A health emergency is no time to sideline the medical humanities

As I write, a coronavirus epidemic in Wuhan has spread to 28 countries, and the World Health Organisation has declared the outbreak a public health emergency of international concern. But while colleagues in the medical faculty of the University of Hong Kong, where I work, rush to lend their expertise, across campus it’s a different story.

In arts and humanities, the non-medics are battening down the hatches, waiting for the next bulk email advisory from the university’s Task Force on Infectious Diseases. The humanities look in, while medicine looks out. After all, what use is a humanist when a fever is raging in the house?

Crucially important, I would argue. The humanities vanish from view at the very moment they are most required. So many facets of the coronavirus outbreak lie beyond the technical scope of biomedicine: from the social world of the Huanan Wholesale Seafood Market in Wuhan, where the novel virus reportedly emerged, to the panic that China’s urban lockdown has induced.

There’s also the politics of the epidemic. At the Hong Kong government’s first press conference on 25 January, the initial decision to keep open the territory’s borders with mainland China was justified on the grounds that public health measures ought to be based on science, not politics. As Groucho Marx allegedly quipped, “politics is the art of looking for trouble” – and no one’s looking for trouble when the main concern is staying alive.

Except, of course, politics isn’t detachable from science: from the pressures that come with funding to the institutional settings that shape research and development; from jostling national and international interests to competing local, regional and national agendas that influence policy. Health, and the science that underpins it, are intrinsically political because they are influenced by political decisions.

None of this has been lost on a jittery Hong Kong public. After all, why did authorities on the Chinese mainland cite the very same science to shut down Wuhan and other Chinese cities? And why, many are asking, did Carrie Lam, Hong Kong’s chief executive, crack down hard on those protesting against a colonial-era ordinance that enabled the banning of face masks (used by protesters in the recent anti-government demonstrations to conceal their identities, protect themselves against tear gas and demonstrate their defiance) while choosing to take a much softer approach when it comes to the coronavirus epidemic?

Then there’s the elephant in the room: China’s one-party rule. And the WHO’s reluctance on 23 January to declare an emergency, even though it was evident that the virus had gone, well, viral. Not to mention the WHO director-general’s effusive praise of the “extraordinary measures” China has taken to contain the outbreak: measures that have manifestly failed to contain the infection. The outpouring of anger over the death of Li Wenliang, a doctor who was punished for trying to raise the alarm about coronavirus in December, has only reinforced the point.

Politics isn’t extraneous to the coronavirus outbreak. It is integral to how it is unfolding, and, as such, to how events should be understood and managed.

An interdisciplinary approach focused on the big picture is urgently required to make sense of biomedicine’s worldliness and disease’s entanglement with social and political processes. This was the rationale for creating the Centre for the Humanities and Medicine at the University of Hong Kong. Here, historians, anthropologists, epidemiologists, microbiologists and others collaborate on research to better understand the drivers of emerging infections and the role that social and cultural factors play in epidemic events: from the challenge posed by panic to the social ramifications of advanced communication and monitoring technologies in disease surveillance.

Interdisciplinary work between the humanities and medicine is often broadly categorised as the medical humanities. As they are currently configured, however, the medical humanities fall far short of meeting the task. In many institutions, they are viewed primarily as a means of enhancing medical education. Mandatory or elective humanities modules are introduced into the clinical curriculum with the aim of cultivating new humanistic skill sets in doctors. Traffic is exclusively one-way, with the humanities conceived as delivering added value to medicine. And while the medical sciences are informed by research, the medical humanities, in contrast, are often research-light.

The medical humanities tend to deal with institutional concerns: with the mitigation of doctor burnout, or with ensuring better, empathetic doctor-patient relations. These are important concerns, to be sure. But they are not enough. As medicine becomes ever more technical, with public health increasingly slanted towards epidemiology and reliant on mathematical modelling, the social and cultural determinants of health are sidelined. The scope of what was once called “social medicine” shrinks, and its value fades.

The humanities must reclaim the social in medicine, reorienting it towards the vital socio-economic and cultural issues that impinge on health and well-being: inequality, poverty and discrimination. Reimagined in this way, the medical humanities would help develop a deeper all-round education for students in both medicine and the arts, and also help to make the humanities more radically outward looking.

There is no better time for rethinking assumptions than in the midst of a viral storm, when the corollaries of history and politics are everywhere apparent, but everywhere denied.

Robert Peckham is MB Lee professor in the humanities and medicine, chair of the department of history, and founding director of the Centre for the Humanities and Medicine at the University of Hong Kong. He is the author of Epidemics in Modern Asia (Cambridge University Press, 2016).