Thursday Lecture Series: Evidence

Medicine, Evidence, and the Grand Inquisitor

Thursday, The Heyman Center

For many years a professor of English at Rutgers, Terrence Holt
is now a geriatrician at the University of North Carolina Medical
School and an award-winning fiction writer, most recently of the
short story collection In the Valley of the Kings (2009). His presentation—
which comprised the reading of one of his stories and
its discussion as a form of medical evidence—addressed the differing
ways in which patients and doctors interpret and respond to
medical statistics: for a patient, a five percent survival rate may be
a cause for hope; for an oncologist, it may be a cause for anguish,
knowing as she does that only one in twenty of her patients will
survive, while the other nineteen will inevitably and pointlessly
suffer more from her treatment than from the disease itself. Dr.
Holt’s story invoked the dilemma posed by Dostoevsky’s Grand
Inquisitor, suggesting that contemporary medicine, in willingly reversing
Dostoevsky’s equation, is blinded by a kind of exceptionalism,
in which the triumph of the one renders the suffering of
the masses invisible. Stories as well as biostatistics are a form
of evidence, providing a narrative context, a background against
which medical data ought to be interpreted in particular instances.
Understanding the meaning of such data within the case histories
from which they have been extracted may point to a more rational
and humane kind of medicine than currently obtains in research
hospitals today.