Coffee with Colleagues: Arden Hegele & Rishi Goyal

Synapsis Editors Arden Hegele, PhD,
and Rishi Goyal, MD, PhD

(Left to right): Dr. Loren Wolfe, Professor Eileen Gillooly, Dr. Rishi K. Goyal, Dr. Arden Hegele together in the Grande Salle at Columbia Global Centers Paris in June 2019.

Arden Hegele, PhD, teaches at Columbia in the Medical Humanities and in English and Comparative Literature. Her two forthcoming books are Romantic Autopsy: Literary Form and Medical Reading (Oxford) and Culture and Medicine, co-edited with Rishi Goyal (Bloomsbury).

Rishi Goyal, MD, PhD, is an Assistant Professor of Emergency Medicine at the Columbia University Medical Center (in Medical Humanities and Ethics and the Institute for Comparative Literature and Society) and the founding director of the Columbia major in Medical Humanities.  He is currently working on Increasing Vaccine Confidence through a grant from Columbia World Projects.

Sarah Berry //

This interview series features educators, scholars, artists, and healthcare providers whose work is vital to the growth of the health humanities. On June 1, I interviewed Arden Hegele and Rishi Goyal, founders and editors of Synapsis, about their work with the journal, their plans for its future, and their vision of the medical and health humanities in a global context.

Sarah Berry: What’s really intriguing about Synapsis is that it’s edited by a physician-scholar, Rishi Goyal, MD, PhD, and a humanities scholar trained in British Romantic literature, Arden Hegele, PhD. How did you meet, and how did Synapsis begin?

Arden Hegele: We met at the Heyman Center for the Humanities at Columbia University. At the time, I was a Society of Fellows postdoctoral fellow working on my book manuscript in Romantic literature and medicine, and Rishi was the director of the Medicine, Literature, and Society program here at Columbia. We immediately recognized that we had mutual interests and aims.

Rishi Goyal: That was a great description. I remember that meeting quite vividly. It was in the common room at the Heyman Center, and a mutual colleague named Eileen Gillooly said, “There’s this really smart person interested in humanities and medicine.” When Arden and I started chatting, there was clearly a feeling we both shared. Our first conversation wasn’t so much about what would become Synapsis, but about what our interests were, and what we were thinking about. And we realized we were both interested in health, from similar but also very different vantage points and certainly very sympathetic ones. We both appreciated where the other was coming from.

SB: How did the journal get off the ground?

RG: As we began talking about our interests in not only modern-day healthcare but also the limits to current humanities approaches to healthcare, we asked about how we could intervene, what could we do that would be engaging and also fun for both of us and for this cool, emerging field, medical and health humanities, really trying to find unions wherever we could. We both like to work interdisciplinarily but also collaboratively, and with a lot of different people.

The original journal title was A Department Without Walls. That was really the ethos that we were trying to develop, something that was on the order of a department or a place where people come together, where minds meet, where you can have conversations, you can have coffee, but that wasn’t siloed off [by] separating divisions. We wanted a space that was really anti-hierarchical. We immediately shared that in our vision of things.

Initially we were even thinking of just making a listserv and other milder forms of what became Synapsis. But quickly, the idea of having something that could help establish certain contours or enlarge the field or represent the field in some way became very appealing to both of us.

AH: We were very committed to having something interdisciplinary that would reach beyond our own institution to other institutions and other scholars working in these spaces. So I think that’s the reason why the idea of a digital journal appealed to us. This is also the rationale for the nontraditional publication format because we really wanted to create a space where people were very much in control of their publication. We wanted a space where people could try out an idea and have it read by interested parties across different fields, and some of those ideas first conceived in short form could be built up into more traditional scholarly publications. This is really a forum for creativity and exploration within a scholarly-sanctioned space; that was our thinking behind the publication process.

SB:  I like how you conceptualize that—“a forum for creativity and exploration within a scholarly-sanctioned space”—as a conduit for new critical and creative endeavors in medical and health humanities. The range of contributors in terms of who they are, where they’re coming from, and what they’re writing about is a great reflection of the “department without walls,” as Rishi phrased it, and the breadth and depth of what you’re covering in the field. Your self-publishing, blog model allows folks to get writing online quickly with the copy-editing service, this year provided by Danielle Drees, which has been brilliant. I’m always so grateful for her edits and feedback. Indeed, she has edited this post—thank you, Danielle!

Looking back, Arden and Rishi, what are some of your favorite posts or projects since your first issue in fall 2017?  What highlights really stand out to you in terms of generating a leading-edge venue for critical thinking in the field?

AH: We went through a site redesign and choose the name for Synapsis in the spring of 2018, with help from our friend and collaborator Lan Li, who’s a professor of Medical Humanities at Rice University now. They helped to redesign the site.

That was an inaugural moment for us.

Another of my personal favorite moments is when we held an in-person retreat at Columbia in November 2019, where writers attended from many places. Writers flew in from Canada and France to be part of this retreat. We had a day-long workshop, conference presentations, and activities we did together. We discussed ideas about how to formulate the journal and new directions to take it. And that was unbelievably helpful in meeting people and also getting a sense of which aspects of this project were most compelling to the writers, who are the community that we’re really trying to serve here. So I thought that definitely was one of the true highlights.

During the pandemic, we have pivoted more, intentionally or not, toward special issues. The first one was a COVID-19 special issue that we put together in May 2020, and it begins with a very deeply compelling and very intellectual and emotional piece by Rishi on his experience of working in the emergency room during the height of the COVID pandemic. And then we have articles from contributors organized in different categories, all of which were written in that challenging moment.

That was our first special issue. We recently did a second one, Justice-in-Education Program Special Issue: COVID-19, in partnership with the Justice-in-Education Initiative at Columbia University, which brings university education into prison spaces. That partnership looked at autoethnography from people who had been incarcerated or were formerly incarcerated during the COVID-19 pandemic.

We also have a forthcoming special issue, which we are putting the final touches on now, led by Max Mishler, a history professor at the University of Toronto. That special issue is also looking at pandemics in prison but from a different vantage point. So, really, we’re sensing interest coalescing around the production of special issues, and I think that’s something we’d like to continue in future.

RG: Completely agree. Just taking it back for a moment to the conception of the journal that stands out because we built it together de novo, from scratch, but we made certain choices that we didn’t even realize we had made until we got to the Synapsis retreat in 2019. What was quite compelling for both of us at that moment was to see how much of a community had been built up out of this journal in terms of the relationship that these writers had with each other by the time they met in 2019. They hadn’t known each other before they had been reading each other’s pieces. I think it was Travis [Chi Wing Lau] and Alicia [Andrzejewski] who met through the journal and, at the retreat, you could just see that they had found like-minded people who shared their engagement and interest.

The idea of allowing people to self-edit was in some ways expedient; it made it a lot easier to get things done. It also said, “We aren’t going to be the final verdict on what’s going on as editors.” It’s not a stamp of approval. It was more a question of, “How do we create a space in which writers get to develop their voices in a scholarly yet public-facing way?” And in the last three or four years, meeting people for me has been generative, such as working with Lan, one of our colleagues, and various writers. We have engaged with them on multiple levels, and they have now gone on to develop a space within the medical and health humanities that has been really fascinating, and it’s been just fun to help that happen.

In terms of how we ended up picking writers, we made sure that we had as vast a geographic distribution as we could have because it was all online and because in the modern world we could have writers in Australia, India, Eastern Europe, Africa, and parts of Latin America. That was incredible, as was the fact that we could think about what fields we wanted represented, from the medical ones to the humanities. All of that allowed us to create a space that is really anti-colonial, that is feminist, that is about anti-essentialist approaches generally.

It’s been the most exciting thing to be able to do all of those things together in the journal. For me, too, writing that introduction to our special issue on COVID-19 in May 2020 was important therapeutically, and it was really important as a venue and a space to be able to convey that personal-meets-professional point of view. The journal allowed me to do that. So that was great on a personal level.

SB: The story behind Synapsis and the opportunity to build a new international community underscores a deeply important humanities enterprise. I’m thinking about the ways in which community-building is important for medical and health humanities in particular. Medical and health humanities is a rapidly expanding field. At Columbia, you have the new Medical Humanities major, and in the US, the number of undergraduate programs continues to increase each year. More medical schools and the AAMC are showing increased interest in humanities education among providers and trainees. What is it about our medical and health humanities field that benefits so much from this model of publication and the journal’s showcasing of a vast array of tools and creative lenses on our contemporary moment with the syndemic, in the US and across the globe?

AH:  That’s a really great question and a challenging question too. Part of our aim as a space is to provide a high-quality intellectual contribution that is scholarly in nature, no matter which fields writers are coming from, but that is also very low in jargon and suitable for a non-specialist audience. This is something we’ve been deeply committed to from the beginning. That open attitude toward communicating across disciplines and across professional spaces is absolutely necessary for the medical and health humanities, because you can see how easily and quickly barriers are raised between departments and between institutions.

We can see with the emergence of these new majors and even our own new major, that there is a real effort—and I think it’s an ethical project on the part of medical and health humanities—to counter some of the academic impetus towards silos. We are naturally trying to counter that. My hope is that by showing what it looks like to do engaged, interdisciplinary, and accessible scholarship, Synapsis will model an intellectual attitude that could be exported from our community to the field at large.

RG:  It’s like parenting, right? You’re trying to model good behavior, and we’re trying to model ethical behavior. We’ve been very conscious of doing that during this whole process. Sometimes, emerging fields or disciplines can become boutique-ish and are only available to one class, gender, or race position, and we have been very careful and conscious about not making Synapsis accessible or available or knowable by one audience. That’s not to say it’s all universal. We’re very clear that context and individual histories really matter; we want all those contexts and all those histories to be represented as widely as possible.

This syndemic, with the epidemic and racism together, suggests the ways in which medical care follows along class, gender, and racial lines where the people who died from coronavirus in the highest numbers were Brown and Black essential workers. That pattern suggests that rather than consisting purely of objective truths, medicine is a social phenomenon, and it ends up reproducing a lot of the same social ills that we see in other fields. As editors, we really thought about how our journal was going to represent all of the voices from both the margins and from the center.

In selecting writers, we were very conscious of those questions as well.

SB:  That’s a deeply compelling aim. Representation in medicine and in medical humanities is essential to working for a better future for survivors of the syndemic. I recently read a New York Times article, “A Once-in-a-Century Crisis Can Help Educate Doctors,” by Molly Worthen, an historian, making a strong case for medical humanities in the ongoing syndemic. I was struck by a published comment by two professors of medicine who were very resistant to offering humanities in a medical school. They argued that the rapid development of mRNA vaccines would not be possible by replacing some of the science education in medical school with “nontraditional medical school courses such as creative writing.”

The idea of Synapsis providing a department without walls holds so much potential for health and healthcare, and I wonder why medicine and humanities is perceived as a zero-sum game or an either-or choice by some people in medical education, when humanities are taught in medical schools now not as a “replacement” for science courses but in addition to science. Have you encountered this logic?

AH:  I remember vividly reading that article because everybody I know forwarded it to me, and I remember reading comments that stated, “This is all being done at the expense of basic science.” I was struck by that idea that it’s a zero-sum game that pits the fields against one another. I wanted to say first that we are absolutely in favor of basic science. We have a deep commitment to the scientific project, and all of our writing, I would hope, has that same commitment to the need for science.

We don’t see ourselves as antithetical to institutions of medicine or as promoting an alternative medicine discourse. Far from it; we very much want to support the sciences. One thing that we have observed is the difficulty of communicating scientific information. We think that that is an area where collaboration with the humanities could be of vital importance. We can actually use the competencies and tools of the humanities to improve the communication of scientific information. That’s just one area in which the fields are working hand in glove rather than in opposition to one another.

RG:  Yes, and “Why?” is always a tricky question. In my mind, the answer is usually power: somebody who’s in power wants to stay in power, and so anything that disrupts or challenges that will be seen as dangerous, in any new field. It’s why Socrates was convicted of corrupting the youth of Athens. But to add to what Arden’s saying, science denialism is a real phenomenon, and that comes out of a lack of participation in modernity or people not receiving benefits accrued through the modern world, or a whole host of other reasons.  There’s been a form of science denialism that actually grew out of the humanities in the late 20th century from misunderstandings of postmodernism and misreadings of Foucault, which led people to think that that science and hegemony were inseparable, but that’s not necessarily true. You can be anti-capitalist or anti-Big Pharma but pro-scientific method and scientific discovery with modern techniques. So, to thread that needle, you have to be able to make those distinctions. Hopefully Synapsis allows you to do that, and to distinguish where to critique and where to understand and accept.

Going back to the pandemic, I remember early in April or May 2020, we noticed that certain people were dying disproportionately, and the scientific community published a few studies relating mortality to Type A blood. What was problematic about that is if you took a squarely biomedical perspective, it might lead you to an answer like that. But if you took a social science perspective and asked, “Where are the people dying?” you’d see that they’re dying in small apartments where multigenerational families live in spaces without ventilation, and you would take a different approach.

You actually need humanities approaches to do sound science, and sometimes that gets lost in these kinds of conversations. It’s not even so much that one discipline is a handmaid to the other, but that, literally, these are both forms of knowing, and they offer different kinds of hypotheses, and they can be tested against each other. Always.

SB: Those replies from your two different perspectives are perhaps the best illustration of Rishi’s hypothesis about the strengths of having different hypotheses!

What vision do you have for the future of Synapsis?

RG: Part of the journey of Synapsis has been to figure out to what degree should it stay with blogging and to what degree should it become more professionalized. We’re always going back and forth on that. We’ve had conversations in the past about peer review and various scholarly apparatuses, but I don’t think we’re going to do that necessarily. We would like to give even more power to the people, but we’d like to have section editors working on different areas of the field to help robustly build that up. Our circulation has gone up every year since we’ve started in terms of volume of posts and number of readers and how much time they spent on posts. So, we’d like to continue growing with reader engagement.

We’ve been really interested in special issue ideas because they’ve resulted in really lovely content. The next big thing that’s coming out is a book from Bloomsbury titled Culture and Medicine: Critical Readings in Medical Humanities, co-edited by Rishi Goyal and Arden Hegele. We’ve taken twelve essays from Synapsis that we’ve found represented the range of the writings, which the writers have expanded significantly (from 1500 to 6000 words), and added critical introductions and conclusions. It’ll be a health humanities reader, and it will be coming out later this year.

AH:  I agree with everything Rishi just said about what mechanisms to do differently. When we had the retreat, we surveyed the participants. There was a lot of enthusiasm for retaining the mechanisms of publishing that are in place at the journal now. One of our recent efforts has been to formalize some of the assistants’ roles within Columbia and to gain more institutional backing for the publication, and we’re successful in doing that, even now with positions like Danielle Drees’s Assistant Editorship and Lilith Todd’s work as the Social Media/Copy Editor. We’re hoping to instantiate positions every year as opportunities for growth for graduate students. So we’re very happy about that. And as Rishi mentioned, the book coming out is a major achievement for us.

Our Justice-in-Education special issue, created with the Justice-in-Education program at Columbia, is coming out as a print volume. With future special issues, we hope to have print editions.

Another feature of Synapsis is guest essays, which constitute quite a large proportion of our editorial work. We’re often approached by external writers with pitches for essays. We review them, and then they go through professional editing. Overall, we have two mechanisms for publication: one is to become a regular writer, at the end of the summer and continuing for the academic year, which comes with an affiliation of Contributor in Residence. The other mechanism is to pitch us with a guest post, and we enjoy taking those as well because often they provide a different disciplinary or national or institutional perspective that we haven’t fully represented.

RG:  Some other things I’m really happy we came up with were having an Artist in Residence [Jac Saorsa; Darian Goldin-Stahl] and we also had Musicians in Residence [Bennett Kuhn; Erica Cao]. In a lot of ways, we focus more on writing and humanities, rather than creative arts or even fiction writing. But the artists injected a really interesting visibility into the journal and made us think about the relationship between arts and health and medicine, which was really very important for us.

SB: What closing thoughts would you like to leave us with?

RG:  A big part of our ethos throughout has been working with junior scholars, graduate students, and undergraduates. We think of this as an educational space for the public readership, and also an educational space in the way that Arden and I are teachers. That’s the commitment we bring to this as well, and we love the idea that we’ve been able to help students and younger junior faculty move through their careers. More than one of our writers has used their Synapsis writing in their tenure folders. And I think that that’s really appealing: that there are these forms that you can create that allow people to progress in their own fields.

SB: I really have appreciated the opportunity to contribute, and engaging with the great diversity of disciplinary and perspectives every month supplies me with a steady dose of invigorating health humanities throughout the year. I’ve also assigned many pieces from the journal. Thank you for sharing your thoughts and behind-the-scenes work with Synapsis with readers. We look forward to the new developments over the summer, the book, the new special issue, and all of the community-building and collaboration to come.

Readers can follow Synapsis on social media or email.

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