Obiturial prosopography of contemporary biomedicine

As contemporary biomedicine -- the use of molecular and digital biological and medical technologies -- is coming of age, its pioneer practitioners are passing away, and as a consequence biography becomes increasingly important as a genre for understanding its development and workings.

Biographies come in many varieties. One of the least conspicuous, but also most read, is the obituary -- a public notice of a recently deceased person, usually in the form of a short life description, often in a newspaper or a popular magazine. Many more people get obituaries than short biographical articles, not to mention full-scale scholarly biographies; in fact, most people of some public importance get at least a minor notice in the form of an obituary.

Obituaries are a potentially very interesting material for representing the contemporary history of biomedicine. Between the lines about the portrayed person the obituary presents pieces (like single pixels on a screen) for a picture of a more complex history, and by accumulating large numbers of obituaries the pixels coalesce and form historical patterns. This way of combining of singular live-descriptions into a larger pattern is what historians call prosopography.

The number of obituaries about biomedical practitioners is growing rapidly. Many who were active in the heroic period of molecular biology in the 1950s and 1960s have already passed away, and now the great names in biovisualisation technologies are following them in turn. For example, in the last couple of weeks many newspapers and magazines have carried obituaries of the 'father of magnetic resonance imaging', Paul Lauterbur (see e.g., this one in The Economist of April 7).

What's interesting about this kind of 'obituarial' contemporary popular history is the variability between the accounts. With few notable exceptions, most scientists and medical people only get one book-size scholarly biography or biographical article (if they ever get one at all). But popular obituaries, like that of Lauterbur, are not only much more frequent -- they also come in many versions written by several obituarists for many different newspapers, journals and magazines, and therefore give a much more composite picture of the history of MRI. Together with obituaries of other pioneers in biovisualisation they add up to what might be called an obiturial prosopography of the field.

The archive is growing ...

I've begun to file a few papers and unpublished talks in the archive -- you can either search for key terms ('biography', 'care of self', etc) or look in monthly folders (see further down in the column to the right).

Using the blog as an archive

The time-stamp feature makes it possible to antedate a post and thus create an on-line searchable text archive. I will begin putting my old texts on representations of individuality in biomedicine in antedated posts. For example, I've just posted the manuscript for a seminar paper that I wrote in September 1991 (gosh, that's along time ago!) and antedated it as if it was written then -- although blogs didn't exist at that time.

Plutarchian versus Socratic scientific biography

I was working on a draft to the first chapter of my biography of Niels Jerne (note 1) when his elder son called me on a Friday morning in October 1994 to tell me that Jerne had died during the night. The funeral would take place on the following Monday. I hastened to say that I was on my way to a History of Science Society meeting in New Orleans and that biographers oughtn’t attend their subjects’ funerals anyway (except perhaps discreetly observing the event from a distance). My excuses were accepted without further ado.

Two days later, while waiting for my connecting flight at the JFK, I bought a copy of the Sunday New York Times which to my pleasant surprise carried a half-page obituary of Jerne, a nice piece of top-notch science journalism. And when arriving at the conference hotel a few hours later, I realized that many other historians of science too had read the obituary, because friends and colleagues who knew about my project came up and gave me their condolences. “I’m so sorry”, said one. “Bad news about Jerne”, said another. “You must be devastated”, said a third. I felt somewhat uneasy, didn’t know what to think, even less what to say.

I got my keys and was just about to go up to my room and get a night’s well-deserved sleep when a tall, white-haired, handsome man in his sixties wearing a worn tweed jacket came out of the restaurant. He caught my eyes, strolled up to me, somewhat hesitantly, and greeted me with a shy smile on his bearded face: “Thomas, you must be relieved!”

In my jet-lagged state I didn’t quite hear if he was serious or in a joking mode. Whatever, his words hit a chord inside me. I stretched out as if to embrace him, then realized that this was perhaps not quite proper procedure, and cried out so that everyone around could hear: “At last, someone who understands how I feel!” That someone was Sam.

Silvan S. Schweber, of all people at the HSS meeting, understood. Not only because he is one of those rare members of American academia who listens to, contemplates and understands what you tell him (another member of this rare breed of academics was the late Larry Holmes). But also because Sam too was living with a problem that had bothered me for years, viz., how to research and write the biography of a living scientist.

A few months before the HSS meeting, we had both attended a meeting at Stanford on oral history of science. Sam and I were the only participants who were writing biographies. I talked about my ongoing study of Jerne, Sam about his work with Hans Bethe. We discovered that not only had we both devoured our subjects’ scientific publications and delved into their personal document files, but also interviewed them at length. And more importantly, we were both interested in the moral lives of our subjects.

To me ethical questions were something new. Sam on the other hand had already spent the better part of a lifetime reflecting on the moral landscape of science, in his case bomb physics (note 2). He was, of course, never involved in any bomb work himself, but the moral aspects of physics have nevertheless loomed large in his intellectual development. Already when arriving in Princeton in the fall of 1949 to do graduate studies in theoretical physics, he was confronted with the debate on whether to develop a hydrogen bomb; he continued as a postdoc with Bethe at Cornell and later became actively involved in the creation of the physics department at Brandeis.

The student unrest that followed in the wake of the escalating Vietnam war in the late 1960s got him even more deeply involved in the moral issues of academia. In the course of this journey Sam has also made a significant detour to the moral grove of biography. In the Shadow of the Bomb (2000) summarizes many years of close insights into the development of theoretical and nuclear physics. In the form of a parallell biography — or rather a sort of modernized, i.e., strongly contextualized, version of the classical Plutarchian format — Sam analyzes the shaping of Bethe’s and Robert Oppenheimer’s moral outlooks and their ensuing struggle with the ethical and political aspects of the new knowledge and technology of atomic fission and its consequences for humankind. Was the Enlightenment ideal still valid? Was knowledge always a good in itself? Should some knowledge be forbidden?

The gist of a Plutarchian biography is the ethical evaluation of two political actors who handle similar kinds of problems in different ways. Oppenheimer and Bethe had much in common, including a strong faith in reason, a conviction that science is always good, and that shared knowledge will sooner or later lead to progress. But they also differed in important respects, and in Sam’s interpretation this was most evident in the way they positioned themselves in the spectrum between individuality and communality.

Whereas Oppenheimer tended to seek individualistic solutions to moral problems and became “a lonely and somewhat solitary personage” (p. 184), Bethe sought solutions at the level of community. Whereas Oppenheimer could so eloquently voice (“and perhaps only voice”) love and the care of mankind, almost as if he were a poet, Bethe created a strong community around him that gave him “sustenance, fortitude, and caritas” ( p. 27).

If Sam would have to choose between the two, he would undoubtedly turn up on Bethe’s side. He does indeed respect Oppenheimer, but his former mentor at Cornell — the subject of the full biography yet to come — is closer to his heart. Even for those of us who do not know Sam well personally, it is evident that Bethe’s ideals are also his. In this sense In the Shadow of the Bomb is a labor of love and a practical demonstration of a central aspect of the Plutarchian biographical tradition, viz., to be edifying. Sam has been edified and wants us to be too.

Much as I sympathize with Sam’s biographical position, however, I am not sure that the future of biography’s edifying capacities lies here. Not because In the Shadow of the Bomb focuses on great men as such and their theories that shook the world; after all, this seems to be a valid account of the situation at the time. But rather because this great men/big theories/dire consequences-kind of biographical poetics may be difficult to apply outside the atomic age, which is unique in that the chain of events could have resulted in the eradication of all of humankind in one singular political act (as it perhaps almost did during the Cuban crisis).

The ethical problems involved in, say, the present development of the biomedical sciences, seem to be of a quite different kind. Unlike classical big physics, biomedicine is a network-like pattern of interaction between the demands of millions of consumers of biomedical products and hundreds of thousands of more or less proletarianized laboratory scientists (with few theoreticians or classical intellectuals among their ranks) in both public and private laboratories; the two sides are mediated by a large number of private biotech companies operating against the backdrop of a volatile stock market. In this scenario there is hardly any place for noble theoreticians who feel responsible for the catastrophic consequences of scientific discoveries.

In other words, even though Sam’s biographical project is commendable for giving us an understanding of the moral dilemmas and responsibilites of scientists in the state-driven atomic era, I believe that today’s fragmented, individualistic, narcissistic and market-driven global technoscientific culture calls for a different sort of ethically-oriented life writing. In short, I suggest that the future for biography as an ethical genre — in contrast to the standard function of the genre as an ancilla historiae, i.e., a way of writing the history of science by other means, or
as sophisticated entertainment á la Dava Sobel — relies on its ability to resonate with the technoscientific culture of the twenty-first century. This resonance lies, I believe, in its capacity for being a Socratic exercise, i.e., for being a genre devoted to the project of “knowing oneself”.

Whereas Plutarchian moral biography has raised monuments to model scientists for us lesser mortals to gaze upon with awe, a renewed Socratic genre of scientific biography (single or double) would rather consist in portraits of how members of the new global technoscientific network (it is rather difficult to see it as a community in the old Mertonian sense), create their scientific and life projects. Such portraits do not have to be restricted to books — in the last decade the film format has proved an increasingly interesting medium for biographical portraits (note 3).

A theoretical and methodological grounding for such a Socratic approach to a renewed ethical biographical genre might be developed with reference to works such as Martha Nussbaum’s, which involves reading fiction as a continuation of the Hellenistic practice of “therapy of desire”, and Pierre Hadot’s — who inspired Michael Foucault to the concept of “souci de soi” (“care of self ”) — proposal that the ancient role of philosophy as a genre for the cultivation of “spiritual exercises” has interesting late modern repercussions (note 4).

By viewing/reading about the cognitive yearnings, professional passions, and life choices of other actors on the technoscientific stage, twenty-first century scientists may thus learn to be more reflexive in their daily life-practices and more willing to engage in practical virtue ethical training. In that way scientific biography might help undo some of the a-morality that permeats today’s global technoscience, not least its biomedical sector (note 5).

Notes:
1. Thomas Söderqvist, Science as Autobiography: The Troubled Life of Niels Jerne (New Haven: Yale University Press 2003).

2. I have borrowed the phrase “moral landscape of bomb physics” from Gregg Herken’s review of Silvan S. Schweber, In the Shadow of the Bomb: Oppenheimer, Bethe and the Moral Responsibility of the Scientists (Princeton, N.J.: Princeton University Press 2000) in American Scientist, vol. 88, nr 4 (July–August), 2000 (quoted from on-line version: http://www.americanscientist.org/template/BookReviewTypeDetail/assetid/25926).

3. Like Richard Eyre’s A Memoir of Iris Murdoch (2001). I must confess, however, that I rather prefer Helen Mirren’s portrait of the daily life and work and moral quanderies of fictional detective chief inspector Jane Tennison in Prime Suspect (1991–1996) to Russell Crowe’s quasi-realistic and sentimental rendering of mathematician John Nash in A Beautiful Mind (2001).

4. Martha Nussbaum, The Therapy of Desire: Theory and Practice in Hellenistic Ethics (Princeton, N.J.: Princeton University Press 1994); Pierre Hadot, What is Ancient Philosophy (Cambridge, Mass.: The Belknap Press 2002); Michel Foucault, Histoire de la sexualité. 3: Le souci de soi (Paris: Gallimard 1984).

5. For a more extensive discussion of scientific biography as a genre of virtue theoretically based research ethics, see, e.g., Thomas Söderqvist, “Immunology á la Plutarch: biographies of immunologists as an ethical genre,” pp. 287–301 in: Anne-Marie Moulin and Alberto Cambrosio, eds., Historical Issues and Contemporary Debates in Immunology (Paris: Elsevier 2001), Thomas Söderqvist, “Wissenschaftsgeschichte à la Plutarch: Biographie über Wissenschaftler als tugendetishe Gattung,” pp. 287–325 in: Hans Erich Bödeker, ed., Biographie Schreiben (Göttingen: Wallstein Verlag 2003), and Thomas Söderqvist, “What is the use of writing lives of recent scientists,” pp. 99–127 in: Ronald E. Doel and Thomas Söderqvist, eds., The Historiography of Contemporary Science, Technology, and Medicine (London: Routledge 2006).

(manuscript to be published in J. Renn and K. Gavroglu (eds.), Positioning the History of Science, Springer (2007). Thanks to Finn Aaserud, Adam Bencard, Janet Browne and Ron Doel for constructive remarks. [Added in May 2007: The volume has now been published!]

Combining wikis and blogs for joint document editing

When thinking about possible ways of working out an on-line writing project of this kind, I was inspired by Laura Cohen's post "Why Can't a Wiki Be More Like a Blog?" on her blog Library 2.0: An Academic's Perspective. Wikis are great for collective editing, but discourages people who "just" want to add comments. Blogs on the other hand don't have the collective editing feature. Why not create a mix, a sort of Wikiblog? An example of a half-way solution that Laura Cohen mentions is the annotated edition of The Iraq Study Group Report which shows a very nice comment system where you can open windows and comment on each paragraph in the document. Says Laura: "Wikis and blogs could benefit from incorporating each others' features. This could move us toward a truly full-featured integrated publishing platform in which the best of both systems are available".

Metabiography

As the number of biographies has grown over the centuries, so has the number of famous people whose lives have been subjected to several or many renditions; some popular historical figures have in fact occasioned more than a hundred biographies (an anonymous blogger recently proclaimed that she had nearly one hundred Marilyn Monroe biographies on her shelves “and I never get bored reading them”). Thus the emergence of a supergenre, the “metabiography,” which does not restrict itself to writing yet another and infinitesimally “truer” version of a life (perhaps based on a newly discovered letter or diary) but primarily analyzes earlier versions to make a critical appraisal of the tradition of life-writing about a particular subject. An excellent recent example is Lucasta Miller’s The Brontë Myth (2004) which is not so much a biography of the Brontës as a book about biography where the author demonstrates how generations of literary historians and life-writers have remolded the Brontë sisters to fit their own agendas.

Scientists have had their metabiographers too. More than fifty years ago, Henry Guerlac (1954) set the example with an essay on Lavoisier and his biographers. He was followed by Dorinda Outram (1976) on the tradition for Cuvier-éloges; David Cassidy (1979) on biographies of Einstein; Marilyn Marshall (1980) on Fechner-studies; Steven Jacyna (1983) on the succession of nineteenth-century images of John Hunter; Frederick Churchill (1982) and Marjorie Greene (1993) on the Darwin-biographical tradtion; and L. Pearce Williams (1991) on Faraday-biographies. The first scientific metabiography in monograph form was probably A. Rupert Hall’s study on eighteenth-century biographies of Newton (1999). The entries on individual scientists in the Reader’s Guide to the History of Science (ed., Arne Hessenbruch, 2000) follows the same pattern — it is not primarily the details of the life and work of the scientist but the changing interpretations by different biographers that is in focus.

Although Nicolaas Rupke was apparently not aware of this emerging metabiographical literature when completing his study of the Humboldt phenomenon in Germany (Alexander von Humboldt: A Metabiography. Frankfurt: Peter Lang AG, 2005) his book fits nicely into the tradition. Alexander von Humboldt (1769-1859) is a good choice for a metabiographer. A celebrated naturalist, scientific traveller-explorer, physical geographer, and intellectual, indeed one the best known figures in the history of German science and learning, he has been the subject of a huge publication industry. Fellow scientists, science popularizers, journalists, and to some extent historians, have contributed to the facets of the many Humboldt portraits.

“Who did the many writers about Humboldt think he really was?” (p. 17), asks Rupke and answers the question by identifying a number of political camps in modern German history that have appropriated Humboldt over more than 150 years and “aggressively recreated” his life and work “to suit contemporary needs” (p. 208). There is Humboldt the national hero of the revolutionaries of 1848; the subversive democrat at the Prussian court; the culture chauvinist of the Weimar republic; and the Aryan supremacist of the Nazi period. Postwar Humboldts include the antislavery marxist of the East Germans; the cosmopolitan friend of the Jews; and today’s pioneer of globalization (there is, of course, even a “green” and a gay Humboldt). Each of these get a separate chapter in Rupke’s well-researched (the list of printed sources is 75 pages long), densely written and fact-heavy study. The only significant political institutions in Germany that have not been involved in the cultural construction of their own Humboldt are the Lutheran and Catholic churches.

Rupke concludes that a study of the Humboldt phenomenon is attractive as a means for understanding changing modern German identities. Humboldt’s life and work was an “agora” that shaped a discourse not only about the natural world, but as much about his own nation, enabling Germans to deal with “national ambitions, shortcomings, guilt complexes and the like” (p. 206). He also concludes that all the Humboldts — whether good or bad, scholarly or popular — are the product of institutional cultures. The task of metabiography, in Rupke’s view, thus is primarily to explore the ideological embeddedness of biographies, not to settles issues of their authenticity.

Despite a concluding section on metabiographical reflections and “an inevitable moment of self-reflection” (p. 217), Rupke never really becomes self-reflexive, however. He reprimands biographers who thought they were only describing the facts of Humboldt’s life; yet he basically treats the political and ideological circumstances around the successive Humboldt constructions in an similar down-to-earth factual manner. And he does not seem to realize that the phrase “In historiography there does not exist an Archimedean point” (p. 217) is as strongly ideologically embedded in contemporary Western culture as the Humboldt-authors whose writings he has so skilfully analyzed. This is a minor point, however. In general, Rupke’s study is a clear improvement of the earlier scientific metabiographical tradition from Henry Guerlac to A. Rupert Hall. It is well-written, (albeit not elegantly) and will doubtlessly become a standard reference for the Humboldt industry and for writers of scientific metabiographies to come.

Dictionary of Medical Biography

I just want to announce the publication of the five volumes of Dictionary of Medical Biography, edited by Bill and Helen Bynum for Greenwood Press. It came out the day before New Year's Eve (30 Dec. 2006), so I haven't seen it in print yet.

Several of my present and former colleagues here at Medical Museion (and myself) have written articles for it (in addition I was area editor for the Nordic countries, i.e., Denmark, Finland, Norway and Sweden; unfortunately no Icelandic medical doctors are included). The Bynums allowed for 38 entries from the Nordic countries out of a total of approx. 1100, so we had to make some pretty tough decisions -- in fact, not even all medical Nobel prize winners have been incorporated.

I'm curious to read the Bynums' editorial introduction. Judging from the original author instructions back in 2004, this is a fairly conventional biographical dictionary. But I will postpone all critical remarks until I have received my area editor's copy (wouldn't dream of buying it myself; it costs 750 USD! -- hopefully major libraries will buy it, though)

A research and writing experiment

Besides posting news and occasional thoughts, this blog is also conceived as an experiment in on-line writing.

A couple of months ago I decided to write a small book on "Individuality in biomedicine" -- and now I've found out that I want to do it in the public sphere. In other words, I will try to develop the manuscript on-line by posting new ideas, readings, successive changes in the argument and chunks of text here.

I'm not intending to be too honest: I will probably spare you too many unfinished fragments and stupidities. This is not going to be warts and all. On the other hand I will really do my best to post text, ideas, questions etc. regularly as the book develops.

Some of my colleagues have told me they would never want to do anything like this, because they are afraid of being scooped if they share before 'real' publication. I see the point -- in some areas competition is indeed high, which means that you risk seeing your ideas ending up in someone else's book or paper before you get them out in print.

But this field (I will try to explain what I mean by "Representation of individuality" in later posts) is almost empty, as far as I know. As things stands now, the hope of finding someone out there to share ideas with trumps my anxiety of having my (probably not very original) ideas stolen.

I don't know if this is going to work or not, but I'm ready to give it a try. You are very welcome to comment, both on the substantive content of individual posts and on the experiment as such.

Welcome

This is the start of my research blog on representations of individuality in biomedicine. I'm already posting on www.corporeality.net/museion. But that's for our joint project. This blog is about my own subproject.

Why are there so few scholarly biographies in the history of medicine and public health?

This paper was given as a keynote plenary lecture to the 7th Congress of the European Association for the History of Medicine and Health (“Health between the private and the public: shifting approaches”) in Oslo, September 3, 2003. It was later published in Michael: Publication Series of the Norwegian Medical Society, vol. 2 (2004). For web version, see here.

A meeting like this is a welcome opportunity to raise historiographical questions, i.e., questions about the many assumptions (ontological, epistemological, cultural, or ideological) that guide professional practice in the field of history of medicine and public health.

One such set of historiographical questions has to do with the place and role of the individual in interpretations of the past. Is the individual subject just a social, cultural or linguistic construct? Are “agents” and “actors” primarily defined by webs of discourse? Or do individuals have a role as free and independent creators of society and culture, i.e., as sources of culture rather than its results? And if so, to what extent? Further (to raise the “utility”-question), is the ultimate purpose of interpretations of the records of the past to teach lessons for future collective action? Or is it also to emancipate the individual and to turn him or her into a morally competent global citizen? And finally (to raise the “reflexivity”-question), to what extent do such different opinions about the individual’s place in history, ­express different cultural and ideological assumptions, or even different personal life-experiences, among historians of medicine and public health?

In the wake of such questions and meta-questions about the place of individuals and their experiences in history, there is a whole set of issues concerning the role of biography in relation to other forms of writing about the past. The individual subject and its place in history is one of those historiographical topics we tend to repress, and biography is one of those genres of writing we tend to avoid. Why is this so?

Ten years ago, Ludmilla Jordanova pointed out in an essay review aptly titled “Has the social history of medicine come to age?” that she was struck by “the restricted range of genres and topics tackled” in the history of medicine and public health. She added that “one of the most dramatic examples of this is the almost total absence of scholarly biographies”, and continued: “Even for the really big names celebrated by Whig history, few have been the recipients of sustained biographical treatment” (Jordanova, 1993, p. 438). In fact, not even Edward Jenner has received any substantial modern treatment.

I think Jordanova was right in 1993. And even though we have seen some rather impressive examples of scholarly biographical writing since then – consider, for example, works such as Patricia Spain Ward’s Simon Baruch: Rebel in the ranks of medicine (1994), Jacalyn Duffin’s To see with a better eye: A life of Laennec (1998) and Michael Bliss’s magisterial William Osler: A life in medicine (1999) – I am afraid that Jordanova’s ­observation is still valid. The absence of scholarly medical biographies, i.e., biographies about people who have been engaged in medical and public health activities in one way or the other, is indeed dramatic if you compare it with the interest in biographical writing in almost all other fields. ­General scholarly journals like the Times Literary Supplement and the New York Review of Books abound with reviews of biographies of all kinds: historical bio­graphies, literary biographies, art biographies, biographies of philosophers, and so on. But rarely medical biographies.

The absence of medical biographies becomes even more dramatic if one takes a look at one of the neighbouring fields: scientific biography. During the last two decades there has been a swell of biographies about naturalists, microbiologists, biochemists, physicists, mathematicians, and geologists; whatever one desires. Books that have made their publishers happy and at the same time have received applause in the scholarly journals. In the last two decades, historians of biology, for example, have produced at least four major Darwin portraits based on meticulous archival research, one even in two volumes (Browne, 1996-2002). Historians of physics have produced several acclaimed studies of Newton and Faraday, and there have been marvellously written treatises of Lord Kelvin, Louis Pasteur, Thomas Henry Huxley, Fritz Haber, Lise Meitner and Rosalind Franklin, just to mention some random fine examples. In my view good biographies not only show how scientists were integrated into the thinking of their time, and how the life and work can shed light on the cultural, political and social context of science, but also investigate the mind and practice of the individual scientist, and even delve into their private lives and existential dilemmas.

Of course, there are many bad biographies as well; some would say too many. But this is what could be expected in global book market that absorbs around one hundred titles of scientific lives every year. Generally speaking, I think there is a general agreement among historians of science today that biography has become a quite respectable scholarly genre over the last two decades. The genre has blown new vitality into our understanding of science past.

If Academia in general and our disciplinary neighbours in particular, have taken biography to their hearts for some twenty years now, why is this not yet the case in the history of medicine and public health? Why are there still so few scholarly medical biographies?

The question becomes even more topical if one contemplates the fact that the medical-biographical genre has a much longer record than most other biographical genres, including scientific biography. Hippokrates, the celebrated, but elusive phantom figure of ancient medicine, had bioi written of him already in the Hellenistic period, none of which, unfortunately, is extant. A thousand years later, the miraculous healing powers of some of the medieval saints and their relics found the way into their vitae, a genre which later came to be known, somewhat condescendingly, as hagiography (literally saint-writing). And yet another half millennium later, Renaissance and early modern period medical doctors had their given place in the emerging secular biographical tradition, for example in funeral speeches of deceased university professors and in the collections of what was called, ­obviously by inspiration from Petrarch, “the lives of illustrious men”. ­Medical biography is thus a very old genre, obviously reflecting the fact that medicine and healing is an old practice, whether pursued by hippocratic doctors, medieval saints or professors in the early modern medical faculties and it continues to be published in great numbers (Morton and Moore, 1994).

In spite of being old and venerable, however, the genre has lagged ­behind its sister genre, scientific biography, for the last three hundred years (the history of the genres of scientific and medical biography remains to be written; see, for example, Söderqvist, 2002a). The first vitae of the pioneers of the so called scientific revolution, including Copernicus and Kepler, came in the first part of the seventeenth century. As natural philosophy, ­astronomy and physics, and later chemistry and the biological sciences, ­advanced toward the top of the academic pecking order, so did biographical portraits of what gradually became known as scientists, whereas the lives of medical men (and later a few women) were gradually assigned a more humble place in the genre spectrum, compared to the lives of the new ­revolutionary scientists. Consequently, one of the few medical doctors who repeatedly received biographical notice in the eighteenth and nineteenth centuries was Hermann Boerhaave. Of the approximately 1200 medical-biographical essays and monographs published in the three hundred years between 1550 and 1850, almost all were singletons (Oettinger, 1854); Boerhaave, however, received a top score of seven, the most famous of which was that of his admiring English student William Burton, whose ­Account of the life and writings of Hermann Boerhaave (1743) came only a few years after the great master’s death. The fact that Boerhaave towers higher than any other in the Enlightenment medical biographical tradition confirms the impression that he was, in the eyes of his successors, the man who brought the scientific revolution into medicine (Cook, 2000).

The triumphs of scientific medicine in the late nineteenth and early twentieth centuries were, of course, reflected in medical lives, too. But they still lagged behind their more illustrious scientific colleagues. Scientists were conspicuously present in the Lives and Letters-tradition; these spectacular and detailed compilations about the great luminaries of the Age of Imperialism, tomes packed with excerpts from letters, often in two, sometimes three volumes. Darwin, Pasteur, Kelvin, Wallace and the other great stars of nineteenth century science all got their tributes. The mathema­tician William Rowan Hamilton was the subject of 2100 pages in three thick volumes (Graves, 1882-89); the physicist and physiologist Hermann von Helmholtz was memorised by three volumes in German (Koenigsberger, 1902-03). But there were not many great medical doctors among them. And when authors of medical lives eventually adopted this grand format, the era of Lives and Letters had already ebbed out, not least thanks to Lytton Strachey’s and André Maurois’s attacks on what they regarded as ­biographical dinosaurs. Harvey Cushing’s two-volume Life of Sir William Osler in 1925 was one of the most celebrated medical biographies of the ­interwar period and was indeed a great tribute to the man. In form and outlook, however, it came almost a quarter of a century too late. It was out of fashion before it was even conceived.

I will not try the reader’s patience by going into the medical biographical tradition of the rest of the twentieth century, but will hasten to my conclusion of this look-back on the record of the genre, viz., that one reason why there are so few scholarly medical biographies today, compared to, for example, scientific biographies, is that even if medical biography is a very old genre, it never really has had a strong presence as a scholarly genre. True enough, tucked away on the shelves here and there are some extremely well-written and thoughtful studies. But, with the risk of sounding contentious, there have indeed been a lot of bad medical biographies. The Biography Room of the Welcome Library in London contains every possible variety of eulogistic, panegyric, hagiographic, badly written, badly organised, badly contextualised biography, in all major languages: English, French, German, Spanish, Italian, Russian, Danish, Swedish, etc. Biographies written by admiring colleagues, devoted students, faithful wives and proud daughters and sons; biographies written out of duty, or as labours of love; bio­graphies that wanted to set the record straight, and so forth, but very few good scholarly biographies.

This lack of a strong scholarly medical biographical tradition may partly explain the absence that struck Ludmilla Jordanova in 1993. But there is also another, and probably more important, reason which has to do with the strong impact that social history has made on the field of history of medicine and health in the last three decades.

If one goes back to the programmatic manifestos of the social historians of medicine in the 1970s and 1980s, one will note the extent to which they were fighting against the biographical genre. They probably did not do so because they were trying to defend a scholarly space of their own against the dominance of scholarly medical biography (because, as we have seen, there was hardly any such tradition), and their fight against biography was probably not driven by a virtuous wish to combat the many bad medical biographies (because there were bad biographies in all possible areas, including lousy art biographies, literary biographies and scientific biographies, now filling dusty shelves in remote library stacks). Neither did the social historians of medicine fight so fiercely against biography because they were influenced by the vague anti-biographical sentiments fuelled by positivism, Marxism, structuralism, new criticism etc., that hovered all over Academia during most of the post-war period (because art historians, literary historians, historians of science etc., continued to produce scholarly biographies apparently without being affected either by the marxist denouncement of individualism, by Roland Barthes’s call for the “death of the author”, or by the young Michel Foucault’s attempt to eradicate the subject (Burke, 1998)).

So why then did historians of medicine in general and social historians of medicine in particular, try to root biography out? Susan Reverby and David Rosner’s influential anthology Health care in America: Essays in social history from 1979 gives a clue. In their introductory chapter, the editors questioned medical doctors’ definitions of health and disease and hegemony over history; they wanted historians to take over professional ownership of the medical past. But there was more at stake. Reverby and Rosner had a much more far-reaching political goal than control of the past: they evidently wanted to have a say about who should control the contemporary medical system. The new social history of medicine was thought to be a weapon that would unmask “the pervasive societal faith in the potential and efficacy of medical science” (Reverby and Rosner, 1979, p. 4). Historians were thought to help break doctors’ control over the health system. Reverby and Rosner took the side of patients against powerful doctors, and in doing so; they particularly questioned biographies of “great men”, because they believed that biographies were an expression of false consciousness. In their view, medical biographies made the presumed real forces in history – social and economic forces, political discourses, ideologies, patients, nurses, etc. – invisible. In short, biographies upheld the power relations in the medical system.

Confirmed social historians of medicine were not alone in attacking biography as an expression of a deplorable “great doctor”-perspective in history of medicine. With very few exceptions, most professional historians of medicine in the 1980s and 1990s have been hostile, or at best indifferent, to biographical writing (Linker, 2002; Söderqvist, 2002a). This is remarkable, because it was in the same period that Academia in general began to shake the ban on biography imposed by Marxism and structuralism off their shoulders. (Indeed, literary and art historians never found it necessary to fight the art establishment and have therefore apparently not felt any strong need to attack biographies of artists. In fact, it seems as if art historians still feel rather cosy with the idea of the “great artist”; more critical approaches to art biography, like Christie and Orton (1988), have not had much impact).

Likewise historians of science have not felt any strong urge to combat the “great men” of science for political reasons; the idea of “great scientists” has just been considered a trifle unfashionable, so it has rather been a question of moving biography out of the “great man” perspective instead of attacking and denying the genre of biography altogether. As Thomas Hankins wrote in an influential article titled “In defence of biography” published in 1979 (the same year as Reverby and Rosner made their attack), the genre could in fact be used productively to show how the political, social, cognitive, philosophical, etc. aspects of science were working together. Hankins did not see biography as the expression of a suppressive professional ideology, but as a useful methodological tool for exploring science in its wider context.

Hankins’s 1979-article announced the come-back of biography as a scholarly genre in the history of science. For the next two decades there has been a surge of scholarly scientific biographies, many of them written with the Hankinsinian purpose in mind. Adrian Desmond’s two volumes about Thomas Henry Huxley (1994-97) is a telling example. “This is a story of Class, Power and Propaganda”, Desmond announced in the preface: this is “a contribution to the new contextual history of science”. And he continued: “Isn’t it the modern function of biography to carve a path through brambly contexts? To become a part of history?... And isn’t that our ultimate aim, to understand the making of our world?” And again:

“Huxley is part of the new contextual history of science. This itself is a reaction to the old history of ideas, which displaced the person, made him or her a disembodied ghost, a flash of transcendent genius. Only by embedding Huxley can we appreciate his role in the vast transformation that staggered our great-grandfathers” (Desmond, 1997, p. 235).

Desmond and other historians of science have thus given good arguments for not setting social history up against biography and the individual. So it may be time for historians of medicine and public health to begin to reconsider the genre of biography. The omnipotent doctor is not the major culprit any more; today the medical system is in the hands of politicians, health administrators, insurance companies and pharmaceutical multinationals as well. Patients’ lobby groups and nursing organisations are beginning to have a say as well. The “great doctor” of the past is largely gone. There is no need to flog dead horses and therefore there is no need to combat biography, because it supposedly obscures power relations, social forces and cultural influences in the medical system.

To use the individual as a lens, as it were, into the larger social and cultural context of philosophy, or science, or art, or literature, or, in this case, medicine and health – i.e., to use biography as a microcosm of history at large, or as an ancilla historiae (a servant of history), as I have called it elsewhere (Söderqvist, 2003) – is probably the most common argument among historians today for the use of biography. It is an important role indeed, which, as I have just tried to argue for, makes it more profitable for historians to work with biography rather than against it. Recent developments in historiographical thinking, such as microhistory and the loose intellectual movement of “new historicism” and its interest in literary tropes, add to the impression that biography and some its salient features, for example the focus on narrativity, are important contributions to medical historiography.

Yet biography is not just history by other means. Even when one speaks of biography as an ancilla historiae, one should remember that servants are never entirely in the hands of their masters. Maybe the notion of biography as a adjunct to history should be dropped altogether? As an alternative I suggest to let the ontological assumption which Plutarch made in the introduction to his life of Alexander two millennia ago – viz., that biography (bios) and history (histoira) are two distinct ways of writing about the past – gloss the present debate about the relation between history and bio­graphy.

Remember that historia literally means “an inquiry”. But in the course of time such inquiries of the past have by tradition come to mean studies of phenomena like nations, classes, economic institutions, political movements, social interactions, cultural constructs, etc.. Bios means “an individual life course”, and even if some historians today pretend they are writing biographies of cities or countries or even diseases, most historians nevertheless prefer to think about biography as the art of writing the lives of individual human beings. So whereas historia by tradition deals with the collective phenomena of the past, bioi (vitae, biographies) deal with its individuals. One past, two genres.

In other words, even though most historians today think of biography as a genre that takes a secondary role in assisting its more influential master, history, this is not the only role there is for it. Biography has other, more independent, roles as well; for example, at least in the last two centuries is has also been written and read as an aesthetic genre in its own right; literary scholars would probably say that biography has in fact always been emancipated from being a servant to history, that it has always blossomed in its own right.

Medical biography as literature is an interesting topic, which I will not pursue further here. Instead I will use my remaining few minutes to sketch out yet another possible role for medical biography (and in doing so, I will switch from a descriptive-analytical to a somewhat more normative stance). I am thinking of biographical writing as an example of the ancient practice of “spiritual exercises”, a tradition which has been high-lighted in Pierre Hadot’s (1987, 1995) recent reinterpretation of Hellenistic philosophy (1984) which has also had a seminal influence on Michel Foucalt’s idea of “souci de soi” (care of self) in the third and last volume of Histoire de la sexualité (1984).

Hadot’s point is that already in classical times there was a pronounced difference between “philosophy” in the sense of systems, concepts and theoretical discourses, and “philosophy” as a mode of life. He traces the distinction through the history of philosophy, from Plato, via Petrarch, Montaigne and Descartes, to Kant, Nietzsche and Wittgenstein. One thing is to philosophise about what the world is like, or to find out what justice and goodness may be, or what characterises true knowledge, etc. Another thing is to live and practice justice, goodness, truth, etc.

Hadot uses the term “spiritual exercises” for the kind of practical thinking that informs philosophy in this second sense, as a mode of life (the term itself is not crucial; for some readers it may smack of cheap therapeutical practices, which is not the intention). The point is that there is a tradition in philosophy for “spiritual exercises” as a practice of intensive focus on the intellectual matter at hand, not primarily in order to contribute to the theoretical discourse of philosophy or to understand the world (even if this is a nice side-effect), but to change one’s own self in relation to the world.

Hadot restricts his analysis to philosophy. But one can easily extend his distinction to other scholarly activities, in science and medicine as well as in the humanities. Following Hadot, one could then say that it is, of course, a good and admirable thing to do science or medicine to understand the physical world and the human body, or to pursue humanistic scholarship in order to understand language or culture. But it is another, and equally good and venerable thing, to be a scientist or a scholar as a mode of life. Similarly with biography. The purpose of the genre is thus not only to help understand a larger historical context, or to be an aesthetic genre, but also to function as a “spiritual exercise”, i.e., to inform the practice of “souci de soi” (care of self), to use Foucault’s wording. In other words, biographical writing enhances both the understanding of individual action in the past and the writer’s and the readers’ understanding of themselves in the world today, thus making them better fit to cope with the present world (cf. Söderqvist, 2002b; Söderqvist, 2003).

Summing up: I believe medical biography has at least two major roles to play in scholarship today. One is to penetrate the intricacies of the medical system of the past by using individuals as lenses, or microcosms, to show how the political, social, economic, military, cultural, and cognitive aspects of medicine and public health have interacted in complex ways. The other is to write and read medical biography as a “spiritual exercise”, i.e., as a contemplation of one’s place in the contemporary medical and health system and in the world at large. In other words, biographies of scientists, doctors and nurses can help medical and health professionals understand the place of their work in the course of life as a whole; similarly biographical stories of patients may help us all, as potential sufferers, to cope with the situation of being ill. (Maybe even biographies of historians of medicine and public health could be of some use?)

I started by asking: Why are there so few medical biographies? I hope my answer has not scared you from inviting me to the next congress to give the concluding address, but now to answer another question: How can we stem the tide of all these many new and good medical and public health biographies?

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Thanks to Beth Linker, Section of the History of Medicine, Yale University, for drawing my attention to Jordanova’s article, and to Hanne Jessen, Signe Lindskov, Søren Bak-Jensen og Adam Bencard, Medical Museion, University of Copenhagen, for constructive comments.