Rivista per le Medical Humanities
Mattia Lepori
Maria Rosaria Valentini
rMH 46, 2020, 13-15
What if one autumn afternoon a doctor and a writer...?
A one-to-one – informal and open-hearted – conversation between Maria Rosaria Valentini, author of the novel Il tempo di Andrea (Sellerio, Palermo, 2018) and the medical doctor Mattia Lepori. The leading character of its storyline is Andrea, a man hospitalised because of his sickness who gives voice to the many sick people met by Valentini in different situations. These are not just ordinary sick people, but people with serious diseases who spend months or even years in hospital wards. Andrea – a person, in the first place – finds himself almost enclosed in a cage. Like every patient, he does not only have a human background, but a hospital history as well. Thus, a temporal relationship emerges between before and after the disease. But the time of hope and encounter also emerges, in which life eventually resumes its course. In the intense exchange of opinions between the writer and the doctor, the latter wonders about the daily need, in the hospital profession, to go beyond the established rules, codes and protocols in order to give voice to patients, to know how to listen to them, seizing this opportunity as an unmissable chance for a comparative approach and growth.
Mattia Lepori
rMH 46, 2020, 16-18
Provided that it is good medicine and good story-telling
Two doctors meet: Mattia Lepori, a specialist in internal and emergency medicine, deputy head of the medical section of the Ente Ospedaliero Cantonale, and Marco Venturino, head of the resuscitation and intensive care department at the European Institute of Oncology in Milan and a novelist. The theme of car- egivers and narrative medicine is tackled through the books writ- ten by Venturino, alongside his work as a doctor: among these, Si è fatto tutto il possibile (Mondadori, Milan, 2008), Le possibilità della notte (Mondadori, Milan, 2010), La vita così, all’improv- viso (Giunti, Florence-Milan, 2019). In them Venturino recounts the vicissitudes and daily life of doctors, when they too get sick, crossing over to the other side in the doctor-patient relationship. Private life, however, also emerges in the dialogue, sometimes inseparable from professional life and yet full of doubts, fears and suffering. As a doctor, Venturino claims to be induced to write by his desire to externalise the weight of a beautiful yet dif- ficult profession. Beyond the work in the ward, writing allows us to dig deeper, in search of a meaning that is always hovering on the limit between usefulness and futility, between uncer- tainty and error.
Nicolò Saverio Centemero
Federica Merlo
rMH 46, 2020, 19-25
The white disease. Interview with Andrea Pomella
The interview with Andrea Pomella, a Roman writer born in 1973, focuses mainly on the theme of depression. In his book entitled L’uomo che trema, published in 2018 (Einaudi, Turin), the author tells of his illness, going into the most intimate details. The text is, nevertheless, just the starting point of the dialogue: the questions ranged far beyond, tackling more general issued such as suicide, the use of metaphors to describe disease, as well as the influence of depression on the relationship between the author, his wife and his son. Finally, another book, published by Pomella also in 2018, entitled Anni luce (Add Editore, Turin, 2018) is the subject under debate. It is a coming-of-age novel, a Bildungsroman set at the turn of the 1980s and 1990s whose protagonist is grunge music: a starting point for a deeper insight into the writer’s relationship with music and, in particular, the role the latter has been playing with respect to his illness.
Antonietta Pastore
rMH 46, 2020, 32-35
Murakami Haruki: a writer on his readers' side
The major theoretical paradigms and methods in medicine and public health focus on how and why different diseases affect various human populations throughout history and the ways perceptions of what constitutes health and illness vary greatly, cross-culturally as well as within one particular cultural domain. Overcoming traditional distinctions between biological, psychological and cultural determinants of health and the increasing role that human sciences play in the contemporary debate on health make it urgent to define new training profiles underlining the importance of a new multidisciplinary approach. The authors describe the reasons why this new focus should see conventional practices – “culture” – as key to understanding and enhancing both biological health and human well-being. Furthermore, they show the obstacles to an effective promotion of health and well-being not only at an individual but also at a collective level, suggesting ways to overcome them. They conclude that reframing global/local healthcare in the context of health/well-being establishes health as a “fundamental human right”, reducing health inequity and promoting individuals and populations to lead “a life fully realized”.
Bernardino Fantini
David Napier
rMH 46, 2020, 67-68
A new focus on promotion of health and well-being
The major theoretical paradigms and methods in medicine and public health focus on how and why different diseases affect various human populations throughout history and the ways perceptions of what constitutes health and illness vary greatly, cross-culturally as well as within one particular cultural domain. Overcoming traditional distinctions between biological, psychological and cultural determinants of health and the increasing role that human sciences play in the contemporary debate on health make it urgent to define new training profiles underlining the importance of a new multidisciplinary approach. The authors describe the reasons why this new focus should see conventional practices – “culture” – as key to understanding and enhancing both biological health and human well-being. Furthermore, they show the obstacles to an effective promotion of health and well-being not only at an individual but also at a collective level, suggesting ways to overcome them. They conclude that reframing global/local healthcare in the context of health/well-being establishes health as a “fundamental human right”, reducing health inequity and promoting individuals and populations to lead “a life fully realized”.
Bernardino Fantini
rMH 46, 2020, 69-78
The right to health: from treatment and prevention to well-being promotion
How did the concept of “health as a fundamental right of the person” arise? And what does it mean to promote this right now- adays? The author explains it using his tools, those of the histo- rian, taking the reader back in time and analysing some elements that underlie modern public health (hygiene and health, epi- demics, vaccinations, social determinants of health). Healthcare is a mirror that allows reading the way a society organises itself. The very definition of disease, which is never just a biological or physiopathological definition, incorporates the way society organises itself and the way it relates to natural reality; it is the reflection of values, attitudes and social relations. Although illness as such is an individual phenomenon, its management becomes immediately a social phenomenon. The “right to health”, already acknowledged in the charter of human rights produced by the French revolution, gradually acquires the status of “fundamental right of the person”.
David Napier
rMH 46, 2020, 79-85
Care and health
This article is an “executive summary” of the Lancet Commission on Culture and Health. This Commission is the first ever detailed appraisal of the role of culture in health, bringing together voices from different fields, including anthropologists, social scientists, and medics. Experts review health practices as they relate to culture, identify and assess important issues, and recommend lines of research addressing critical issues and emerging needs. The Commission examines three overlapping domains of culture and health: cultural competence, health inequalities, and communities of care. With reference to these domains, the Commission shows how inseparable health is from cultural perceptions of well-being. David Napier challenges the view that culture can be considered a set of subjective values opposing scientific objectivity, by claiming that all people have systems of value that are unexamined. Such systems are, at times, diffuse, and often taken for granted, but are always dynamic and changing. They produce novel needs, to which established caregiving practices often adjust slowly. Ideas about health are, therefore, cultural, Napier claims. They vary widely across societies and should not merely be defined by measures of clinical care and disease.
Francesco D'Agostino
rMH 46, 2020, 86-90
Well-being and ill-being: preliminary considerations
The article has its starting point in the description of how difficult it is to provide a true definition of well-being, quite an elusive, ambiguous and contradictory theme that seems to be in radical dialectical antithesis with the theme that is at the centre of the Western tradition: the theme of evil, of ill-being, which Christian tradition introduced two thousand years ago into history with such force that not thinking of evil is today absolutely impossible for us. In the Western world, confrontation with evil has followed at least two paradigms. A first paradigm is that of attributing the character of absolute negativity to evil and suffering. A second one is what may be defined as “dialectical”: without denying that pain is the most powerful figure of the negative, it identifies in this dimension of negativity the presence of an extraordinary possibility of openness to good. Suffering thus acquires the value of a path to which every man would be called to achieve a higher level of self-awareness, to transcend a passively biological identity, i.e. ultimately to conquer a fully anthropological identity. To this end, pain should be understood, not accepted. With an elegant and intriguing writing style, quoting Euripides, Tomasi di Lampedusa and – along with much more – even the mind uploading of the transhumanist move- ment, the author of the article accompanies the reader along a path of understanding through the different dimensions of pain in Western society.
Emmanuel Kabengele Mpinga
rMH 46, 2020, 91-99
Health promotion: criticism of a concept and conditions for its implementation
Although the field and practice of health promotion underwent significant developments over the last decades, they have been exposed to the extensive criticism that has arisen in the mean-while, starting with those relating to the concept itself. Based on Rodgers’ evolutionary approach and Rotman’s deconstructivist approach, the study referred to herein is aimed at clarifying the fundamental criticism addressed to the field and practice of health promotion and at identifying the obstacles as well as the conditions for success of the implementation of the related programmes, and finally at outlining the possible prospects for its development. The results of the study show that the concept of health promotion is complex and deserves a clarification as for its use. Four orders of criticism have been identified, namely: general, of sociological nature, drawn from feminist currents, from the humanitarian and human rights sectors, respectively. At the same time, the implementation of health promotion programmes must take into account the general framework within which they are implemented and must be interfaced with the already existing public health programmes. Finally, it is in the reconciliation between science and activism that a culture of Public Health capable of integrating the different social cultures can emerge.
