Loretta M. Kopelman, PhD
Beginning in the fifteenth century, anatomical dissection became a basis for medical advancement and education and many anatomical atlases began to appear. The first of these was Johannes Ketham’s Fasiculus Medicinae (1491), which sought to confirm the work of earlier anatomists, primarily Galen’s second century texts.
From 1495 on, successive editions of Fasiculus Medicinae included an elegant woodcut called “An Anatomical Lectre at Padua.” Nine figures stand over a cadaver, with their status indicated by their positions. At the top, in terms of position and importance, the Professor reads from a great volume in a lofty, elaborate pulpit, seemingly insulated and oblivious to everyone and everything going on below him. At the next level down, five men stand, all but one ignoring the dissection. Lower still, the two technicians stand with heads bent, involved with the dissection, but lowest of all is the man doing the cutting.
This picture captures the pre-Renaissance veneration of authority. The professor’s job is to inform people what they should see. If the corpse did not correspond to the revered book, the corpse was pejoratively labeled a non-classical case. It was another fifty years before Andreas Vesalius moved beyond veneration of Galen’s work in De Humani Corporis Fabrica (1543). Vesalius pointed out problems and inconsistencies that he judged were the result of Galen’s reliance on animal dissections. This excessive veneration of teachers and revered texts was challenged in the Renaissance for perpetuating powerful biases and stifling creativity. However important it is to learn texts and the received wisdom, students need to be encouraged to look at ideas and the world for themselves and challenge what they are taught.
Telling people what they should see and believe creates powerful biases. Influenced perhaps by the accounts of creation of men and women in Genesis, for example, Galen “counted” one less rib in men than women, just as Aristotle before him “observed” fewer teeth in women than men, confirming his view that women were inferior to men.
The Department of Medical Humanities at The Brody School of Medicine was founded twenty-five years ago. We have not only given students a good basis in the important principles and concepts, but also encouraged them to look critically for themselves at issues and challenge what they are taught. To do this, we make room for creativity in our teaching through small group discussions and essays where they are free to select topics and positions. In fast moving fields like medicine, students need to learn the skills to take on and solve new problems.
Our six full-time faculty provide over 70 contact hours in the required medical school curriculum, 30 contact hours for graduate students, and monthly programs for most residents. Our goals are to have students and residents systematically reflect on a variety of moral and social problems they are likely to encounter in their professional lives. We want to give them the skills and dispositions to frame and evaluate solutions, appreciate diverse views, and gain some legal, cultural and historical perspectives about their duties. Writing essays is an important way to help identify such problems and develop skills to formulate, evaluate, and defend particular positions. We use other techniques as well, including a free exchange of ideas in our small group teaching, combining case-based discussions with theory, and team-teaching with co-instructors from our clinical faculty (for medical students) or basic sciences (for graduate students). Having many of our colleagues participate also promotes curriculum integration.