I can't imagine doing medicine without humanities. For me, they're inseparable.
Lillian Wieland (Brown College ’22) sees health care and the humanities as inexplicably intertwined. As a philosophy major with minors in biochemistry and medical humanities on the pre-med track, Wieland has crafted a dynamic interdisciplinary education that reflects the social awareness and flexibility expected from 21st-century doctors.
Years before she was getting hands-on experience in the Texas Medical Center and winning back-to-back awards at Rice’s annual Undergraduate Research Symposium, Wieland was introduced to the world of medicine when she learned about bioethical arguments surrounding organ donation in her high school debate club.
“I got into philosophy and medicine at that same time, they felt very connected to me from the beginning,” Wieland says.
However, these ethical debates surrounding palliative or “end-of-life” care were not just restricted to debate club meetings. The issue became personal when an ailing family member expressed a desire to voluntarily die with physician assistance, but could not due to laws prohibiting physician-assisted suicide. At the same time, another member of Wieland’s family who has a disability expressed concern that legalizing physician-assisted suicide could pose dangers for vulnerable populations.
As she grappled with these opposing perspectives, Wieland decided to dive deeper into the issue. This deeply personal inquiry opened the door to a world of ethical questions surrounding end-of-life experiences, which she continued to explore as she entered Rice. After declaring her philosophy major and choosing to pursue the pre-med track, Wieland soon discovered the medical humanities minor in the School of Humanities, an interdisciplinary program that lay at the nexus of her dual interests in health care and philosophy.
Wieland honed in on palliative care, a medical field which she says is particularly open to humanistic approaches. According to her, this particular specialty is not necessarily about achieving a certain outcome, but rather paying attention to the feelings behind the diagnosis. Palliative physicians, Wieland says, often have an eye for the non-medical things that matter to their patients.
“At the end of life, you're going to try to control pain and alleviate symptoms, but you're not trying to stage an intervention that's going to prolong [the patient’s] life,” she says. “Science sometimes fades a little to the background and you start to deal with those aspects of spirituality, for instance, that start to matter so much more.”
Wieland says her most profound experiences in the medical humanities program were the opportunities she had working with professional physicians. By enrolling in the medical humanities practicum course MDHM 430: Health, Humanism, and Society in her sophomore year, Wieland was connected with the Institute for Spirituality and Health at the Texas Medical Center. As an intern with the institute, Wieland says she had a profound experience learning how humanistic studies of spirituality are translated in real-world clinical settings.
The following academic year, Wieland enrolled in Health, Humanism, and Society Scholars practicum, at which time she was connected with Texas Children’s Hospital physicians Amanda Ruth and Daniel Mahoney. Wieland worked with Ruth and Mahoney to write a research article titled “Against Constraint: The Freedom of Liminality at the End of Life,” which was published in the scholarly journal Departures in Critical Qualitative Research in 2021. The article examines the consequences of categorizing the death of a loved one in a dichotomy of “good” or “bad” and advocates for a “meaning-making approach” that broadens conversations about how suffering, life, and death can be transformational in positive ways.
“The practicum classes are amazing. I'm just blown away by how much I've gained in those experiences.”
Wieland is currently juggling several projects that expand on her previous work. The first is a collaboration with the Independent Living Research Utilization program, which aims to expand and disseminate knowledge on independent living, to identify barriers for students with disabilities entering medical careers.
She is also working on finding ways to educate health care providers on navigating end-of-life religious rituals so they may better address their patients’ spiritual wishes. Finally, she is expanding her work on storytelling ethics, which has to do with how people should be respectfully represented within narratives.
Like her interest in palliative care, Wieland’s interest in storytelling ethics emerged in a personal context. Reflecting on what she had learned about narrative ethics in her philosophy courses at Rice, Wieland realized that she had used a story about her uncle’s death in a personal statement without honoring the dignity of her uncle and his story. Wieland found herself approaching this personal misjudgement through the lens of intellectual philosophical analysis rather than a gut reaction of shame, and reflected on the experience in a post on the Medical Humanities blog. Wieland plans on expanding this initial work into a full-length article which will use philosophy to explore how stories can be told while honoring the people whom those stories represent.
As she begins to contemplate life after Rice, Wieland is intent on continuing her research on death and dying, meaning-making and telling stories about the end of life. She says she is considering programs that recognize the value of humanistic medicine and provide pathways for pursuing both medical school and a master’s humanities degree. Wieland says that no matter where she goes, she is determined to keep the humanities a part of her life and seek out collaborators who recognize the inseparability of health care and human care.
“I could never be a physician without first considering humanities. You take the humanities out of medicine, and it's not medicine anymore.”