Popular Books Give Residents Door to Human Condition

Something’s the matter. What’s the matter?, she asked herself. She didn’t know what she looked like and was not curious. But suddenly she saw her hands and thought with a clarity as simple as it was dazzling: “These hands belong to me. These are my hands.” Next she felt a knocking in her chest and discovered something new: her own heartbeat.

    —From Beloved

    By Toni Morrison

On a journey to freedom in the aftermath of the Civil War and emancipation from slavery, Baby Suggs—the central character in Morrison’s 1987 novel—has experienced an epiphany that will prove to be a signal event in her spiritual reawakening. It is a story that readers everywhere have resonated with for its powerful narrative of rejuvenation in the aftermath of a desolating experience.

But for psychiatry residents at Harlem Hospital, who read the work as part of the innovative Integrative Psychiatry Journal Club, Beloved is also an instructive text on the pathologies—and the possibilities for triumph over those ills—of the patients they will treat as psychiatrists.

Henry L. McCurtis, M.D., acting director of psychiatry and director of psychiatry residency training at Harlem Hospital, told Psychiatric News that the journal club is a unique exercise in blending humanistic and scientific learning for third-year and fourth-year residents. By reviewing popular literature of all kinds—in addition to scientific readings—residents and instructors seek to gain entry into the human condition in a way not possible through medical and psychiatric textbooks alone.

Begun by McCurtis in the 1980s, the Integrative Psychiatry Journal Club has become a tradition. This year’s class of six PGY-3 and four PGY-4 residents has read Grace Edwards’ No Time to Die, James McBride’s The Color of Water, and Possessing the Secret of Joy by Alice Walker, among other works.

What is it that fictional novels can offer to the young psychiatrist that cannot be derived from a standard text?

“I believe that artists are able to look reality in the face and not blink,” said McCurtis. “They are able to take the experience of human behavior and condense it in powerful ways. You can take a patient’s history, but if you have a sense of the poetry of human nature, it gives you a perspective you can’t get from simply trying to master the clinical skills. Literature rounds us out, softens us, and cultivates our empathy.”

Surely, psychiatrists in training and their instructors bring to literature a perspective not typical of the average reader. As an example, McCurtis said, journal club members have read the story of Baby Suggs—and the sudden revelation that she owns her body—as a case study in what their less inventive clinical textbooks describe as posttraumatic stress syndrome.

According to McCurtis, Baby Suggs’s experience and her sudden awareness of the sensations of her own body mirror the psychiatric understanding of dissociation accompanying PTSD and the reintegration that can come with treatment.

“It’s an awakening, a spiritual thawing out,” he said. “It is no different from our understanding of the dissociative phenomena that accompany people who have been traumatized by child abuse or women who have been raped. People can dissociate themselves from the experience by saying, ‘You can take my body, but you can’t take my mind.’ You freeze out experience in order to survive the experience.”

In the novel, McCurtis said, Baby Suggs extends this spiritual thawing out to her fellow former slaves in a strange and marvelous ministry. “She becomes an evangelist of sorts,” McCurtis explained. “She would hold these meetings in the woods, and people would flock there to revel in being together in the context of their freedom. She would take people by the hands and tell them, ‘These are my hands, feel my hands; this is your face, feel your face.’ ”

In other words, McCurtis said, “Become aware of your own body.”

In this way, McCurtis believes the story is a potent allegory for the spiritual “thawing out” that has been the historic experience of all African Americans in the aftermath of slavery.

“The slaves, having had the experience of being beaten, and seeing their children taken away and their relatives killed, develop a dissociative phenomenon where they don’t feel things around them,” McCurtis said.

Olubansile Mimiko, M.D., chief psychiatry resident at Harlem and a journal club participant, said that such a perspective on the history of a community is crucial to understanding individual patients in treatment. Beyond its utility as a device for training psychiatrists, the literature of a given community offers a pathway for discourse with the patient, enabling and strengthening the therapeutic alliance, he said.

“If you are a psychiatrist, one of the richest resources for helping you understand the culture of your practice is the literature of the community,” Mimiko said. “If I pick up a book about life in Harlem by Grace Edwards, that body of information tells me a lot about my patients before I even talk to them.”

Ultimately, the Integrative Psychiatry Journal Club, as its name suggests, is an exercise in biopsychosocial education that seeks to find common ground among the sometimes conflicting perspectives of psychiatry. As McCurtis said, “We attempt to take the biological, psychological, and social paradigms of psychiatry and review various readings, including fiction, to help residents integrate a perspective of psychiatry that doesn’t push them off into different camps.” ▪