In 1872, Ralph Waldo Emerson wrote, "Science does not know its debt
to imagination," words that still ring true in the worlds of health
and health care today. The checklists and clinical algorithms of
modern medicine leave little space for imagination, and yet we
depend on creativity and ingenuity for the advancement of
medicine-to diagnose unusual conditions, to innovate treatment, and
to make groundbreaking discoveries. We know a great deal about the
empirical aspects of medicine, but we know far less about what the
medical imagination is, what it does, how it works, or how we might
train it. In The Medical Imagination, Sari Altschuler argues that
this was not always so. During the eighteenth and nineteenth
centuries, doctors understood the imagination to be directly
connected to health, intimately involved in healing, and central to
medical discovery. In fact, for physicians and other health writers
in the early United States, literature provided important forms for
crafting, testing, and implementing theories of health. Reading and
writing poetry trained judgment, cultivated inventiveness,
sharpened observation, and supplied evidence for medical research,
while novels and short stories offered new perspectives and sites
for experimenting with original medical theories. Such imaginative
experimentation became most visible at moments of crisis or novelty
in American medicine, such as the 1790s yellow fever epidemics, the
global cholera pandemics, and the discovery of anesthesia, when
conventional wisdom and standard practice failed to produce
satisfying answers to pressing questions. Throughout the eighteenth
and nineteenth centuries, health research and practice relied on a
broader complex of knowing, in which imagination often worked with
and alongside observation, experience, and empirical research. In
reframing the historical relationship between literature and
health, The Medical Imagination provides a usable past for
contemporary conversations about the role of the imagination-and
the humanities more broadly-in health research and practice today.
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