and processes because as long as everything is going smoothly, these are part of the bodily background that enable more interesting things to take place. ... It is only when something goes wrong with the body that we begin to notice it. Our attention is drawn to the malfunctioning part and suddenly it becomes the focus of our attention. (p. 31)
If we substitute “life” for “body”, then the analogy of the impact of the pandemic takes hold. So many aspects, maybe the totality of our lives, were taken for granted until the pandemic impacted upon life, shortening our breath and causing us to metaphorically gasp. But let us take Dr Ahmad’s words, let us breathe into this new world. It is a metaphor which conjures images of letting go, releasing the old and inhaling the new. It also conjures a recognition of gaining strength through the right cadence of breathing in, holding and gently releasing in a rhythmical way, repeating this over and over again using a delicate yet firm pace, as circumstances unfold and allow. And with the breathing let us look at where we have been, where we are and where we may be going in health humanities. Because together with these senses of right-timing and breath, which is the essential activity of life, we also need to understand this past, present and future. It is well known from research, that under conditions of stress we almost inevitably develop tunnel vision (Weltman, Smith & Egstrom, 1971), we concentrate on what is immediately before us. But as the fogs of the pandemic shift and thin, and we breathe the clearer and cleaner air, and see further, we have the opportunity to create things anew.
The humanities are uniquely placed to provide this vision over the coming months and years, and the health humanities will have a crucial voice. Why? Because one of the humanities greatest strengths is its ability to help widen people’s vision, deepen empathy, broaden the focus of attention and thus bring more into view. “He rangi tā Matawhāiti, he rangi tā Matawhānui: the person with narrow vision has a restricted horizon; the person with wide vision has plentiful opportunities” (Alsop & Kupenga, 2016, p. 27). And one aspect of the pandemic which has been brought into high focus as never before, is the highlighting of long-standing health inequities (Hall et al., 2020). And as such, I argue, the future of health humanities lies in the political realm as much as that of healing.
To understand this further, I draw on the work of Alan Bleakley (2015) who has described three phases in the history of health humanities. The first phase was characterised by medicine regarding the humanities as a nice addition, a welcome break from the proper, rigorous and scientific pursuit of biomedical medicine where a medical student or doctor could learn a new gentlemanly or ladylike hobby. These sentiments were encapsulated in the approach of William Osler, the hugely influential physician and medical educationalist, who wrote: