Literacy and Medicine

You are reading this, so you are literate.

Nowadays written language is all around us from birth. It appears on toys, clothing, tools, soap, decorations, packaging, and even food. Try finding a product with nothing written on it anywhere! We take for granted that everybody is literate.

Written communication is considered to be nearly as old as humanity itself. By definition human history begins when the human experience began to be recorded in writing. Biologists speak of “homo sapiens sapiens" (sic), the human who is more than intelligent. And intelligence is closely associated, at least by those who claim to be able to measure it, to literacy skills. This, together with our own experience of literacy, leads us to imagine that it is a universal human quality.

It is in fact not. Literacy has never been universal. Only in our (yours the reader’s, and mine the writer’s) little corner of time and place can we take literacy for granted. In other parts of the world there are still large illiterate populations. During most of history the ability to read and write were by no means attributes of the masses. Farmers, bakers, shoemakers, merchants, architects, physicians, and midwives, all at one time and place were likely to not have or need these skills. They learned their occupations from their parents or gild masters, not from texts. Even kings often couldn’t read. Messages to other kings were sent orally through messengers. When a written document was required, the king called upon a specially trained scribe. Knowing how to read and write was the scribe's profession.

For most people most of the time, life was a hand-to-mouth existence. Earning a living was a family affair. Only in rare wealthy families could supporting non-productive members be afforded. Not being compelled to perform labor, these non-workers could apply themselves to acquiring literacy and engaging in activities that require it, such as philosophy or literature. They were but a tiny minority of the population.

In medieval Europe one of the greatest contributors to literacy was Christianity. Large families could often afford to sacrifice one son, perhaps the one who was least suited to labor anyway, to the monastery. There he would receive a religious education, which would necessarily include reading and writing. These were skills that served religious goals only, and did not contribute to productivity. Productive people had neither time, need, nor interest in literacy.

The turning point came with the industrial revolution. It gave rise to a new type of society. There was massive movement from the countryside to the city. Until then, cities had been the dominion of kings and other rulers, their servants, passing merchants, and those who catered to them. Now cities were becoming populated with a new kind of family: the factory worker’s. If he was a foreman, he earned enough for his wife to not have to work, but not enough to hire staff to run his home and raise his children. If he was a low-paid laborer, his wife had to take a job outside the home too, to make ends meet. Young children could no longer share in economic activities the way they had done since time immemorial in the countryside. Instead, they had to be put up somewhere until they were big enough to take jobs themselves. Unlike the children of farmers and craftsmen, they couldn’t learn a trade from their parents, as they were separated from them during working hours.

Thus the modern school made its inroads largely as a place to warehouse children, a function it still has, even though we like to imagine that school is an essential part a child’s biosocial development. Youngsters from the lowest economic levels were now kept out of trouble and indoctrinated into good citizenship by collecting them together in schools (hence the name, as in a school of fish). There they were kept busy with learning the rudiments of literacy. The rise of socialist thought brought the “right to an education” which soon turned into an obligation, compulsory schooling. Thus literacy lost its exclusiveness. From a rare skill it burgeoned into a basic one, at least in our industrialized societies.

The level of literacy required simply to participate in society kept rising higher and higher. Today, in our neck of the woods, there is practically no job left for which knowledge not only of reading and writing, but also of computers, is not taken for granted. Running a household is also no longer possible without literacy. Even entertainment requires it. It is no longer a skill associated with a specific occupation, but a basic skill every competent person must have. We begin instilling it in our children almost from birth.

The clock, or the calendar, cannot be turned back. We wouldn’t want it to be. Education is knowledge, and knowledge is power. Literacy skills have become a basic human need, rather than the profession of a small specially trained minority.

Conversely, medical literacy has developed in the opposite direction. Instead of becoming the general domain of mankind, it has become the occupation of a diminishing specially trained minority. This development even extends inside the profession. The specialist is expected to know extremely much about extremely little. The non-physician is expected to know nothing at all about medicine, nor to aspire to knowing anything about it.

MeTZelf proposes to turn this trend around. Medical knowledge should become as universal as literacy. Every person has a body, and so needs to be educated about it’s function, what can go wrong, and how it can be remedied. Diagnosis and treatment should be skills we take just as for granted as reading and writing.

Medical literacy should not be reserved for an elite minority admitted to medical faculties on whatever grounds. It should be as universal as general literacy. It should be taught in the home and at school. Like all skills, the earlier they are taught, the better they are learned. Not the high school biology class should be the scene of youngsters’ first lessons, but pre-kindergarten. By middle school, students should be ready to learn what today is reserved for medical school.

This doesn’t mean that the medical profession would become obsolete. There will always remain a need for highly trained surgeons. Furthermore, some people will seek medical advice from others they consider more skilled than themselves, just as today some people, whether pupil or president, seek advice in writing a speech. But like consulting a speech writer, consulting a physician should be a strictly contractual affair, not compulsory. The ordinary citizen who is as skilled in diagnosis and treatment as he is in reading and writing, can choose his own advisors, if any, and needs no restrictions on his access to medical products.

Medical education is knowledge, and knowledge is power. Medical education, like general literacy, is a human right.