What I learned from the ‘Medical Humanities’ as a doctor from Japan

Our guest blogger, Japanese surgeon Ryoko Narui, tells us about her experience as an MSc Medical Humanities student at the Centre for the Humanities and Health, KCL

Ryoko Narui with Brian Hurwitz, Director of CHH
Ryoko Narui with Brian Hurwitz, Director of CHH

I was working as a general surgeon in Japan. I mainly operated on cancer patients, such as patients with stomach cancer, colorectal cancer and breast cancer. As there are not enough oncologists in Japan, general surgeons often have to do chemotherapy and radiotherapy before or after surgery. I have met many severely ill patients.

I realized I could not help patients as much as I wanted and I have encountered many situations I couldn’t improve at all. Though I became a doctor because I wanted to help people, I began to feel powerless. My words were often neither what patients expected nor what healed them, but I did not know what to say, they didn’t tell us at medical school. Also, very important decisions (DNAR, artificial nutrition, chemotherapy…) are often left to the doctor, but I was at a loss what to choose in my patients’ interest. Some patients and their families wanted the treatment which medical professionals thought absolutely useless and perhaps vice versa. When many patients and their families often asked me ‘Why me?’ I did not have an answer for that question.

When I was struggling with those issues, I came across the book ‘Narrative Based Medicine’ written by Trisha Greenhalgh and Brian Hurwitz. They maintain that there is a huge gap between  between doctors’ and patients’ understanding of illness and each disease can be understood according to different systems.  Impressed by this idea, I decided to study ‘Medical Humanities’ at King’s College last year, in order to find out what  current clinical medicine (and my own practice) could not explain.

In the MSc, we learned medical history, read various literary works and research about narrative medicine, and discussed the humanities in medicine, which I had never done at medical school in Japan. I could learn a lot from the characters in books and films, who can be models of a vast range of real people. I learned how ambiguous and transient people are, which is so much different from the black-or-white facts of much medical science.

I understand now that the medical humanities try to discover individual truths, while medical science tries to discover generalizable truths. And, to achieve this goal, as compared with medical science which uses plenty of algorithms in diagnosis or treatment, medical humanities use narratives in the broadest sense. Narrative is what gives someone or something a meaning and what could make up for the huge gap between patients’ and doctors’ understandings of illness.

Though I still have unanswered questions, the MSc in ‘Medical Humanities’ has given me many hints to solve complicated and difficult problems in clinical settings. The happiest experience for me was meeting  plenty of people with interests similar to mine. I hope I’ll be able to make the best use of what I have learned in this programme.


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