Humanities workbook

for Birmingham Conference 2005, as part of workshop:

Educating For Ritas’–

Developing A Curriculum In Medical Humanities For Doctors In Training

Dr. Mike Deighan    Curriculum Development group Royal College of

                            General Practitioners

Dr. Kay Mohanna    Principal Lecturer in Medical Education

                            Staffordshire University    

Dr. Steve Walter    Primary Care Medical Educator    West Midlands Deanery

 

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LOSS

 

By Wendy Cope

  

The day he moved out was terrible –

That evening she went through hell.

His absence wasn’t a problem.

But the corkscrew had gone as well.

  

Facilitators notes –

Wendy Cope suffered from many failed relationships and uncertain sexuality in her early life.

Seemingly humorous but sardonic tone

Is that all there was to say about the end of the relationship – rather desolate

What has not been said?

Importance of small nuisances in traumatic situations

Need for alcohol in stressful situation

 

GROUP ONE

Excerpts From

1. Dead Poets Society - A different view

Scene:

Charismatic English professor John Keating arrives at a strict boarding school. His unconventional teaching methods breathe new life into the curriculum and inspires his students to pursue their individuality.

2. Educating Rita

Scene 13 ‘New found independence’

Rita has been to Summer School and is well advanced with her studies. In the meantime Frank’s personal and professional life is in free fall.

The pupil has outgrown the teacher, but have her ultimate goal, aims and values been a mirage?

 

GROUP TWO

Excerpt From

About a Boy

Background

Will is a single man with plenty of money but no sense of direction. He befriends Marcus  in his attempt to curry favour with a woman he fancies.

Marcus lives with his mother who is a single parent and suffers with recurrent bouts of depression. This culminates in an attempted suicide she was found by Marcus and Will.

Scene 7 ( 26:08 – 28:19)

Marcus’s mother returns home from hospital following the overdose.

 

Facilitator's notes

This scene illustrates the unforeseen and unexpected consequences of a failed suicide attempt when you are confronted with those who would have been left behind.

Marcus feels he is responsible for supervising his mother.

He feels vulnerable at the prospect of being left alone.

His mother feels guilty and has to regain his trust.

She is unable to explain her feelings to him.

 

Dead Poets Society

Charismatic English professor John Keating arrives at a strict boarding school. His unconventional teaching methods breathe new life into the curriculum and inspires his students to pursue their individuality.

Scene 7

Find you own walk.

 

Facilitator's notes

This scene exemplifies his exhortations to be your own person and not feel compelled to conform. It is also OK to exercise your right not to do so.

 

GROUP THREE

Excerpt From

Shine

Background

True story of child prodigy David Helfgott. The film examines his journey from a childhood dominated by an overbearing father to his nervous breakdown as a young adult

Scene 4

‘A difficult piece’

David has been entered by his father into a competition with an inappropriately difficult piece. The scene examines the tense family dynamics on his return home

 

Facilitator's notes

Explore the undertones of pressure in the family.

His sister can tell from his walk home that ’he is for it’

His father's exhortation to Win, Win..

His father's resentment at the treatment by his own father

His mother's fearful reticence

His sister's anger that David has lost at chess and so made his father angry.

His father's reluctance to allow anyone else to teach him

His dismissal of his prize ‘for losing’.

 

Shine

Scene 10

‘Deranged’

David has been accepted at the Royal College of Music and wants to leave home to further the ambition that his father has created for him.

It erupts into a full – blown domestic violence.

 

Facilitator's notes

Lying in wait for him

Physical  violence

Emotional blackmail that he will destroy the family.

Psychological abuse of disowning and rejection

Some show of remorse at violence

Family reaction – ‘frozen watchfulness’


 

Not Waving But Drowning

Stevie Smith

Nobody heard him, the dead man,

But still he lay moaning:

I was much further out than you thought

And not waving but drowning.

 

Poor chap, he always loved larking

And now he's dead

It must have been too cold for him his heart gave way,

They said.

 

Oh, no no no, it was too cold always

(Still the dead one lay moaning)

I was much too far out all my life

And not waving but drowning.

 

Facilitator's notes

How often do we see people who have been ‘too far out all their lives’ and struggling to cope?

How do we recognise the distress signals?

What are the causes of it being ‘too cold always’?

Larking – external  mask of the clown to hide the tears?

 

 An Excerpt from The Curious Incident of the Dog in the Night

 Mark Haddon

  

My name is Christopher John Francis Boone. I know all the countries of the world and their capital cities and every prime number up to 7,057.

Eight years ago, when I first met Siobhan, she showed me this picture



and I knew that it meant 'sad,' which is what I felt when I found the dead dog.

Then she showed me this picture


and I knew that it meant 'happy', like when I'm reading about the Apollo space missions, or when I am still awake at 3 am or 4 am in the morning and I can walk up and down the street and pretend that I am the only person in the whole world.

Then she drew some other pictures


but I was unable to say what these meant.

I got Siobhan to draw lots of these faces and then write down next to them exactly what they meant. I kept the piece of paper in my pocket and took it out when I didn't understand what someone was saying. But it was very difficult to decide which of the diagrams was most like the face they were making because people's faces move very quickly.

When I told Siobhan that I was doing this, she got out a pencil and another piece of paper and said it probably made people feel very


and then she laughed. So I tore the original piece of paper up and threw it away. And Siobhan apologised. And now if I don't know what someone is saying I ask them what they mean or I walk away.

 


 

Robert Frost (1874–1963).  Mountain Interval.  1920.

 

1. The Road Not Taken

 

 

 

TWO roads diverged in a yellow wood,

 

And sorry I could not travel both

 

And be one traveler, long I stood

 

And looked down one as far as I could

 

To where it bent in the undergrowth;

        5

 

 

Then took the other, as just as fair,

 

And having perhaps the better claim,

 

Because it was grassy and wanted wear;

 

Though as for that the passing there

 

Had worn them really about the same,

        10

 

 

And both that morning equally lay

 

In leaves no step had trodden black.

 

Oh, I kept the first for another day!

 

Yet knowing how way leads on to way,

 

I doubted if I should ever come back.

        15

 

 

I shall be telling this with a sigh

 

Somewhere ages and ages hence:

 

Two roads diverged in a wood, and I—

 

I took the one less traveled by,

 

And that has made all the difference.

        20

 

 

 

Facilitator's notes

The path as a common metaphor for life

Only one traveller – we only have one life

How far can we see down .

Both look the same – we are unable to predict the future

We have to make choices and are unlikely to get a second chance

It is the journey itself that matters

We should do it our own way

 

Where would a doctor be standing in the woods?

What could he / she be doing?

 

 

 

 

from   Cause of Death

Jane Rogers

Jim Richardson hated religion. He hated bullshit, hypocrisy, fatalism, bigotry. He hated the passivity it induced and the wars it fuelled and the weakness – the weakness the need of it revealed. He was a great, good, humane, honest atheist.

He has carcinoma of the pancreas. Inoperable. He told me cheerfully he’d got about a month to go.

‘Did you diagnose yourself?’ I asked.

He smiled. ‘First symptom – jaundice’.

He used to do this routine with me. He was the senior in the practice where I did my first spell of GP training, I think he was really the reason I decided to become a GP. ‘First symptom, constipation.’ First symptom, stiff neck.’ ‘First symptom, blurred vision.’ When I didn’t guess what he was thinking of from the first symptom, he’d go to the second, third, fourth, until I did: if I made a plausible guess but it wasn’t what he had in mind, it counted as wrong. ‘40% medical knowledge, 60% telepathy to be a good doctor,’ he said. ‘Your telepathy needs practice, Christine.’

He was a great teacher, he made things simple. The first symptom, like the first fact, is simple. It’s the accretion of facts, the multiplicity of symptoms, the symptoms’ symptoms, which lead to confusion and mask the true nature of the case. I had a baby die last week. Viral pneumonia, I wrote on the certificate. But the real cause of death? I could have put manslaughter. Neglect. If the mother’d brought him in 24 hours earlier we could have saved him. I don’t know why she didn’t. Unhappiness, ignorance, maybe she didn’t have the bus fare. I could have put social causes; poverty. The flat was hot and damp as a sauna when I took her back from the hospital; the windows’d been nailed shut, and there was a thick grey fungus right up the wall next to the child’s cot. Where was the health visitor – had she ever called? I could have put, failure of health education (my failure; I was her GP). She hadn’t wanted another baby – but never came to family planning, never came at all till she was 7 months gone. Really, the child’s conception was the cause of its death. Cause of death: life.

Then I want to know why, and have to grasp with shaking hands at the plank a man like Jim Richardson could pull from the wreck; at least get the social workers in, at least give the other kids a chance, push the family to the top of a list somewhere and get them rehoused. Fight, get angry, don’t take no for an answer, call the inspectors, get the whole block condemned. Cause of death; life.

 

BUT, REMEMBER –

 

Sometimes

Sheenagh Pugh

Sometimes things don't go, after all,
From bad to worse. Some years, muscadel
Faces down frost; green thrives; the crops don't fail,
Sometimes a man aims high, and all goes well.

A people sometimes will step back from war;
Elect an honest man; decide they care
Enough, that they can't leave some stranger poor.
Some men become what they are born for.

Sometimes our best efforts do not go
Amiss; sometimes we do as we meant to.
The sun will sometimes melt a field of sorrow
That seemed hard frozen: may it happen for you.