Event Review: New Weapons, New Wounds

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.

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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.

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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.

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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.

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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!

Opinion Piece: OB_S__Y

Are Health Campaigns Failing Us or Are We Failing Them?

Recently, two public health campaigns about obesity have come under fire for being insensitive and potentially dangerous. One of these, Change4Life, is a project of Public Health England and aims to instil a healthy lifestyle in young children, whilst educating parents on the impact their bad habits have on their family. The other was a campaign from Cancer Research UK which aimed to inform the public that obesity is a major preventable cause of cancer. Vicious arguments have lit up social media between those who have expressed their hurt and those who think people are being too sensitive. The backlash surrounding these campaigns has made me ask the question, are these campaigns failing us or are we failing them?

The Change4Life Campaign

The Change4Life campaign launched in 2009 with the aim to initially target families with children from 5-11. Due to its success, the campaign has become multifaceted with branches such as Start4Life, which is aimed at pregnant women and new parents. The 4life campaigns are all focused on providing health information to each demographic in an age-appropriate way. Their resources for children are fun, brightly coloured and explain the health risks of an unhealthy lifestyle in a non-scary but informative manner. In a clever move, they also utilise the marketing strategies that have previously used by fast food companies to appeal to children. For example, they have partnered with Disney to create fun ’10-minute shake up’ games which include much loved Disney characters. The National Social Marketing Centre reports that the Change4Life has been a monumental success and in its first year reached 99% of its target audience, 413,466 families joined Change4Life and had 1.9 million responses via the web, post, face-to-face and through phone calls.

Their most recent advert, however, has been met with angry responses from the public and from eating disorder charity Beat UK. The advert encourages children and parents to choose snacks which are a 100 calories each and to limit snacks to two a day. The advert has an accompanying jingle which sings the phrase, ‘100 calorie snacks, 2 a day max.’ Critics of the advert have argued that it equates restricting calories with being healthy and encourages behaviours which may evolve into disordered eating. The delivery of the advert has also been challenged as the jingle has been used as a Spotify advert replaying in between songs. If someone vulnerable to disordered eating were to hear this over and over it may reinforce any intrusive or compulsive thoughts that they may already be experiencing.

The Change4Life campaign as a whole has consistently delivered in providing a holistic view of nutrition which by no means champions calorie counting as the be all and end all of health, but this particular advert ignores other important factors involved in choosing snacks, such as satiety and nutritional impact. For example, A 100 calories of chocolate and a 100 calories of chicken have the same calorie count but are vastly different in terms of protein content and amounts of saturated fat. The campaign also ignores the idea of activity levels affecting calorie requirements. Eating disorder charity, Beat, released a statement which argued that ‘It is important that messages aimed at reducing obesity consider the impact they may have on individuals at risk of developing an eating disorder’ and asked that ‘Public Health England to listen to concerns about the impact this campaign could have on those at risk of developing an eating disorder and change the campaign to focus more on healthy eating rather than calorie counting.’ Beat has publicised petition against the Change4Life ‘100 calorie snacks, two a day max’ campaign and a response video made by blogger and eating disorder survivor Tallulah Self.

Cancer Research UK

The second campaign which has come under fire is Cancer Research UK’s obesity campaign, which aimed to raise awareness of obesity’s link to preventable cancers. As part of the campaign, Cancer Research UK put up billboards featuring the word obesity in a hangman style with some letters missing. Underneath the word, the advert asks readers to guess what the second largest cause of cancer is, after smoking. An online torrent of criticism was spurred by comic Sofie Hagen labelling the advert as fatshaming, saying, “Right, is anyone currently working on getting this piece of s*** CancerResearchUK advert removed from everywhere? Is there something I can sign? How the f***ing f*** is this okay?” One twitter user even suggested she would stop any support of the Cancer Research charity if they did not remove it. The angry response to the campaign has been visceral and heated and this was only furthered by those mocking those who expressed their hurt on social media.

The billboards are designed to raise awareness of an objective fact, and a fact which the UK’s public didn’t know. There is a lack of nuance and complexity to the advert, but how much nuance can you put on a billboard? If you google the campaign, the page features detailed information about the cancers linked to obesity and how to make healthy changes to reduce your risk. As the site explains, the cancers to which obesity is linked, such as oesophageal and pancreatic, are complex and difficult to treat. Not making the public aware of this for fear of backlash would be unethical. People should know the risks of obesity, just as they know the dangers of smoking.

The advert itself succinctly highlights the response to it — the word OBESITY presented with gaps in place of some letters. It is these gaps which are filled by the viewer of the advert. Those that feel that it is fat shaming are filling that space with their previous experiences. Whilst the advert itself is an objective fact (studies and data are provided on the campaign’s website), we live in a culture where those who are overweight are bullied, whether it be in the school ground or the workplace. Another fact that Cancer Research UK’s research has discovered; fat shaming is not conducive to weight loss and ‘may even exacerbate weight gain.’ Perhaps if there were less bullying be it on the playground or elsewhere, the campaign may have produced a different response.

Cancer Research UK have stood by their campaign, stating that there were no plans to change their campaign surrounding obesity’s link to cancer and that “This is not about fat shaming. It is based on scientific evidence and designed to give important information to the public. Only 15 percent of people are aware that obesity is a cause of cancer. Cancer Research UK has a duty to put that message in the public domain” (PR Weekly, 2.3.18).

What now for health campaigns?

The response to Change4Life’s campaign highlights the need to include an element of sensitivity these campaigns, especially where children are involved. One sentence highlighting other aspects of choosing healthy snacks, such as protein or vitamin content, could have made a world of difference. The mode of transmission is equally important too – to have that jingle repeating over an over through a vulnerable person’s earphones could have catastrophic consequences for their health.

The obesity campaign merely stated a fact rather than encourage a potentially dangerous dieting method and Cancer Research UK’s response to the controversy highlights the difficulty involved in creating health campaigns. The campaigns have to be short, snappy and memorable and so there is little room for nuance. A health campaign is by definition a campaign to change the public’s behaviour and so has to be somewhat shocking or motivating. Cancer Research UK’s billboard is nowhere near as graphic as the campaigns which aim to encourage people to stop smoking. Clearly, a balance needs to be struck between a scientific neutral fact and the way that fact will be received in our society. The message of the Cancer Research UK’s campaign has been completely overshadowed by the controversy over its reception. Are we heading for a situation where public health campaigns, fearing a backlash, dilute their message to the point where they are rendered completely ineffective?

Event Review: The Snowy Secrets of the Blood

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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.

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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.

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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.

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‘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.

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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.

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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.

A Love Letter to the Little Museum

 

 

We all know the big guns; the British Museum, the Rijksmuseum, the Louvre, the Smithsonian, the Guggenheim and so on. These bustling hubs of historical and artistic scholarship welcome millions of visitors each year and some visitors travel across literal oceans to see the artefacts that have captured their imaginations since childhood. When I travelled to London for a palaeography summer school, I was so excited that Senate House was close enough to the British Museum to allow a trip to see the Rosetta Stone. The story of the stele had enchanted me since I was in primary school – how amazing that a stone once used as building material was the key to deciphering hieroglyphs – and to see it in person was nothing short of magical. However as much as I love the British Museum, this Valentine’s Day I am giving my heart to another. This is a love letter to the small folk museums, heritage museums, maritime museums, agricultural museums and historic houses that bejewel the landscape of the UK.

These museums, which are often run mostly (if not exclusively) by volunteers, welcome guests in the thousands rather than the millions, but this by no means makes them less worthy of praise than their monolith counterparts. In fact, I would argue that they have a massive impact on their communities. Through storytelling, dress up and activity packs, children learn the stories of those who have come before them. Museums allow them to make emotional and empathetic connections to history which could never be gained from a textbook. Events and exhibitions allow families to spend time together and create memories on a budget. For those who have watched their community change over their lifetime, museums and historic buildings provide a chance to reminisce about times gone by and tell their own oral histories. Small museums by their nature are niche, containing a wealth of information on their locale which historians, genealogists, and any interested amateur can get lost in.

Children areas

On a purely selfish note, Saint Andrews Preservation Trust Museum, ‘my’ little museum, has allowed me to gain invaluable work experience, both as a tour guide and behind the scenes. I have learned how to use Adlib software and helped at Museums at Night events. But more importantly, I have been able to have a lot more access to the inner workings of the museum than I would be afforded at a larger institution. I have met trustees and board members and had unfiltered access to the curator’s extensive knowledge of the industry. I have met the people who have lovingly put exhibits together to pay homage to the town that they have loved and lived in their entire lives. Over the next two months, I will be helping create an exhibition on St Andreans during WWI. This immeasurable fulfillment has come directly from this little museum and those who pour their heart and soul in to its upkeep, and I am so thankful for it.

This Valentine’s Day, send some love to your local historic building or museum for whilst they are little, they are so, so important.

 

Book Review: From Here to Eternity

 

 

Book Review: From Here to Eternity, Caitlin Doughty

I was first introduced to Caitlin Doughty by a friend who recommended her YouTube channel Ask A Mortician. Due to experiencing both a bereavement and a personal brush with death within an eighteen-month period, I was paralysed by a fear that something bad would happen to me or someone I cared about. I was anxious that it was negatively influencing how I was living (read: not living) my life. I was pretty sure the last thing I needed was to listen to someone talk about death, but I was quickly proved wrong. I was being incapacitated by a fear of the unknown and it was Caitlin Doughty, with her perfect bangs and cheerfulness (and taxidermy), who opened the door on the world of death literacy. Through her videos, Doughty broke down the stigma around talking about death and gave me a space to confront what was troubling me. Remember, Deathlings, you will die.

It is unorthodox to start a book review, a piece which is by nature about the book you are reading, by talking about yourself. However, I think it highlights the profound effect that Doughty has on the lives of those who follow her. In a Western culture which deems any talk of death a taboo, most of us have become ill-prepared for facing the death of loved ones and ourselves. Doughty’s debut, Smoke Gets in Your Eyes, is a moving account of her journey into the funeral business. Her second book, From Here to Eternity, is a global tour of death practices, shedding light on the differences between cultures but also highlighting the universal qualities of mortality and bereavement.

There is always an element of voyeurism to learning about another culture’s rituals, but Doughty is aware of this and approaches each chapter with the sensitivity it deserves. What makes From Here to Eternity stand out from the online listicles and videos on ‘weird death rituals’ is precisely that she does not sensationalise or fetishize these practices. Instead, Doughty takes us on her travels as a guest, grateful and appreciative to be allowed into these private moments. By providing the stories of the people featured within the book, both deceased and living, we are reminded that it is the same deep love and respect for the deceased behind each practice, despite how different they look to each other.

Following suit from her debut, From Here to Eternity does not flinch away from difficult topics, such as the loss of an unborn child. Doughty shares the moving and poignant story of fellow death acceptance activist Sarah Chevez, whose reconnection with her Mexican heritage gave her the space to grieve her loss. From Here to Eternity covers expansive ground, both geographically and thematically, exploring not just the practicalities of different death practices themselves, but the tensions and issues that arise from them. From the contentious relationships between traditional magic and religion to the use of technology to honour the forgotten dead, Doughty provides a comprehensive and nuanced depiction of each culture’s practise. Woven throughout the book is Doughty’s trademark humour. Humour and death may seem like strange bedfellows, but many of these death rituals are times of celebration and gaiety as well as poignancy. What’s more, sharing a chuckle with Doughty felt like a small subversive triumph over death itself; you can’t be afraid of something whilst laughing at it.

From Here to Eternity is also a visually stunning book. Landis Blair’s illustrations capture the beauty of the death traditions. Some are busy scenes of ritual celebration, some are quiet and meditative. I sincerely hope that the frontispiece illustration is available as a print because it is a striking Memento Mori. Not just a traditional ‘remember you will die’ but a ‘remember you can return to the earth. There are options out there aside from those encouraged by the mercenary funeral industry.’ A sentiment which very much encapsulates the message of From Here to Eternity.

Book Review: The Butchering Art

 

 

 

The Butchering Art, Dr Lindsey Fitzharris’ debut, follows the life of Joseph Lister, the ‘father of modern surgery’ and pioneer of antiseptic surgery. The book isn’t purely a biography though. Fitzharris’ style flits expertly between time and space, seamlessly bestowing little morsels of medical history knowledge without any cost to the narrative. In a relatively short book, Fitzharris explores medical advancements from America, Continental Europe, and of course, Edinburgh and London- making this book a must-read for anyone interested in the pioneers of modern surgery.

The Butchering Art dishes the dirt on the unsanitary hospitals of the past, detailing the devastating effects of the ‘big four’-erysipelas, gangrene, septicaemia and pyaemia- on the wards. Nowadays, the wealthy choose to be treated in private hospitals but during Lister’s time, those who could afford it were treated at home on their dining room tables. It seems a foreign concept to a modern reader but with postoperative infection ravaging the wards it was the safer option. Fitzharris doesn’t skimp on the gruesome details either. She perfectly captures the brutal nature of pre-anaesthetic surgery, recounting an incident were celebrated surgeon Robert Liston broke down a door and dragged a terrified patient back to the operating table to which he was subsequently bound. Liston is painted as brilliant, all fierceness and fire.

By introducing the reader to Robert Liston before Lister, Fitzharris creates an artful juxtaposition between Liston’s showmanship and Herculean strength and Lister’s contemplative quietness. Born a Quaker, Lister was mild, well-mannered and polite in the face of his rival’s criticism. I had no idea that a book which details the development of antiseptic surgery would be such an emotionally gripping read. Fitzharris describes Lister with such tenderness that I became quickly invested in his journey. I have read other reviews of The Butchering Art which lament Lister’s ‘amiable’ nature, asserting that perhaps a more hot-tempered nature would have made for a better story. I disagree. Lister’s cool methodical nature was precisely what surgery needed after the introduction of anaesthesia when speed was no longer such a pressing issue. Lister’s breakthroughs weren’t made in Robert Liston’s brutal and bloody operating theatre, but under the microscope – a tool which his own father had advanced.

One thing I really appreciate about The Butchering Art is its focus on the surgeons and physicians themselves. Fitzharris provides humanizing and touching details about the lengths the surgeons took to be as compassionate as possible to their patients, whom they knew weren’t likely to survive. The book also highlights how dangerous it was to be a surgeon which is something I had never previously considered. An accidental nick with a scalpel and a surgeon could die of one of the very infections he was fighting so hard to eradicate.

Overall, The Butchering Art is an amazing debut; Fitzharris doesn’t just describe the world of Victorian medicine, she transports you there. The Butchering Art is a testament to the stoicism of the pioneers who fought an uphill battle against injury and disease. The history of medicine has so many facets, and I can only hope that Fitzharris writes a book for each and every one of them!

 

Think Piece: I’m not a medic, can I enjoy medical museums?

My fascination with medical museums started with a college trip to the Hunterian Museum in London. The trip was a whistle-stop tour of as many science museums as possible in one day ending with a long coach ride home, and I hadn’t given much thought to the Hunterian at all. However, I do remember entering the museum with some trepidation. I had spent a lot of time in hospitals when I was young, and I wondered how I would react to a place dedicated not only to medicine but to the suffering that medicine aims to cure. My worries were unnecessary, I would fall in love with the place.

I was drawn in by the pale specimens resting in their jars. At some angles, the curvature of the glass had a magnifying effect and I found myself peering even closer, playing with the distortion, scrolling the enhanced image for some hidden clue about what made this organ special and how it affected or ended the life of whoever owned it. Far removed from the pain and heightened emotion I had witnessed in hospitals, laid out in front of me were all the secrets of the body. I was struck by the notion that we are all, quite literally, walking contradictions. The human body is an oxymoron; strong and resilient yet so fragile. We can endure terrible trauma and still survive, but we are all just one injury or illness away from the end. One person may survive being hit by lightning, another may be carried off by the winter flu. An individual may seem the perfect model of health, but below a deadly disease may be patiently biding its time until it makes its presence known. The only time I faltered was when I saw a well-developed foetus still snug in the womb. I looked around at my peers and teachers animatedly discussing the exhibit and then back at the specimen. I thought to myself that it was ironic that a foetus who never opened its eyes, preserved and well cared for, would probably physically outlast those of us that got to live. Pulvis et umbra sumus. We are dust and shadows.

I held that experience very close to my heart and thought of it often. I also went on a tour of the travelling Bodies Revealed exhibit. During the trip, I enjoyed it. A moment that stands out in my memory is when I looked at a brain tumour and thought it looked quite small- only to look across to the plaque and read that it was fatal. On reflection, I didn’t enjoy Bodies Revealed as much as I enjoyed the Hunterian. I quickly forgot about it, until I came across a news story that the company that treated the specimens had been accused of using the bodies of political prisoners. Article after article blasted the company, or raised ethical issues that I hadn’t previously considered, and I felt sickened with my enthusiasm for all things medical.

Most people are familiar with medicine’s graverobbing past, Resurrectionists would stalk the graveyards to relieve coffins of their occupants and sell them to medical schools. Fewer people are aware that an allotted number of executed criminals were given to medical schools each year by the Parliament. This may sound purely pragmatic as academics were desperate for cadavers for students to examine, and further study of anatomy would undoubtedly lead to new discovery and developments, but there was an unsavoury punitive element to the policy. The Murder Act 1751 drips with contempt when it says, ‘in no case whatsoever the body of any murderer shall be suffered to be buried; unless after such body have been dissected and anatomized.’ In a time when it was widely believed a body must remain intact to be resurrected on Judgement Day, the act took retributive justice an extra step by robbing the criminal of their chance at eternal life. It was also an act of humiliation designed as a deterrent to would-be criminals. In 1829, Burke (of Burke and Hare infamy) was hanged and publicly dissected. This was a poetic punishment for a man who killed innocent people to sell their bodies to anatomists. His skeleton resides at the Anatomical Museum of the Edinburgh Medical School and a book said to be made from his skin is on display at the Surgeon’s Hall.

The fear of being robbed from one’s grave led to the installation of watchtowers and mortsafes in graveyards, but for those who lived with a disability or visible illness the fear of being anatomized was more than just the era’s zeitgeist but a real threat. Alexis St. Martin, an American, developed a fistula after being shot in the abdomen as a teenager. For a decade of his life, he was experimented on by ‘Father of gastric physiology’ William Beaumont, who observed the effects of digestion by inserting pieces of food tied on to silk string into the fistula and removing it after different time intervals. When St. Martin died, his family were so concerned his body would be stolen for experimentation that they left St. Martin’s corpse out in the sun for days before burial to encourage decomposition.

Charles Byrne, whose skeleton resides at the Hunterian, also went to great lengths to attempt to avoid his fate. Byrne had acromegaly, a hormonal disorder caused by the pituitary gland producing too much growth hormone. His large size gave him the moniker of “The Irish Giant” and he made his living from being a human attraction. When his family attempted to bury him at sea in accordance with his wishes, Hunter bribed an undertaker in Margate to swap the body for weights. His family went ahead with the sea burial believing Byrne to still be in his lead coffin. In 2011, an article by Dr Len Doyle and Dr Thomas Muinzer about Byrne’s body was published in the British Medical Journal. The article weighs up the benefits of using Byrne’s body for research against the ethical issue of defying Byrne’s behest. Doyle and Muinzer draw parallels to the organ donation debate; those that die do not need their organs and organ donation, when given to a viable candidate, increases longevity and quality of life. However, to take organs against the donor’s wishes strips that person of their agency and their rights over their own body. The article also points out that even if Byrne’s body has a scientific value, that doesn’t mean his skeleton needs to be displayed as an exhibit. The article led to public pressure being applied on the Royal College of Surgeons to remove Byrne’s body. In 2017, the college stated that they had no plans to remove Byrne.

The question of whether it ethical or right to display these specimens is not easy to answer. The fact that Byrne was well known within his lifetime and made his wishes clear makes him a great cases study for examining the ethics of exhibiting human remains. However, a lot of human remains in museums have murky or anonymous providence and any opinion the person may have had on the topic is unknown. To deprive medical museums, which often are associated with Royal Colleges and medical schools, teaching aids on the idea that specimens might have objected seems extreme. Museums now make concerted efforts to treat human remains with the utmost care and consideration. There are strict legal and ethical guidelines that must be adhered to when dealing with human remains as detailed in “Guidance for the Care of Human Remains.” This guide, which can be found online, acknowledges how human remains have been used in the past and aims to provide a future for those remains which is culturally and religiously sensitive. There are even procedures in place for de-accessioning of remains and for returning remains to those who have a rightful claim to them.

I have made the conscious decision to be discerning about which exhibits I choose to see. I still enjoy medical museums and their public events, because I know those that host them have a deep respect for both their subject and the museum exhibits. I am not going to be a medical professional and so the knowledge I gain from these museums will never practically help anyone. However, these museums are important to the public in general. It is only recently that knowledge of the inner workings of the body has been accessible to the layman, and if I was bold I would argue this knowledge is still not accessible enough. With public health campaign after public health campaign encouraging people to take ownership of their own health, it’s clear there is a need for more in-depth education surrounding health, illness and our bodies. A little trip to a medical museum might be just what the doctor ordered.