The rise of technology and data overload looms large over medical practice, threatening the human interactions at the core of the doctor-patient relationship. And as it continues, “something definitely will get lost,” says Alan Wasserstein, MD, an associate professor in Penn Medicine’s division of Renal, Electrolyte and Hypertension. “The danger,” he says, “is that physicians turn their work into a pure exercise.”
Educators, researchers, and practitioners across in the United States and abroad have been working to address the rift between personal and impersonal care by developing models that introduce ways to encourage humanism and professionalism to the practice of 21st century medicine. For more than a decade, Penn faculty – including Dr. Wasserstein – have helped put programs and activities in place to help students and staff that teach caregivers how to show respect and be sensitive to their patients’ needs, as well as demonstrate cultural competency at the bedside.
About four years ago, Dr. Wasserstein hit on the idea of a lecture series that would feature presentations exploring the topics of humanism and professionalism in medicine, delivered by experts from both medicine and the humanities. He wanted to name the series after an appropriate role model, and the choice of William Carlos Williams was a natural and obvious choice. Williams, a graduate of Penn’s medical school, was both a practicing physician and venerated poet.
“Williams successfully united humanism and professionalism in two careers, in poetry and in medicine,” says Wasserstein.
The difference between humanism and professionalism in medicine is a topic that has been the subject of several scholarly articles, but for Wasserstein the two are not distinct from one another – rather, they are co-dependent. “For me, humanism is an internal attitude, the attitude of putting patients first. Professionalism is the external behavior that results from putting patients first.”
The first William Carlos Williams Conference in Humanism and Professionalism was given by Jack Ludmir, MD, vice chair of Penn’s department of Obstetrics and Gynecology, about his experiences providing care to illegal immigrants at Pennsylvania Hospital. Other presenters have included David Thomas Stern, MD, PhD, author of Measuring Medical Professionalism, and Lance Wahlert, PhD a member of Penn’s Center for Bioethics, whose talk depictions of physicians on television fused pop culture and the practice of medicine through the ages. The lecture series meets five times a year; an upcoming session with address “compassion fatigue” and burnout.
For Williams, the confluence of being a writer and being a physician was seamless. He says in “The Autobiography of William Carlos Williams” that, “As a writer, I have been a physician, and as a physician a writer…” But as with most things Williams writes, the true relationship between his two professions is not only more complex, but also more obscure. It was while performing the ministrations of a physician that Williams was able to glimpse the quality he called “the thing” in human existence and use it as inspiration.
“It is an identifiable thing, and its characteristic, its chief character is that it is sure, all of a piece and, as I have said, instant and perfect: it comes, it is there, and it vanishes. But I have seen it, clearly. I have seen it. I know it because there it is. I have been possessed by it…”
And when inspiration struck, Williams began writing. He kept a typewriter under his consulting desk, and scribbled on prescription pads.
At the most recent session of the series, Richard Gunderman, MD, from Indiana University, ended his talk, entitled; “Why Do Physicians Need to Write?” by suggesting that the way Williams engaged in the practice of medicine also provided him with the means to access his humanism – not just to write poetry, but also to provide compassionate care for his patients.
Gunderson concluded his talk in a way that Williams himself might have, by challenging the audience to write a love letter. “I guarantee you will discover something about yourself, something positive you can apply to work.” Like Williams, Gunderson believes that the act of writing itself taps into our innermost selves, deepening our experience as human beings and helping physicians become better healers.