Using Literature and Photography to Teach Social Justice and Encourage Activism for Public Health

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Using Literature and Photography to Teach Social
Justice and Encourage Activism for Public Health

• Martin Donohoe

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Portland, OregonMount Hood
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Multnomah Falls, Oregon
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Medicine and Public Health

• Schism between the fields
• Witnessed victims vs. statistical victims
• Medical ethics / public health ethics
• Activism

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Harvey Cushing

• A physician is obligated to consider more than a
  diseased organ, more even than the whole man. He
  must view the man in his world.

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Martin Luther King

• Injustice anywhere is a threat to justice
  everywhere

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Important Historical Figures in Medicine/Public
Health and Social Justice

• Florence Nightingale
• Clara Barton
• Margaret Sanger
• Thomas Hodgkin
• Albert Schweitzer

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Important Historical Figures in Medicine/Public
Health and Social Justice

• Charles Dickens
• Anton Chekhov
• Upton Sinclair
• George Orwell
• William Carlos Williams

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Rudolph Virchow

• Founder of modern pathology
• Thrombosis, pulmonary embolism, leukocytosis,
  leukemia
• Member of state and local government for over 30
  years
• Founded journal Medical Reform

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Rudolph Virchow

• Argued that many diseases result from the
  unequal distribution of civilizations
  advantages
• Advocated public provision of medical care for
  the indigent
• Promoted universal education

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Rudolph Virchow

• Worked to outlaw child labor
• Improved water distribution and sewage system
• Enhanced food inspection process
• Published study of skull volumes to dispute myth
  of larger Aryan brains

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Rudolph Virchow

• Passed hygiene standards for public schools
• Set new standards of training for nurses
• Improved local hospital system

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Rudolph Virchow

• Doctors are natural attorneys for the poor If
  medicine is to really accomplish its great task,
  it must intervene in political and social life

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The Role of Literature

• Vicarious experience
• Explore diverse philosophies
• Promotes empathy, critical thinking, flexibility,
  non-dogmatism, self-knowledge
• Encourages creative thinking
• Allows for group discussion/debate

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Why Use Literature

• Encourage appreciation of non-medical literature
• Develop reading, analytical, speaking and writing
  skills
• Promote ethical thinking (narrative ethics)
• Identification with doctor authors (e.g., Keats,
  Chekhov, Maugham, Williams)

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Readings

• Oliver St John Gogarty
• Keats
• Chekhov
• Maugham
• WC Williams

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Stigmatization

• John Updike
• From the Journal of a Leper.
• Am J Dermatopathol 19824(2)137-42

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Homelessness

• Doris Lessing
• An Old Woman and Her Cat
• From the Doris Lessing Reader (New York Knopf,
  1988)

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Race and Access to Care

• Ernest J Gaines
• The Sky is Gray
• in Gray, Marion Secundy, ed. Trials,Tribulations,
  and Celebrations African American Perspectives
  on Health, Illness, Aging and Loss. Yarmouth,
  Maine Intercultural Press, 1992

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Poverty

• Orwell, George. How the Poor Die. In Sonia Orwell
  and Ian Angus, eds. The Collected Essays,
  Journalism and Letter of George Orwell, IV In
  Front of Your Nose, 1945-1950. New York
  Harcourt, Brace and World, Inc pp.223-233.
• Eighner, Lars. Phlebitis At the Public Hospital.
  In Travels with Lizbeth. New York St. Martins
  Press, 1993.

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Domestic Violence

• Michael LaCombe
• Playing God
• In LaCombe M, ed. On Being a Doctor.
  Philadelphia American College of Physicians, 1994

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Human Subject Experimentation / Human Rights
Abuses

• Shusaku Endo
• The Sea and Poison
• (New York Taplinger Publishing Co., 1972)

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Conflicting Responsibilities of Physicians

• Pearl S. Buck
• The Enemy
• In Far and Near Stories of Japan, China, and
  America (New York The John Day Company, 1934)

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Famous Novels of War and Peace

• War and Peace, Tolstoy
• Red Badge of Courage, Crane
• All Quiet on the Western Front, Remarque
• Johnny Got His Gun, Trumbo
• A Rumor of War, Caputo
• A Canticle for Leibowitz, Miller

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Christopher ColumbusUpon meeting the Arawaks of
the Bahamas

• Theybrought usmanythingsThey willingly
  traded everything they ownedThey do not bear
  armsThey would make fine servantsWith fifty men
  we could subjugate them all and make them do
  whatever we want.

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John Wayne

• I don't feel we did wrong in taking this great
  country away from them. There were great numbers
  of people who needed new land, and the Indians
  were selfishly trying to keep it for themselves.

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Josef Stalin

• The death of one man is a tragedy. The death of
  millions is a statistic.

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Horace Odes (III.2.13)

• Dulce et decorum est pro patria mori
• It is sweet and fitting to die for ones country

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"Dulce Et Decorum Est"Wilfred Owen, 1917-18

• In all my dreams, before my helpless sight, He
  plunges at me, guttering, choking, drowning.
• If in some smothering dreams you too could pace
  Behind the wagon that we flung him in, And
  watch the white eyes writhing in his face, His
  hanging face, like a devil's sick of sin

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"Dulce Et Decorum Est"Wilfred Owen

• If you could hear, at every jolt, the blood
  Come gargling from the froth-corrupted lungs,
  Obscene as cancer, bitter as the cud Of vile,
  incurable sores on innocent tongues,- My friend,
  you would not tell with such high zest To
  children ardent for some desperate glory, The
  old Lie Dulce et decorum est Pro patria mori.

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2009 Federal Budget2.65 trillion
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Dwight D. Eisenhower

• Every gun that is made, every warship launched,
  every rocket fired signifies, in the final sense,
  a theft from those who hunger and are not fed,
  those who are cold and not clothed.

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Martin Luther King, Jr.

• Our only hope today lies in our ability to
  recapture the revolutionary spirit and go into a
  sometimes hostile world declaring eternal
  hostility to poverty, racism, and militarism.

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Martin Luther King, Jr.

• Darkness cannot drive out darkness only light
  can do that. Hate cannot drive out hate only
  love can do that.

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Mothers Day Proclamation, 1870Julia Ward Howe

• Arise then...women of this day!Arise, all women
  who have hearts!
• Say firmly"We will not have questions answered
  by irrelevant agencies,Our husbands will not
  come to us, reeking with carnage,For caresses
  and applause.

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Mothers Day Proclamation, 1870Julia Ward Howe

• Our sons shall not be taken from us to
  unlearnAll that we have been able to teach them
  of charity, mercy and patience.
• From the bosom of a devastated Earth a voice
  goes up withOur own. It says "Disarm! Disarm!

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Mothers Day Proclamation, 1870Julia Ward Howe

• Let women
• promote the alliance of the different
  nationalities,The amicable settlement of
  international questions,The great and general
  interests of peace.

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• W Eugene Smiths Photos of Minimata Disease

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• More W Eugene Smith Photos

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• Sebastiao Salgado
• Photos

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Gold MiningThe Reality
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Suggestions

• Use literary selections, photography, and art in
  courses and community work
• Interdisciplinary education
• Share stories with colleagues, patients/clients

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Suggestions

• Create dedicated reading and writing groups, art
  groups
• Comedy
• Encourage conferences
• Read activist journals

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Nurse Margaret Sanger

• Books have been to me what gold is to the miser,
  what new fields are to the explorer.

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First they came for the Jewsby Pastor Niemoller

• First they came for the Jews, and I did not
  speak up, for I was not a Jew.
• Then they came for the communists, and I did not
  speak up for I was not a communist.
• Then they came for the trade unionists, and I did
  not speak up, for I was not a trade unionist.
• Then they came for me, and there was no one left
  to speak up for me.

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Günter Grass

• The first job of a citizen is to keep your mouth
  open.

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Anita Roddick

• "If you think you are too small to have an
  impact, try going to bed with a mosquito in your
  tent"

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Contact Information

• Public Health and Social Justice Website
• http//www.phsj.org
• martindonohoe_at_phsj.org