Histories of Medical Progress

Module Overview

This module introduces students to historical perspectives on technological innovation in healthcare and the tools history offers for understanding the idea of healthcare futures. It invites students to recognize the celebratory promise of progress that attends technological innovation while pressing students to consider the dangers of such uncritical celebration by heeding the lessons of history.

The first class presents contemporary celebrations of the digital and datafied future of healthcare. The second class asks who is included and who has historically been left out of such future imaginings. It also considers three Nobel Prize inventions from the past that posed more long-term problems than initial celebrations suggested they would. The third class introduces the long-term harm such boosterism has historically introduced, especially during the environment, and the fourth class teaches students about the racist histories enacted in the name of medical progress, as well as the hierarchies that enable healthcare’s abuses. Significantly, the second, third, and fourth classes all focus on moments in the so-called “Golden Age” of medicine–one in which healthcare’s rapid progress was widely celebrated and medical authority went largely unquestioned.

Class 1: When did medicine start looking towards the future?

Read for this class:

In class group assignment: Spend 5 minutes jotting down notes individually followed by 15 minutes discussing in a small group. Each group will report back to the class. Questions: After reading the Jeroen Tas piece, describe how it markets healthcare. How does it portray of the future and what assumptions underlie the argument? Note that the Tas is an advertisement while the Topol is not. What differences can you identify between the advertisement and the popular book? What do you make of their similarities?

Class 2: Whose Future? 

Assignment to bring to class: Write 500 words in which you discuss the particular vision of healthcare expertise offered by this video. Who gets to be a doctor? How does the AMA film represent medical expertise? You may wish to write specifically about particular lines from the film, how the scenes are shot, what kinds of props and images it uses, etc, to support your argument.

In Class Assignment: In small groups, read and analyze three Nobel Prize acceptance speeches (1948, 1949, 1952). Answer the following questions:

  • What is the discovery being honored and why is it receiving this honor?
  • How is its promise for the future of health and healthcare framed?
  • After you have answered 1 and 2, look up the discovery if you are not already familiar with it. How do we understand the significance of the discovery today? What was imaginable about this discovery the year it was celebrated and what was unimaginable? Why do you think that is?
  • Finally, what lessons do these answers hold for healthcare innovation today?

Class 3: Medicine as War, Medicine as Victory

  • Edmund P. Russell, III, “Speaking of Annihilation”: Mobilizing for War against Human and Insect Enemies, 1914–1945,” Journal of American History, Volume 82, Issue 4, March 1996, Pages 1505–1529
  • skim third chapter of Silent Spring

Bring to class: Please write 500 words about Russell’s argument. How does he make his argument? Outline it. What are the steps? Next, pick two pages from the text that have significant footnotes. What kinds of sources does he use? How do they help him make his case? The idea behind this assignment is to get a sense of the tools historians use to understand questions of health and healthcare in the past.

Class 4: Progress for whom? 

Videos / Audio

The AMA video, “Doomsday for Pests,” and the CBS Reports videos offer primary source material for students to analyze. They demonstrate how healthcare innovation was viewed at the time of its emergence. “Doomsday” and the CBS Reports in particular offer before-and-after sources that show the kinds of  unforseen consequences of technological innovations once heralded as miraculous solutions using the example of DDT. The Choice/Less podcast likewise demonstrates how healthcare research and innovation seemingly undertaken with good intentions can, nevertheless, result in horrific healthcare abuses.

Readings

There are two kinds of readings for this module: primary sources and secondary sources. The secondary sources teach students how arguments are made–both how historians make arguments (Russell) and how those arguments differ from healthcare professionals’ arguments (Carson, Rosenhan) or from popular boosterism about healthcare innovation (Tas, Topol). The primary sources are speeches given at Nobel Prize ceremonies. Students are encouraged to practice the tools of historical analysis on these primary sources to evaluate how technological innovation in healthcare is framed at the time of its emergence.

Historical Documents

Secondary Sources

  • Rachel Carson, Silent Spring (1962)
  • David Rosenhan, “On Being Sane in Insane Places,” Science 179, no. 4070 (1973): 250-58.
  • Edmund P. Russell, III, “Speaking of Annihilation”: Mobilizing for War against Human and Insect Enemies, 1914–1945,” Journal of American History, Volume 82, Issue 4, March 1996, Pages 1505–1529
  • Jeroen Tas, “Seven Visions of the Future of Healthcare” The Telegraph (2016).
  • Eric Topol, The Patient Will See You Now (2014)