AMH Truro 2005

Metaphors for Practice: The Art of Healthcare


Psychological research into expertise and decision making demonstrates that experts make judgements under conditions of uncertainty and ambiguity guided by tacit knowledge rather than explicit protocols. Further, tacit knowledge is organised poetically: as metaphor rather than algorithm. It would then make sense to turn to experts in the field of metaphor and image – writers and visual artists in particular – to help doctors and healthcare practitioners make explicit such tacit knowing and to educate facility in use of metaphor.


This conference will reinforce the value of collaboration between medical and healthcare practitioners and practitioners from the arts and humanities, emphasising in particular what the humanities can offer clinicians for their everyday work. The framework for the conference is ‘metaphors for practice’. The title is deliberately ambiguous and can be read as metaphors that describe practice such as ‘artistry’ and ‘connoisseurship’, as well as metaphors used in practice such as a range of visual resemblances used for diagnosis (e.g. ‘strawberry gallbladder’).


Common metaphors for clinical practice drawn from the humanities include practitioner-centred descriptors such as practice ‘artistry’; audience-centred descriptors such as ‘connoisseurship’; dramaturgical descriptors (practitioners as ‘actors’, operating room as theatre); and narratological descriptors (practitioners as storytellers in a particular genre). Medicine has also been compared to sleuthing. These metaphors clash with the dominant professional images of the rational scientist and the rational, bureaucratic manager.


In an exciting and innovative range of plenary presentations, papers and exhibitions, conference delegates will discuss and debate the place of metaphor in medicine and healthcare, the relationship between the humanities/arts and medicine, science as an art and what the arts and medicine may gain from mutual practice. We see this as a pivotal conference in re-defining both what we mean by ‘medical humanities’ and the place of the medical humanities in the medicine undergraduate curriculum. These issues are reflected in our paper themes: medical aesthetics, writing healthcare/ healthcare writing, medical education through the medical humanities, identity construction and governance, metaphors for practice, and performance. Two workshops address key themes involving key stakeholders: first, the strategy of the Arts Council in supporting the relationship between arts and health, including the role of the medical humanities; and second, writing about the medical humanities for medical and medical education journals. Our plenary papers get under the skin of the relationship between the humanities and medicine/healthcare in a critical manner addressing a range of issues: why it matters that we are able to read practice as rhetorical strategy reinforcing professional interests and identities; the relationship between the pen and the stethoscope where doctors can benefit from knowledge of literary practice; understanding of the relationship between the brain and music helping us therapeutically; medical students learning to be more sensitive practitioners through engagement with art practices and visual representations of medicine; medical environments making a difference to practice as they shape identities; and clinicians coping with ambiguity when making judgements.