The Act of Becoming: History and Process

DailyDose_PosterAs I have been researching for the Dittrick Museum’s NEH funded How Medicine Became Modern project, one thing continues to rise, like persistent smoke over a not-dead fire: We are all becoming.

If you take a slice of time, section it out from history, and reproduce it, you necessarily remove it from its social, economic, cultural, and medical context. We might compare this to other dissections; if you were to remove an organ from the body with the object of “preserving it,” you would cut the vessels and arteries, sever the nerves. You would preserve a moment in time, cut off from the living, constantly changing organism in which it once flourished. Our bodies, our systems, our governance, our societies, are in a constant state of flux.

Some call this entropy. In thermodynamics, entropy is the measure of disorder–of decay. In ecology, however, entropy is the measure of biodiversity–of life itself. Change is the indicator of life, or living, and of have-lived. We are change.

IMAGE_2In the history of medicine, this sense of change shows up as very non-linear progress. A quick case study: germ theory offered a true paradigm shift, a huge leap forward in understanding the cause and consequence of disease. But the implementation of the theory went in several directions; living in the moment, you could not have predicted its course. The carbolic acid sprayer represents one way forward; you could spray down the surgery, the surgeons, and everything else with the caustic stuff and kill the germs that were there. It saved lives! But it was, itself, short lived. Why? Because aseptic medicine (gloves, gowns, sterilization, etc) made it possible to keep the germs from getting in to begin with–no need to hose down the hospital room. The latest innovation gets relegated to the museum in short order, and that, for a successful device! Imagine those unsuccessful ones, the attempts, the trials. “What was 19th century medicine like?” There isn’t a single answer. And someday, when the same question is posed about our modern medicine, it will be just the same.

Looking at a slice can be useful–as useful as examining a preserved organ. But it can be misleading, too. Slate carried a response today to the Vox Victorians, the couple (Sarah Chrisman ad her husband) who claim to live “just like” the Victorians. The criticism: you cannot. Because this is not the Victorian Age. That era has passed, and along with it, many of the diseases and public health problems that plagued its people and dirtied its cities. Sarah Chrisman herself suggests that historians make this error all the time, misinterpreting the past. Of course, as historians, we are often very cognizant of our limitations (and usually list those very biases in the research). But Chrisman’s attempt at recapturing the past is likewise flawed. Just as the Victorians were in their own process of becoming–driven by the thrush and thump of a nation’s heartbeat, fed by its food, circulated by its air, debilitated by its diseases–so too is she (and all the rest of us). We cannot escape our moment in time, though we trail the spiderwebs of by-gone eras, and grasp at the starry field of yet-unfolded tomorrows.

It is a privilege to look into history from so healthy and unencumbered a vantage point. I know I am enriched by the discoveries and progress of my forebears, even while I inherit a still-ailing world. I say frequently that you can’t know where you are going without understanding where you have been; I think, though, the inverse is also true. You cannot really know the past without a recognition of your present, and of your hopeful contribution to the future.

And it is something I continue to be mindful of, even as we seek to share: How Medicine Became Modern.