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Storied accounts of nurses’ representations on the battlefield become vital records of personal or communal histories that otherwise may not be voiced or even acknowledged. What we have today is a fairly accurate account of the harsh realities nurses endured at the battlefield and how these horrific situations shaped them as nurses who would act as role models in the brink of death. While women’s writing about war has received much critical attention that has established its authenticity as witness to war, scant attention has been paid to how women see the trauma of nursing at the frontline and how it influences the narrative. The scope of this article is to understand the connections between nurses’ narratives from the First World War and Vietnam. It tries to elicit common elements in how war is seen and consequently to the relationship between seeing and bearing witness to wars.

Kostas Karyotakis (1896-1928) published three poetry collections: The Suffering of People and Things (1919), Nepenthe (1921) and Elegies and Satires (1927). A leading Greek poet, he influenced a significant number of poets, and this phenomenon became known as “Karyotakismos”. Quite autobiographical, his poetry shows his agony, concerns and fears. The pessimistic atmosphere and the biographical elements the reader sees in Karyotakis’ poems make his poetry distinct and it is still popular in our day. An important dimension of his poetry is the disease he had: syphilis. Karyotakis’ syphilis has been discussed extensively, nevertheless none of the previous analyses attempted to read it through the lens of the medical humanities. Such a reading shows that apart from the biographical elements one may detect, there is a deeper meaning: the voice of an individual who experiences the disease at a time when there was no cure, syphilitics were stigmatised, and people treated them as outcasts. Karyotakis uses his poetry to share his personal tragedy and trauma. He is a syphilitic who wants his voice to be heard and his poems are valuable material as pathographies and for the study of the history of medicine.

Critical acclaim and popular opinion have elevated Kesey’s first novel, One Flew over the Cuckoo’s Nest published in 1962, to something of a modern classic, much read and written about as well as adapted for film. Cuckoo’s Nest offers an interesting alternative scenario to the usual depictions of the nurse as Angel of Mercy, the unskilled handmaiden or the ministering angel found in literature. In giving Nurse Ratched tyrannical authority, demonising the institution and its representative, Kesey elicits the themes of control, submission and alienation through the structure of nursing and care involved. These same themes also link to gender, representing similar fears of female empowerment and male power rendered impotent by a sterile social structure. This paper aims to analyse the sardonic representation of the power and authority in Nurse Ratched and how gender and the spectacle of masculinity is defined through discourse. This is imperative as literature and the media have a strong influence on public views, shaping the way the public values and treats professions in health care. Nursing is plagued by feminine stereotypes that continue to undermine the profession up till the present day. This reading of One Flew over the Cuckoo’s Nest provides educational opportunities to engage in critical dialogue around this and other texts which speak to nursing and human concerns. This will equip nurses with the right tools for discernment so that they can challenge rather than accept how nurses are represented in the literature.

Going by the current physical reach of the COVID-19 pandemic in the population there are bound to be long-term socio-economic and psychological implications. The swift rise of fear and anxiety among people due to uncertainty of the disease are coupled with essential yet socially disruptive measures like lockdowns and quarantines. These can lead to significant psychological and psychiatric disturbances such as post-traumatic stress disorder, depression, anxiety, panic disorders, and behavioural disorders. Predisposing factors include staying away from family, loneliness, misinformation on social media, financial insecurity and stigmatization. Healthcare workers, too, have a high risk of developing post-traumatic stress disorder and burnout; therefore, it is paramount to understand and research the psychological impact and key determinants to prevent, identify, and manage such problems. Suggested actions include support lines for anxious people, tele-counselling, virtual connecting & help groups, encouraging meditation, conducting research on psychological consequences, and developing and utilising suitable interventions.

Henry Peach Robinson’s “Fading away” can be interpreted either through a reductionist approach or a holistic approach. He perfected this fictional photograph through five negatives to create an anecdote and change attitudes towards tuberculosis. While there are many interpretations of this piece of art from a reductionistic approach – literary, artistic, humanistic, or illness-narrative – there are hardly any from a holistic perspective integrating all these angles. When used during a medical humanities course, the photograph provoked students to think beyond the purely artistic and the purely medical aspects of disease. Some of the messages that medical students took home were: ‘grief could be experienced by anyone’; ‘love expands into diverse manifestations during times of sadness’; ‘we must empathize with others and what they go through’. This paper reports on our attempt to adopt a holistic approach to analyze the photograph from Robinson’s perspective and with respect to modern medicine.

The article is about what happens when students of govt-aided schools don't get the government sponsored midday meals.

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People see the world through their eyes. The world gets blurred if their vision gets blurred. As ophthalmologists, the onus of care falls on us. What makes ophthalmology different from other surgical branches is that it is a delicate surgery and is challenging for the ophthalmology professors to teach the surgeries and postgraduates to learn the same. So the concept of wetlab is introduced in many colleges where a goat's eye is used to practice skills of surgery before an actual hands-on experience on human eyes. In this narrative, I share my experiences as a postgraduate student in the wetlab using a goat's eye for learning cataract surgery. The journey commences from first hearing about goat's eye, to acquiring it, to using it, and ends with the opportunity to work on human eyes.

This paper discusses Alexandros Papadiamantis’ (1851-1911) novel 'The Murderess' and analyses the protagonist’s (Hadoula or Frankojannou) psychological state and the reasons behind her actions to murder girls. Papadiamantis’ protagonist does not compromise on her role in society and the ‘superiority’ of men in a man-made world, but, beyond the obvious, she is not a typical old woman. Reading through the book from the perspective of the medical humanities shows that Hadoula suffers from mental health problems, which make her see the murders she commits as a reasonable reaction to protect girls from the injustices of a patriarchal society. Papadiamantis gives the portrait of a ‘serial killer’, who has almost convinced herself that these murders constitute an ethical action. Although a fictional account, the book allows one a glimpse into mental illness from the perspective of the person who is ill.

It's becoming increasingly common to spot clinical images being shared on social media sites like Facebook and WhatsApp. Patients in operation theatres, newborns in incubators, women in labor ward and even cadavers in Dissection halls are photographed and shared. Many of these images reveal the identity of the patients and are posted for non-professional reasons without their consent. This is an illegal and unethical act which is liable for punishment and deregistration from medical council. Medical students and doctors need to be made aware of the legalities and ethics of posting clinical images on social media. Sensitization should start right from the dissection hall and need repeated reinforcements right through the internship. This calls for the role to be played by all concerned stakeholders including medical colleges, Medical Council of India, Indian Medical Association and social media sites. This would be a small step in restoring the crumbling doctor-patient relationship.

This is a story about my autistic son's surgery. Autistic patients are very common in the medical field but they aren't very well represented in graphic novels or medical literature. This is a simple story about my 6-year-old son's minor dental surgery and the various steps that medical professionals must take to accommodate autistic patients. Through this graphic story I try to show the challenges that parents and doctors must deal with on a daily basis when it comes to the health of autistic children.

The last few decades have witnessed the emergence of the field of bioethics. Students entering medical college face unique ethically charged situations. Cadaveric dissection is one such area of ethical uncertainty. Studies have shown that an appropriate orientation towards the values inherent in a doctor's relationship with patients, colleagues, and society might help medical students learn how to navigate ethical dilemmas they face. The aim of this article is to examine the feasibility of incorporating ethics teaching in anatomy education, and to emphasize the crucial role of professional identity in shaping the inner image of the “to-be” physician. We also discuss ways by which professional identity can be emphasized right from the 1st-year of medical school. Such endeavors may help learners find ways to respond ethically in their professional life. Understanding the role of bioethics in anatomy education with regard to professional identity formation can guide policy-makers and medical educationists.

Aim: The aim of this project was to determine if visual art serves a purpose in medical teaching establishments, particularly in hospitals and medical schools, or if it is largely invisible. Methods: After a literature review revealed a lack of robust or extensive evidence on the effects of displayed art in buildings that comprised medical schools, a questionnaire was distributed opportunistically to the students attending lectures or clinical skills training and to the staff at their offices in the Aberdeen University Medical School. The questionnaire sought to evaluate the effect of the art installed at the newly built Suttie Centre, an integral building of the Aberdeen University Medical School, on staff and students using the building. Results: Of 75 questionnaires distributed, 52 were returned complete in all respects. Most respondents agreed that the artwork was appropriate and aesthetically pleasing for the medical school, and helped enhance the ethos of learning. Conclusion: The literature review, though scanty evidence is available, is backed by questionnaire responses to show that art serves to epitomize the ethos of a medical institution. A medical school with a ‘soulless environment’ is less likely to enable students and staff to learn and work to their best potential. Subjective opinions regarding which artworks to display and qualms about the costing of artwork and prioritization of money must be considered; however, overall, visual art seems to have a place in medical school buildings.

One of medical humanities’ main goals, as it has emerged in recent years, is to promote and establish a more humane perspective in medicine. Doctors should focus on the patient and on his or her individual voice rather than on the disease. Through a study of Alexandros Papadiamantis’ novel ‘Vardianos sta sporka' (‘Guardian of the Quarantined Ships’; 1893), I seek to show how this humane attitude is reflected in the German doctor in the story. The doctor, apart from utilizing the healing force of medicine, recognises the importance of faith and a mother’s care as important elements for recovery in a patient with cholera.

Introduction: Professionalism is emphasized in medical school curricula; however, there is lack of consensus on what constitutes professionalism. This study aimed at exploring incoming medical students’ views on professionalism through student constructs of the ‘good’ and the ‘bad’ doctor. Methods: After Institutional Ethics Committee approval and informed consent, all (n=150) incoming first-year medical students were asked their reasons for pursuing medicine and their perceptions of the attributes of a ‘good’ and a ‘bad’ doctor. Following the anonymous survey, we used nominal group discussions to achieve consensus about the desirable and undesirable attributes that emerged from student responses. After an iterative theming process, a list of themes were derived from the written reflections of students. Results: Competence, communication, and professionalism were some of the perceived attributes of a good doctor, while being money-minded, having inadequate knowledge or competence, and rudeness were some of the reported attributes of a bad doctor. We identified six themes for the question 'Why pursue medicine?': affective / humanitarian response; thoughts about further pursuits; fulfillment; traits of the profession; ability to contribute to society; and personal experiences. Conclusion: Our results suggest that first year medical students have a fair idea of the behavior expected from a good doctor. Formal reflection on these expectations may hone the concept of professionalism for new entrants into the profession. The teaching of professionalism could incorporate such activities to allow students and educators to articulate and explore tensions between what is taught and what is experienced as they progress through the profession.

I lost my husband to a road traffic accident when he was in the prime of life. His passing shattered the family and imposed terrible psychological and unanticipated financial burdens on me and on our young children. We recovered our balance eventually; however, I am often plagued by the thought that he might have been saved if only certain measures and systems had been in place in the emergency department where he was brought in when he was still alive and conscious.

“Fading Away”, the combination photograph by Henry Peach Robinson, has been critically reviewed by many authors in the past. This article attempts to interpret it using an imaginative process. The objective is to examine how Fading Away can be used as a learning resource for a ‘Narrative of illness’ session in a medical humanities class in undergraduate medical education. The authors demonstrate that the combination photograph could be used to explain how the coping concept is different for a dying patient. Depressive cognition, or in other words - coping in isolation - could lead to a strategy of visual rumination that can influence the dying patient to adopt a self-reflective style in dealing with death. It could be argued that this reasoning neatly corresponds with Kubler-Ross’s well-known model of the five stages of grief that most patients go through upon facing death - denial, anger, bargaining, depression and acceptance. It explains how dying patients can adopt a strategy and style of temporal travel of mind to relive the past and ‘prelive’ the future that they will never get to see.

Even though the struggle for LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual; with the + indicating myriad others) rights is an ongoing one, we have come a long way in terms of acceptance and inclusion. In spite of the progress, the LGBTQIA+ community in India still faces rampant bias in society as well as in healthcare. This is fueled by misinformation, which leads to prejudice and violence against these individuals. This paper discusses this struggle, touching upon the legal and social aspects. The focus is on the detrimental effects of stigma on health outcomes and health disparities for LGBTQIA+ individuals. The outlook of some in the medical fraternity and the deficiencies in medical training, including redundant and outdated curriculum/ textbooks, are discussed. It is implied that these factors result in biased and ill-informed doctors who are poorly equipped to meet the health needs of the LGBTQIA+ population. Correcting the deficiencies is a priority in the face of the recent ruling by the Honorable Supreme Court of India striking down Section 377 of the Indian Penal Code that previously criminalized consensual carnal intercourse among consenting adults of this community of people.

A 59-year old man suffers from illness anxiety disorder. The patient, caught in a hypochondriacal vicious cycle, is convinced of having stomach cancer although medical practitioners have discarded such a diagnosis. He requires them to prove him wrong; however, he distrusts the rigor with which medical examinations of his stomach are carried out, and so the cycle continues. Narratives are known to help one make sense of one’s own, and also of other people’s actions and intentions. The author shares a narrative that represents a patient’s speech which was translated from Spanish into English by the author. By deconstructing the patient's narrative, the author aims to demonstrate how a narrative approach can help doctors to empathize with hypochondriacal patients, earn their trust, and break the vicious cycle of repeated hospital visits and doctor shopping.

Mass market fiction influences public perception of psychiatric services. Stieg Larsson’s “Millennium” crime fiction series is an absorbing one; however, the portrayal of child and forensic psychiatry in the trilogy is sensationalised and demonised, and compares poorly to the less paternalistic, more holistic, and more pedagogical-driven methods employed by contemporary child and adolescent services. This negative portrayal can lead to enacted public stigma, self stigma, and stigma from within the healthcare professions. This can adversely affect feelings, thoughts, behaviours and resource allocation towards psychiatry, and may also impair the self-esteem and adherence levels of people with psychiatric illness. There is a need for mass media to act as social watchdog, be an educational resource for long case histories, or serve to document contemporary perceptions of psychiatry. Anti-stigma movements, to counter the effect of negative media portrayal, should come from within psychiatry itself.

A book review on Leah Lakshmi Piepzna-Samarasinha, Care Work: Dreaming Disability Justice.

As scientists we look for intellectual advancement through every encounter, yearn for new knowledge, and search for ways to further our learning. We are programmed by our nurturing to identify, analyse, and solve. Horses with blinders, we are obtuse in our ignorance; however, our nature, if we allow it, will find emotional growth - some encounters will compel us to introspect, so the learning becomes about ourselves, even as we may struggle to align our (unrealistic and idealistic) views with the (subjectively bleak) reality.

The humanities are increasingly being introduced into the medical curriculum. Suggested benefits include increased observational skills and ability to consider alternatives or perspectives thus leading to improved person centred, empathic and clinically excellent care. A pilot creative writing workshop was offered and six students volunteered to take part. The workshop was facilitated by a general practitioner poet who conducted two 3-hour workshops and included in-between a writing activity with students receiving feedback. Each student also undertook a learning preference inventory and agreed to a one-year follow-up. The data from the inventory was analysed; each student scored differently on the four learning preference dimensions. Five themes emerged in the follow-up qualitative survey: creative arts a surprise; creative arts appreciated; the impact of the workshops; continuing to write; more creative arts opportunities. More initiatives are needed for humanities in medical education. These can be introduced to develop particular skills and/or humanities substituted for teaching or assessment methods in existing topics.

The humanities are increasingly being introduced into the medical curriculum. Suggested benefits include increased observational skills and ability to consider alternatives or perspectives thus leading to improved person centred, empathic and clinically excellent care. A pilot creative writing workshop was offered and six students volunteered to take part. The workshop was facilitated by a general practitioner poet who conducted two 3-hour workshops and included in-between a writing activity with students receiving feedback. Each student also undertook a learning preference inventory and agreed to a one-year follow-up. The data from the inventory was analysed; each student scored differently on the four learning preference dimensions. Five themes emerged in the follow-up qualitative survey: creative arts a surprise; creative arts appreciated; the impact of the workshops; continuing to write; more creative arts opportunities. More initiatives are needed for humanities in medical education. These can be introduced to develop particular skills and/or humanities substituted for teaching or assessment methods in existing topics.

A medical student narrates a tale of two young girls - both struggling with pulmonary tuberculosis. The story highlights the consequences of social inequity especially how it impacts healthcare and health outcomes. It also addresses the impact of the disease on the sufferer, an impact that goes beyond the mere physical, and continues even after cure is achieved.

Background: Humanities programs in South Asian medical schools are slowly growing in popularity. Art-making opportunities within those programs, however, are limited despite their potential benefits including solidification and integration of learning. Aim: to examine art created by medical students for the breadth and depth of conceptual understanding that formed the foundation for its creation. Settings and design: Medical school in Nepal; qualitative study. Material and methods: First year medical students at the Patan Academy of Health Sciences in Nepal, in 2011, 2012, 2014 and 2016, were asked to volunteer and submit artistic interpretations of “cardiac science” during five weeks of learning about the cardiovascular system using any media. Submissions were digitally recorded. This art repository was used as the data set for the present study. Data analysis: curatorial analysis of a repository of art pieces using Rose’s criteria for critical visual analysis. Results: Four main categories were generated: Anatomy Literal Representation, Artistic Representation, Tactile Renderings, and Linked to Health/Nepal. Conclusions: From literal to artistic/fanciful representation, student’s art revealed a strong conceptual understanding of the cardiac science topic. A subset of tactile art highlighted the student’s manual dexterity and propensity for kinesthetic learning. The links made by their art to socially relevant health issues, illustrated the student’s ability to connect science to the needs of their patient population, and the important role for education in disease prevention. This is the first study that has explored art-making in the context of Nepali medical education and its potential role as an adjunct to science learning.

This article narrates my personal encounter with a terminally ill cancer patient at our rural clinic. I learned a lot from the experience. It made me reflect on the importance of palliative care in terminally ill patients and the practical difficulties with getting the care in rural settings. I realised that even simple interventions can be highly supportive both physically and mentally.

The “pandemic” has come with “panic” embedded within it. The panic among health care workers is enormous. There is a fear of being infected and carrying the infection home to their children and to the extended family. There is a constant tussle between overcoming these fears and stepping forward to take up responsibilities and duties. The article is a narrative of an ophthalmologist trying to think right and doing what best she can in times of the pandemic.