From the December Issue: From hermeneutics to heteroglossia

In today’s post, we preview From hermeneutics to heteroglossia: ‘The Patient’s View’ revisited, by Benjamin Chin-Yee, MD MA, and his co-authors,  Pablo Diaz, Pier Bryden, Sophie Soklaridis, and Ayelet Kuper. Read the article here at BMJ MH. A short audio clip and summary appears below:


History of medicine is often written from the perspective of physicians, with historical accounts focusing on doctors’ stories, for example, examining their roles in medical innovation and discovery. Patients are often relegated to the background as objects of investigation, rather than subjects with their own stories to tell. There has been a push over the past few decades to recover patients’ voices in history, and to conduct ‘patient-centered’ rather than ‘physician-centered’ history of medicine. Critics, however, have argued that this task is not easily accomplished because the representation of patients is always mediated by the gaze of physicians, making patients’ perspectives beyond recovery. In our article, we apply theories of interpretation put forward by two thinkers, Hans-Georg Gadamer and Mikhail Bakhtin, to develop an approach to recovering patients’ voices in the history of medicine. We apply these ideas to a case study from a Canadian psychiatric hospital during the twentieth century to show how this approach may help us gain insights into patient perspectives and work towards a more ‘patient-centered’ history of medicine.

Read the full article on the Medical Humanities journal website.


Headshot: collared shirt, hair pulled back, smilingMore about Dr. Benjamin Chin-Yee

He is a clinical fellow in the Division of Hematology at Western University. He completed his internal medicine residency at University of Toronto, where he also received his MD and MA in the history and philosophy of science. His research spans a range of areas in the history and philosophy of medicine, with particular interest in the history of the patient-physician relationship and the impact of technology on person-centered care.

Twitter handle: @BenChinYee

About Dr. Ayelet Kuper
Dr Ayelet Kuper MD DPhil is a Scientist and Associate Director at the Wilson Centre for Research in Education, University Health Network/University of Toronto, as well as a Clinician-Scientist and Associate Professor in the Department of Medicine at the University of Toronto. She is a member of the Division of General Internal Medicine at Sunnybrook Health Sciences Centre where she attends on the inpatient Clinical Teaching Units. She has authored over 75 peer-reviewed publications and regularly presents her research nationally and internationally. She is currently focusing on drawing out some of the critical educational implications of her program of research; in so doing she foregrounds work related to key patient-care-related concepts such as power, reflexivity, and social justice.

Twitter handle: @ayeletkuper

About Dr. Sophie Soklaridis

Dr. Sophie Soklaridis is a Senior Scientist at the Centre for Addiction and Mental Health (CAMH). She is also an Associate Professor at the Departments of Psychiatry and Family & Community Medicine, Faculty of Medicine, University of Toronto. She is a Cross-appointed Scientist at Wilson Centre for Research in Education. She is the Canadian lead and a core faculty member for the Master of Health Sciences Education in Ethiopia through the Toronto Addis Ababa Academic Collaboration (TAAAC).

Soklaridis’ research program uses critical social science and qualitative research approaches to explore the inclusion of clients/families in the life of the hospital as advisors, educators and experts. Her approach to research moves beyond current biomedical research priorities to understand the client as a person; to emphasize the importance of considering relational dimensions in health professions educational initiatives and research and; to develop strategies that reflect how the concepts of diversity and social justice can inform both education scholarship and influence the client/family experience of mental health service provisions. She is part of the creation of a digital health certificate in mental health education and is supervising a CIHR postdoctoral fellow to explore the concept of fairness in artificial intelligence and machine learning. The issues of power, privilege, equity, identity and relationship-centred care are the threads that weave across her research program in mental health and substance use education scholarship and care.

About Dr. Pier Bryden

Dr. Pier Bryden has been a staff psychiatrist at Sick Kids since 2001. She is an Associate Professor and Senior Advisor, Clinical Affairs and Professional Values, for the Faculty of Medicine at the University of Toronto. Dr. Bryden is a graduate of the University of Toronto, the University of Oxford, and McMaster University. She has subspecialty certification in Child and Adolescent Psychiatry with the Royal College of Physicians & Surgeons of Canada.

Her academic publications include papers on medical education, medical professionalism, and ethical and legal aspects of child psychiatry.  She is the co-author, with Dr. David Goldbloom, of a popular book on psychiatry, “How Can I Help: A Week in my Life as a Psychiatrist”, and with Dr. Peter Szatmari of “Start Here: A Parent’s Guide to Helping Children and Teens Through Mental Health Challenges”. Dr. Bryden was the 2018 Recipient of the University of Toronto’s prestigious President’s Teaching Award.

About Dr. Diaz

Dr. Diaz is a staff psychiatrist in the Schizophrenia Program at the Centre for Addiction and Mental Health (CAMH), and Assistant Professor in the Department of Psychiatry at the University of Toronto.He obtained his Medical degree from the University of Mexico and postgraduate training in Family Medicine at the University of Western Ontario. He worked as a Family Physician for the Grenfell Mission, in Labrador and Newfoundland, before starting his residency program in psychiatry at Dalhousie University.

Dr. Diaz spent 10 years providing clinical leadership in the integration of several in-patient and outpatient psychosocial rehabilitation services in Halifax. N.S.   He is currently working as a consultant in the Medication Assessment Program for schizophrenia and as an in-patient psychiatrist at the Schizophrenia Division of the Complex Mental Illness Program at CAMH. He completed an Education Scholar’s Program in 2010 at the University of Toronto and his main academic activity is teaching and research in Education and knowledge translation. He has spent the last 10 years teaching primary care multidisciplinary teams in Chile, Brazil and Mexico to strengthen the management of mental health and addiction problems in the primary care setting.

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