Should medical humanities be a multidisciplinary or an interdisciplinary study?

These eminently practice-centred objectives require, of course, to be approached in the spirit of what we might call ‘‘interdisciplinary theory’’, that is, theoretical reflection on interdisciplinarity. Interdisciplinarity is perhaps easier to claim than it is to demonstrate, and putatively interdisciplinary work frequently turns out to be merely multidisciplinary, in the sense of involving relatively disconnected contributions from different disciplines—contributions which, taken in isolation, exhibit no real trace of contact with any other discipline beyond their own. Too often one attends discussions that consist in a succession of speakers presenting essentially discipline based perspectives, with little or no genuinely crossdisciplinary dialogue among them. Medical humanities requires, however, that we attain more than this, for reasons including those that are set out below. The forthcoming conference is, therefore, both timely and important; its objectives moreover are challenging. For instance, in considering ‘‘the interface between medicine, health care, and a range of humanities disciplines’’ we need to ask whether the interface is a single meeting point of all the disciplines involved or whether a number of different shared boundaries might be involved. Would those sharing a boundary all recognise it to be a boundary, and would they see it in the same terms, for instance, with curiosity, suspicion, lack of interest, bafflement, distaste? Do the parties agree where the boundary lies or might there be contested territory (such as whether a clinical question is wholly the preserve of clinicians or whether its ethical dimensions legitimate the scrutiny of theologians, sociologists, and philosophers)? Again, a ‘‘context in which professionals from a variety of backgrounds can exchange ideas and experiences’’ must be one that supports at least a partly shared understanding of those experiences, and of the terms in which they are to be reported. This requires some common vocabulary, or at least the hope that such a vocabulary may be sought; but we cannot assume this, and apparently simple terms such as ‘‘population’’, ‘‘text’’, and ‘‘duty’’ are all capable of tripping up discussion where the contributors’ disciplinary backgrounds variously include, say, public health, ethnography, history, nursing, and philosophy. Moreover—as we shall explore in greater detail below—terms which have an apparently descriptive meaning within a particular discipline may seem clearly, even extravagantly, metaphorical to the outsider (think of gene ‘‘transcription’’, ‘‘messenger’’ RNA and—in immunology—‘‘helper’’ cells, for instance). It is in recognition of these perhaps taxing requirements of genuine interdisciplinarity, then, that we raise the question in this editorial’s title: should medical humanities be multidisciplinary or interdisciplinary? For many readers the answer is, clearly, ‘‘Both’’. Other readers may wonder, ‘‘What is the difference in practice’’ and ‘‘Does it really matter’’. The nature of interdisciplinarity was explored in Howard Brody’s keynote talk at last year’s Association for Medical Humanities conference in which he reflected on the process he and his four coauthors went through to write Cholera, Chloroform, and the Science of Medicine: A Life of John Snow. In writing this biography the team wished to address how Snow managed to excel in both scientific anaesthesia and epidemiology. Their approach was to bring together disciplinary experts in medical practice, epidemiology, history, and biography. Each author drafted appropriate chapters from his own disciplinary perspective then over a period of five years the chapters were revised four times with input from all five coauthors. In the course of this laborious process each coauthor received what Brody called a ‘‘mini-apprenticeship’’ in the others’ disciplines. The result, they hoped, was a book in which the insights on Snow’s achievements were the more revealing and truthful, coming as it did from a real engagement with his own interdisciplinarity. Brody used this example to make the case for medical humanities as a field which should be characterised by this kind of interdisciplinary study and practice. What exactly is meant by interdisciplinarity, however, and how is it to be distinguished from multidisciplinarity?