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.

Medhum Monday: Embracing Digital History with How Medicine Became Modern

index What was it like to be sick 50 years ago? 150 years ago?
What medical innovations most changed American lives?
How did Cleveland rise to importance as a medical city?
In other words:
How did we get here?

We at the Dittrick Medical History Center and Museum received some excellent news last week! In collaboration with design partners and funded by the National Endowment for the Humanities, we present: How Medicine Became Modern, an innovative new way to explore the artifacts, people, and stories behind the great innovations of our age!

Museums nationally and internationally are reaching new audiences—while retaining and engaging present ones—through the medium of digital technology. The Philadelphia Museum of Art presented inter-actives for Treasures of Korea; the Field Museum of Chicago showcased a 3D exhibit about Tyrannosaurus bones; the British Museum of London installed 3D touch-activated Explorer Tables allowing virtual autopsy of a mummy. More locally, the Cleveland Museum of Art opened the award-winning Gallery One.

Now, the Dittrick Museum embarks on a project to make history come to life through a 10ft by 4ft interactive digital wall–a place where visitors can “handle” artifacts (rotating BC-Logo_LGand zooming), and more importantly, a place to engage with the human stories behind them. Partnering with Zenith Systems and Bluecadet, and supported by NEH’s Museums Libraries & Cultural Organizations grant, How Medicine Became Modern will go live in 2017!

Exhibit Details:

  • 6Free-standing 10ftx4ft wall in the main gallery
  • Ability to zoom, rotate, interact with artifacts
  • Links to the stories behind artifacts/Access to interactive game-play
  • Four lenses into medical history:

HMBM

 Want to hear more?

How would something like this work? Why would a museum want to take part in digital mediums? The 225th anniversary of the College of Physicians of Philadelphia Historical Medical Library (also the parent body of the Mütter Museum) asked these very questions in 2013. The answer? Museums and libraries must see new ways of engaging the public–and of building community. As I say in an essay for H-Sci-Med-Tech, History—far from being lost in the past—is by these means coming out to meet new friends. The story of medicine’s past offers something valuable to medicine’s future, a new way of interfacing between worlds that is both physical and digital, then and now. We enter the story through these public spaces, and through digital mediums, medical collections around the world are beginning to reach beyond them as well. What we see is a convergence of exhibit, interaction, and digital outreach.


A Practical Example from the Project:

The history of medicine offers much more than static displays or old tech. Each object, from a cast of Joseph Lister’s hand to a full-scale working x-ray machine, tells a tale of personal tragedy and triumph, of success and failure, of hopes and dreams.

Take, for instance, the phrenology bust. Sleek, smooth–replicas are attractive enough to show up on end-tables and mantle pieces. But what’s the story? It’s about Diagnosing by the Bump!

Franz-Joseph Gall (1758-1828), proposed that different functions, such as memory, language, emotion, and ability, were situated in specific “organs” of the brain. These portions of the brain would grow or shrink with use, and the changes would appear as bumps or depressions on the skull. Called Phrenology, the practice of “reading” the bumps supposedly allowed a practitioner to assess different abilities and personality traits. Does that make sense? What might our own phrenological assessment look like? The digital display allows the viewer to see a chart with interactive sections of the brain. Why not do your own “reading”?

William Cowper. 1737. The anatomy of humane bodies
William Cowper. 1737. The anatomy of humane bodies

But that’s not the only story. Phrenology resonated with the American Dream. Johann Kaspar Spurzheim (1776-1832) arrived to begin a speaking tour, and found a very willing audience. Why? It fit the “American Dream” idea of rising from nothing, emphasizing the ability to train the mind and attain social mobility. In other words, despite the bumps you were born with, we could all get better, a kind of rags-to-riches idea very popular even today. One of Cleveland’s own doctors had his “head examined”—Jared Potter Kirtland. On the other hand, phrenology and it’s sister pseudoscience physiognomy had a dark side; they privileged one race, one class, and one sex. Not exactly a “dream” of equality. (And for the record, Kirtland did not apparently agree with the reading; the booklet has his marginal notes!) The digital display offers the visitor a window in time; they can see the images and texts (and hand written notes!) while learning about larger ethical dilemmas.

Phrenology was later abandoned and its practitioners were attacked as charlatans and fakes. Even so, phrenology helped to move psychological understanding forward in two important ways: 1. it suggested that different parts of the brain did different things and 2. It demonstrated that individual effort could be just as, if not more, important than biological inheritance. The take-away? Through digital means, the visitor doesn’t just see the bust in a cabinet. Instead, he or she can look at it closely, from all angles, and then walk through time.

Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy
Johann Heinrich Oesterreicher. 1879. Atlas of human anatomy

Better yet, the visitor can walk through the body—through anatomies and flip books of fugitive sheets (where each layer reveals more of the anatomy underneath). So much of our fragile history remains out of reach for visitors–but digital humanities/history projects can do much more than show the item itself. It can open up that artifact as a window into another time, another place.

We look forward with great anticipation to bringing this digital history/digital humanities project to life–the human story behind medical history: “How Medicine Became Modern.”

 

ORIGINALLY POSTED TO DITTRICK MUSEUM BLOG

MedHum Mondays: Why Medical Humanities?

DailyDose_darkstrokeI have worked in the medical humanities for a number of years, now, and probably the one question that I hear most often is: what is it? I’ve defined it a number a times, a number of ways, but at its most essential “medhum” operates at the intersection of medical practice, medical history, and the studies of social science, ethics, anthropology, literature, and the arts. I like to think of it as a lens for examining health and the human, not just for buttressing medical studies but for looking carefully and analytically at how medicine influences and is influenced by culture. But I’m not principally going to speak about that today; instead, I want to address the second most important question I hear: why is it important?

Actually, that’s not the most accurate representation–it usually doesn’t come as a question at all, but an assumption. Things I have heard from people I’ve met (many of them medical practitioners): Medical humanities is “fluff stuff,” is “not important for the practice of medicine,” is “not real,” or alternatively–it is important, but insignificant enough to be shoe-horned into existing programs as a means of rounding out a doctor’s education.  On one hand, there is nothing particularly malicious here. It’s even complimentary in it’s way, and I’ve certainly met a number of physicians and directors trying to incorporate medical humanities in a positive and constructive manner. The trouble is, in an already robust program, you can’t really provide more than add-ons, and, given the strictures already placed on beleaguered med students, these are necessarily going to seem like “fluff.” This would explain the fairly luke-warm reception I get when I present medhum to doctors and residents at hospitals (something I do with some regularity). It’s not hostility. It’s often unintentional. After all, there is respect for what I do or they would not have invited me. The trouble is, you can’t answer “is medical humanities important” until you have radically reconsidered the question.

Not “what is it” or “is it important,” but “what are medical humanities for?” Let’s answer that first, and see where it gets us with the other two.

1. Medical Humanities provides a new way of seeing the connection between health and the human.

It’s for troubling the waters of progressive histories and instead stopping to reflect on the people, the doctors and patients, and what is at stake for them.

2. Medical Humanities can help us see how culture influences and is influenced by medicine.

It’s for stepping outside ourselves, using social medicine, anthropology, and history to see beyond our own culturally informed beliefs.

3. Medical Humanities can provide new means of expression about health and the body, specifically for under-served or unheard populations.

It’s for using the arts and literature not just to make doctors more humane (though this is often a positive outcome), but to provide an outlet for patients, their families, and others about health, body, illness, and medicine. It can be a means of hearing new voices, too, particularly those not “heard” in traditional discussions of medicine.

4. Medical Humanities serves as the basis for a broad, interdisciplinary field and can make important contributions to our understanding of medicine.

It’s for study, for research, for building knowledge. One reason medhum does not “shoe-horn” well is because it represents an enormous field of inquiry. Entire departments, centers, and schools have been dedicated to its study. Then why not just say “arts and sciences?” A reasonable question–but again, slightly wrong-headed. Medical Humanities are not for general education and study, but directed approaches that use the humanities, arts and sciences to critically analyze our relationship to medicine.

These four outcomes help to explain why medhum is important, while helping to elucidate what it is: show, don’t tell. Do, don’t speculate. It’s an active perception, a researched and guided approach. I’ve come at it from history and literature, others have come at it from sociology and anthropology, and still others from medicine and ethics. All of that is allowed. Encouraged, even. The intersection matters–it’s our greatest strength. Rather than assuming medhum to be some small component, some insignificant piece of a wider puzzle, we should see it as a meeting place. Here, we can make connections. Here, we can be heard.

And that’s why it matters.