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Dr. Rafael Campo spoke to the Hamilton College community in a lecture titled "Fact Versus Truth: Examining Health Disparities through Diverse Illness Narratives" on Thursday, Sept. 27. Campo argued that literary works may have equal or greater power than traditional biomedical knowledge to understand and treat illness. 

Campo came to the mixture of narrative and medicine through personal experience: he majored in English and neuroscience at Amherst College and took a brief absence from Harvard Medical School to pursue creative writing. In addition to medical practice at Beth Israel Deaconess Medical Center in Boston and teaching at Harvard Medical School, he has written several works of poetry that have earned him numerous awards (including a Guggenheim fellowship) and have been published in The Best American Poetry 1995 and The New York Times Magazine. Campo said that his interest in poetry arose from his cultural heritage as a Cuban-American, and believes that joining the two disciplines of literature and medicine "enriched [his] work in both areas." 

The lecture was presented as a colloquium, in which audience members presented their own perspectives on literary works that Campo distributed. Campo first asked the audience to consider the literature, a collection of poems and short passages about illness, in light of the "tension, if you will, [of] fact versus truth" that he perceives between biomedical and "biocultural" narratives. According to Campo, while medical narratives provide objectivity, they may ignore the social context of illness (such as disparities in access to health care) and "frustrate understanding" for patients by employing highly technical language. Furthermore, medical explanations for problems may be distrusted by segments of the community, such as African-Americans who remember the unethical Tuskegee Experiments (where African-American men went deliberately untreated for syphilis) or the gay community remembering the 1980s when AIDS went unchallenged by authority figures. While Campo stated that he did not "want to pit medicine against art," he held that literary narratives can better convey the experience of illness and can help bridge the gap between culture and medicine. 

The discussion of literary works that followed provided support for Campo's claims. The first work, "Poem" by Frank O'Hara, discusses the collapse of famous actress Lana Turner from alcoholism. Campo traced the tension between factual and metaphoric content in the work, pointing out that the poem resolved into an empathic transformation that conveyed more "truth" than the mundane "fact" of Turner's condition. 

The next work, an excerpt from the essay "Last Things" by Debra Spark, described the death of Spark's sister from breast cancer and the reactions of her family. This narrative displayed the contrast between human and medical perspectives on an illness; for example, Spark describes her physician father repeatedly checking her sister's X-rays in an effort to disbelieve her sister's condition. Thus, the father's actions illustrate the human impulse to disbelieve hurtful facts, a perception that medical research would fail to resolve. 

Spark also brings up the different experiences of breast cancer as felt by women patients and by doctors, by evoking the seminal work on women's health, Our Bodies, Ourselves, which was contested by medical professionals as trespassing on their expertise. Thus, the essay comments on the experience of illness beyond simple diagnoses. 

The third work, from the biography My Own Country by Abraham Verghese, discusses the experience of medical knowledge as modified by culture. Verghese was a doctor in a small Tennessee town, and he describes a locally based medicine in which all patients were known by name and medical conditions were identified in colloquial terms (such as calling cirrhosis "roaches in the liver" or anemia "low blood"). Campo commented that this poses "questions" about the effectiveness of the standard biomedical narrative, in which patients are treated in a "generic" fashion and are asked to learn the doctors' language for medical conditions rather than expressing conditions in their own terms. 

Finally, "Cancer Winter" by Marilyn Hacker is a poem that conveys a different sense of death than biomedicine assumes. In the poem, the speaker makes a plea to cancer to preserve her life until she is ready to die and accepts the changes of cancer in her through natural imagery. Campo contrasted this accepting perspective, only asking to survive, with the biomedical view that always seeks a cure and "pits patient against disease" in a moral battle of "good doctor against bad cancer." He elaborated that "ending isn't always in a biomedical cure," and Hacker's poem shows the power of imagination to transform terminal cancer into a livable experience rather than viewing the disease as a loss. Biomedical doctors, Campo said, often "disappear at that juncture" in which only palliative care is possible, whereas narrative resists the tendency to give up. 

In questions after the presentation, Campo further elaborated on the power of narrative to physically heal. He cited a study in the Journal of the American Medical Association in which patients who wrote expressive journals about their illnesses (including serious conditions such as arthritis) actually improved their physical condition, and he suggested there is evidence that cancer may react well to "positive metaphoric thinking." Furthermore, he pointed out that narration is important for its ability to break down the isolation between a patient and a doctor. Through literary examples, Campo presented a compelling case for his overall goal—a greater marriage of medicine and art. 

--by Kye Lippold '10

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