Keeping body and soul together
For one doctor, history and the other humanities are a vital part of medicine.
If you type the name “Halperin EC” into the medical journal search engine PubMed, the results—nine pages worth—seem to be the works of different authors. There are articles about brain tumors and radiation treatments. But then there’s one about the theft of the bodies of African Americans for anatomy classes in the late 18th and early 19th centuries. There is one entitled “The pornographic anatomy textbook?” And there is “Should academic medical centers conduct clinical trials of the efficacy of intercessory prayer?” All were written by Edward C. Halperin, M.A., M.D. ’79, a pediatric radiation oncologist, dean of the School of Medicine at the University of Louisville, Ky., and a passionate devotee of the liberal arts.
“Physicians like to be convinced that they’re rarified and scientific,” Halperin said, “but medicine is a social activity that takes place in the context of its times.” Knowledge of the cultural, historical, and philosophical underpinnings of medicine, he believes, is central to medical education. When he became dean at Louisville in 2006, Halperin instituted three compulsory humanities classes for medical students—Intersection of Religion and Medicine, History of Medicine, and Literature in Medicine—and helped start a joint M.D./M.A. in medical humanities there. He earned a master’s in liberal studies himself while at his previous post as vice dean of Duke University’s School of Medicine, attending classes like The Human-Animal Boundary, Travel Writing in the Ancient World, and South African History.
For his master’s thesis on drug screening of medical residents, he asked doctors-in-training at Duke whether they thought drug tests violated their civil rights. They didn’t, it turned out. “Interns and residents are so acculturated to jumping through hoops, that if you say ‘Urinate in the cup,’... They say, ‘Which way is the bathroom?’ ” He is troubled by evidence that criminal background checks on medical students are racist—minor crimes like marijuana possession can lead to very different consequences for minorities as opposed to affluent whites. And he is leery of medical students doing “audition electives” at faraway hospitals in the hopes of matching at competitive residencies, since the inherent expense discriminates against less affluent students.
A native of Somerville, N.J., Halperin developed a passion for ethics and human rights in childhood. He idolized lawyers, including a relative who sat on New Jersey’s Supreme Court, as well as then-Justice Department lawyer Nicholas Katzenbach. Katzenbach’s 1963 “schoolhouse door” confrontation with Gov. George Wallace, who opposed desegregation at the University of Alabama, deeply impressed Halperin. After seeing photos of the event, he decided to become a civil rights lawyer. Eventually, though, he realized that most lawyers don’t wind up on supreme courts or engaged in historic civil rights struggles. “I might end up having to do parking tickets, divorces, house closings,” he remembers thinking. “That might not make a really big difference in society.
It was then that Halperin turned to medicine. He chose radiation oncology in part because he felt it was one of the most consequential, high-stakes things a doctor could do. He trained at Stanford and at Massachusetts General Hospital and is now an authority on childhood cancers.
The patients Halperin cares for are indeed those who force doctors to think about whether the world makes sense. “Doctors have a lot of rationalizations that get them through the day,” he said. A long-time smoker with untreated hypertension who has a stroke, or a woman with cervical cancer who had dozens of sexual partners and never got a Pap smear may prompt a doctor to privately rationalize that the patient’s irresponsibility is to blame. “But there’s nothing to blame when a 7-year-old has leukemia,” he said. “Children with cancer bring up the problem of evil.”
Medicine and the humanities are part of the culture of Halperin’s family. His wife, Sharon, and his eldest daughter, Rebecca, are physical therapists; the two of them recently volunteered their expertise in Nicaragua. His middle daughter, Jennifer, works in fashion as a dress buyer for Victoria’s Secret, while his youngest, Alison, is a senior at Barnard College and studies limb injuries and artificial limbs during the Civil War.
That interest in medical history is part of the cultural legacy Halperin tries to impart to his students. One of his most remarkable articles concerns a 1971 anatomy textbook that included chauvinist remarks and photographs of women in an alluring pin-up style; the textbook met with outrage and was withdrawn soon after publication. “The story of discrimination against blacks and Jews and Catholics and women is part of the story of medicine, and is worth telling,” he said. “If we fail to tell these tales and remember our history, we’ll be the worse for it.”