Vulnerable reading and the sensibilities of health humanities

Abstract Objectives This essay presents one model of medical humanities as a complement to clinical biomedicine: not a supplement but an equally necessary component of clinical practice. Biomedicine is continually criticized for its inadequacy in addressing the existential, spiritual, relational, and ethical sufferings of being ill and caring for the ill. This essay comprises two sections. First, a practice of vulnerable reading is proposed as one way of preparing oneself for encountering suffering, either as an ill person or as someone caring for the ill. The second section discusses Heidegger’s distinction between calculative reason, exemplified by scientific biomedicine, and meditative reason, which this essay presents as the role of humanities in medicine. Methods Meditative health humanities rests on four methodological principles: contingency, non-finalizability, ineffability, and letting go (Heidegger’s Gelassenheit ). Contingency means accepting that clinical practices will be unpredictable in their potential effects, including unanticipated diffuse effects. Medical humanities can offer resources to ill people and to clinicians, but when and how these will prove useful in specific instances is indeterminate. Non-finalizability means that no final word, no totalizing statements such as the scientific usage of “findings” implies, can be spoken about persons or actions. Ineffability is the recognition of the limits of language and symbolic expression, extending to the limits of reason itself. Letting go indicates giving up fantasies that human lives can be predicted and controlled, including the fantasy that any set of routinized procedures can lead to statements that predict and thus provide for control of lives. Thus, the method of meditative medical humanities is to model forms of practice , not to teach in a didactic, prescriptive sense. In keeping with the principle of non-finalizability, these methodological principles are open-ended, inviting supplementation and revision. Results To follow its own methodological presuppositions, humanistic work in medicine refuses any pretence of claiming specific results. Instead, it can offer only individual testimonies that describe particular experiences of discovering value of diverse kinds in suffering and in the care of those who suffer. To further develop Heidegger’s distinction, calculative reason seeks predictable results of practices; meditative reason dwells in immanent and indeterminate values of practices. Vulnerable reading imagines multiple possible results—or, it imagines not yet imaginable results—depending on the contingency of individual lives. Living with suffering is understood to depend upon giving up projections of specific outcomes, except eventual death. Conclusions Clinical biomedicine’s dependence on calculative reason renders it unable to address more than material, physiological pathology, yet it claims pride of place in what counts as “medicine”. Calculative reason excludes meditative reason, at most relegating it to a secondary role. For medicine to be a healing art concerned with what is often called the whole person, a complement of meditative reason is needed as equally necessary, not supplementary. The humanities can provide resources for practices of meditative medicine. One initial resource is the legitimacy of refusal of statements that conclude in the sense of claiming to have the last word about anything. Meditative reason is resolutely non-conclusive.

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