Germany

Semi-Live Blogging from the EAHMH Conference in Heidelberg, “Global Developments and Local Specificities in the History of Medicine and Health”

The editor

Day 3 – Final thoughts

Scholars take a lot of ribbing for going to conferences in lovely places like Heidelberg, the sometimes-not-so-friendly suggestion being that it is little more than tourism by other means. No doubt there are plenty of conferences that do fit that bill, though very few for practicing historians. The luggage stacked in the foyer on the final day is an indicator of the fact that you actually work your ass off at a conference like this, and so many of the participants carve out the time to attend from the precious little they have for family and life outside of work. You travel, often long ways, to coincide with a weekend, engage intensely for two or three days, then travel long ways home. You rip yourself up trying to find a way to make your paper work in the small space available, and most people squirm about the actual presentation itself not unlike an actor’s stage fright. Every trip is more difficult to make the time for, the travel more exhausting and grinding each time.

Obviously, when it goes well, as it has here, it is immensely satisfying and indeed creative work, but it’s work just the same. I am often aware of how poorly those not involved in academia understand the nature of a university professor’s job, especially that of a professor in the social sciences and humanities. Most people assume we are basically teachers of already existing ideas and texts (research, to most, is something that goes on in laboratories run by engineers and chemists and medical types). Misunderstanding the nature of the academic conference is part of that.

And no wonder, since conferences are irresistible targets for ridicule across the board, from the yellow press to sophisticated literary fiction. I myself used to engage happily in poking fun at university types and their conferences when I worked on The Great Eastern, a radio humour show with commendable academic pretensions of its own. David Lodge and Don DeLillo are genius at this sub-genre of satire, and also careful to make sure they are not caught denouncing the practice as simply sham. Still, not even good fiction ever quite captures what’s going on at a scholarly conference, and ends up simplifying the ideas, analyses and debates, tidying up and closing off the endless avenues left messy and open-ended in real conferences, and turning the whole thing into a play of individual characters living out, closing out, a story. The philandering and the egos take centre stage, the misunderstandings and the mistakes among organizers are over-played for dramatic effect, and the quiet tragedies, disappointments and snubs (perceived and real, intended or not) are milked. To me, this manner of representing the conference entirely misses what is actually going on, though it makes for titillating stories that academics themselves quite like to read (and perhaps you have even been reading this hoping for some salacious tidbits of this kind from Heidelberg).

The groove of the academic conference – at least, the academic conference like this one, of this size and character and coherence — is not approached by any of these satirical roads. The truth — probably to most people boring — is that a conference of this nature, convened and organized and engaged in the right spirit, really is about the exchange of ideas and research findings, and about the need of scholars to find others like them who will understand, comment, contribute more data and refine with their critical edge the pursuit of new ideas and ways of telling about what happened in the past — in our case, with the way humans have suffered and healed, and pathogens have been tracked down and travelled, and with the way states and specialized groups have used medicine and health for power, good and ill.

I used to be more cynical, and I’m still ambivalent about the huge conference of thousands which often seem mostly about the reproduction or fashioning of professional identities and hierarchies. Certainly, the standard structure of the conference, with its sequential individualized presentations, has its problems. A historian of medicine and friend, Alexandra Stern once told me how she longed for conferences where people staged conversations rather than presenting papers followed by circumscribed and ritualized Q & A. And I admit that a more conversational model is appealing to me, and agree that the stock formula needs reinventing somehow. On the other hand, not everyone is comfortable contesting their thoughts in public, and there are certain kinds of formal data that cannot really be presented in the course of a conversation. With the classic conference structure, employed without any agonizing here in Heidelberg, each one is presented with a similar stage and given a decent chance to get it out there.

Richard McKay, from Oxford (and also, we discover by coincidence, a fellow graduate of UBC’s liberal-experimental Arts 1 program), presents an engaging paper on the myth of “Patient Zero” – the way that CDC epidemiologists half unwittingly served up a questionable whodunnit narrative that was irresistible to the media to explain how HIV-AIDS had entered the USA. He artfully introduces audio clips into the presentation from interviews he has done with leading actors in the story, and as an old radio hand I love it because it underlines once again the power of the particular grain in the human voice – the potency of audio that is so overlooked in a visually obsessed present. Perhaps the academic conference has to do with this – with only really being able to convey one part of the ideas we want to share when we do it in person, with our voices. And maybe this is why the only piece I have read that I think really captures the spirit and doings of conferences was one by Hugo Williams in the TLS about attending a poetry conference.

Anyway, having worked as a volunteer officer of an association not unlike this one, having been involved in conference organizing, I cannot find anything that is not positive to say about this gathering in Heidelberg, that has been organized so sincerely, and generated so many superb papers and discussions and connections and new thoughts. It was, in its own particularly and ritually structured way, a great conversation and I leave enriched and rewarded with a new repertoire of understanding and acquaintance in the practice of medical history.

What else can I say? Come, come to the conference, if you think you might be interested, if you think you might have something to confer about, come to the next one, next time. The European Association for the History of Medicine and Health will hold its next conference in 2011 in the Netherlands; the closely related Society for the Social History of Medicine will hold its next conference a year from now in Newcastle – look out for the call for papers coming soon. Thanks to everyone for a great gathering this time, and special thanks to all those in Heidelberg who worked hard to make us welcome and able.

I will simply repeat what Volker Roelcke said in his remarks at the AGM, and insist on what a great job Philipp Osten of Heidelberg University did in stage-managing the event with such good humour and such great care. Also to the very pleasant and charismatic group of undergraduate students from Giessen and Heidelberg who were so helpful and always around to trouble-shoot: Roman Brzukalla, Janine Linke, Tobias Laible, Rosa Hollekamp, Jan Braunschweig, Charlotte Konenkamp, Vera Schleich, and Teresa Roelcke (some of them pictured below).

Last, but certainly not least, thanks to Alexander Bowitz, Mathias Pütz, and Leon Lampe from Ursula Pütz’s Party Service Feinkost Metzgerei (Haupstrasse 4 – 69190 Walldorf – Telefon + FAX 06227/64310), for catering with such class, and for the tastiest and prettiest and home-madest finger food, by far, I’ve ever savoured at a conference (not to mention the incredible generosity of the exquisite, complimentary Swabian maltauschen).

It was a great pleasure to talk with you all.

Alexander Bowitz with some premium, home-made maultaschen to satisfy the hungry Paris mob.

Day 3 – Going back

Just quickly on Ann Hardy’s keynote that started off the final morning, “Global Futures: Travel, trade, and the salmonellas in the twentieth century”. A very deftly laid-out work on the unnerving proliferation of salmonella serotypes in the post-WW II period due to increasing and changing patterns of trade and the practices and lack of regulation in industrial food production. Her reconstruction of changing disease ecologies is illuminating, and the particular episodes and quotes chosen very lively and engaging. Enviable blend of technical-scientific understanding, environmental and social history – and, well, for that matter, once again political economy. And not even the bells could stop her!

It was actually quite incredible when they started up, about ten minutes into her talk, close and rolling in that way that only real bells can sound. And going on and on in the way that real bells do on the continent. Philipp Osten saves the day by getting the microphone going, and our attuning ears eventually forget the bells until their clang starts to slow, bell by bell, to a close – just as the talk enters its closing remarks!

Wonderfully, one of the main serotypes Hardy discusses is called salmonella-Heidelberg (all are labeled with a place, if I understood right, of first discovery). Frank Huisman, acting as presenter at the session, jokes that the bells were Heidelberg’s attempt to suppress the fact.

Just one more post left, I think, to bring this blog to a close with some final reflections…

Day 3 – looking back

Well, I had meant to get into more discussion of Walter Bruchhausen’s keynote from way back yesterday morning, “Export and Adaptation, Import and Integration: European and Local Agency in East African Health Care”. It was a very nicely placed keynote, shifting us from the global syntheses of Cook and Cueto on day 1 (that took us from the early modern world trading systems to the very recent past of an organized world health system — again, hats off to the programmers), to a more theoretical level of inquiry that encourages us to go beyond a critical history of colonial medicine, without leaving it behind obviously, but to look now also at the actual engagement on the ground in the colonial medical encounter — to look at local actors as subjects in this history, as transformers of the local encounter, and so, too, of the global encounter. I totally agree with this thrust.

All four keynotes are very good – a rarity in my experience of conferences – and serve as signposts and reference points both implicitly and in explicit comments and connections made spontaneously by many speakers in the sessions I was at. I think it is wise to choose, as they have done here, your keynote speakers, or most of them, from distinguished scholars in your own association and its networks (and this association is not lacking in them). That way they know the context, and the audience, and they care about the talk – something that is often lacking in the big-shot hired guns who give you something from out of the bin (when they don’t screw the organizers by cancelling at the last minute or demanding to be treated like royalty).

On that note, I am very impressed by the open-ness and egalitarianism of this event. There are some real academic stars here, and many who also have positions with quite a lot of institutional power and significance (editors of leading journals in the field, directors of institutes, authors of works that have transformed the practice of history beyond the field of medical history). To be a Professor in Germany, for example, is still something much more high and mighty than anything a North American professor could hope for. Yet I wasn’t aware of any posturing or aloofness here, and found the established figures quite down-to-earth and approachable. Great atmosphere.

Day 3 – a while ago

In the end some of the panels did have a no-show, but actually I found this improved the quality of the sessions themselves. Many of them had originally planned for four speakers in two hours, so the no-show brought it down to three. This allows everyone to relax into their talks, not rush them or be cut off or fear being cut off or check their watch nervously every few seconds.

The extra space is especially nice for grad students who have the least experience with talk time management, which is a bitch at the best of times, and the benefit of the extra few minutes is palpable on a number of occasions, and lets the Q & A linger into that state where the second questions and afterthoughts often bring out the true gems, and sometimes even the best of the speaker, who is finally relaxed. It’s amazing how often a little bit of extra time with questions, even a few lulls as another one is awaited, can lead to the crystallization of ideas that turn out to be transformative.

The impressive thing is that no one abuses the gift of the extra time, again a testament to the quality of the papers which have, without exception in the sessions I attended, been well prepared.

Of course for any conference organizer every no-show is a pain because it mocks the program you’ve painstakingly put together and gives you feelings of dread about what the lack of expected registration fees might do to your budget plan. But in my experience organizing conferences with the Canadian Association of Latin American and Caribbean Studies, which is somewhat analogous (in size, in inviting and attracting a constituency from all over the world, and in accepting a lot of individual submissions to its conference), no-shows are inevitable. Especially true when, as it seems in this case, stickiness granting visas may explain the absence of some.

Day 3 – winding down after the conference (and posting now in true semi-live fashion from Paris where I’ve come to do some research at the Archive of the Pasteur Institute – never been to the place and am very excited to see this iconic site of medical research).

Most people have moved on now, but a small group of us show up to head to the Prinzhorn Collection of psychiatric art at the local pysch hospital, attached to the U, a related cultural event that has been offered by the organizers as an optional and very good finishing touch. Donated by a pychiatrist who worked there from 1919-21, it features a collection of artifacts and art relating to mental and spiritual health from many cultures. Art therapy was also introduced to patients in the asylum at this time, and some of the results were truly extraordinary (the sculptures of Lange (?) in particular). The collection and the work of the in-patients quickly became a stop on the pilgrimage of artists from around the world, German expressionists among them. The influences are clear.

Unfortunately I have to leave before the well-guided tour of the exhibition is over to rush back to the hotel to grab my bag, pay the bill, and race to the train station in a cab. My Czech driver tells me he’s thinking about checking out the Leonard Cohen concert in Prague next month. No electrical current on the train (probably is in first class — injustice!) and my computer was so low that it dies before I can even figure out whether or not I can work out a wifi connection on the TGV.

Day 3 – 1:45
A couple of lovely celebratory moments during the AGM. Volker Roelcke says he’s just realized that this is the 20th anniversary of the EAHMH, and that, appropriately, it is also the birthday of one of the founding members, Oivind Larsen, of Oslo. Professor Larsen, who I was lucky enough to chat with briefly yesterday, is warmly applauded and presented with a gift relating to Heidelberg and photography (one of his special interests) from the organizers. Happy birthday, Dr. Larsen (Oivind)! Also best wishes from me on your upcoming visit to our fair Montréal.

Day 3 – 1:42
An efficient business meeting assures us that the organization is in sound financial and administrative shape thanks to Treasurer Christian Bonah and Secretary Alex Mold. The current scientific board is renewed through democratic vote notable for its consensus in endorsing each person who has put themself forward for this curious but essential volunteer academic work. Outgoing president of the association, Volker Roelcke completes his term by presiding over the session in style, and the torch is passed to new president, Frank Huisman, who hopes to host the next conference two years from now in the Netherlands. Congratulations to both.

Day 3 – 12:46
Well, that’s it. The academic portion of the program is done, but the infrastructural and political work goes on: the AGM of the EAHMH is gathering and, as a new member, I am entitled to attend.

Day 3 – 12:33
I meet the very fine Spanish historian, Esteban Rodríguez Ocaña on the way in this morning (sun finally out and a magical mist floating up the valley hills as I cross the river – wow). He is carrying his suitcase and as we enter the plaza before the Main Building we hear and see a few others rolling their suitcases across the cobblestones. We laugh at this and dub the piece “La Procesión de las Maletas”. Esteban is on a tight schedule and, like so many others, will have to stay as long as he can risk it, then rush for a train for a flight. A collection of luggage gradually rises in the foyer.

Day 3 – 12:27
Three minutes until the formal end of the final panels. When I get a chance, more on Anne Hardy’s amazing talk, not to mention her amazing ability to carry it off despite the disconcerting (if at least mellifluous) intrusion of bells pealing from the church across the way.

Day 3 – 12:07
Some of the wonderful student organizers of the conference who have created a great vibe and lit the paths even as they check out the talks.

Tobias Laible, Jan Braunschweig, Rosa Hollekamp, Roman Brzukalla, and Janine Linke

Day 3 – 9:17 am
As it turns out, Anne Hardy’s keynote, the fourth and final of the conference, is as well attended as the first one. Volker Roelke prefaces the talk by noting that it is the 20th anniversary of the EAHMH.

I linked to the program earlier, but forgot to note that the abstracts are also available on the EAHMH website.

Beginning of Day 3 now, the final morning of the affair, and as I wait in the nearly empty foyer of the Main Building waiting for it to begin, knowing that some have now travelled on to other destinations or begun their journey home, I think of the ebb and flow of conferences. It will be interesting to see how well the energy holds through the last day, and whether the ebbing will affect the EAHMH general meeting of members, which will be held at the very end.

Day 2 – 6:25 pm
Day two has drawn to a close, except for those in the EAHMH sister society, Society for the Social History of Medicine, who now cap their absorbing day with an AGM.

By now certain things are clear.

First is that this is a magnificently organized conference, and many congratulations are in order to the lead organizer, Volker Roelcke, a professor at the Institute for the History of Medicine at the University of Giessen, and all those many who have worked with him to stage this wonderful production in which we are all players who get to write and deliver our own lines. The true measure of the organizing is that it is essentially invisible, never in the way, and so has enabled many thousand opportunities, formal and informal, for sharing critical inquiry. Uberkudos.

Second is that the theme of the conference, global developments and local specificities in the history of medicine, really does correspond to what most of the people have come here to present and discuss. No doubt this has something to do with the fact that those who submitted proposals tailored them to a conference call for papers that they found interesting and appropos of their work (as was the case with me). But the correspondence is an indication that this is where one very important sensibility in historical studies of medicine is right now.

Even in the sessions I attended today where I thought that the relevance of the papers to the theme would break down, I was mistaken. Elizabeth Toon, talking on cervical cancer screening and the British health system in the 1960s, invokes in passing a reference to contemporary developments in Western Canada; Esyllt Jones’ talk on the origins of Canadian medicare concentrates on excavating the international models that were considered by Saskatchewan locals, and brought to Saskatchewan for local consideration by international actors like Henry Sigerist — a twist on Cook’s idea, since Sigerist is hardly a liminal figure, though his journey to Saskatchewan was certainly a liminal moment in the life of a central actor (though a central actor who was always, in some sense, liminal).

Not only is the “median erudition” extraordinary, but the third thing in evidence is the overall quality of the scholarship and presentation, which is very high. I have to say, I’m impressed, perhaps most of all by the poise and intellectual maturity of graduate students who have consistently delivered papers that show depth of scholarship, command of the historiographical and theoretical stakes, and a serious verve in presentation.

The custodian wants to lock up and leave now. I’ll lose the wireless connection, and will have to post later. The sun, out for a minute, has retreated again and rain will fall on me as I return to the hotel. Tonight most of us will get on a boat to have a bite and a drink and watch a fireworks display that re-enacts the burning of the castle of Heidelberg by Louis XIV. In the end the setting sun pokes through the clouds down river and the skies clear up a bit so that we get to watch the graceful dance of exploding colour floating under a fullish moon.

Day 2 – 12:37
Too much going on to blog without losing the moment, then came lunch in the foyer, much talk spilling over from the previous sessions, and some colourful and beautifully ornamented sandwich snacks which, however, were best kept away from computer keyboards. Suddenly, there’s only 15 minutes before the next session. For now, a shot of us enjoying Walter Bruchhausen’s remarkable keynote that kicked off day 2, “Export and Adaptation, Import and Integration: European and Local Agency in East African Health Care”. More on that later.

Day 2 – 9:13 am

The Main Building

Day 2 – 8:52 am
The day dawns dry, cloudy and cool. This may be the first time in my life I’m one of the first to arrive at the conference site. Sitting now in the foyer of the main building with the clink of coffee cups being set in their saucers.

No doubt there are more ornate and architecturally splendid university buildings, but the main building is not grand. It is austere and has been functionally modernized a number of times — most recently with a digital technology face-lift — without undoing the simplicity of the original building. A couple of the conference rooms are lecture halls that have a Protestant churchy feel, the pew-like seats tightly packed and wooden, with rails that swing down for writing once you’re seated. A good place to concentrate, and surprisingly warm in tone.

I will try to get a few pictures up. People arriving now in the foyer, small groups gathering, some greeting one another after a long time apart and talking recent projects, others going over organizational details of the day. The coffee looks ready.

Day 1 – 11:37 pm
Hal Cook, whose book, Matters of Exchange, on the relationship between science and trade in the early modern period received much worthy acclaim over the past couple of years, delivers a suggestive and nicely conversational talk that opens up many avenues. “The importance of acquaintances: collecting information about medical practices in the 17th century” encourages us to pay close attention to liminal figures as key players in the transmission of knowledge, and provides a number of intriguing examples featuring historical actors with multiple geographical ties and identities. One moment in his talk recreates a wild episode bringing together a Dutch medical man and shogunate translators fluent in Portuguese in an early attempt to communicate European and East Asian medicines.

Responding to a comment from the audience underlining the incompatibility of contemporary and medieval notions of the local and the global, Cook reflects on the importance of “deep time” in historical studies, especially in the current context when we are all being pressed to “be relevant” by granting agencies and collaborators in medical schools.

Most all the papers and lectures at the conference are on 19th- and 20th- century topics, with only a handful of early modern and one medieval talk. Still and all, the line-up is wide-ranging and the conference theme, which at first might appear one of those open and vague catch-alls, is in fact an appropriate leitmotif to link and sustain the papers being given. It is really a conference on world medical history. Unlike some HM conferences where the odd paper that doesn’t deal with European or US medicine is anxiously found a token place, the papers and authors at this conference all seem keen to sail into any port.

Alongside medieval European medical classrooms and an Indonesian island where the Dutch East Indies Co conducted its exchanges with Japan, my own way through today’s talks and panels has brought me to the heart of German medical thinking on tropical colonies real and imagined, to Irish medical and religious missionaries in late colonial and early independent Nigeria, to the progressive medical networks inside Franco’s Spain, to pharmaceuticals and eugenics in early 20th-century Brazil, to Belgian drug trials in the Congo, to the radical transformation of thinking about malaria wrought by 15th-century Portuguese contact with Brazil and West Africa, to the lunatic asylums of the colonial British Caribbean, to the young medical research communities of post-colonial Latin America. Appropriately, thinking through and beyond the medical colonial past is what lets all these papers talk to one another and reconstitute a global medical arena.

Another emerging theme, perhaps even incipient method, is meditation on the relationship between medicine, trade, and commerce with a political economy inflection, though saturated now with an awareness of the potential for autonomy of the social and cultural domains that have preoccupied historians for the past two or three decades.

The conference day draws to a close with Marcos Cueto’s keynote, “The Challenges of Engaging the Local: The World Health Organization and Primary Health Care in Latin America and Africa during the 1980s”. Part of a history of the WHO that he is completing with Elizabeth Fee and Theodore Brown, Cueto draws a vivid macro-sketch of the great international health battleground of the late Cold War. The Utopian vision for collective transformation through primary health care that informed the 1977 Alma Ata declaration of “health for all by the year 2000” was driven by developments in primary care in revolutionary projects of the so-called Third World. Cueto explores how this vision was beaten back in the ‘80s, stripped of its radicalism in the “selective primary care” packages introduced by most developing states and new global health institutional actors like the World Bank that had as a goal limited extension of basic medical services to those outside the reach of the state.

Heavy.

In the Q & A, Cueto talks about interviewing Halfdan Mahler, who was Director-General of WHO when Alma Ata crowned its agenda. Maller insisted that the only place where the full form of primary health care as imagined in Alma Ata was realized was … Western Europe.

Good place to end for the day. Very heartening 12 continuous hours of intellectual exchange.

Day 1 – 6:30 pm
This is actually Day 2, since I didn’t arrive in time for the reception last night and the official, political welcome from the mayor. Sorry I missed it, because it’s always curious — sometimes painfully so — to see how elected officials situate the importance of academic discourse and activity in civic life. I trust that the mayor of Heidelberg, due to the centrality of the history of the U to the city’s identity, has a more sophisticated take on this, and I would have liked to hear it.

In any case, today’s welcome and plenary lecture were the opening of the conference. The surprise was not simply that it was a formal welcome by a series of people involved in organizing the conference, and a formal lecture by a distinguished invitee, that managed to maintain a light touch and stick to time. Unexpected was the welcome to the university, by a Heidelberg professor, Wolfgang Eckart that eschewed the generic fluff and celebratory nonsense of most such discourses, and instead talked about the many rises and falls, dark periods and re-foundings of the university since it first appeared in 1386. The presence of Goethe, Hegel, Jaspers, Schumann are invoked — heady stuff! But he addresses straight on the role of the university as a site for the intellectual preparation of the National Socialist program in the 1930s, and the subsequent complete take-over of the institution by the Nazis. He captures the moment by recalling the Nazi removal of the statue of Pallas Athena at the entrance to the university and its replacement by a statue of the German eagle and the cross of National Socialism. He closes his talk explaining the revival of the university in the post-war period and looks forward to a future university that remains the site of freedom of speech and scientific inquiry. A high bar is set for the event.

Day 1 – 6:11
Last regular panel of the day has just come to a close, the rain has stopped, and day 1 has been as compelling as the program promised. Presenters have heroically stuck to time to give each session a coherent shape. Power-Pointism has been notable for its absence, with graphic material and text used sparingly to enhance the communication and translation of ideas. English (of a very high quality) is the lingua franca, even though first-language English speakers are few. Quite fantastic, though there’s no time to blog, especially as the discussion flows out and through the breaks over good victuals. Conferences of this size can work very well. Three or four panels going on simultaneously to mix up the configurations and agendas, and all in close proximity, with a central common discussion area.

Day 1 – 2:49 pm.
The wonderful motto of this university is Semper Apertus – Always Open – and true to its credo, it has open and unfettered wireless internet access. No conference password required, no fee – clean and connected. So I have decided to seize the opportunity for some semi-live blogging from this fascinating, eclectic and warm conference of the European Association for the History of Medicine and Health.

It’s my first time attending the EAHMH and so far I’m delighted to be here, despite the uncooperative bucketing rain. I got into Frankfurt last night after long storm delays, just in time to catch the last train to Heidelberg, arriving 1 am. Small hotel closed, but had left me a note on front door indicating that the key to my room was under the backdoor mat, a welcome that took the edge off a long journey and is a nice expression of the size and charm of this pretty riverene city. Then up early to walk briskly across the old bridge, through the gates of the old town, and quickly to the fabled university platz, register, take in the unexpected welcome and plenary lecture by Hal Cook, and deliver my paper at one of the first four panels of the conference. That jittery rush behind me, I am settling in to enjoy what looks to be a superb three days of talks from about a hundred and fifty people who’ve come from across the world to talk history of medicine. More on the plenary surprise next time there’s a break.

You can look at the intriguing preliminary program, which has held surprisingly firm (most conferences have a lot of cancellations and no-shows, but not this one) by going to the main page of the EAHMH website.

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