Relevant, Relatable: The Role of Humanities in Neurology

This transcript has been edited for clarity. 
Andrew N. Wilner, MD: Welcome to Medscape. I’m Dr Andrew Wilner, and my guest today is Dr Heidi Moawad. Heidi is a fellow neurologist and associate editor of the humanities section of the journal Neurology. Heidi is also an editorial board member of Neurology Clinical Practice and past editor-in-chief of Neurology Times. Welcome, Heidi.
Heidi Moawad, MD: Thank you so much for having me.
Wilner: Today, I’d like to focus on your role in publication in the humanities. Tell me, how did you get interested in that?
Moawad: I’ve always been interested in writing. I’ve been involved as a reviewer for several of the neurology journals over the years. The humanities section had a little bit of reorganization a few years ago, so there are three humanities editors. I am the handling editor, so I’m the one that looks at the reviewers and what they’ve written and puts that all together to make the final conclusion.
Wilner: Do the humanities belong in a scientific neurology journal? I think there’s been some debate about that.
Moawad: That’s a really good question. I think that the data tell us the answer to that, which is that it is a very popular section. When we have the online statistics, many people click on the humanities and read this section. We do know that it’s very popular. We do know that neurologists really like it. I think that’s the most clear answer, really, rather than thinking about should it or shouldn’t it be there. The fact that so many people want to read it is our answer.
Wilner: I have a personal interest. I’m the course director for humanities for our medical school here at University of Tennessee Health Science Center in Memphis, and humanities and medicine has been an interest of mine for a long time. I want some inside information now. If one of my students, for example, wanted to submit an article on the humanities, what would increase the likelihood that it would get published?
Moawad: There are a few things that we look for. One is that it has to do with neurology. We do get many submissions that are wonderful pieces, but they have to do with either life in general, medicine in general, work-life balance, or these kinds of things. If they’re not specific to neurology, we’re not going to accept them.
The reason for that is that we get so many submissions that we have to really focus on those that are relevant to neurology. That’s one thing. It has to be relevant to neurology.
It has to be something that in some way deepens the connection between neurologists or between neurologists and patients. What I mean by that is it has to be relatable. What humanities does is it builds community. It makes us feel like we are part of something.
Sometimes people do write for themselves, journaling or writing a poem or something like that and never share it, right? Those things that are shared are the things that make us understand how other people feel. The way other people feel is something we can learn about if we don’t feel the same way, or something we can connect with if we do feel the same way. It’s usually some kind of combination of learning something about how others are experiencing life and neurology, and also recognizing that same thing that we are experiencing as well.
Relevant to neurology, relatable, and also kind. No stereotypes or something that would be mean or insulting to an individual or a population.
The last thing, which is probably the hardest, is well written. Not something that seems like someone just did it in 5 minutes.
Wilner: Is there just one humanities article per issue?
Moawad: No. Sometimes there might be just one, and sometimes there might be two or three. We don’t accept it based on numbers.
Wilner: You mentioned that it was highly competitive. What percentage of articles do you actually publish that are submitted?
Moawad: Oh, gosh. I’m thinking it’s less than 50%, but I don’t have the exact number.
Wilner: It’s not less than 1%, for example.
Moawad: No, it’s not like that.
Wilner: It’s a reasonable expectation that at least if you submit, it will be carefully reviewed and there’s half a chance.
Moawad: Yes. The carefully reviewed is another important thing. The reviewers give very specific comments and feedback, even for submissions that are not going to be accepted. For the most part, we’ll either say this is not appropriate for this journal, but if it is, and it just isn’t acceptable, there’s usually going to be some suggestions of how to improve it.
Unless there’s something about it that’s really offensive or very much not original, you can find it anywhere, then we’re unlikely to give very specific feedback. If it’s offensive, we’re unlikely to give specific feedback, but we will at least mention that.
We’re not going to just leave people totally hanging. If they really want to keep trying, they can revise it, they can address the reviewer’s concerns, and they can resubmit several times if they’re really devoted to this piece.
Wilner: There can be some back and forth with the journal. It’s not just yea or nay and try your luck elsewhere.
Moawad: A big thing that I always think about is that I do care about my readers, but I also care about my authors. When you have a humanities piece published, your name is on that for a long time. Your colleagues are going to see that. Potentially patients could look it up.
I really care that I’m not going to accept something that will reflect poorly on the author. Sometimes authors may not see that, but it’s actually even more important to me that I take care of my authors than I take care of my readers.
Many times, rejection is because I don’t think, in the long term, someone will want their name associated with that piece they submitted, even if they feel it very deeply. This is something that they’re putting out into the world.
Wilner: I believe at the American Academy of Neurology, recently, you spoke about this topic. Is there anything you’d like to add?
Moawad: We had two talks at the national meeting. One of them was talking about what are we looking for; how people can get published; and what kind of pieces, should they be fiction or nonfiction — these kinds of things. Anything that’s nonfiction has to de-identify patients. We did talk about those kind of logistics.
We also had a workshop where we had attendees write poems and share them. It wasn’t required to share them. That was very popular, really well liked. Many people wrote poems from the heart. They all thought that they could have probably revised them if they had more time, but it was a really enjoyable and fun experience and really built a sense of community between everybody.
Wilner: It sounds like the journal’s getting a little less stodgy than I remember.
Moawad: In neurology, there’s clinical research and basic science research. That’s never going to go away, and that’s what’s going to keep our specialty moving forward to help patients in the future.
Of course, this other aspect, the humanities, is just another piece that you can’t totally ignore because people really want it. It makes people feel heard and understood, and it helps people understand others. I think it’s more of adding like a 360° viewpoint of neurology.
Wilner: Heidi, that’s really encouraging. I expect as soon as this program is published, there’s going to be a bounce in submissions.
Moawad: Probably, yes. Whenever we have a program, we do get many submissions, which is always welcome. It’s wonderful to see them.
Wilner: Dr Heidi Moawad, I want to thank you for your insights on publications in the humanities.
Moawad: Thank you.
Wilner: I’m Dr Andrew Wilner, reporting for Medscape.