Skip to main content
search
Tag

syllabus

Designing an Interdisciplinary Course on Epidemic Narratives in India | Dilip K. Das

By Essay, Health Humanities, Pedagogy No Comments
Cite this Essay

MLA:
Das, Dilip K. “Designing an Interdisciplinary Course on Epidemic Narratives of India.” Indian Writing In English Online, 04 Sept 2023, <link to the post> .

Chicago:
Das, Dilip K. “Designing an Interdisciplinary Course on Epidemic Narratives of India.” Indian Writing In English Online. September 4, 2023. <link to the post> .

The COVID pandemic is the latest in a series of new infectious diseases that have broken out almost every year since the beginning of this century, making public health once again a global concern:  Severe Acute Respiratory Syndrome (SARS), H1N1 and swine flu, dengue haemorrhagic fever, Middle Eastern Respiratory Syndrome (MERS), ebola, Zika and Nipah virus disease. With the development of vaccines and antibiotics in the first half of the twentieth century, epidemics had seemed to be a thing of the past. The last major pandemic had been the Spanish Flu outbreak of 1918-1920. When the World Health Organization declared in 1980 that smallpox had been eradicated, it was hailed as an “unprecedented achievement in the history of public health” (WHO 1980). This story of medicine’s triumph over the microbial world, however, was cut short with the emergence of HIV/AIDS in the 1980s: AIDS, as Mark Honigsbaum notes in The Pandemic Century, “forced scientists to confront the hubristic assumption that medicine was on the verge of conquering infectious disease” (165). Most of the pathogens that have emerged since then are of zoonotic origin, from increased contact with animal hosts due to deforestation and urban development. Once the animal-human barrier is crossed, the pathogens are transmitted rapidly across the world through international travel. COVID-19, for example, spread from Wuhan in China to more than 114 countries in just three months from January to March 2020, causing about four thousand deaths and two hundred thousand infections.

In May 2020, in the midst of the first COVID lockdown, I gave a pre-recorded talk for the English department at the University of Hyderabad on the plague outbreak in U.R. Ananthamurthy’s Samskara. In the course of writing it I thought of designing a course on Indian epidemic narratives, and I thank the department for giving me the opportunity. There was hardly any literature on epidemic narrative as a genre and Indian stories in particular, though the pandemic had revived interest in classic texts like Daniel Defoe’s Journal of the Plague Year and Albert Camus’ The Plague. There was Priscilla Wald’s Contagious, published in 2008, but it was an empirical study of American narratives dealing specifically with the event of outbreak. Given that we were then going through one of the worst pandemics in recorded history, and, moreover, one that has generated an unprecedented corpus of stories in print, cinema and social media, I realized the urgency and value of such a course. When I offered it once again the following year, I redesigned it to make its focus clearer. In the sections that follow I will discuss the redesigned course in terms of (I) conceptual framework and (II) organization of course content; in concluding section (III), I will suggest how it can be modified for an Indian Writing in English programme.

I

Epidemics are contingent events that put unprecedented stress on a community’s medical and moral resources. They are random and unpredictable; they cause death, bodily suffering and economic distress on a large scale; and they put to test the community’s capacity for enduring in the face of crisis. This, lest we forget, was what we all went through in the initial COVID years. As such, they symbolize what Clifford Geertz calls “chaos” – “a tumult of events which lack not just interpretations but interpretability,” that threaten “to break in upon man … at the limits of his analytic capacities, at the limits of his powers of endurance, and at the limits of his moral insight” (100, italics in original). If the first response to an outbreak is incomprehension, as Charles E. Rosenberg (1989) explains, the second is the effort to make sense of it and to formulate collective strategies to mitigate its effects. Rosenberg presents the structure of an outbreak as a three-act drama, the first being its acknowledgement as a crisis, the second being the creation of a frame of explanation to manage its randomness, and the third the adoption of disease control measures based on how its cause comes to be understood.

I have argued elsewhere that there are two broad paradigms for making sense of an outbreak, naturalistic and magical, based on two different theories of causation, biomedical and cosmological (18). The naturalistic paradigm holds that it is caused by factors such as the human body’s relation to its physical and microbial environment: it is the aetiology underlying biomedical explanations in public health (though literate medical traditions in India like ayurveda and unani are also naturalistic, they do not deal with public health). The magical paradigm holds that an outbreak is caused by non-natural factors such as the anger of a deity or an ancestral spirit provoked by a transgression of the cosmic order – the aetiology on which cosmological explanations of outbreak are built. By cosmos, I mean the entire material and symbolic universe that we inhabit with other beings natural and supernatural. Collective measures to mitigate the crisis derive from these two aetiologies and their explanatory paradigms: in the first case they involve rituals of appeasing the deity or spirit or of invoking their aid, in the second therapeutic regimes and preventive practices like wearing masks, quarantining infected persons and maintaining social distance. Both are effective in their different ways, one addressing epidemic panic and moral uncertainty and the other addressing bodily health. Though magical-cosmological styles are often dismissed as ineffectual and superstitious, they have, as Marcel Mauss says of magic in general, “a special kind of effectiveness, quite different from their mechanical effectiveness” (25). The distinctions that I make between magical-cosmological and naturalistic-biomedical, however, are only schematic – actual frames and practices in any society often draw on both to varying degrees, in a manner more heterogeneous than any schema would suggest.

In constructing the significance of an epidemic outbreak, narratives draw on the aetiologies and explanatory frames prevalent in particular historical and cultural contexts. As such, they draw on one or both of the types I discuss above. This provides the basic theoretical argument of the course, while other arguments pertain to narrative mode, time-space representation and emplotment. The magical-cosmological style uses a mode of narration that is primarily mythic, and its quintessential example is the liturgical narrative of epidemic deities like Sitala, the goddess of smallpox. In many of the stories or kathas of Sitala that are recited during her worship she appears to her devotees in dreams and visits their homes to lie down in the hearth, which must be left cold overnight. The devotees invoke her by singing her praises and receive her with an offering of stale food and curd, a fare that is cooling (her name means ‘cold’). She rewards them with protection from disease if she is appeased, or unleashes the pox on them if angered by an invocation or reception improperly performed. The narrative unfolds, thus, in a mythic landscape that is timeless and spatially unspecific – a katha usually begins with ‘Once upon a time in a land …’. In contrast, the naturalistic-biomedical style uses a mode that is realistic, its quintessential example being the epidemiological report and media story that document the time-space of emergence, transmission patterns and rates, and statistics of morbidity and mortality – data that are objective and verifiable. Literary narratives and fiction films lie in between these polar types, drawing on both modes. Ananthamurthy’s Samskara, thus, provides two explanations for the deaths in Durvasapura. For the brahmins of the agrahara they are the outcome of “Naranappa’s untimely death” and their “dereliction of duty in not performing his final rites,” while for Manjayya they are caused by the plague bacillus which Naranappa carries from Shivamogge, “and plague spreads like wildfire” (89). In style it hovers between realism and myth, an apt instance being the ending of the story when Praneshacharya wanders into the chariot festival at Melige.

Time-space representation, or what Mikhail Bakhtin calls “chronotope,” is integral to narrative, since it is in time and space, real or imagined, that events and acts unfold: “In the literary artistic chronotope, spatial and temporal indicators are fused into one carefully thought-out, concrete whole” (84). It is what links the represented world of narrative to the real time-space that we inhabit: “The work and the world represented in it enter the real world and enrich it, and the real world enters the work and its world as part of the process of its creation, as well as part of its subsequent life, in a continual renewing of the work through the creative reception of listeners and readers” (254). Myth constructs time-space as symbolic, while realism constructs it as factual. The chronotope of epidemic in any given narrative, accordingly, lies between these two polar forms, represented (as I have mentioned above) by the liturgical story on the one side and the epidemiological report on the other.

By ‘narrative’ I mean any text that organizes a sequence of events and actions both causally and chronologically towards a closure. The events may be objective, as in historical, biomedical and media accounts; subjective, as in memoirs; or imaginary, as in short stories, novels and films. What links these distinct genres of narrative is emplotment, or the structuring of the plot. To explain this I draw on arguments from Paul Ricoeur’s Time and Narrative and Hayden White’s Tropics of Discourse. White’s argument is that the distinction commonly made between history and fiction, the one ‘real’ and the other ‘imagined,’ becomes irrelevant insofar as the organization of the plot is concerned. Both follow the same procedure: “The events [in a historical narrative] are made into a story by the suppressing or subordination of certain of them and the highlighting of others, by characterization, motific repetition, variation of tone and point of view, alternative descriptive strategies, and the like – in short, all of the techniques that we would normally expect to find in the emplotment of a novel or a play” (84, italics in original). All narratives draw on a repertoire of “story types that we conventionally use to endow the events of our lives with culturally sanctioned meanings” (88). Putative differences between history, memoir and fiction collapse, as they all organize their events and actions in accordance with plot structures already given in culture. In a telling phrase, he calls historical narratives “fictions of factual representation” (121, italics added). Ricoeur, drawing on Aristotle’s theory of mimesis or artistic imitation, comes to a similar conclusion. He divides the process of mimesis into a sequence of three parts: mimesis1 refers to the cultural con-figuration of events and actions in reality, mimesis2 to their re-figuration in narrative emplotment, and mimesis3 to their trans-figuration in the process of reading, achieving thereby an “intersection of the world of the text and the world of the reader or hearer” through which narratives make sense (54-71). Both history and fiction, as representations of the world, unfold in this tripartite process that links our experience of reality with its figuration in culture on the one side and the text on the other: “The historian, as writer, addresses a public likely to recognize the traditional forms of the art of narration. These structures are not therefore inert rules. They are the forms of a cultural heritage” (168).

Narratives of epidemic, to conclude this section, construct its meaning and significance through the emplotment of events, time-space configurations and narrative modes derived from cultural memory of past epidemics, built on aetiologies and paradigms prevailing in particular cultures at given historical moments. In both narrative and sociocultural understanding, which mutually condition and shape each other, an epidemic comprises a staged sequence that begins with acknowledgement of outbreak and is followed by comprehension of its cause and evolution of strategies to mitigate its effects. An interdisciplinary approach to epidemic narrative, built on concepts from literary as well as social and cultural theories, can enable us to appreciate its generic forms, its relation to lived experience, and its relevance in times of epidemic crisis.

II

The course was divided into three segments: (i) conceptual framework, (ii) stories of outbreak, and (iii) biomedical and cosmological narratives. Readings for the first segment, which I have outlined above, were: Charles E. Rosenberg’s “What Is an Epidemic? AIDS in History” and “Disease in History: Frames and Framers”; an extract from Mikhail Bakhtin’s “Forms of Time and of the Chronotope in the Novel”; a chapter from Paul Ricoeur’s Time and Narrative, vol.1 (52-87); and my essay “Epidemic Narratives: Two Paradigms.” To understand two associated pairs of concepts, ‘disease’ and ‘illness’ and ‘curing’ and ‘healing,’ it included extracts from Andrew Strathern and Pamela J. Stewart’s Curing and Healing: Medical Anthropology in Global Perspective (6-15, 20-23, 218-225) and Cecil B. Helman’s “Disease versus Illness in General Practice.”

The second segment began with a reading from Priscilla Wald’s Contagious: Cultures, Carriers, and the Outbreak Narrative (1-28). Wald’s argument is that the outbreak narrative has a distinct generic form most suited to new diseases or diseases that had not hitherto achieved epidemic proportions. It “follows a formulaic plot that begins with the identification of an emerging infection, includes discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment” (2). Wald discusses a wide corpus of literary, cinematic, journalistic and scientific accounts to illustrate this. Given that the diseases they deal with are usually new, outbreak narratives are informed not so much by the memory of past epidemics as by images of holocaust and apocalypse. Outbreak narratives in literature and film are typically recent, like the novels of Robin Cook (Outbreak, Contagion, Invasion, Vector and Pandemic) and films like Wolfgang Petersen’s Outbreak and Steven Soderburg’s Contagion. The primary texts in this segment were a chapter from Ahmed Ali’s novel Twilight in Delhi recounting an outbreak of Spanish flu (229-233); two stories from the newsmagazine India Today by Supriya Bezbaruah, “SARS: Mass Attack” and “SARS Alert: Why India Should Be Scared”; and Aashiq Abu’s fiction film on Nipah outbreak in Kerala in 2018, Virus. Though the segment did not include COVID stories in its core readings students were encouraged to write assignments on them, some of which were quite original and insightful.

The third segment comprised narratives that construct epidemic events in the biomedical-realist and cosmological-mythic styles. The segment began with an epidemiological report, William G. Eggleston’s “Oriental Pilgrimages and Cholera” and Alfred C. Reed’s disease travelogue “Medical Sketches in the Orient,” followed by Susan Wadley’s translation of the kathas of Sitala in her essay “Sitala: The Cool One.” The objective of this segment was (a) to highlight the differences between the two styles and (b) to show how they coexist often in the same narrative. The other texts were: a chapter from Narayan’s novel Kocharethi: The Araya Woman (40-50), U.R. Ananthamurthy’s Samskara, Fakir Mohan Senapati’s short story “Rebati,” Satyajit Ray’s film Ganashatru, extracts from Kalpana Jain’s journalistic account of the HIV/AIDS epidemic Positive Lives, and the first Indian feature film on AIDS,  Mahesh Manjrekar’s Nidaan. These narratives show how epidemics are imagined in complex ways, drawing on both scientific and religious ideas, often within the same text as either alternatives or as conflicting views. In Kocharethi, for instance, both frameworks are presented in the form of medical pluralism, while in Samskara, “Rebati” and Ganashatru the scientific is used to criticize and dismiss the religious paradigm as irrational and regressive.

III

The central theme of the course was that narratives shape the cultural understanding of epidemic, even as they draw their ideas from it. This dialectical relation between narrativization and cultural repertoire is what produces the heterogeneity and transformability of epidemic knowledge. An epidemic outbreak may be a biological event, but it is rarely experienced solely as such. Both narrative and culture draw on objective and scientific as well as subjective and allegorical frames of explanation, as they unfold in the gap between the apprehension that epidemic provokes and its comprehension. The study of epidemic narratives (more generally, the social understanding that they draw on) calls for an approach that is interdisciplinary as well as a broader definition of narrative that can include a range of genres and media. It was with this in view that the course included epidemiological reports, media stories and films alongside texts that were literary in a conventional sense.

The course can be redesigned for a programme in Indian Writing in English by changing the core readings in segments two and three, without changing its interdisciplinary character. The segment on conceptual framework, which draws on literary theory (Ricoeur, Bakhtin), medical anthropology (Strathern and Stewart, Helman) and history of medicine (Rosenberg) can be retained as such. The IWE corpus can be expanded to include translations as one may not find many texts in English, especially with regard to past epidemics. (J.G. Farrell’s The Siege of Krishnapur, though written by a British author, recounts in part an outbreak of cholera in a colonial outpost during the Revolt of 1857. Ashoke Mukhopadhyay’s A Ballad of Remittent Fever, originally written in Bengali, is about outbreaks of cholera, plague, typhoid, malaria and kala-azar in early 20th century Calcutta.) The AIDS epidemic generated a number of stories in India, though far less than those in the US, England, Canada and Australia – one reason being that in the latter countries it primarily affected a gay community that had acquired by then immense cultural capital and access to publication. AIDS Sutra, an anthology of writing sponsored by the Bill and Melinda Gates Foundation and Avahan, includes narratives in English by authors like Sunil Gangopadhyay, Salman Rushdie and Shobhaa De. And, as I have mentioned above, COVID has generated an impressive source of narratives that capture well our experience of the ongoing pandemic.

Epidemics are complex bio-cultural phenomena that call for an approach based on both objective knowledge and subjective experience. The human sciences (medicine, sociology and anthropology) provide the former, and the humanities (especially literature) the latter. In their interdisciplinary convergence with the human sciences, the humanities can leverage critical insights into the experience of epidemics that science must suppress as a methodological necessity. The pedagogic value of such a course lies in this – the explication of a crucial dimension of social phenomena that cannot be explicated by the more objectivist human sciences.

WORKS CITED:

Akhavi, Negar, editor. AIDS Sutra: Untold Stories from India. Random House India, 2008.

Ali, Ahmed. Twilight in Delhi: A Novel. Rupa, 2007.

Ananthamurthy, U.R. Samskara: A Rite for a Dead Man. Translated by A.K. Ramanujan, Oxford University Press, 1976.

Bakhtin, M.M. “Forms of Time and of the Chronotope in the Modern Novel.” The Dialogic Imagination: Four Essays, edited by Michael Holquist, University of Texas Press, 1981, pp. 84-258.

Bezbaruah, Supriya. “SARS: Mass Attack.” India Today, April 8-14 2003, pp. 45-48.

Bezbaruah, Supriya and Nidhi Taparia, “SARS Alert: Why India Should Be Scared.” India Today, April 29 – May 5 2003, pp. 18-25.

Camus, Albert. The Plague. Translated by S. Gilbert, Penguin, 1960.

Contagion. Directed by Steven Soderberg. 2011.

Cook, Robin. Outbreak. G.P. Putnam’s Sons, 1987.

___________. Contagion. G.P. Putnam’s Sons, 1995.

___________. Invasion. Berkley Publishing, 1997.

___________. Vector. G.P. Putnam’s Sons, 1999.

___________. Pandemic. Pan Books, 2019.

Das, Dilip K. “Epidemic Narratives: Two Paradigms.” Pandemics and Epidemics in Cultural Representation, edited by S. Venkatesan, A. Chatterjee, A.D. Lewis and B. Callendar. Springer, 2022, pp. 13-27.

Defoe, Daniel. A Journal of the Plague Year. Heritage Press, 1968.

Eggleston, William G. “Oriental Pilgrimages and Cholera.” The North American Review, vol. 155, no. 428, July 1892, pp. 126-128. https://www.jstor.org/stable/25102418.

Farrell, J.G. The Siege of Krishnapur. Wiedenfeld & Nicolson, 1973.

Ganashatru. Directed by Satyajit Ray. National Film Development Corporation of India. 1990.

Geertz, Clifford. The Interpretation of Cultures: Selected Essays. Basic Books, Inc., 1973.

Helman, Cecil B. “Disease versus Illness in General Practice.” Journal of the Royal College of General Practitioners, vol. 31, 1981, pp. 548-52. PubMed Central, PMCID: PMC1972172.

Honigsbaum, Mark. The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19. Penguin, 2020.

Jain, Kalpana. Positive Lives: The Story of Ashok and Others with HIV. Penguin, 2002.

Mauss, Marcel. A General Theory of Magic. Translated by Robert Brain. Routledge Classics, 2001.

Mukhopadhyay, Ashoke. A Ballad of Remittent Fever. Translated by Arunava Sinha. Aleph, 2020.

Narayan, Kocharethi: The Araya Woman. Translated by Catherine Thankamma. Oxford University Press, 2011.

Nidaan. Directed by Mahesh Manjrekar. Pan Pictures, 2000.

Outbreak. Directed by Wolfgang Petersen. Arnold Kopelson Productions and Punch Productions, Inc., 1995.

Reed, Alfred C. “Medical Sketches in the Orient.” The Scientific Monthly, vol. 31, no. 3, 1930, pp. 193-216. https://www.jstor.org./stable/14970.

Ricoeur, Paul. Time and Narrative, Volume 1. Translated by Kathleen McLaughlin and David Pellauer. The University of Chicago Press, 1990.

Rosenberg, Charles E. “Disease in History: Frames and Framers,” The Milbank Quarterly, vol. 67, supplement 1, 1989, pp. 1-15. http://www.jstor.org/stable/3350182.

__________________. “What Is an Epidemic? AIDS in Historical Perspective.” Daedalus, vol. 118, no. 2, 1989, pp. 1-17. http://www.jstor.org/stable/20025233.

Senapati, Fakir Mohan. “Rebati.” The Greatest Odia Stories Ever Told, selected and translated by L. Mohapatra, Paul St-Pierre and K.K. Mohapatra, Aleph, 2019, pp. 204-214.

Strathern, Andrew and Pamela J. Stewart. Curing and Healing: Medical Anthropology in Global Perspective. 2nd ed., Carolina Academic Press, 2010.

Virus. Directed by Aashiq Abu. OPM Cinemas, 2019.

Wadley, Susan S. “Sitala: The Cool One.” Asian Folklore Studies, vol. 39, no. 1, 1980, pp. 33-62. http://www.jstor.org/stable/1177516.

Wald, Priscilla. Contagious: Cultures, Carriers, and the Outbreak Narrative. Duke University Press, 2008.

White, Hayden. Tropics of Discourse: Essays in Cultural Criticism. The Johns Hopkins University Press, 1978.

WHO (World Health Organisation). Declaration of Global Eradication of Smallpox. 1980. https://apps.who.int/iris/bitstream/handle/10665/155528/WHA33_R3_eng.pdf.

Illustration by Guru G. for IWE Online.

Teaching Health Humanities: Challenges and Insights | Sathyaraj Venkatesan

By Essay, Health Humanities No Comments

 

The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.

William Osler

Health humanities in English Department: Implications

Health humanities is an emerging interdisciplinary field that examines the interaction and intersection of humanities (such as literature, history, philosophy, ethics, and the arts) with health/illness. It encompasses various disciplinary contexts and departments—for instance, health anthropology, medical sociology, public health, medicine, health economics, and religion among others. Unlike medical practice which focuses on the scientific and clinical aspects of illness, health humanities recognizes the value of biographical, social, and cultural dimensions of the illness experience. By doing so, health humanities sheds light on the often ignored, understated, or unsaid aspects of illness. As Martyn Evans puts it, health humanities is “an integrated, interdisciplinary, and substantially philosophical approach to recording and interpreting human experiences of illness, disability, medicine and health care” (509). Patient and social movements (such as disability rights movements) in the 1960s and 70s, the recognition of the importance of patient-centred care, the role of cultural competence, the narrative medicine movement along with the recent medical developments have paved the way for the growing prominence of health humanities.

However, when health humanities is taught in an English/Cultural Studies department, it serves a unique purpose that distinguishes it from the integration of humanities in medical curricula. The broad objectives of health humanities courses taught through an English/Cultural Studies department are (a) to analyse through close reading and other modes (for instance, reparative reading[1]) the representational politics and cultural logics of disease conditions through the study of the visual/textual/oral narratives of patients/(paid/unpaid) caregivers and medical professionals (b) to study the narrative (narrator, voice, structure, etc.) and figurative aspects of the illness narratives (c) and, to investigate the ethical stakes of both storytelling and listening. Put differently, health humanities treats health/illness/medicine as a cultural phenomenon shaped by practices, discourses, and beliefs, and also concentrates on interpreting disease and illness culturally.

In contrast, the same course taught through a medical school would emphasize on improving the core physician skills (such as observation, tolerance for ambiguity, clinical empathy, communication, listening skills etc.) through reading and reflecting on the literary/cultural/visual texts among others. A crucial element here is the personalizing of the medical experience in order to make it more human-centred. In fact, aligning with the global trends, the Medical Council of India (MCI) has in recent times integrated Health Humanities into the MBBS curriculum as a foundational core course. Humanities in Medical Education by Rajiv Mahajan and Tejinder Singh provides a comprehensive overview of the role and the need for humanities in Indian medical education.

Designing the Syllabus: Challenges and Insights

Health humanities can be taught in multiple ways, including but not limited to medium approach (comics, films, verbal narratives, paintings, etc.), period approach (colonial/ postcolonial,  18th century, 19th century etc.), region/geography approach (India, Canada, South Asian, etc.), disease approach (HIV/AIDS, polio, TB etc.), thematic approach (bio-capitalism, medical pluralism, pharamaceuticalization, epidemics, organ transplantation), archives/medical histories and social histories of disease/organs (such as Skin by Claudia Benthien) among others.

Designing a health humanities syllabus in Indian/South Asian contexts also involves negotiating with vernacular/regional language literatures on health/illness narratives, as well as with English texts in translation and those originally written in English. Unlike the west (the USA/UK/Canada) where primary/secondary sources on/in health humanities are typically in English language, India has a rich cultural tradition and a number of languages. Thus, as an instructor, one has to be mindful of the diverse cultural traditions and languages present in India while determining the texts to be included in the syllabus. To address this challenge, as an instructor, I have chosen to include books originally written in English (for example, Jerry Pinto’s Em and the Big Hoom), as well as translations of works in other languages (for example, translation of Fakir Mohan Senapati’s Odiya short story “Rebati”). This approach ensures that the syllabus is inclusive and accessible to a wide range of students. The guiding principle should be to examine how Indian/South Asian literary imagination has influenced and shaped a unique approach to the practices and ideas of health humanities.

I teach a survey-level graduate course titled Health Humanities that consists of five untitled modules and is taught through the Department of Humanities and Social Sciences (English) at the National Institute of Technology, Tiruchirappalli.  Each module focuses on a specific aspect of health humanities, including the principles and theories of health humanities, physical and mental illness, disability studies, pandemics/epidemics, and health representation across media.

My institution as well as the students welcomed such an interdisciplinary course. This course has now been incorporated into the MA syllabus as an open elective and is also a core course for PhD students who are pursuing their doctoral work in Health Humanities. In addition to this, some health-related topics are covered under “graphic medicine” in another undergraduate (B. Tech.) Open Elective course that I offer, titled Introduction to Comics Studies. This course is designed to cater to the diverse interests of students pursuing programs in Cultural Studies/English literature, as well as those studying engineering/science (with minor modifications tailored specifically for B. Tech. students). The overarching objectives of this discussion-based course are threefold: (a) to introduce how literary/visual cultures conceptualize bodies, health, and illness, (b) to gain insight into how  the arts and culture influence and shape human condition, and (c) to delineate the wider social implications of medicine through various literary and media forms. This is a 3-credit course that runs for 45 hours and draws on multimedia and interdisciplinary archive to address these objectives. The course ran for approximately 12-13 weeks, spread across three sessions per week, each lasting 50 minutes.

Here I am sharing my pedagogical practices and reading list which I believe can provide a valuable foundation for anyone interested in exploring the intersection between health and the humanities. In this foundational course, I teach a diverse selection of Indian and western texts across various media to provide a comprehensive learning experience. Given that health humanities is a relatively new field in India, the syllabus should include and balance both Indian and Western texts, and also consider what sets Indian Health Humanities apart. Further, exposure both to western and non-western texts also helps students develop a comparative perspective of the issues related to health. The instructor may choose to use (a) primary sources in full/excerpts as well as, (b) research essays/book chapters/books for intensive and extensive reading. Finally, as with any syllabus, there is always the possibility of overlooking important texts.

Unit one

In the initial classes, I shall provide a working knowledge of the operative terms of health humanities such as “health,” “illness,” “disability,” “disease,” “sickness,” and “well-being.” In order to do so, I prescribe excerpts from  The Illness Narratives by Arthur Kleinman, Eric J. Cassell’s essay “Illness and Disease,” and Michael Bury’s “Chronic Illness as Biographical disruption.” I shall also introduce some essays from the first issue of Literature and Medicine (1982) journal published by Johns Hopkins University which articulates the major concerns, scope, and representational practices of health humanities. Virginia Woolf’s “On Being Ill” and Michel Foucault’s The Birth of the Clinic will be introduced at various junctures of the course. We particularly liked Woolf’s “On Being Ill” which offered a rich source of thought-provoking discussion, such as her assertion that “illness has not . . . taken its place with love, battle, and jealousy as one of the prime themes of literature” (3-4). Here Woolf emphatically argues that illness has not received the same level of attention as love, war, and jealousy in literature. This assertion prompts reflection on the importance of illness and its depiction in literary works, as well as within the broader field of health humanities.

After introducing the key terms, I shall provide a brief overview of the evolution of health humanities in the west. Although the terms medical humanities, health humanities, and critical health humanities are often used interchangeably, they have a distinct scope that should be clarified. While the scope of medical humanities is limited to doctor-patient interaction and on improving medical education/clinical practice, health humanities embraces a variety of perspectives including that of a patient and a caregiver. Critical health humanities, on the other hand, is premised on the posthuman idea of species health and an intense examination of social, cultural, ethical, and political dimensions of health/illness. The introductory chapter of The Edinburgh Companion to the Critical Medical Humanities edited by Anne Whitehead and Angela Woods provides a valuable resource for introducing these three phases of health humanities. I also assign introductory chapters from Medical Humanities: An Introduction edited by Thomas R. Cole, Ronald A. Carson, and Nathan S. Carlin, as well as the Health Humanities Reader edited by Delese Wear, Lester D. Friedman, and Therese Jones. “Why Medical Humanities?” an essay by Upreet Dhaliwal published in RHiME adds a unique Indian perspective to the module.

Unit two

The objective of this module is to arrive at the non-clinical aspects of illness,  compare different concepts of health (comparative health humanities) and also, to introduce the narrative and figurative aspects of illness narratives. To these ends, I introduce The Wounded Storyteller by Arthur Frank and his elaboration of three narrative modes: restitution, chaos, and quest narratives. Frank’s ideas will be tested alongside Yuvraj Singh’s The Test of My Life, a celebrity illness narrative that employs restitution tropes. Additionally, we also read excerpts from Manisha Koirala’s Healed: How Cancer Gave Me A New Life . While these narratives are not fully representative of cancer as experienced by an “ordinary” sick person, they offer provocative examples for discussing the social aspects of health such as class, social power, and financial resources, on health outcomes.

Mental illnesses, on the other hand, are critically misinterpreted and are fraught with stereotypes and misconceptions. This is particularly true in India where mental illness is  often misread as personal weakness, forcing the sufferers to feel shame and self-blame. Despite the concerted efforts by the government and by various NGOs, mental illness remains a significant public health concern in India.  We read excerpts of William Styron’s Darkness Visible, Kay Redfield Jamison’s  An Unquiet Mind: A Memoir of Moods and Madness, and Jerry Pinto’s Em and the Big Hoom (fiction). Using these texts, we discussed stigma and discrimination, coping mechanisms and recovery, as well as questions of identity and self-reflection in relation to mental illness. The boldness of these representations deeply moved the students leading to an environment of openness and expansion of perspectives.

Unit three

The objective of this module is to introduce different study approaches to disability art and cultural practices. I will cover the differences between medical and social models of disability, develop a comprehensive vocabulary to describe various disability conditions (such as normal, ableism, inclusive design, access etc.) and finally, investigate how the disabled are portrayed in arts and literature. We will read the introductory chapter from Lennard J Davis’s The Disability Studies Reader. Davis’s “Crips Strike Back: The Rise of Disability Studies” published in the American Literary History is particularly useful in that the essay makes a case for the centrality of disability studies scholarship in literary studies. One of the primary goals of this module is also to challenge the globalizing tendencies of western disability discourses and to ground such discourses within the socio-political contexts of India.

Disability studies in India has made substantial progress in terms of availability of primary and secondary sources. Some resources on disability that the prospective instructor may consider consulting include: Disability in Translation: The Indian Experience edited by Someshwar Sati, G.J.V. Prasad, Reclaiming the Disabled Subject: Representing Disability in Short Fiction (Volume 1) edited by Someshwar Sati, GJV Prasad, and Ryswick Bhattacharjee, Rethinking Disability in India by Anita Ghai, and Disability Studies: An Introduction by Banibrata Mahanta. I introduce the film Margarita with a Straw (2014) followed by Preeti Monga’s The Other Senses (2012), and Firdaus Kanga’s fictionalized autobiography, Trying to Grow (2008) to discuss disability, desire and identity. These works offer valuable insights into disability from different perspectives and help broaden students understanding of the experiences of people with disabilities.

Unit four

This module will examine key concepts related to pandemics (such as cholera, HIV/AIDS, COVID-19), epidemics, and endemics. In fact, the outbreak of COVID-19 has sparked a renewed interest in the pandemic and plague literatures. Two guiding questions inform this module—what does it mean that epidemics are partially social constructs? , and how do literary and cultural texts negotiate and represent epidemics? Charles E. Rosenberg’s “What Is an Epidemic? AIDS in Historical Perspective” and “Framing Disease: Illness, Society, and History,” in Explaining Epidemics and Other Studies in the History of Medicine was  discussed in the class not only to evolve a working definition of pandemics but also to delineate the characteristics of modern pandemics Additionally, by examining pandemics through an intersectional perspective, I aim to shed light on the intricate web of interconnected factors (such as caste, religion, colonialism, gender, and class) that influence  health. To facilitate this examination, I introduce Rabindranath Tagore’s short novel Chaturanga (tran. “Quartet”) which looks at the intersection of pandemics and religion,and Rajinder Singh Bedi’s short story “Quarantine” that studies pandemics and caste.

While the excerpts of the classical texts such as Michel Foucault’s The Birth of the Clinic and The Pandemic Century: One Hundred Years of Panic, Hysteria and Hubris by Mark Honigsbaum are useful to initiate discussion on pandemics, books/essays by David Arnold (for instance, Colonizing the Body: State Medicine, and Epidemic Disease in Nineteenth Century India or Pandemic India: From Cholera to Covid-19) deepen our understanding of pandemics in Indian/South Asian contexts. Particularly, the second chapter in The Birth of the Clinic titled “A Political Consciousness” is useful in that it provides valuable insights not only into the differences between ‘endemic’ and ‘pandemic’ but also in cultivating students’ understanding of the relationship between political power and individual/collective health. By incorporating the concept of biopolitics, the discussion expands to encompass the ways in which power structures influence the management of health at both the individual and collective levels.

To support my discussion, I will draw on a range of primary texts including Fakir Mohan Senapati’s “Rebati” which discusses cholera, a common epidemic in the nineteenth and early part of the twentieth century India; “The Sultan’s Battery,” a short story on STD by Aravind Adiga; Master Bhagwandas’s “The Plague-Witch” and Arundhati Roy’s essay “‘The Pandemic is a Portal.” The recently published Literary Representations of Pandemics, Epidemics and Pestilence by Nishi Pulugurtha and Pandemics and Epidemics in Cultural Representation by Sathyaraj Venkatesan et. al. are useful books in the study of pandemics.

Unit five

The objective of this module is to offer a perspective about media affordances and how these are utilized to represent illnesses. Through an exploration of diverse forms of media, including web series, films, advertisements, comics, and new-age digital formats, students gain a comprehensive understanding of how health and illness are represented in different media forms. They also examine how media as a significant force (for instance, raising awareness, influencing health behaviours etc.) shapes perceptions, attitudes, and behaviours towards health and illness. While there are several media texts that could be presented under this module, I particularly introduce the following: the web series Breath (on organ transplantation), Vipul Amrutlal Shah’s television series Human (on pharmaceuticals) and films such as Phir Milenge (on HIV/AIDS), Black (on blindness and Alzheimer’s), and Munnabhai MBBS (to discuss doctor-patient relationship). The graphic narrative Menstrupedia by Aditi Gupta and Tuhin Paul provides a platform for discussing sensitive topics such as the stigma and body shame related to menstruation, and also prompts reflections on the role of comics in healthcare settings and beyond. Finally, I shall introduce a few advertisements to discuss a range of health-related issues such as hygiene, disease-mongering, and commercial interests. Students watch/read these materials eventually leading to collective close reading and media analysis from multiple levels such as film’s content/approach, health campaign, and public health infographic/challenges. One of the useful texts in this context is Research Methods in Health Humanities (2019). Edited by Craig M. Klugman and Erin Gentry Lamb and published by the Oxford University Press, Research Methods in Health Humanities while surveying the history of health humanities also offers guidance on how to conduct research on various media including archives, paintings, films, and comics. The aforementioned media texts are solely based on my personal interest. Prospective instructors may choose any media forms and related texts as per the learning objectives, availability of resources, and class size, among others.

Assignments and Assessments

The prospective instructor may include a range of assignments with different weightage. While traditional assessments such as group/individual oral presentations and (open/close) examinations are common, the instructor can develop a range of interesting assignments like field trips to hospitals for patient-doctor interviews, creation of short videos, debates (for instance, on euthanasia), role plays, podcasts, and case studies, among others. The course instructor may also invite a guest speaker to discuss relevant topics and themes of the course.

My course followed a continuous evaluation system consisting of four assessments: (a) oral presentation, (b) mid-semester open book examination, (c) studio hour, and (d) a short close reading assignment. Collectively, these assessments fostered active participation, encouraged critical engagement, and facilitated a holistic understanding of the key concepts of health humanities among the students.

One of the most intriguing assessments is the studio hour which encourages students to draw/write about their own experiences of illness in the form of critical/creative/visual work (such as creating a documentary film, writing a play, developing a public art installation, drawing comics, writing poems etc.). The following prompts were designed to encourage reflective thinking among students regarding their health-related experiences/insights related to their illnesses: (a) reflect on the emotions you experienced during your illness journey, (b) reflect on the ways in which your perspective on life, health, and mortality has changed as a result of your illness, (c) consider the broader societal or cultural implications of your illness, and (d) how can you use your creative work to raise awareness, challenge stereotypes, or generate conversations about illness-related issues? These prompts are just a starting point, as there are many more questions that can further facilitate self-reflection and exploration of the unique health-related experiences of the students. At the end of the semester, the creative works of the students are curated and presented in a class exhibition, providing them with an opportunity to share their experiences and receive feedback from their peers. During the class exhibition, they share their work and discuss with peers, further exploring the course material. Peers offer feedback, thought-provoking questions, and expand the student’s understanding of illnesses. This reflective activity has proven to be a valuable and meaningful way for students to engage with the course material and connect with others in the class.

Coda

Although medical humanities as a term was adumbrated in 1948 by the historian George Sarton in an obituary column published in the journal ISIS, it gained prominence only in the 1970s in the USA and 1990s in the UK. In India, the field of health humanities is still in its early stages of development, with relatively few practitioners and limited awareness among the general public. Nonetheless, there are some promising signs of progress. Through my course, Health Humanities, I aim to introduce students to the essential tools (such as critical analysis, interdisciplinary approaches, media affordances and narrative forms), research methodologies, and major texts of Health Humanities.   By doing so, the course places a strong emphasis on critical thinking, urging students to challenge the Eurocentric paradigms of health, and consider and reflect on the socio-cultural realities of India, including how they might shape and intersect with health and illness.

Select Health Humanities journals
Literature and Medicine
Perspectives in Biology and Medicine
Medical Humanities
Journal of Medical Humanities
Health
Asian Bioethics Review
Hastings Center Report
Journal of Visual Communication in Medicine
Indian Journal of Medical Ethics
Indian Journal of Critical Disability Studies
Research and Humanities in Medical Education

Select websites
Graphic medicine: <https://www.graphicmedicine.org/>
Literature, Arts, Medicine Database:<https://medhum.med.nyu.edu>
Science, Medicine, and Anthropology: <http://somatosphere.net/>
Narrative Medicine: <https://www.mhe.cuimc.columbia.edu/our-divisions/division-
narrative-medicine>
Synapsis: <https://medicalhealthhumanities.com/>
PubMed: <https://pubmed.ncbi.nlm.nih.gov/>
Medicine and Muse program, Stanford University: < https://med.stanford.edu/medicineandthemuse/about.html>
The Medical Humanities Colloquy, IIT Gandhinagar: < https://hss.iitgn.ac.in/project/medical-humanities-colloquy-1/>
Archive of Science Gallery’s Second Digital Exhibition: <https://bengaluru.sciencegallery.com/psyche-archive>
BMJ Blogs and Opinion: <https://www.bmj.com/news/opinion>
The Polyphony: https://thepolyphony.org/.

 

Works cited
Adiga, Aravind. “The Sultan’s Battery.” Between the Assassinations. Simon and Schuster, 2009.

Arnold, David. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. University of California Press, 1993.

Banerjee, Ishani, et al., writers. Human. Directed by Vipul Amrutlal Shah and Mozez Singh, 14 January 2022. Disney+Hotstar.

Benthien, Claudia. Skin: On the Cultural Border between Self and the World. Columbia University Press, 2002.

Bedi, Rajinder Singh. “Quarantine.” Orientalia Suecana, vol. 69, 2020, pp 42-48.

Bhagwandas, ‘Master.’ “The Plague-Witch.” Medical Maladies: Stories of Disease and Cure from Indian Languages, edited by Haris Qadeer, Niyogi Publisher, 2023, pp. 269–287.

Bhansali, Sanjay Leela, writer. Black. Directed by Sanjay Leela Bhansali, Applause Entertainment SLB Films and Yash Raj Films, 4 February 2005.

Bose, Shonali, director. Margarita with a Straw, Netflix, 2015, https://www.netflix.com/in/title/80018695?source=35.  Accessed 19 Mar. 2023.

Bury, Michael. “Chronic Illness as Biographical Disruption.” Sociology of Health and Illness, vol. 4, no. 2, 1982, pp. 167–182., https://doi.org/10.1111/1467-9566.ep11339939.

Cassell, Eric J. “Illness and Disease.” The Hastings Center Report, vol. 6, no. 2, 1976, pp. 27-37. https://doi.org/10.2307/3561497.

Cole, Thomas R., et al. Medical Humanities: An Introduction. Cambridge University Press, 2021.

Crawford, Paul, et al. The Routledge Companion to Health Humanities. Routledge, 2020.

Davis, Lennard J. “Crips Strike Back: The Rise of Disability Studies.” American Literary History, vol. 11, no. 3, 1999, pp. 500–12. JSTOR, http://www.jstor.org/stable/490130. Accessed 19 Mar. 2023.

—.“Introduction: Disability, Normality and Power.” The Disability Studies Reader, Routledge, 2017, pp. 1–16.

Dhaliwal, Upreet. “Why Medical Humanities?” RHiME, vol. 1, 2014.

Evans, Martyn. “Reflections on the Humanities in Medical Education.” Medical Education, vol. 36, no. 6, 2002, pp. 508–513., https://doi.org/10.1046/j.1365-2923.2002.01225.x.

Foucault, Michel. The Birth of the Clinic. Routledge, 2012.

—.The Birth of the Clinic: An Archaeology of Medical Perception. London, 1976.

Frank, Arthur W. The Wounded Storyteller: Body, Illness, and Ethics. 2nd ed., University of Chicago Press, 2013.

Ghai, Anita. Rethinking Disability in India. Routledge India, 2015.

Girija, K. P. Mapping the History of Ayurveda: Culture, Hegemony and the Rhetoric of Diversity. Routledge India, 2021.

Gupta, Aditi, and Tuhin Paul. Menstrupedia Comic: A Friendly Guide to Periods for Girls. Menstrupedia, 2021.

Honigsbaum, Mark. The Pandemic Century: One Hundred Years of Panic, Hysteria, and Hubris. WW Norton & Company, 2019.

Hirani, Rajkumar, et al., writers. Munna Bhai M.B.B.S. Directed by Rajkumar Hirani, AA Films, 19 December 2003.

Jamison, Kay Redfield, and Solomon. An Unquiet Mind: A Memoir of Moods and Madness. Picador, 2015.

Jurecic,  Ann. Illness as Narrative. University of Pittsburgh Press, 2012.

Jones, Therese, et al. Health Humanities Reader. Rutgers University Press, 2014.

Kanga, Firdaus. Trying to Grow. India, Penguin Random House India Private Limited, 2018.

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition. Basic Books, 1988.

Koirala, Manisha. Healed: How Cancer Gave Me a New Life. Penguin, 2018.

Klugman, Craig M., and Erin Gentry Lamb, editors. Research Methods in Health Humanities. Oxford University Press, 2019.  Literature and Medicine, vol. 1, no. 1, 1982, pp. 37–37.

Mahajan, Rajiv, and Tejinder Singh. Humanities in Medical Education. CBS Publishers and Distributors, 2020.

Mahanta, Banibrata. Disability Studies: An Introduction. Yking Books, 2017.

Monga, Preeti. Other Senses: An Inspiring True Story of a Visually Impaired. Roli Books, 2012.

Osler, William. Aequanimitas: With Other Addresses to Medical Students, Nurses and Practitioners of Medicine. Blakiston Company, 1904.

Pinto, Jerry. Em and the Big Hoom. Penguin, 2015.

Pulugurtha, Nishi, ed. Literary Representations of Pandemics, Epidemics and Pestilence. Taylor and Francis, 2022.

Qadeer, Haris, editor. Medical Maladies: Stories of Disease and Cure from Indian Languages. Niyogi Publisher, 2023.

Rosenberg, Charles E. “What Is an Epidemic? AIDS in Historical Perspective.” Daedalus, vol. 118, no. 2, 1989, pp. 1-17.

Rosenberg, Charles E., and Janet Lynne Golden, editors. “Framing Disease: Illness, Society and History.” Explaining Epidemics and Other Studies in the History of Medicine, Cambridge University Press. 1992.

Roy, Arundhati. “The Pandemic is a Portal.” Financial Times, vol. 3 no. 4, 2020, pp 45.

Sabharwal, Atul, writer. Phil Milenge. Directed by Revathi, Percept Picture Company, 27 August 2004.

Sati, Someshwar, and G J V Prasad. Disability in Translation: The Indian Experience. Routledge, Taylor & Francis Group, 2020.

Sati, Someshwar, et al. Reclaiming the Disabled Subject: Representing Disability in Short Fiction. Bloomsbury India, 2022.

Senapati, Fakir Mohan. “Rebati.” Fakir Mohan Senapati Stories. Translated by Paul St-Pierre, Grassroots, 2003.

Singh, Yuvraj, et al. The Test of My Life: From Cricket to Cancer and Back. Random House Publishers India, 2013.

Sharma, Mayank., and Abhijeet Deshpande, writers. Breathe. Directed by Mayank Sharma, Abundantia Entertainment, 26 January 2018. Amazon Video.

Styron, William. Darkness Visible: A Memoir of Madness. Vintage, 1992.

Venkatesan, Sathyaraj, et al., editors. Pandemics and Epidemics in Cultural Representation. Springer, 2022.

Whitehead, Anne, and Angela Woods, editors. The Edinburgh Companion to the Critical Medical Humanities. Edinburgh University Press, 2016.

Woolf, Virginia. On Being Ill. Paris Press, 2012.

[1] Eve Kosofsky Sedgwick introduced the concept of “reparative reading,” challenging “paranoid reading.” This alternative perspective emphasizes a hermeneutic of empathy and positive engagement, contrasting with the suspicious and negative affects associated with paranoid reading. While paranoid reading tends to focus solely on problematic elements within a text, reparative reading seeks a more holistic comprehension of the text. In health humanities, reparative reading refers to a compassionate and humanistic approach that involves placing trust in both the narrator (the suffering self) and the narrative (illness narrative). This method of interpretation encourages empathy and understanding towards the text. For more on this, see Illness as Narrative by Ann Jurecic.

Copyedited by Sreelakshmy M.
Illustration by Guru G. for IWE Online
Close Menu