New Weapons, New Wounds: Medicine in War and Rebellion is the Royal College of Physicians Edinburgh’s contribution to Edinburgh’s International Science Festival. The event is running 3-5 April at the Royal College. The event focused on medicine’s relationship with war and featured talks on shell shock, the dual duty of field medics, the evolution of the field kit and venereal disease within troops. What made this event stand out from other RCPE events I’ve attended was the dynamic way the talks were presented; attendees were split into four groups and at the ringing of a bell, shuttled to different areas of the building for each talk. This allowed each presenting academic to fill their station with displays of relevant books and artefacts and gave guests the opportunity to explore the college and its stunning decor.

The first talk I attended was by Napier lecturer and author, E.S Thomson, and discussed the diagnosis and treatment of ‘shellshock’ during WWI. Despite being a lecturer at Napier University, where the building of the famous Craiglockhart Hospital still stands, Thomson only briefly mentioned its most well-known patients, the war poets Siegfried Sassoon and Wilfred Owen. Thomson argued that there is perhaps too much focus on the war poets link to the hospital which ignores the larger context writing war poetry had within Dr Arthur Brock’s ‘Shell Shock’ treatment. This certainly mirrors my knowledge of Craiglockart, which I acquired by studying Pat Barker’s 1991 novel Regeneration which explores Owen and Sasson’s relationship and treatment by the now renowned psychiatrist W.H.R Rivers. ‘Shell shock’ or what we would now term P.T.SD. Hysteria, a traditionally female illness, did not fit as a diagnosis for these men who were debilitated in the most masculine of pursuits, and so neither did Weir Mitchell’s ‘bed rest cure.’ (Although those who have read Perkins Gilmore’s The Yellow Wallpaper may argue that Weir Mitchell’s treatment was equally as useless for treating women!) Thomson’s talk charted the attempts of healthcare professionals to define, name, and treat the psychological trauma sustained by those who witnessed the horror of the trenches.

Illustrations showing a single bullet wreaking enormous havoc by perforating the small intestine.

Next up was a talk by PhD candidate Sam Klein of The University of St Andrews. I found this talk particularly interesting as I had never considered its subject matter before. This segment highlighted the complexities of providing medical care during wartime. Usually, on some basic level, the interests of a health provider and their patients are same – they want the condition of their patients to improve and, if that is not possible, provide sufficient palliative care. During wartime, a doctor is not only accountable to his patients but to the War Office and this inevitably has repercussions for the patient. An example Klein gave was the way in which the triage process is reevaluated. Usually, triage is quite egalitarian – those whose are most in need, whose life hangs in the balance are prioritised. However when under the pressure, triage on the field becomes more utilitarian in efforts to fit with military principles. Those who can be treated in the shortest time are prioritised in an effort to ensure a higher number of active soldiers than the enemy. For example in WWI, 5 patients could be treated per patient with an abdominal or chest wound and so these patients were at an extreme disadvantage. Therefore despite needing urgent care, patients with a chest or abdominal wound were pushed further down the list. For me, the most interesting aspect of this talk was the consideration of how the ethos of medicine, which dates back millennia, does not exist in a vacuum and as a result must interact with politics, bureaucracy and circumstance.

In the beautiful blue coloured Cullen Room, Prof Angela Thomas OBE showed us the medicine chest of Bonnie Prince Charlie. This was an amazing artefact and being allowed to interact with it and see it up so close was such a great experience. The design of the cabinet is deceptively intricate with compartments that pop out when pressed and multiple drawers containing all manner of substances. These would be used to make poultices, liniments and potions for whatever ailment was troubling a patient. As well as looking like something that belongs in a magician’s or alchemist’s study, the chest was a great artefact to springboard discussion concerning the advancement of medicine and the evolution of military medical kit. A large amount of the substances within the cabinet were botanical (although the chest does feature a ground insect or two!) and were made by grinding up or treating plants and roots. Since the 1700’s many of the active ingredients of these plants have been identified and used in modern medicine. Seeing this chest in person also highlighted the how difficult it must have been to use in a war zone. The chest is made of lead and wood and is enormously heavy. It is hard to imagine it being used to treat the wounded during the Jacobite uprising. Field kits which soldiers carry today are only 1lb and there is now an onus on soldiers being trained to carry out immediate first aid on themselves and their peers whilst waiting for medical attention. The 40 hours first aid training which all soldiers now receive has drastically improved survival rates of those wounded in battle.

Finally, Mona O’Brien, a doctoral scholar at the University of Glasgow, gave a talk about the history of venereal disease in the military. Specifically, she talked about syphilis, which is one of my favourite diseases of all time from both an etiological and sociological point of view. Syphilis has always been linked to the military with outbreaks being linked to the movements of troops for centuries. One of the most interesting aspects of O’Brien’s talk was the examination of military attitudes to syphilis and how they contributed to the spread of the disease. For centuries blame was attributed to the women soldiers had sex with and this blatantly ignored the fact that armies left outbreaks in their wake. This led to acts such as the Contagious Diseases Act which allowed the forcible internal examination of any woman suspected to be a prostitute or of having VD. If deemed to have a venereal disease, a woman could be essentially locked away and confined. These acts did nothing to stop the spread of syphilis and instead were a method of shaming and punishing the vulnerable. Syphilis was even a major issue during WWII, Winston Churchill himself instructed supplies of penicillin to be diverted from the wounded to soldiers who found themselves inflicted with syphilis. A personal highlight of this talk was talking to O’Brien about William Clowes, a royal physician on whom I wrote extensively in my dissertation.

The talks themselves all approached the relationship between the military and medicine through different angles and provided a time travelling and comprehensive exploration of the subject. The range of artefacts and books on display was also impressive and was definitely one of the best features of the event for me! The dynamic structure of the event allowed attendees to see the beauty of the college building as well as ensuring our brains were awake. By moving around to different locations, I felt like I was able to absorb a lot more information than I would if I had just sat in the main hall for four talks.

To summarise, this event was one of the best heritage events I’ve ever been to and I hope this format is adopted for future talks!

So not to detract from what was an amazing lecture, this blog post is split into two parts; the first half is an event review and the second is the story of how going to the event nearly killed us…

Part I: Secrets of the Blood

The Royal College of Physicians London is celebrating its 500 year anniversary this year and as part of its celebrations, the college has put together an exhibition on Dr William Harvey. London’s Scottish counterpart, Royal College of Physicians Edinburgh, hosted the Curator of RCPL, Dr Kristin Hussey, for a fascinating talk on Harvey and his legacy.

Harvey’s discovery of the circulatory system made him one of the most well known historical doctors – details of his life and work are still taught in GCSE history classes. In light of this, Hussey’s talk didn’t focus too much on the precursory details. Instead, the talk delved into complex issues surrounding scientific discovery; personal conflicts of belief, the political nature of the scientific community, and the fact that a pioneer of science has surprisingly little control in how their work will be used by others.

Hussey painted Early Modern medical culture with great nuance. Before Harvey’s discovery was accepted, the heart wasn’t exactly well regarded. Medical theory was practically unchanged from Galen and the heart was thought of more an accessory to respiration than the ‘pumphouse of the body’ it would later be imagined to be. Harvey’s work directly contradicted Galen, whom he had to recite verbatim to become a licensed physician. Harvey was a conservative and against the idea of a mechanical body, so would he be pleased or horrified at his posthumous ‘revolutionary’ status?

Harvey’s work is championed as a pivotal shift in science – a move from the rhetorical to the demonstratable and objective. However, whilst he may have learned anatomical objectivity in Padua, he couldn’t abandon the calculating and political nature of the English medical culture which produced him. He hid his discovery for ten years in an attempt to quietly gain support from well-respected colleagues. When he did finally publish De Motu Cortis, he cunningly dedicated it to King Charles, both currying favour with the King and legitimising his work. Harvey perfectly illustrates the precarious situation that discovery-makers find themselves in; they straddle both sides of progress and that cannot be an easy place to stand. This gap between theoretical progress and practical application is encapsulated by an anecdote Hussey shared about Harvey himself: despite him discovering that there is a finite amount of blood in the body, he still wanted to be bled after suffering a stroke. In fact, bleeding was still practised for centuries after Harvey’s discovery. This raises the interesting question of how doctors balance meeting a patient’s cultural expectations of a physician with acting in their patient’s best interests.

A really fascinating aspect of the talk was the examination of Harvey’s legacy. Harvey was a Royalist and a conservative as well as a ground-breaker. He was, like anyone, multifaceted. Various aspects of his life have subsequently been used in the agendas of others. For example, after the civil war, the College of Physicians London used their connection to the Royalist Harvey to appease the monarchy. Thomas H. Huxley emphasised Harvey’s scientific method to support his own Darwinism. Victorian doctors romanticised him as a ‘father.’ It is easy to see how the ‘real’ Harvey (if there still is such as thing) can get distorted and lost within the voices who herald him. In the Q&A section of the talk, I asked, to what extent can we even know who Harvey was, and does it even matter who he ‘really’ was if his legacy is so great? Hussey’s answer was really insightful. She argued that it is the job of the historian to look at the context in which people exist and to be removed from the subject in a way which those close to the subject matter cannot.

It was really great meeting Dr Kristen Hussey and hearing her speak. I was glad she talked a little bit about her career journey. When I was a teenager, I had the most profound experience the Hunterian Museum (Read about that here!), so it was amazing to meet someone who had worked there in a curating capacity. As someone who is about to embark on her first role ‘curating’ an exhibition, it was comforting to hear Hussey talk about how she approached curating an exhibit that was initially outside her comfort zone and speciality. Dr Hussey is both #careergoals and #brightbluehairgoals and it was really motivating to see a young professional woman talk about her passions and career trajectory.

Overall, the talk was an insightful look into the cultural afterlives of well-loved pioneering figures and the possible conflict between the legacy we celebrate and who they really were. I think these are really pertinent sentiments for someone who wants to work in the heritage sector – it is so easy to get lost in the romanticism of a figure and it is a lot harder to look at things, like Harvey did, in the cold light of objectivity.

Part II: Snow place to go – Stranded in Edinburgh!

On the 28th of February, the MET office released a ‘red’ weather alert which warned people not to travel unless absolutely necessary. At this point, my friend Anna and I were on a bus which was crawling at a snail’s pace towards Edinburgh. Were we perturbed? Yes. Could we get off the bus immediately and easily get home? No – we had no idea where we were and standing at a rural bus stop with no way of knowing if buses were running back towards St Andrews seemed pretty precarious. We decided the best thing to do would be to continue to Edinburgh and turn back as soon as possible. Anna rang RCPE asking if the talk was still on and we decided that if we were going to have to wait for the snow to pass, we might as well attend the talk. After all, the RCPE is only a five minute walk from the bus station.

After being told by our friends from home that our local Tesco was in chaos and expected to close, Anna and I thought it would be prudent to stock up on non-perishables on the way to the RCPE. We were both girl guides and so we were smug in the thought that we would arrive home from Edinburgh that afternoon (how naive!) with an abundance of provisions for our friends.

Anna upon realising that beans may be the ‘Today’s Special’ for the foreseeable future.

It was my third visit to the Royal College of Physicians Edinburgh and the staff were as friendly as ever. Despite arriving unbelievably early for the talk, they welcomed us in. We hung up our coats and made ourselves comfortable in the hall. It was completely empty and we were slightly concerned that we would be the only attendees.

We checked the bus timetables before we left the hall to ensure the buses were running before venturing out into the cold. Head of Heritage, Iain Milne, kindly made sure we knew the best route home. We ventured out back in the snow thinking that we would be back in time to cook our provisions and have an early night.

However, when we got to the bus station we were informed that all buses had been cancelled until further notice. We were well and truly scuppered. Realising it would be too dangerous to implore our car-owning friends to come and pick us up, we made the decision to book a hostel. With our groceries weighing us down (not so smug now!), we carefully trudged to the local SYHA – cold, hungry and one slip away from a broken appendage.

‘Anna take a picture of me on the bunk bed but let me hide first because I am tired and inhuman looking’

We were exhausted and stressed. We made sure to ring our families to let them know that we were, at this point in time, still alive and faring well. We hid our valuables, stored away our darn provisions (read: increasingly heavy dead weight), and went to bed ridiculously early. The sooner we slept, the sooner it would be the next day, and the sooner we could get home…We thought.

The next morning we woke up to a raging blizzard. We checked the public transport but neither the buses nor the trains were running. We sat in the foyer of SYHA and resigned ourselves to being stuck in Edinburgh for at least another night. We sat for two hours whilst the sky tempted us with blue before unleashing yet another torrent of snow. We had only been in the hostel overnight but we were getting cabin fever. Checking my phone, I saw that the Surgeon’s Hall was open despite the weather. We jumped at the chance to leave the hostel even if just for a few hours.

We bought our tickets to the Surgeon’s Hall before leaving to find a place to get a hot drink. Our restless sleep and difficult walk had taken its toll on the both of us and we needed to take stock of our situation. Should we stay in Edinburgh? Or should we make a break for it whilst it was light out and a little warmer? Inadvertently fitting into our medical theme, we got coffee at Black Medicine Coffee Co. Choosing to stay open during the weather was a lucrative decision and the place was packed. On a day when I was not worried for my safety, I would have loved the decor and atmosphere of the coffee shop. Alas, we were too stressed and squished to appreciate our surroundings.

Eventually, we found a taxi who would take us home for a pittance. He had been helping people out of Edinburgh since the ‘Beast From The East’ had hit. He said the main roads weren’t so bad and he would ring us when he was back in Edinburgh. We got his call when we were at the Surgeon’s Hall – He could take us back to St Andrews on the condition that we were back at the SYHA in half an hour. The race was on. We had to run through the piles of snow heaped upon the pavements, get to the SYHA, gather our things, check out and be standing outside within 30 minutes. There were a few slips and we had to run the last stretch, but we made it. I breathed a sigh of relief. The roads weren’t bad, I thought, I’ll be home soon.

But the journey was treacherous. We had low visibility and had to deal with other vehicles which had become stuck on the roads. There were a few close calls but I won’t go into them (purely because if my mother knew how bad it was, she would build a tower and lock me in it for the rest of my life). We made it home in one piece. Anna’s boyfriend, Reuben, made us tea whilst we showered and got in to warm PJ’s. It was a perilous adventure but we got home safe- thanks to our girl guide sensibilities and Scottish kindness.

My next trip to RCPE is at the end of March. I hope the weather has thawed by then, but if it hasn’t, we have enough canned food to feed the whole town.