I had an unsettling realization during my fourth year of medical school. I had forgotten how to read. Not only had I lost track of the how – the mechanics of running my line of sight smoothly past each word, putting them together in my mind to make sense of a sentence – but I had similarly lost the why. Why read? Or rather, why do we as individuals, we as humanity, read? My partner can finish a stack of books in a month; she can finish a book in a day if it is dreary enough. And yet, I find no similar impulse to read within myself, nor do I find any of the same joy.
Throughout medical school, the simple thought of nonmedical reading made me feel overwhelmed. I felt the dread of yet another task to complete and the guilt of not being able to engage life outside of medicine. Most reading in medical school is mandated (or at least feels that way). Each day I was responsible for hundreds and hundreds of unique PowerPoint slides. Imagine collections of cold, pale backgrounds splashed with nauseating walls of monotonous black text. On a good day maybe there would be some poorly formatted clip art or an image with resolution so poor it made me wonder if I needed new glasses. Single slides would amass into a lecture, and lectures would stack together to form a typical day, and the weeks would arrive punctually, and ultimately, I felt as though I were blindly wading into an ocean of knowledge, tasked with counting each and every water molecule, only to realize I had forgotten to account for the rain. How could I? You would forget how to read too.
Feeling obligated to read is itself a troublesome relationship to have with literary works. I recall cleaning out my boyhood room after graduating high school and coming across Seuss’s Oh the Places You’ll Go. A feeling of nostalgia and inspiration coursed through me. Where will I go? The book carried the same words as it always had, yet my shifting stage in life brought new meaning. I was receptive. For the sake of delineation with a risk of over-dramatization, consider someone hearing this book as they are wrongfully sentenced to life in prison. Or consider the birds reciting tales of exploration and odyssey to Prometheus as they pick at his liver. In these cases, there is no choice of receptivity. There is no purpose or intentionality, only dire irony. The reader has not signed the tacit agreement to welcome new worlds. Whereas words under normal circumstances would combine to form a powerful and moving creation, much like Chuck Close would compose Frank (1969) one small grid at a time, a mind coerced to appreciate art will only observe the superficial contents, devoid of depth, devoid of substantial meaning. (Frank may be glossed over as a neat photograph.)
Meaning is in the details. Yet reading as a medical student is about efficiency, about ignoring superfluous details. For example, it may not be necessary to read the wall of text when the last sentence is most likely to be tested. That is to say, can I count the most relevant water molecules, the ones in my immediate surroundings, so that I can at least float and avoid drowning? This likely constitutes the bare minimum of what qualifies as reading. The enjoyment of swimming does not come from the avoidance of drowning, and similarly the enjoyment of reading does not come from only grasping the main plot points. The enjoyment of swimming is in the experience – the waterline that rises and falls on the chest, the clouds above that either welcome or warn, the chilling expanse of the lunar sea floor, the reefs teeming with color, the mystery that lies beneath. Similarly, the enjoyment of reading is in letting the details wash over you.
The style of reading that I adopted in medical school would yield a summary of Tolkien’s The Lord of the Rings trilogy that clocks in at a cool one or two pages. Some sort of small prototypical human obtains an invisibility ring that is the root of all evil. He and some friends decide to destroy it in a volcano. On their journey, they are chased by some ghosts and goblins, the trees are alive with the sound of smashing things, the wizard decides he looks better in white, and the friends realize two breakfasts are better than one. The home team wins a lot of battles before properly destroying the ring, they catch a direct flight home, and the main character decides to celebrate by sailing around the world.
I expect it is clear how ridiculous that all sounds. For meaning is in the details, not the plot points. Meaning is in the human experience of adventure, in the emotional highs and lows that we relate to. Meaning is in the warmth of enduring friendship and the heartbreak of loss. Meaning comes from taking the time to reflect, not from memorizing the plotline. The fact of Frodo’s success is meaningless without knowing how his intimate friendship with Sam underscored the world’s survival. Forget the plot points.
The question becomes, does it matter that medical students are forgetting how to read, or more cynically, that medical students are mandated to forget as a means of survival. Afterall, our patients would rather have calculated, informed logicians than sappy dreamers, right? I do wonder if this deeply flawed thinking is responsible for the societal perceptions that physicians are arrogant, self-assured, poor listeners. I unequivocally feel that it does matter that we are forgetting to read. As we internalize our shortcuts to obtain information, I fear the consequences spill over into our patient encounters. I fear that we instinctively continue our hunt for plot points, missing key details that would reveal three-dimensional narratives from one-dimensional facts.
As much as technology has advanced since human inception, I question to what degree our emotions have evolved. That is to say, is the experience of being human that much different than it was thousands of years ago? Do we experience the emotions portrayed by Homer more or less vividly than he? I would say, “no.” Even if there is a semblance of truth to a universality of human existence across time, the outcome would identify literature as the great uniter – untold volumes of joy, suffering, hope, and despair.
I am reminded of one of Sigmond Freud’s famous disciples, Carl Jung, and his thoughts on the “collective unconscious.” This is the idea that all humans share an unconscious ancestry, a collection of memories deep within us that explains how archetypes seemingly transcend culture. Assuming there is even a mild degree of truth to this, narratives become our expression, exploration, and perpetuation of innate commonalities. In this way, literature is a conduit of emotion, a thread which loops our hearts and ushers them intimately into the minds of our peers in humanity.
Assuming this to be true, it is intuitive that physicians are in danger of losing touch with the common threads of humanity. There is understanding that comes with reading. We not only gain insight into how other minds think, but are provoked to overlay our experiences onto the lives of others. We recall personal life events that match the emotional experience of a fictional character, thus contemplating our own values, motives, fears, and passions. We reflect. We pour over the lives of patients we may never meet. Though we might make radically different choices than a character, we respect their decisions because we understand the emotional context in which those decisions exist. By disconnecting from the literary threads of humanity, we may feel that we fully understand a patient from a ten-minute focused interview when we wholly do not. We risk mistaking bullet points for a complex novel. Thus is the importance of studying humanity as much as we study the human body.
And so, I am inclined to make the distinction between those who treat and those who heal – between those who cool the fever and those who warm the soul. Although biased, I am optimistic that I have the soul of a healer. I fear, however, that current systems (and a lack of good literature) have molded my body into one that only treats. I like to think that my soul, knowing its own cachexia and seeking sustenance, guided me unconsciously towards this reckoning with reading. I feel I have been warned and made aware of the dangers of such neglect. For that I am grateful. I have many miles to go before I heal, but I am okay with that because even in the short time since this epiphany, I have come across so many lovely sentiments. I have come to realize that the journey towards healing is filled with woods that are lovely, dark and deep; moons that never beam without bringing dreams; poppets who feel infirm; happy cities whose citizens neither bow down to pestilence nor become saints; and masked figures who arrive at midnight. Beautiful.
I have decided to wade back into the ocean. I still have many water molecules left to count. I am not sure if I will ever finish. Yet counting is now a brand-new occurrence. I need not miserably float, frantically shifting my attention from one infinite square foot to the next. Perhaps I will start with the biggest wave. Or the cool ocean spray that is birthed from a blow hole. Or maybe I will begin with a snorkel and count the molecules that round themselves against scarlet coral. Ah, no! I know what sounds best today. I think I will start on my back, counting the glistening drops of rain as they are liberated from the expansive sky, open like arms.
I still do not know how to read. I am learning.