Hospitalism and Hospitality: Restoring the Narrative Context to Hospitalized Patients
Evan Beacom, University of Minnesota Medical School, Division of Hospital Medicine, Minneapolis, MN, Pellegrino Center for Clinical Bioethics, Georgetown University, Washington D.C.
Hospital medicine is a relatively new medical specialty focusing on the care of hospitalized patients. Although its name is drawn from its place of practice, hospital medicine necessarily inherits the cultural legacy of the hospital itself, including the hospital’s original purpose as a place of hospitality rather than medical cure. However, hospitalization is often an isolating, industrial, and fragmented experience for patients, and the hospitalist community has not obviously prioritized hospitality in education, research, or quality improvement initiatives.
In this paper I will propose that hospitalists are especially suited to recover the virtue of hospitality in medicine by drawing on their institutional heritage and their experience with patients in this relatively controlled but isolating setting. I will put an emphasis on the family as a social determinant of health, examining the relative exclusion of the family from the experience of hospitalization, and the importance of family context for the patient narrative. Drawing on Emmanuel Levinas’s notion of being-in-relation and Ratzinger’s account of the notion of person, I will argue that hospitality towards patients by involvement and accommodation for their families can broaden the view of patients’ narratives. By doing this, hospitals and their staff can help bridge the gap between what Wendell Berry calls the “world of love” and the “world of efficiency” which coexist in hospitals but fail to cohere.
In this paper I will propose that hospitalists are especially suited to recover the virtue of hospitality in medicine by drawing on their institutional heritage and their experience with patients in this relatively controlled but isolating setting. I will put an emphasis on the family as a social determinant of health, examining the relative exclusion of the family from the experience of hospitalization, and the importance of family context for the patient narrative. Drawing on Emmanuel Levinas’s notion of being-in-relation and Ratzinger’s account of the notion of person, I will argue that hospitality towards patients by involvement and accommodation for their families can broaden the view of patients’ narratives. By doing this, hospitals and their staff can help bridge the gap between what Wendell Berry calls the “world of love” and the “world of efficiency” which coexist in hospitals but fail to cohere.