I continue to read experiments from the various branches of psychology. And they continue to mystify me. Who do they apply to? What is one to make of these generalizations derived from incomprehensible statistical analyses? When examined closely, the differences between conditions or individuals are due to multiple factors and relatively small, albeit statistically significant. What kind of game is this statistical analysis anyway? When I find myself pondering these questions, I often turn to the work or Robert Coles. Coles is one of those rare individuals who combine a deep appreciation and knowledge of literature with his work as a physician, social researcher, and child psychiatrist. A recipient of one of the first MacArthur genius awards, he is the author of over eighty books and is Professor of Psychiatry and Medical Humanities at the Harvard Medical School.
For years Coles has taught a legendary course on the relationships between literature and the practice of medicine. He attributes his life-long interest in this topic to the work of the poet and doctor William Carlos Williams who became a close friend while he was a medical resident. In an interview Coles said, “I became so impressed with the dual life he lived as a physician and as a writer/social observer of sorts that I thought maybe I’d give it a try myself.”
In Times of Surrender Coles writes about his friendship with Williams and how it led him to realize the inherent affinity between medicine and literature—their common interest in the concreteness of particular human experience. Williams had written
“The abstract, categorical mind can be wonderful…But we‘ve got to keep a close check on all that....The doctor treating a patient out there on the front line falls back on himself…and he has to come to terms with not only a disease but a particular person: this patient, not patienthood, not lungs, in general, or kidneys or hearts in general, but one guy, one gal, one kid who has some trouble and is handling it in a way that may be different than anyone else’s way!”
And in his own work, Coles has emphasized he uniqueness of each individual; that variation is ever-present in the work he does. He put it this way, “I’m constantly impressed with mystery, and maybe even feel that there are certain things that cannot be understood or clarified through generalizations, that resolve themselves into matter of individuality, and again, are part of the mystery of the world that one celebrates as a writer, rather than tries to solve and undo as a social scientist.”
This is why he and other physicians have turned to literature and to writing about the lives of particular individuals, whether in a work of fiction as in Chekhov, Walker Percy and recently Rivka Galachen or non-fiction, as exemplified in the recent articles and books of Jerome Groopman and Autul Gawande, both of whom I have written about in this blog.
Doctors often write well because they never loose sight of specific patients and the way they express their illness. In his essays, Groopman has reminded us how our current medical beliefs are subject to qualification and often refutation. This is often the case with comparative research studies (clinical trials), whose findings may be relevant to some patients but not to others. These studies usually fail to pinpoint those to whom it applies and those to whom it doesn’t.
In reading literature we get to know a person as an individual, not an example of a personality dimension or character type. Quite often we get to know them better than the so-called real people we know or read about in research reports. In Reading Chekhov, Janet Malcolm wrote, “We never see people in life as clearly as we see the people in novels, stories, and plays; there is a veil between ourselves and even our closest intimates, blurring us to each other.”
And we don’t have to worry if their lives follow a common pattern or theoretical prediction. Their life is its own truth--unique and non-replicable.
