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Forty-one years ago, physician-essayist Lewis Thomas proposed that applicants to medical school who were traditional premed science majors be considered last, if at all, for admission.1 Instead, he wrote, preference should be given to students who concentrated on “some central, core discipline, universal within the curricula of all the colleges, which could be used for evaluating the free range of a student’s mind, his [sic] tenacity and resolve, his innate capacity for the understanding of human beings and his affection for the human condition. For this purpose,” he concluded, “I propose that classical Greek be restored as the centerpiece of undergraduate education.”
In other words, future physicians should be able to read, in their original language, the great works of the tragedians (Aeschylus, Euripides, Sophocles) and of Homer, including and perhaps especially the dramatic scene at the end of The Iliad in which Priam, king of Troy, visits the Greek warrior Achilles and begs him to return his son Hector’s body for a proper funeral. Achilles had killed Hector in a fury at having lost his best friend Patroclus to Hector's sword and, in violation of the mores of men and gods, dragged Hector’s corpse around the walls of Troy for 11 days in grief and vengeance. In his appeal to Achilles, Priam invokes his grief for his son and his old age and that of Achilles' own father, causing the 2 men to weep together—Priam over Hector; Achilles over his father Peleus and his friend Patroclus (Supplement).
The Brygos Painter, Hector’s Ransom Skyphos, circa 490 bce, clay pottery (h, 250 cm), Kunsthistorisches Museum, Vienna, Austria (for complete details see ja.ma/PriamAchilles). Priam, king of Troy (left) approaches a reclining Achilles (right) to solicit the body of his son Hector (beneath the couch).
This passage is justly deemed one of the gems of Western literature and is paradigmatic of the many contingencies of human life—honor, compassion, grief, loss at the hands of apparently meaningless forces beyond our control, tragedy, and our human capacity and willingness to share all of these even with those who have hurt us. These are scenes, themes, and experiences known by Thomas to reside in the Greek and other classics, and he anticipated that students literate in the canon could access them in their clinical relationships with patients.
If students can read The Iliad and other classics in highly regarded translations,2,3 why bother with Greek? Thomas’ take was that “The capacity to read Homer’s language closely enough to sense the terrifying poetry in some of the lines could serve as a shrewd test for the qualities of mind and character needed in a physician.” He may have known that the original Homeric Greek conveys meaningful lessons to students training in the caring professions such as medicine. For example, when Priam reaches his hand to Achilles’ lips in line 506 (Supplement), the text uses the verb form ὀρέγεσθαι (oregesthai) in the Greek middle voice, which gives it a reflexive meaning that has 2 equally valid interpretations: Achilles touching Priam's mouth in respect and pity, or Priam touching Achilles’ in ritual supplication.4 Either is possible, and both are correct, signaling mutuality and a moment of connection and compassion.
Similarly, the Greek word for remembering in line 509 (μνησαμένω [mnēsamenō]; Supplement) is a participle in the dual number modifying 2 people.5 Although not a verb form we can appreciate in English, it succinctly signals to the reader that the 2 subjects it describes, Priam and Achilles, are not only 2 in number—2 men already in a relationship of physical exchange thanks to that middle voice verb of reaching/touching 3 lines previous—but also intimately related. It thus sets up the climactic dual weeping, in concert, 2 persons affected by the war as a duet, crying as one, a linguistic reminder that in their grief and compassion, these 2 war-torn men, caught up in a conflict not of their making, are doppelgängers, indistinguishably unified in suffering. Try translating that in a single verse. English poet William Cowper came close more than 200 years ago with the translation “Remembrance melted both.”6
Padovanino (Varotari Alessandro Leone), Priam and Achilles, 16th century, oil on canvas, 35.9 × 28.1 cm, Far Eastern Art Museum, Khabarovsk, Russia.
In both examples, the verb form captures the essence of empathy (from the Greek language for in and feeling). The mutuality of the patient-physician relationship is inherent to the grammar and is surely a component of what Thomas had in mind when he voted for Greek as the basis of a physician’s education. In medicine, the English verb form to care easily takes on a similar dual meaning in the middle voice, as any physician who has cared for patients realizes, one caring for the other and thereby caring for himself or herself as well.
By all appearances Thomas’ proposal did not go far, though the humanities have advanced undeniably in some curricula and campuses of undergraduate medical education.
Consider a more modest proposal: that all students applying for admission to medical school major in the humanities with an optional minor in biology and science topics. No premed majors need apply; the science training will come after acceptance. Any grounding in the humanities would suffice. As Thomas hinted, patients could look forward to being cared for by physicians “who have learned as much as anyone can learn, in our colleges and universities, about how human beings have always lived out their lives.”
Whether they are art history majors who have learned a visual language of compassion from Michelangelo's Pietà; French majors learning the secret passages of the heart from Marguerite Duras or Marcel Proust; African Studies majors reading Mazisi Kunene’s magisterial Zulu myth-epic Anthem of the Decades; philosophy majors reading about alterity in Gabriel Marcel, Emmanuel Levinas, or Martin Buber (who reflected on the philosophical middle voice in his sentiment that the “purpose of relation is the relation itself—touching the You. For as soon as we touch a You, we are touched by a breath of eternal life”7); or English majors reading Shakespeare—any Shakespeare; or Ralph Ellison’s Invisible Man—any firm basis in the humanities will, as other advocates of Thomas’ proposal have affirmed,8 prove efficacious for “evaluating the free range of a student’s mind, his tenacity and resolve, his innate capacity for the understanding of human beings, and his affection for the human condition.”
Compassion expressed in any genre or format is moving, edifying, and life-changing. Journeying into and through the humanities, studying them, discussing them—these are the fruits of the education Thomas so desperately wanted physicians to enjoy for themselves and to reach forth to the lips of their patients.
On behalf of our patients, our profession should require it as a condition of medical school acceptance. Forty-one years later, are any medical school admissions committee chairpersons up to the challenge?
Corresponding Author: Richard M. Ratzan, MD, Hartford Hospital, PO Box 270026, Hartford, CT 06127 (firstname.lastname@example.org).
Additional Contributions: I would like to thank David J. Elpern, MD, for prompting me to write this essay and Sally Kennedy for useful comments during its adolescence. Neither was compensated in association with their contribution to this article.
eAppendix. The Iliad by Homer, Book 24, Lines 503-519, Author’s Translation
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Ratzan RM. How to Fix the Premedical Curriculum—Another Try. JAMA. 2019;322(8):710–711. doi:10.1001/jama.2019.11480
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