Collaborating with Medical Communities: Personal Experiences of Digesting the Medical Past

digestingthemedicalpastIan Miller, Irish Research Council Postdoctoral Fellow at the Centre for the History of Medicine in Ireland, University College Dublin, writes: As I stood at the back of the operating theatre dressed in a blue surgical gown watching a stomach tube gradually slide into the patient’s gullet, the physical discomfort involved in diagnosing gastric illness seemed increasingly obvious. As the tube slowly descended into her body, the patient gargled, choked and squirmed. The small camera attached to the end of the tube allowed me to observe the instrument’s gradual descent into her digestive tract; a journey displayed on an external monitor to allow the gastroenterologist performing the procedure to search for signs of gastric ulcer disease (GUD). The patient would probably have been highly surprised had she learnt that I was a historian invited into the theatre to witness her uncomfortable examination to aid my research.

The importance of interdisciplinary collaboration is being increasingly recognised in the medical humanities. Interactions between medical professionals and historians of medicine can, in theory, enrich and add depth to historically-focused research in medicine. Simultaneously they can grant medical experts with a unique opportunity to reflect upon the nature, origins and development of their particular specialism. Of course, there is a high risk of clashing perspectives and differing research priorities, not to mention the formidable difficulties involved in reconciling past and present medical evidence. Nonetheless, my collaborative doctoral research – co-supervised by medical historians and a gastroenterologist – offered me a fascinating, insightful and unique doctoral experience. It also demonstrated to me the value and benefits of interdisciplinary research in medical history and humanities.

At the time, being invited to stand at the back of an operating theatre watching a gastroenterologist set to work on a patient seemed to me to be a somewhat gory, almost unnecessary, collaborative step too far. But it did allow me to appreciate the pain and discomfort often caused by chronic gastric illness as well as the intrusive nature of the diagnostic techniques relied upon to investigate gastric symptoms. Ultimately, this deeply influenced my approaches to recapturing past personal experiences of chronic gastric pain and exploring historical encounters between patients and medical experts.

During my doctoral studies, I also embraced opportunities to discuss with leading British gastroenterologists the declining popularity of ideas that gastric conditions are somehow stress-related; a once-popular idea that swiftly fell out of fashion in the 1980s once H pylori bacteria was proven as responsible for GUD. My private communication with gastric experts revealed a persistent, but publicly unspoken, suspicion that stressful life-changes and the psychological anxiety that accompany them could still be somehow linked to the onset of gastric illness. Conversations such as these encouraged me to produce a study that asked how ideas about gastric illness fell in and out of fashion over time; that inquired into the interplay between physical and psychological views on the stomach; and which considered the potential implications of this for current medical practice.

My experiences with gastroenterologists were certainly mixed. Some were remarkably receptive to the methodologies of medical historians and willingly reconsidered the ways in which they had previously thought about their profession’s past in terms of medical heroes and grand discoveries. Others remained less enthusiastic. Some experts whom I communicated with critically queried my approaches to interpreting historical medical data. On one occasion, a leading gastroenterologist informed me that all medical records from around 1820 are accurate and precise due to every single cadaver having been opened up by anatomists to establish a cause of death. As a medical historian, I considered this perspective to be alarmingly simplistic and highly problematic.

In 2011, I revised my doctoral research in a monograph entitled A Modern History of the Stomach: Gastric Illness, Medicine and British Society, 1800-1950 published with  Pickering and Chatto. I have since continued to expand upon some of the key themes identified in my thesis by pursuing postdoctoral research into the history of food, diet and nutrition, as well as the general development of modern scientific medicine in both Britain and Ireland. Recently, I established a new blog – in which I will regularly communicate the most interesting aspects of my current and earlier research. The blog will also serve as a useful resource for historians interested in food-related issues by providing regular news and reviews.

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