Conference Report: Doctor, doctor: Global and historical perspectives on the doctor-patient relationship

Rebecca Fallas, Visiting Research Fellow, Classical Studies (Open University) and History and Philosophy of Science (University of Leeds).

‘Doctor, doctor: Global and historical perspectives on the doctor-patient relationship’ was a one-day symposium held at St. Anne’s College, University of Oxford. The remit of the conference was wide with the organisers aiming to showcase aspects of the doctor-patient relationship not only in different geographical areas but also in different historical and sociological contexts. In this the day definitely did not disappoint. The conference brought together around 70 delegates from many different disciplines including Medicine, Biomedical Sciences, Classics, History, Anthropology, English, French, Literature, Psychology to name but a few.

The keynote address by Anna Elsner (Zürich) titled ‘Four models of the physician-patient relationship? A literary perspective’ introduced not only the four models of the doctor-patient relationship (informative, interpretive, deliberative, and paternalistic) but also some of the wider themes that would continue to be discussed throughout the day. Within the paper Elsner discussed Simone de Beauvoir’s Une mort très douce in which the author describes that final weeks of her mother’s life as she succumbed to intestinal cancer in 1964. This fascinating account, brought to life by Elsner, showcased many relationships between medical professionals and not only the patient but also their families. I say medical professionals here because it became clear that in addition to doctors there are also interactions with nurses and other hospital workers both with the patient and each other. There are also the relationship between patient and their families to be considered. One of the things I took away from the keynote and other discussions from the day was that there is rarely only two participants within the doctor-patient relationship and that those on the periphery, such as nurses and family members, have great influence over how such a relationship plays out.

Over the course of the day there were 32 papers spread over four panel sessions with papers exploring many different aspects of the doctor-patient relationship from both the practitioner’s viewpoint and that of the patient. Parallel sessions are always a blessing and a curse as it means a much wider range of papers and research can be presented but there is always the difficulty of choosing between attending different papers. Invariably I found myself making the final decision of which session to attend only minutes before the session was due to start which is a testament to the range and quality of the papers on offer. This means, of course, I can only offer views on the papers I attended and the discussions I had with other delegates.

The panel ‘Medicine and Material Culture’ focused on the relationship between medicine and objects and space. Olga Sotliarova (Moscow) and Melissa Dickson (Oxford) both explored the use of technology in the doctor-patient relationship. Also in the panel was Harriet Barrett Dorling (Sussex) who looked both technological and non-technical objects involved as well as the space in which the doctor-patient relationship takes place. What became clear in this panel is that doctor-patient relationship is influenced by not only the participants but also the objects involved and the spaces such encounters take place.

In the panel ‘Medical Practitioners: Knowledge, Power, and Professional Identity’ it became clear that the identity of the health care professional themselves is not straightforward. Ian Sabroe (Sheffield) discussed the doctor’s identity – as a physician, writer, parent, spouse as well as a patient themselves. Emmylou Rahtz (Exeter) explored the UK healing movement which includes techniques such as energy healing and Reiki. Rahtz focused on the relationship between ‘healer’ and ‘healee’ once again it was clear that although we talk about the ‘doctor-patient’ relationship that actors involved can be a lot wider than the name suggests. Rahtz discussed was some of the responses in a study talking to those who considered themselves as healers – one of the things that struck me was that the healers themselves gained from the healing process of their clients. These papers emphasised that although we tend to focus on either the story of the patient or the professional aspects of the doctor when discussing the doctor-patient relationship there is also a story to be told of the medical professional themselves and what their experiences both inside and outside of medicine bring to the encounter.

The ‘Early Modern Medicine’ featured two papers Carolin Schmitz (Valencia) discussing patient and healer identities in Early Modern Spain and Lauren Kassell (Cambridge) talking about the Casebooks Project (http://www.magicandmedicine.hps.cam.ac.uk/). Although in essence very different papers what this panel showcased was the range of evidence that can be used to look at historic accounts of the doctor-patient relationship. Schmitz utilised among other sources the archives of the Spanish Inquisition in which there are details of trials of physicians including patient testimonies which provide a fascinating account of Early Modern medicine.  Kassell’s evidence of doctors notes could be described as more traditional in that when looking at later historical periods case notes often form a basis for discussion. However, case books from the 16th century are quite rare and those of Simon Forman and Richard Napier which form the basis of the collection are particularly rich in detail.

Somewhat unusually for a medical humanities event when giving my own paper I found myself on a panel with two other Classicists. The papers in our panel included my own on infertility in the Hippocratic texts as well as Nikolas Hächler (Zurich) and Ben Cartlidge (Oxford) who spoke respectively on Galen and the doctor in ancient comedy. Even though all the speakers were Classicists it was clear once again that many different approaches could be taken within our own discipline. Whether examining the medical texts themselves or looking exploring the wider literary sources such as ancient comedy and though on first glance very different papers they could be brought together to gain a wider understanding of the patient in the ancient world.

It was evident from discussions throughout the day and the closing remarks that the symposium was just the start of new conversations and research on the doctor-patient relationship. The organisers discussed developing a research network on the doctor-patient relationship and holding regular seminars exploring this area. There will continue to be posts, such as this one, on the conference website giving different perspectives on not only the ideas which came up on the day but also future research. The organisers also discussed a possibility of a publication based on papers at the conference.

I would like to take this opportunity to extend my thanks once again to the conference organisers Alison Moulds and Sarah Jones for putting together such an excellent conference. Also to St. Anne’s College for hosting this event and providing the perfect space for such interesting conversations to happen. I would also like to thank all the speakers and delegates at the conference for sharing their research and experience not only in the panel sessions but also in informal conversations over lunch and at breaks. The discussions I had on the day will have an impact not only on my understanding of the doctor-patient relationship in different historical and social contexts but also in my own research on the topic in the ancient world for a long time to come.

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