Medical school is a journey of visceral emotions and experiences unique to the field. As a first year, students walk into a brightly lit room lined by white walls to meet a donor lying on a table. As a second year, students will take an exam that will shape the trajectory of their careers. As a third year, students will work in the hospital and see everything from births of healthy babies to somber end-of-life care conversations. Lastly, fourth year students will spend months waiting to hear back from a residency program as to which city they may be living in for the next three to seven years. These highs and lows are difficult to navigate. It is for this reason that doctors must start reading literature.
I entered medical school with the quintessential scientific paradigm. After graduating with a degree in engineering and working as a data scientist for a year, my lens of the world was empiricism and logic. If numbers could not describe something, it was unlikely to be of any use to me. After all, decisions made in professional roles as a researcher, program manager or data analytic centered around improving particular metrics. There was no room for emotions when numbers made the decisions. There was a proven algorithm for every problem, an article for every illness and a computer program for every project. Imagine my state when I entered medical school and was faced with life’s realities — I was left struck to the core. Like many other students, I was moved by the nature of mortality, filled with fear at the prospect of failure and unable to relate to the serious bioethical aspects of medicine.
It was at this time that I found the antidote to my crisis. I started to read books … not about science. Alexander Dumas taught me about mortality. Mark Twain taught me about failure. And Dostoevsky taught me about ethics. My teachers were no longer just those wearing white coats presenting in medical school lecture halls. They were the great thinkers and writers of past generations. These teachers provided a human lens to the rigors of medical school and transformed me into a better person and, consequently, a better future physician. If it must be narrowed down, three reasons reign supreme in explaining why reading had such a positive impact on my medical development and why it may be a critical tool for medical students across the country working to reach their full potential.
First, literature contextualizes the human experience. Feelings of loss, love, jealousy and anger have been described in vivid detail for millennia. One only has to open Pride and Prejudice to gather insight into the complexities of human relationships. Or read a few chapters of War and Peace to empathize with a young person trying to carve out their place in the world. With the insight provided by literature, we can find words to characterize our pain, role models to direct our growth and a form of empathy for those experiencing challenges we have not experienced ourselves. As a result, a developing physician will be better prepared to connect with a grieving family member or articulate how life’s challenges affect them. Our problems are not unique; they are just another formulation of perennial themes experienced by thousands of generations before us.
Second, literature will provide understanding and appreciation for all people. If a book is the physical manifestation of the mind, then every book will provide insight into a different perspective of human experiences. One can read Hemingway to experience the reality of war, Miguel De Cervantes to see the beauty of the Spanish countryside and Alex Haley to witness racial injustice in America. Physicians will be better able to connect with patients of varied backgrounds. They will have a stronger appreciation for their culture, their values and some of their shared experiences. Although the human experience is not ubiquitous among all identity groups, storytelling remains an effective means of sharing experiences and emotions from a different perspective.
Third, literature provides physicians with the tools to participate in conversations on bioethics. The answers to difficult questions are crucial for medical progression and serve as divisive topics in medical discussion. The position one adopts will not only stem from a study in the lab but a complex mixture of rationality, emotion and faith. Those contributing to these conversations must have the tools to think through these problems and not be limited by empirical parameters.
I remember reading When Breath Becomes Air by Dr. Paul Kalanithi for the first time. In this autobiographical telling of his journey from neurosurgery resident at Stanford to being diagnosed with brain cancer, Dr. Kalanithi repeatedly returned to one theme: the numbers and statistics provided him no benefit as a patient. In the story, the warmth and comfort of his caring providers and family made the journey bearable. A life subjected to only numbers is devoid of color and meaning. It is compassion that drives quality patient care, understanding that repels bias and humility that contextualizes challenges. Anyone striving to be a better physician should pick up a book — a book that has nothing to do with science.