Full transcript
0:04[music]
0:09[music]
0:17Hello everyone. I welcome you to my
0:19course introduction to medical
0:20humanities. This is the lecture 10 of
0:23our course in which I explore COVID 19
0:26as a turning point in medical
0:28humanities.
0:29Now if you think of literature as the
0:33reflection of life, literature in a very
0:36broad sense of the term then covid-19 in
0:41fact was a turning point. It taught us
0:44new ways of learning, new ways of
0:47leading our lives and hence in medical
0:50humanities too which theorizes the bio
0:54aspect of our lives it became central.
0:58What I do in today's lecture is that I
1:00map the coid9 pandemic globally as well
1:04as what it did to people in the Indian
1:06context. Now why this is important
1:08because as I mentioned earlier health is
1:12not something which is individual. It is
1:15a community oriented aspect and
1:18therefore we have to look into it not
1:21only in totality of its being but also
1:24in totality of who is what in what
1:28sphere.
1:30How pandemics have functioned as
1:32historical turning points. If you look
1:35into the history, you will find that
1:38there are several pandemics that have
1:41kind of restructured a country's entire
1:45discourse, not just economic but
1:48otherwise. One example that I can take
1:51up here is the black death or maybe the
1:55Spanish flu of 1980 and most recently
1:59the HIV AIDS crisis that produced
2:02long-term changes in public health
2:04policies and medical practices.
2:07covid-19 in fact was the turning point
2:10for all of us because it it came out in
2:14a time which people did not expect that
2:18to happen. It just came from nowhere and
2:21changed the entire discourse of how we
2:24were visualizing the medical
2:26infrastructure not only in our country
2:28but worldwide. There was probably no
2:31country which was ready for coid9
2:33pandemic and that's why you will find
2:36that the chaos that happened everywhere
2:39led to a very different kind of shift in
2:41the medical humanities space as well.
2:46Now uh when we think of the covid-19
2:48pandemic and what it did to literature
2:51you will find that there is a sense of
2:53deep entanglement that you will come
2:55across. Now what is this deep
2:58entanglement? It means that the health
3:02is not about biology alone. If you look
3:06at the conceptual shift during coid9
3:09pandemic, Jane Mcnotton describes it
3:14as deep entanglement between biological
3:17process and social life. This means that
3:20each one's life is entangled not only by
3:25their biological self but also in the
3:28social space that they exist.
3:31This concept also was extended by Tim
3:36Ingold and Gizley Palson as bioosocial
3:39becomings in which it said that human
3:43beings cannot be understood as isolated
3:46biological entities but as evolving
3:50trajectories shaped through continuous
3:52interaction with their environment. Now
3:55when I was also theorizing medical
3:57humanities for uh you all I emphasized
4:00on this point and this is a recurring
4:03thread throughout the lectures that I
4:04will be taking. In fact health they say
4:08was not the property of an individual
4:10but was marked by a condition produced
4:13through relationship between people's
4:15communities and their surroundings. So
4:17when you say that health is once
4:21property it wasn't like that. In fact,
4:23it is a community oriented
4:26responsibility. That is something that
4:28we have to talk about. Hence, different
4:30theorists explored this entanglement
4:33between individual, community, society
4:37at large and of course uh the countries
4:40mapping all their interest, all their
4:43health interests together as deep
4:45entanglement and it's very complex
4:48structure as well.
4:50Now uh when the pandemic happened you
4:54realize that it was not just a personal
4:57suffering even in the context of India
5:01the slogans that came the uh measures
5:05that were taken to combat covid-19
5:08pandemic all of them had a collective
5:11story too. So even when we think of our
5:15coid9 pandemic whether it was in the
5:18first phase or in the second phase we
5:20have similar kind of stories like all of
5:24us experienced the coid9 pandemic
5:26differently but there is also a shared
5:30story that we have. Therefore
5:33traditionally the medical humanities
5:35focused on pathographies. What are these
5:38pathographies? They are personal
5:40narratives describing an individual's
5:43experience with illness. And therefore,
5:46COVID 19 transformed these individual
5:49stories into broader narrative of
5:52collective suffering. So, my suffering
5:54was not my suffering alone. It was
5:56somebody else's suffering too. And
5:58similarly, somebody else's suffering
6:01became my suffering as well. There was a
6:03global account of sharing that was
6:05happening. So in this space of how
6:10personal became collective, we realized
6:13that narration or storytelling as we can
6:16call it became a collaborative social
6:19process that allowed communities to
6:22organize resources, share knowledge and
6:26construct a collective understanding of
6:28pandemic's meaning. In fact, there is a
6:30small exercise that you can do. Maybe
6:32you can in whatever region you are from
6:35just stick to your specific region and
6:39look at how collective stories during
6:43pandemic
6:44shaped. They were indeed personal
6:47stories but they became collective in
6:50the process of their action. So this is
6:53something which is very important in
6:55terms of uh covid-19 pandemic and other
6:57pandemics too. covid-19 pandemic made us
7:01realize this collective bearing of the
7:03pandemic. Mikail Bhaktin has a term
7:06called chronotope and it is important
7:08discourse in literature but in medical
7:10humanities too you find uh this
7:13particular concept uh very pertinent and
7:16why do I say pertinent because it talks
7:19about how time and space combined to
7:23shape human experience and in if you
7:26look at the experiences of covid-19
7:29pandemic it dramatically changed the
7:33relationship in everyday life. Now, why
7:35do I say that? Because all of a sudden,
7:39am I audible?
7:41Am I are you able to hear me? Can you
7:44see me?
7:46Am I online? All these phrases that were
7:50not there earlier in our vocabulary,
7:53social distancing for that matter. Um I
7:56mean this was not part of our vocabulary
7:58earlier during lockdown. Ordinary spaces
8:02like our bedrooms became our office
8:04spaces. Who would have imagined? They
8:06became the classrooms where we taught
8:08and time had slowed or thickened while
8:11daily routines collapsed into single
8:14environment. So it was not like only one
8:17person was affected that way. uh each
8:19one of us were changing the spaces and
8:24making it ready according to the work
8:27that we were doing according to what our
8:30daily life was before the pandemic.
8:32Additionally, we also started dividing
8:35making that temporal division because of
8:37the coid9 pandemic where we thought our
8:41life existed before pandemic and after
8:44which we call precoid and postcoid time.
8:47So there are so many activities that we
8:49were doing during precoid times and we
8:52questioned if ever we will get back to
8:54the normal of what we did in the
8:57pre-COVID times during COVID times and
8:59postcoid only makes us full of
9:02gratitude. Whenever we per when we are
9:05out in a public uh place in parks where
9:08there are so many people we are just
9:10full of I mean gratitude but we at the
9:13same time also acknowledge that this is
9:16the new normal that we have come to
9:19where every action of ours is with a
9:21caution. So you know these this covid-19
9:25pandemic redefined the normal for us.
9:28Now the hybrid mode is even if we take
9:32classrooms for example, if we take the
9:34academic space for example, work from
9:36home, this became our new normal. So we
9:39do think of
9:41covid-19 pandemic as that turning point
9:44which altered our ways of living and uh
9:48uh this we can definitely talk about in
9:50terms of how Bhakin talks about it in
9:53the in his theory or in his concept
9:56chronotope.
9:58Now if you remember I spoke about Rita
10:02Sharon's uh concept narrative medicine
10:06in lecture four. I will keep on asking
10:09you to go back to that lecture time and
10:12again because that those are
10:13foundational texts. There are many we
10:16can talk about but primarily because it
10:18is an introductory course. I thought
10:20these three theorists uh Arthur
10:22Kleinman, Susan Sontag and Rita Sharon
10:25they were not to be compromised with and
10:27there was some amount of idea you should
10:29have if you are interested in medical
10:31humanities as a discipline and medical
10:34humanities or as a course. So if you
10:36look at Nita Shahon's concept of
10:38narrative medicine, it emphasizes the
10:41importance of recognizing and responding
10:43to stories patients tell about their
10:47illness experience. So you please look
10:49at your screen and you will find this
10:51definition and you notice that when she
10:55talks about this illness experience, how
11:00does one shape those experiences? The
11:03shaping happens through language and
11:06there is where the process of the
11:09metaphor of the heart comes into play.
11:12She says that if you look at the
11:15metaphor of the heart, attention
11:17represents the ability to absorb the
11:20patient's story while representation
11:22refers to transforming that experience
11:25into meaningful language. Which means
11:28that
11:29experience is contingent upon the
11:32language we use and language can have
11:36metaphors and it can totally alter the
11:40meaning because language is culture
11:42contingent. Hence it can have different
11:45kind of meanings for different kind of
11:48illnesses. Therefore she uh uses this
11:52term uh called reflective listening and
11:55stereophonic listening. She says that
11:58clinicians learn to hear both the
12:00biological voice of the body and the
12:03personal voice of the patient thereby
12:06making medicine a more human practice.
12:09So when a clinician uses uh the
12:12stethoscope to measure the breath of you
12:15to listen to your heartbeat, it's not
12:18just a clinical thing. It is also a a a
12:23recognition of I am listening to you, I
12:27can hear you. Something like that to get
12:29into your space where it's not just the
12:33clinical space that one is sharing.
12:37And when we talk about heartbeat the
12:39experience of breath I mean in covid-19
12:42pandemic you know there are so many
12:45people breathlessness was the first
12:47thing they experienced apart from the
12:50lack of smell breathlessness was
12:53something that was very crucial and
12:57therefore during the pandemic the act of
12:59breathing became both a biological
13:02concern and a powerful metaphor for
13:05being vulnerable. able and this leads to
13:10how you know medical humanities scholars
13:12have also gone on to talk about this
13:14whole experience when you start feeling
13:17this breathlessness and realize that
13:19probably coid9 pandemic has hit you and
13:23you know the symptoms and probably there
13:24is some calamity that is to follow. What
13:26is that experience like? And therefore
13:30scholars have argued that breath should
13:33be understood not merely as a
13:35physiological function but also as
13:38relational and ethical dimension of
13:41human life reflecting what Ashile mebe
13:44calls a universal right to breathe. So
13:47all of us have the right to breathe and
13:50this is very much in line with what I
13:52said earlier of health being the basic
13:55human right. Now many patients who were
14:00already facing long-term respiratory
14:03system often described that this coid9
14:07pandemic heightened their bodily
14:09awareness and chronic fatigue
14:12challenging biomemed models that reduces
14:15illness to measurable clinical
14:17indicators. What does this mean? That
14:19sometimes the symptoms were absent and
14:22still people could feel that something
14:24was happening to them. So covid-19
14:26pandemic in that sense was very vague
14:29and that is where it also made us
14:33realize of the gray spaces in which our
14:36lives occur.
14:38Then uh once we uh talk about these the
14:42importance of these physical symptoms we
14:45come to the narrative uncertainty of the
14:48covid. Now the emergence of the long co
14:52presented a major challenge to
14:54conventional biomedical frameworks
14:57because patients were experiencing
15:00I mean the symptoms for a long time.
15:03What happened this this led to the gap
15:07between clinical explanations and lived
15:10experiences and this is called as
15:13narrative dissonance. What is narrative
15:16dissonance? In this particular kind of
15:18phenomena, patients struggle to
15:20reconcile their illness with medical
15:22knowledge. So there is a gap between
15:25what you can call the knowledge of the
15:28illness and what you are feeling. So
15:30clearly there is a gap to be bridged. In
15:33response, individual turn to online
15:37communities and digital platforms to
15:40document their lives, their experiences,
15:43producing new forms of collective
15:45knowledge and what Mcnotton calls
15:48expertise by experience. So maybe there
15:52was theoretical knowledge pertaining to
15:54coid9 pandemic. But what happened when
15:58so many people started experiencing the
16:02COVID 19 in their own way, they started
16:05narrating their own experience in their
16:08own words and at some point of time
16:11there was a shared knowledge that was
16:14being created and in digital times that
16:17became a repository of experience but at
16:20the same time that also became a
16:22repository of or for that matter archive
16:25of stories. Now,
16:28so uh when COVID 19 pandemic happened
16:31and post that we adopted to new culture
16:34like I said uh the bedrooms became our
16:39office spaces, our home work from home.
16:43I mean many people before the pandemic
16:45would have very clear guidelines as to
16:48what time they will work in the office,
16:50what time they will work at home. But
16:52when home becomes your workspace, how do
16:56you navigate this new normal? I mean
16:58they started representing they started
17:01adapting to these new challenges. The
17:04idea of new normal represents not only a
17:07temporary adjustment but the emergence
17:09of a broader cultural transformation
17:12following the pandemic. Now mask is
17:14something we all know now. We knew about
17:19masks in a particular context say
17:22clinical hospitals or uh other related
17:25areas people having certain kind of
17:27disease but it was not the normal of
17:30every person but now everybody knows
17:33about it even a small kid will know
17:35about it. So this became a new knowledge
17:38that we acquired during the coid9
17:42pandemic and uh Jeff Clyde Corpus
17:45describes this transformation through
17:48three R. Now what is this three R? He uh
17:52talks about resilience, recovery and
17:54restructuring. So what happens that
17:58first you combat the situation, you
18:00recover from that and then you
18:04restructure your knowledge base. You
18:06restructure your experience only to live
18:09further. Now this captures how societies
18:13adapted their institutions and everyday
18:16practices in crisis conditions. These
18:19changes ranging from remote education to
18:23normalized maskearing demonstrate how
18:26pandemic experiences reshaped social,
18:30economic and spiritual aspects of
18:32everyday life. Some people resorted to
18:34spirituality. Some people uh went on to
18:37watch lot of digital content. Some took
18:40up cooking. Some uh started doing a lot
18:43of cleaning. Uh you know different kind
18:45of some started just narrating their
18:47voices. So many uh YouTubers uh we have
18:50seen coming up during covid-19 pandemic
18:54because that was their combating
18:56phenomena.
18:59There are three uh aspects of literature
19:01that I will talk about quickly. Graphic
19:03medicine and covidity. Uh I mean if you
19:06look at this particular term it was uh
19:09coined by uh Saji at all. In fact, Saji
19:13and Satirajankan who proposed the
19:16concept of coidity to describe the
19:18shared emotional and cultural
19:20subjectivity that emerged during the
19:22pandemic. In fact, pandemic triggered a
19:25significant rise in graphic medicine as
19:29a field that explores how comics and
19:31visual narratives can communicate
19:34experiences of illness and healthcare.
19:35In fact, I will take an entire lecture
19:38on how COVID 19 was represented uh in uh
19:44graphic narratives in due course of
19:46time. But at this moment it was it is
19:48important to point out that graphic
19:50narratives explored uh covid-19 pandemic
19:54not only in its representation but also
19:58in its uh reflection. Okay. So uh uh I
20:02mean also creating a lot of awareness.
20:03It was very important a medium at that
20:06point of time and through visual
20:08metaphors such as anthroorphic viruses
20:10or superhero healthcare workers, graphic
20:14narratives helped audiences understand
20:16complex medical realities in very simple
20:18terms. The second that I can talk about
20:22is the meme culture when it became the
20:23coping mechanism. In fact, during the
20:26pandemic, internet memes became a widely
20:29shared cultural tool for coping with
20:31anxiety and uncertainty. All of us had
20:35more screen time in one way or the
20:38other. I'm not saying just watching
20:40memes and digital content, but all of us
20:43I came across a term which uh I read
20:46it's called work therapy. I think uh
20:49covid-19 introduced me to this uh
20:52particular word. there were a lot of
20:53people who were dealing with uh mental
20:55stress and anxiety and at in some blog
20:59in some forum I don't remember as of now
21:01but I read about work therapy and they
21:04said that one of the ways in which they
21:06were combating this anxiety during the
21:08coid9 pandemic was work therapy and that
21:11is when I thought maybe that is a good
21:13idea to keep myself engaged because
21:16before pandemic we were not used to
21:18living at home for such a long time and
21:21therefore that was that became my
21:24experience and I'm sure that is
21:26experience of many of you uh who are
21:28watching this video and uh so meme
21:31culture I come back to what I'm talking
21:33about where wherein you find that meme
21:36culture became a method of coping the
21:39pandemic and how we were dealing with
21:42it. So if you uh look at the origins of
21:46meme culture, Richard Dawkins originally
21:49introduced the concept of the meme, but
21:52today it refers to any digital content
21:54that spreads rapidly online and allows
21:57people to comment collectively on shared
21:59experiences. By sharing memes, what
22:03happens? people or individuals create
22:06informed digital communities and signal
22:09emotional solidarity helping them
22:12process fear and stress through humor
22:15and shared recognition. So when there is
22:17a meme if you even look at your own
22:21phones you will find that uh there is a
22:24particular meme AI algorithm sets it
22:26also that is also something uh you
22:28people must be aware of. You will come
22:31across memes of your own interest and
22:33why they are sharing that content
22:35because it is a kind of a shared
22:37recognition that you have. The third and
22:41important is tele medicine and how it
22:44reconfigured how we process caregiving.
22:48So you know that at the time of covid-19
22:51pandemic teley medicine uh significantly
22:54transformed health care delivery by
22:56allowing patients to access medical
22:59services from the home and I just spoke
23:02about anxiety and stress at that point
23:05of time. Teley psychiatry in particular
23:07enabled individuals who faced social
23:10barriers including gender discrimination
23:12or age related marginalization to
23:15receive mental health support remotely
23:18like you could book a counseling
23:20session. You could talk to people and
23:22talk about what you were feeling. So
23:24that also became an important aspect of
23:27how teley medicine was resilient or
23:30building as a recovery phenomena for
23:33reconfiguring the care. From the medical
23:36humanities perspective, it is an
23:37important intervention because teley uh
23:40medicine highlights how health care
23:42functions not only as biomedical
23:44practice but also as a communicative and
23:47relational process. you know with the
23:49way AI has been intervening I think tele
23:52medicine is also the future of medical
23:54science.
23:56Uh this is perhaps the last of what I
24:00want to say in the sense that how
24:02medical professionals build their
24:05resilience. If you look at a particular
24:07term that I mention here it's called
24:09battle buddy. Now what does that battle
24:12mean? So if you see the coid9 pandemic
24:15there are many stories around how health
24:18care professionals were also dealing
24:21with the situation despite facing a lot
24:24of risk a lot of danger in the setup
24:27that they were working. Imagine we were
24:30not going even out but they were always
24:3224 into 7 in the hospital in other areas
24:36where people were quarantined. So you
24:38find that that there was also a lot of
24:42emotional stress for them because when
24:45they left their home we didn't know if
24:48they would come back. To address these
24:51pressures some hospitals introduced this
24:54particular system. It's called battle
24:56buddy. And what did they do? Their
24:59colleagues regularly check on one
25:01another and provide mutual support. This
25:04means that the phenomena of support
25:07system that medical humanities talks
25:09about hey I'm there for you this was
25:12promoted during to the coid9 pandemic
25:15swads round also allowed clinicians in a
25:19different setup to discuss the emotional
25:22aspect of their work promoting
25:24organizational justice and improving
25:26well-being among health care staff
25:28because they were at the forefront and
25:31hence the stress for them was no less.
25:33Yes. In conclusion, we can say uh and
25:38what a remark that I made earlier that
25:40COVID 19 not only fundamentally
25:43transformed medical humanities or
25:46medical science but also medical
25:48humanities by demonstrating that health
25:50care must integrate scientific knowledge
25:53with narrative, ethical and cultural
25:56understanding. So narrative cultural
25:59competence is integral to understanding
26:02of medicine is what covid-19
26:04fundamentally acknowledged rather than
26:07focusing on just the data. So data
26:09suggests something. Yes. But it was also
26:13a point of emphasis made that the
26:16importance of witnessing individual
26:18experiences and recognizing the shared
26:21dimensions of illness was also
26:24complementing to the data. It was not
26:28like data was something else and
26:30experience was something else. They both
26:32have to be looked in tandem with each
26:34other. And that is where the
26:36interdisciplinary and reflective
26:38approaches of medical humanities have
26:42made a intervention. They have
26:44increasingly become vital for
26:46understanding the broader human
26:48significance of global health crisis. On
26:51that note, I will end this lecture.
26:53We'll meet soon in the next lecture.
26:56Thank you.