Stuart Murray, Medical Humanities and Disability Studies: In/Disciplines

Stuart Murray, Medical Humanities and Disability Studies: In/Disciplines (London: Bloomsbury Academic, 2023), 144 pp. £40.50 Hb. £13.49 Pb. £10.79 E-book. ISBN: 9781350172180

‘Diagnosis and prognosis are moments that are full of words’, writes Stuart Murray, in his new monograph, Medical Humanities and Disability Studies: In/Disciplines: ‘they might be comforting, terrifying or mystifying’ (6). In his provocative and engaging book, Murray offers theoretical models and shares lived examples of how he interrogates, critiques and understands diagnostic and prognostic vocabularies. Murray is Professor of Contemporary Literatures and Film at Leeds University, where he studies the representation of disability in film and fiction. As well as being one of the UK’s leading critical disabilities scholars, Murray is Head of the Department of Medical Humanities at Leeds.

As readers may expect, this monograph showcases Murray's unique knowledge and expertise. Murray’s personal essays, about his lived experiences of epilepsy, as the father of an autistic child, being the son of an unwell mother and of having a terminally-ill sibling, give this work depth and complexity. I appreciated these glimpses into the emotional landscape of life with the undiagnosed, the under-diagnosed and the unseen.

To illustrate this, Murray reflects on the Pantone colour known as 342 Green, using it to frame experiences of regaining consciousness after an epileptic seizure, and seeing a paramedic dressed in this colour. For Murray, 342 Green has become ‘a herald of the brightly light, noisy, uncomfortable hours in an emergency department that inevitably follow, fighting the need to sleep, to be in the dark’ (25). Through his meditation on colour, I came closer to understanding the embodied experience of epileptic aura and post-seizure cognitive absences. 

In turn, Murray’s analytical sections offer vital context to his candid autobiographical writing.

In Chapter 1, he is concerned with ideas of difference and sameness, using the illustrative model of the differences between disability studies and medical humanities, and also between medical humanities in the UK and the USA. Although these are examples that are relatable to his intended audience, I preferred his insights drawn from the deaf community in Bangalore. Within this community, people use the signed greeting, ‘deaf deaf same’ (37), which Murray presents as an example of disability-first language.

In his second chapter, Murray discusses life writing on schizophrenia, arguing with conviction and flair that this is best understood through a disability studies frame. Murray proposes that lexical choices create the parameters that shape people’s experiences of being hospitalised against their will. I found much to admire and agree with in this chapter, but disagree with his conclusion: ‘detainment often becomes forced coercion and treatment, with assumptions made about what constitutes individual best interests’ (79).

My experiences as psychiatrist differ. For over a decade as a member of HM Tribunal for Mental Health, I have been hearing judicial appeals of patients detained under the Mental Health Act. In my experience, great thought and care is rightly devoted to people with a mental health disorder who need urgent care, but are also at risk of serious harm to themselves or others. There are robust legal processes for specialist second opinions for proposed treatment, for example, which must be proven to be medically necessary, and the views and rights of patients must be accounted for in those opinions.

Murray is scathing about clinically-qualified writers, including Andrew Solomon, Professor of Clinical Psychology at Columbia Universtiy Medical Centre, damning Solomon’s book, Far from the Tree: Parents, Children and the Search for Identity, as ‘a hateful account’ (78). He asserts that this form of medical humanities is, ‘not the view that most close to the subject would is nevertheless an intellectual and practice-based position common in many who work in medicine’ (78). I found this boundary policing of a broad and diverse interdisciplinary field unhelpful.

Solomon’s book is set up in opposition to the set of videos, Voices for Choices, produced by a US-based mental health rights organisation, where interviews are interspersed with historical footage of cruel treatment. It is disappointing that no contemporary psychiatric voices were included in his conclusion to this chapter. Perhaps this is why Murray’s over-sweeping conclusions appear closer to the the anti-psychiatry movement of the 1960s and 70s, than to contemporary psychiatry. I found this understandable in the context of Murray’s life-writing about his mother’s incarceration in a West German psychiatric hospital and his father’s enduring silence about this distressing time.

Murray further draws a distinction between medical humanities used to teach medical students, which he suggests occurs in the USA, and the critical, interdisciplinary branch of the humanities, which he practises in the UK. In my experience as a clinician and an academic, the medical humanities are widely used in clinical practice and medical education in the UK as in the USA, and interdisciplinary, critical medical humanities is thriving across the world.

In Chapter 3, Murray is concerned with chronic pain, specifically women’s pain, and also with autoimmune illnesses and reflects on how this might be problematic: ‘I am aware that in writing this there is a danger of my perpetuating a discourse in which men write about women’s bodies’. I do not doubt his sincerity, but found his justification less than satisfactory. Murray writes: ‘For me, the issue is not in who writes what, but whether the writing prioritises a considered, ethical approach and commits to an appropriate respect’ (96). Murray does not define his ethical approach nor offer an explanation about what constitutes, in his view, ‘an appropriate respect’, but then uses the subtitle ‘Bloody Women’ (104). This made me wonder whether using this misogynistic slur is 'an appropriate respect’. As a medical doctor, I struggled to follow his argument when he drew scientifically false equivalences between endometriosis and schizophrenia. I agree that ‘women’s bodes have always been misrepresented, disciplined and subject to correction’ (101), but am already persuaded by Elinor Cleghorn’s history, Unwell Women.

Curiously, it is in this chapter, that Murray offers a different, broader, more inclusive definition of medical humanities, which he describes as, ‘a dynamic and flexible set of academic approaches to manifestations of medicine and health. It includes models that that investigate the processes of healthcare... from fields that explore history, philosophy, bio-politics, developments in technology, narrative, imagination, or ideas of citizenship - to name just some’ (100). This much more relatable framing of the medical humanities would have been helpful in his earlier chapters.

Although I was not always persuaded by Murray’s arguments, I enjoyed this monograph. Murray writes beautifully throughout, but his best writing is about his sister Alison, diagnosed with motor neurone disease just as Murray began writing this book. Alison sadly died when he submitted the manuscript. In a series of blistering vignettes, he describes the care home Alison was residing in as, ‘a product of a privatised healthcare system that seems to have accepted its creation of incompetence and indifference, hidden behind slogans, one that signals good intentions but knows it doesn’t deliver them and often seems not to care’ (119). As a memoirist, Murray intervenes, to great effect, in precisely the way that he distances himself from in the theoretical chapters. His life-writing humanises clinical conditions, centres lived experience and casts patients, not healthcare staff, as the protagonists.

In reviewing this monograph, I often had the sense of reading two different books. Murray the lecturer was always interesting, often galvanising, at times polemical, but my enjoyment of his academic discourse was eclipsed by Murray the memoirist, so rich in wisdom, sharing a generous and enriching work of scholarship.

Sabina Dosani

Biographical note: Sabina Dosani is a consultant child and adolescent psychiatrist, specialising in neurodiversities, a medical educator in medical humanities and a visiting research fellow in Literature, Drama and Creative Writing, at the University of East Anglia. Sabina is interested in the arts in mental healthcare, illness narratives and in narrative medicine in medical education.