A novel approach to work

On a brisk winter evening in Brunswick, Maine, about 20 animated adults gather in a corner room of MidCoast Hospital. The roar of a nearby vacuum cleaner signals what should be the end of the day for many of them. But members of this group ignore the signal, settling down instead at a table and cracking open the books they've brought.

Their energy may stem from what lies in front of these healthcare professionals: a nonfiction work by Susan Sontag. For the next few hours, white coats and patient charts will be put aside as this unusual book club ponders how to weave literary lessons into the text of their work lives.

These monthly meetings, they say, give them a rare chance to pause from a busy schedule and scientific conversations - an opportunity to think more deeply about their profession. "We use literature to help strip away the assumptions we bring to work, and improve our understanding of our patients and each other," says Peter McGuire, a family physician who has attended the voluntary seminars at MidCoast Hospital for the past three years.

Indeed, many professionals, from lawyers and doctors to teachers and probation officers, are finding that the lens of literature can offer deep insights into their work.

The Maine program, called Literature and Medicine and sponsored by the state humanities council, started in 1997 and has expanded to 24 of the state's 35 hospitals. In the past 10 years, state humanities councils in more than a dozen other states have started similar programs for professional groups. Meanwhile, a pioneer in the concept, Brandeis University in Waltham, Mass., has served more than 7,000 professionals since 1981.

Groups might use "Antigone" to launch a debate on moral dilemmas, "Billy Budd" as a case study in justice and abuse of power, or "The Bluest Eye" for a look at a fresh cultural perspective.

For former Maine Chief Justice Daniel Van Wathen, it was an essay by Michel Eyquem de Montaigne that shed light on decades of bland legal dockets. He was participating in a course for lawyers and judges when he read a passage on how nothing is so universal among humans as diversity.

"I realized how easy it can be, after seeing thousands of cases, to think 'oh, this is one of those,' " he says. "But you really have to consider the complexity and diversity of every human affair - and when you forget that, you start doing injustice."

Justice Van Wathen also used to teach law courses and would point to Oliver Wendell Holmes's statement that "law is more experience than logic." He says he taught the importance of "the vicarious experience of delving into literature to acquire a proper legal imagination."

Physician Geoffrey Gratwick says the Literature and Medicine program in Maine helped him "become more aware of the need to slow down, and listen to what my patients' needs are." He cut back the number of patients he sees so that he can spend more time with them. "It's fun to be a doctor again, and it puts pleasure back in the practice for me," he says.

The concept of book discussions is nothing new - indeed, it is as old as books themselves. And the notion that a cross-pollination among the arts and sciences is ideal harks at least as far back as the Renaissance. But more recently, it was only in the 1980s that the idea that literature and other humanities add real value to professions such as law and medicine gained solid footing.

Daniel Terris, coordinator for the Brandeis Seminars in Humanities and the Professions, says his program was partly a response to the reaction against US professionals in the 1980s, many of whom were caught up in money and status. "Many professionals were recognizing the need to not only have the requisite skills to do your work, but also to pay attention to your own values and the values of the institution you were a part of," he says.

Similarly, in the medical world, technological advances had taken off, "and people started saying, 'wait a minute, technology is wonderful, but we're emphasizing technology at the expense of talking to patients and hearing how they're feeling,' " says David Svahn, a retired doctor who is now the coordinator of the humanities and medicine program at Bassett Healthcare in central New York.

Rita Charon, a national authority in the field of literature and medicine, also began her work during that time. A few years into the practice of medicine, she says she "realized that what patients paid me to do was listen very attentively to their extraordinarily complicated narratives ... and to cohere their stories into something that could be acted on."

Dr. Charon became one of the first doctors in the US to obtain a PhD in English. She now directs a program at Columbia University medical school in what she calls narrative medicine.

Dr. Svahn acknowledges that not everyone may be taken with the approach. "The idea that the skills of reading and writing literature are necessary for doctors may cause some to think, 'well, this is just too cute,' " he says. "But we're at a time when people are complaining that we spend too much money on medical care, on unnecessary diagnostic tests, when the best way to figure out what's wrong with a patient is still the content of his or her story."

An increasing number of medical schools also have begun to offer or require courses in the humanities. The Association of American Medical Colleges reports that in 1995, 30 percent of medical schools offered some form of literature class. By 1998, 74 percent offered literature courses - and of those, 39 percent required them. "Textbooks may teach you theories and terminology, but literature gives you an actual viewpoint from the patient," says Bret Rutherford, a Columbia medical student who designed an independent-study course on author Samuel Beckett.

Similarly, the practice of writing literature can provide important insight. Svahn says medical students who work at the hospitals for a few weeks are asked to write a reflection and share it at the end of their stay. "They learn to be so much more perceptive when they know they'll be writing something down in the end," he says. The collection of poetry and essays has been so poignant that in June he's publishing a book of 40 of the pieces.

So far, the groups most receptive to the literature-infusion seminars hail from the healthcare and courtroom set, mostly because they are least likely to run into poetry and novels in their daily lives, or gather in one room to ponder the deeper matters of their fields.

But a growing number of similar programs have been adapted for groups of teachers, philanthropists, prisoners, and even diverse members of a community.

"Literature gives any group of people a mirror to look through ... an abstract commonality that allows them to dig deeper, reflect harder," says Elizabeth Sinclair, Literature and Medicine project coordinator.

Coincidentally, a recent Harvard Business Review echoes that sentiment. Justifying why its list of the top 10 business books of 2001 includes the novel "Empire Falls" by Richard Russo, the magazine says: "Art is a big, pumped up, operatic version of real life; it's the lie that tells the truth better than the truth does."

• Send e-mail to sara@csmonitor.com.