Biomedicine on Display

Recently I announced a quiz to get more information about a historical syringe that a couple of friends had bought for me. This quiz was far from easy since we had no information on the syringe whatsoever. Medical Museion’s guest researcher and former chief physician Sven Erik Hansen was the first to make a suggestion on our Danish blog — he thought it might had been be used to treat haemorrhoids.

Sven Erik’s was a qualified guess, but it seems like the area of expertise that we are dealing with here is rather odontology. Thomas put a query about the syringe on rete, the mailing list for curators, historians, students, collectors, dealers, etc, interested in the history of scientific instruments, and immediately received some very interesting answers. First out was Frank Manasek: 

This type of syringe was common in dentistry or in minor surgery where local anesthetics (such as lidocaine) would be used. Later syringes of this style were designed to use disposable ampoules of anesthetic, and disposable needles. (This one predates both.) The needle on this example is long, suggesting its use in mandibular blocks.

Following Franks lead Alistair Kwan elaborated:

I was just about to write almost the same thing. The last time I asked a dentist about the move away from these, he said that patients are more scared of them because they are big and shiny, and harder to
keep out of sight — convenience and cost of disposables did not play into his decision, though they are primary issues in debates between surgeons, surgical nurses and hospital administrators.

If you compare with today’s common disposables, the plunger design involves a different handhold that increases control through tight spaces and increases pressure on the contents. If you try them out, you can experience how the palm-grip hold is much less subject to little wobbles in the finger and thumb joints. (A high-stability grip for the disposables is to wrap them in all four fingers of a fist, which limits where you can work.)

You can also experience how the palm-grip hold and the lighter two-finger hold are suited to injecting targets at different heights and orientations. You cannot comfortably inject straight down with the
palm grip hold unless you are leaning right over the patient. But your forearm is positioned for easy aiming sideways or forwards or upwards, as into the nerves in the mandibular joint.

For times when you want a pistol or palm grip (e.g. in veterinary medicine), there are handles for disposable syringes. The handles derive from earlier syringes in which they were inbuilt. In recent years (decades?) they have simply had the syringe removed, leaving a hollow or brackets in which to insert a disposable. Similarly with ring grips, now marketed for use by non-medical people with frail hands who need to administer to themselves or family members, and for cake decorating.

Easy disassembly makes cleaning easier but it sometimes owes more to manufacturing processes than concern for scrubbing and autoclaving. A device like this is often cheaper to mass-produce from standard stock than by building all components from scratch. If it goes together easily, it often follows that it comes apart easily as well. Today’s one-way barbed fasteners and sonic welders have of course
cancelled that rule.

Now what began as an artefact without a history suddenly had spawned a fascinating insight into the world of dentistry. Peter Morris continued (still on the rete list):

These syringes are still in very common use by dentists in the UK. I don’t recognise the disposables mentioned by Alistair. Personally I always try to avoid the jab if I can which provokes friction between me and the dentist. I would say the needle is a little bit thicker than it appears in the photograph, but it may just be a matter of the scale of the photograph (and the psychological effect of it going into your mouth). A quick look on the web throws up JS Dental Manufacturing Inc of Ridgefield Connecticut. I cannot find out how long it has been in business but it seems well established.

And back to Alistair:

I should clarify a bit though: the common disposables are less stable than the big dental model when used in the mouth owing to how they  have to be held. What I originally wrote (in a low-energy moment at the end of work yesterday) was unclear, though I’m sure that your exhibit writers will have no trouble doing better. (I’m now at the start of the day so am more critical of what I write!)

And that critical attitude might be what made Alistair return with one last comment:

It might also be worth indicating that some anaesthesia techniques begin with aspirating by withdrawing the plunger to suck a little on the tissue that the needle has entered. This tests whether you are in the right place: the colour of the liquid obtained indicates the extent of blood supply. If you get blood, you know to withdraw the needle and start again. (I find needle-guiding techniques very clever. Other common rules are to locate external markers for guidance, and to hit bone or a sudden resistance change as an indicator for depth. Some markers for mandibular anaesthesia are in the ear which is why the dentist puts his finger there — as target to aim for — while inserting the needle.)

Aspiration is reflected in some plunger handles: they have a ring for the thumb.

It’s more difficult to aspirate with pistol-grip and palm-grip syringes because pulling and pushing require different holds. That may entail having an assistant steady the patient’s head.

Following Peter’s post, I had a quick look at some on-line catalogues and saw that both metal and disposable plastic syringes are sold by dental equipment suppliers.

So thanks to our fellow histrorians and curators on the rete list, we’ve been able to construct a much more detailed curatorial story about the syringe than I ever imagined when I first posted the original quiz.

And so we need a winner. The stern panel of judges (who will remain anonymous) has decided to a name Alistair Kwan the winner. So Alistair, whenever you come to Copenhagen, please visit us here at Medical Museion and claim your prize.

As mentioned in a previous blogpost, I’m currently doing a ph.d.-project here at Medical Museion concerning the history of the concept of successful aging in neuroscience and its relation to ideas on cognitive enhancement.

Part of my work, therefore, is going to conferences like this one, held in Copenhagen last week:

The conference was arranged by the Danish research center GNOSIS, and featured both neuroscientists and philosophers – as an attempt to bridge the disciplinary boundaries and maybe produce some kind of synergy.

The first day especially had that feeling. Themed under the headline ‘Brain Plasticity’ and featuring, among others, the English philosophical-minded neuroscientist Steven Rose, German phenomenological philosopher and psychiatrist Thomas Fuchs, and Danish biologist and anthropologist Andreas Roepstorff, there was a real feel of cross-disciplinary science communication. A science communication which was also a communication of the immense complexity of the brain and of the production of knowledge concerning it.

As Steven Rose pointed out, neuroscience is ‘data rich, but theory poor’, needing some theorizing on how best to manage the complexities of the huge amount of collected data. One common perspective to most of the talks at the conference were that the brain’s workings can best be understood viewed as a complex, irreducible and indeterminate, continuously developing process. This was conceptualized from both phenomenology, developmental systems theory (or autopoiesis, as Rose termed it), and biosemiotics – all in one way or the other emphasizing the brain as embodied (or the body as ‘embrained’, as someone smartly put it), and emphasizing the body’s embeddedness in the world (emworlded). Dichotomies and dualisms, determinacy and reductionism were (with maybe one exception) not only forcibly opposed, they were long left behind, it seemed.

But still there was a sense that, despite agreement on the general perspective, this did not solve the concrete methodological challenge of, for instance, going from correlates to causality, inducing from the particular to the common, or explaining the relationship between brain and mind/consciousness/awareness/attention etc. Neuroscience, it seems, brings new attention to a lot of old philosophical problems. The multidisciplinary collaborations within the field of neuroscience, and the demand for new theoretical developments and new conceptualizations, may not find a solution to these problems, but it sure sets the stage for interesting theoretical developments in the years to come.

As for the link to my project on successful aging, this development in neuroscience seems to run almost parallel to the overall development of the field of gerontology and aging research in the last couple of decades from around the time that the concept of successful aging was introduced. Many of the same philosophical problems are also seen in other parts of aging research than the parts including the neurosciences.

Aging research (as well as maybe most other fields in the health sciences?) is becoming a multidisciplinary field where dichotomies and dualisms between brain-mind, body-world, and individual-society are being tested and challenged.

Medical museums are usually full with old and new medical science instruments. But they tend to be kept in storage because it is difficult to display them in a meaningful way. It’s much easier to put moulages, pickled organs and surgical instruments on show. Medical science instruments usually need truckloads of description and contextualisaton to make sense in museum displays. (Probably because they don’t ‘talk’, some people would say :-)

Neither do many museum curators give much thought to the historicity of their display techniques. How have display practices changed over time and how do these practices reflect museum culture, politics and technologies?

Such question wil hopefully be discussed at the 29th symposium of the Scientific Instrument Commission, which will be held in Firenze, 4-9 October 2010 on the theme ‘Instruments on display’, i.e., how instruments have been presented in scientific collections, museums and permanent and temporary exhibitions throughout modern history up to the present:

Did didactic, scientific, celebrative, propagandistic and rhetorical considerations significantly influence the manner of displaying instruments? How were instruments presented in a Wunderkammer of the Renaissance, in a 18th-century cabinet or in a 19th-century exhibition? How and why are they shown in contemporary science museums?

This year’s symposium is sponsored and organized by Istituto e Museo di Storia della Scienza (Museo Galileo) and Fondazione Scienza e Tecnica. The meeting is open to “anyone interested in the history, preservation, documentation of use of scientific instruments”, whether academic scholars, curators, collectors or students.

Send abstract before 1 June, 2010 by filling in this template.
More info on the symposium website.

This is the last part of my project description for the Ph.D.-project called “A genealogical study of the concept of ’successful aging’ and its relation to the idea of ‘human enhancement”. See the first two parts here and here.

 ’Successful aging’ in the neurosciences and the link to ‘cognitive enhancement’
In order to narrow the problem field, the project will look closely at how the notion of ‘successful aging’ has been understood and defined in the field of neuroscience in the last decades, and how ‘successful cognitive aging’ has played together with discussions — both in the scientific literature, in science policy documents and in general public discourse — about the possibility for so called ‘cognitive enhancement’ (‘neuro-enhancement’) [12][13][14][17]. Both in the scientific literature and in policy documents on ‘successful aging’ and ‘human enhancement’, the neurosciences are considered as the primary field of research; neuroscience also figures prominently in the corresponding public discourse [7][21][23], cf. [25]. The brain and cognition are ascribed significant cultural value in the emerging ‘knowledge society’; healthy cognitive abilities are considered necessary for a life-long contribution to the labour market and for well-being in everyday life, and not surprisingly some of the exponents for the notion of ‘knowledge society’ are also exponents for ‘converging technologies’ [17][21].

Current developments in the field of aging research also have strong discursive links to cognitive enhancement. As the aforementioned EU parliament study argues: “The growing problem of neurodegenerative diseases in ageing societies has turned research and development in therapeutic cognitive enhancers into a very dynamic field with significant resources” [21:26]. Likewise, in enhancement discussions special attention is being ascribed to cognitive enhancement: “’neuro/ brain enhancement’ as a research field stands at the centre of the CT [converging technologies] debate. It attracts the largest share of attention due to its plans to simulate and manipulate brain processes, which – if realized successfully – could directly affect our concepts of the human self and identity” [17:382], cf. [21][23][25]. Also here there may be a significant aspect of user-driven innovation: medications developed in research into age related diseases like Alzheimer’s disease is already being used by young, healthy individuals to (presumably) enhance their cognitive abilities [14][17][21], and, conversely, one could therefore expect that the market for cognitive enhancement may stimulate research in the prevention and treatment of age-related neurodegenerative diseases.

These interconnected arenas of aging research, enhancement discourse and general ideas about successful aging will be the focus point of this project. The point of departure is that the connection between the discussion about successful aging and the discussion about human enhancement has been overlooked in the scientific literature and that the two discourses are more closely related than usually presumed. Shedding light on the historical relation between the two notions both in the scientific and popular discourses will potentially have significant consequences for future research, for research politics and for the public understanding of successful aging.

References:
7. Kirk, H. (2008). Med hjernen i behold – Kognition, træning og seniorkompetencer. København: Akademisk Forlag.
12. Balling, G. (2002) (ed.). Homo Sapiens 2.0. Når teknologien kryber ind under huden. København: Gads Forlag.
13. Balling, G og Lippert-Rasmussen, K. (2006). Det menneskelige eksperiment. København: Museum Tusculanums Forlag.
14. Greely et al. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456, 702-705.
17. Beckert, B., Blümel, C and Friedewald, M (2007). Visions and realities in converging technologies. Innovation: The European Journal of Social Science Research, 20(4), 375-395.
21. European Parliament Science and Technology Options Assessment (2009). Human Enhancement Study. Awailable at http://www.europarl.europa.eu/stoa/publications/studies/stoa2007-13_en.pdf (14.08.09)
23. http://www.humanityplus.org/read/2009/07/human-enhancement-what-should-be-permitted-geneva-october-20-21-2009/ (14.08.09)
25. Dumit, Joseph (2004). Picturing Personhood. Brain Scans and Biomedical Identity. Princeton: Princeton University Press

This is the second part of my project description for the Ph.D.-project called ‘A genealogical study of the concept of ’successful aging’ and its relation to the idea of ‘human enhancement’. See the first part here.

The relation between ’successful aging’ and ‘human enhancement’
The project will particularly focus on an analysis of the possible connection between ideas about the prevention and treatment of age-related diseases, on the one hand, and the current merging discourse on ‘human enhancement’, on the other. Like ‘successful aging’, the notion of ‘human enhancement’ — including a large variety of different ideas about the future possibilities for technological improvements of human bodies — became widely spread in the 1980’s and 1990’s [11][12][13][14].

A preliminary survey of the literature indicates that the notions of ‘successful aging’ and ‘human enhancement’ often seem to appear together in the scientific literature and in medical and health policy documents. For example both the European Union (EU) and the National Science Foundation (NSF) have published reports that deal with so called ‘converging technologies’, usually defined as a convergence of nano-, bio-, info-, and cogno-sciences and technologies (NBIC). In such reports, the notion of ‘human enhancement’ is a central concept, around which the discussion of the aging population in the developed countries revolves [15][16][21], cf. also [17][18][19][20]. As a study commissioned by the EU Parliament says, “it is safe to say that a side effect of the fast-growing research and development into pharmaceuticals for age-related neurodegenerative diseases will be a number of new drugs which can be used for the enhancement of performance of young, healthy people.” [21:7]

Similarly, in a large number of websites and blogs published by organisations and individuals that support and promote the notion of ‘human enhancement’, the possibility for using such technologies as life extension devices and for delaying age-related physical and/or cognitive decline constitutes one of the central arguments for developing enhancement technologies [11][22]. Websites that express the opinions of the so called transhumanist (posthumanist) movement is one of the most vociferous exponents of this argument. Both these pro-enhancement advocates and science policy reports (like the EU parliament study and the NSF reports) emphasize the fact that the biomedical sciences, biotechnologies and medicotechnical technologies are increasingly producing new technologies capable of simultaneously enhancing the capacities of healthy people and treating diseases, especially age-related diseases [16][21][23]. Thus the discourse about ‘human enhancement’ and ‘successful aging’ are discursively intimately connected.

In addition, this integration of the ‘human enhancement’ and ‘successful aging’ discourses seem to have a strong element of user involvement. The strong ideological commitment to the integration between the two notions among individuals that view themselves as members of a loose ‘transhumanist’ intellectual movement is probably the best example of user involvement. It is unclear, however, to what extent the scientific community, the ‘transhumanist’ intellectual movement and the public at large differ with respect to an active commitment to integrating the two notions. However, I will suggest that the increasing use of performance-enhancing drugs in the general population (especially among young people) and the increasing dissemination of pro-enhancement policies and visions that challenge traditional views of the use of medicine both work in favour of a similar integration between the two notions.

Furthermore one might expect that the general and widely spread popular attitude to performance-enhancing drugs in Western cultures is an underlying Zeitgeist which supports the current political, scientific (and ethical) discussions about the integration of the two notions in the ‘transhumanist’ movement and among scientists. Finally, one might also expect that such popular attitudes will effect strategic market evaluations in the pharmaceutical industry and thus spill over to strategies for future drug pipelines. In all these respects, the integration of the notions of ‘human enhancement’ and ‘successful ageing’ may well be framed with reference to broader user involvement and user driven innovation (cf. [14][15][16][21][24]). These are preliminary hypotheses only, however, which need further empirical substantiation.

References:
11. Bostrom, N. (2005). A History of Transhumanist Thought. Journal of Evolution and Technology, 14(1).
12. Balling, G. (2002) (ed.). Homo Sapiens 2.0. Når teknologien kryber ind under huden. København: Gads Forlag.
13. Balling, G og Lippert-Rasmussen, K. (2006). Det menneskelige eksperiment. København: Museum Tusculanums Forlag.
14. Greely et al. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456, 702-705.
15. Roco, M and Bainbridge, W (2002) (eds.). Converging Technologies for Improving Human Performance. NSF/DOC-sponsored report. Awailable at http://www.wtec.org/ConvergingTechnologies/Report/NBIC_report.pdf. (29.05.2009)
16. Innovation: The European Journal of Social Science Research, 20(4) (December 2007). Special Issue: Converging Science and Technologies: Research Trajectories and Institutional Settings.
17. Beckert, B., Blümel, C and Friedewald, M (2007). Visions and realities in converging technologies. Innovation: The European Journal of Social Science Research, 20(4), 375-395.
18. Det Strategiske Forskningsråd (2006). Det aldrende samfund 2030 – Rapport fra Styregruppen for det strategiske fremsyn om det aldrende samfund 2030. Awailable at http://fi.dk/publikationer/2006/det-aldrende-samfund-2030-rapport-fra-styregruppen/det-aldrende-samfund-2030.pdf (29.05.2009)
19. Murphy, T. F.(1986). A cure for aging? The Journal of Medicine and Philosophy, 11(3): 237-255
20. Veatch, R.M. (1979). Life Span: the Hastings Center report on values and life-extending technologies. New York: Harper and Row.
21. European Parliament Science and Technology Options Assessment (2009). Human Enhancement Study. Awailable at http://www.europarl.europa.eu/stoa/publications/studies/stoa2007-13_en.pdf (14.08.09)
22. http://www.humanityplus.org/learn/philosophy/transhumanist-values (14.08.09)
23. http://www.humanityplus.org/read/2009/07/human-enhancement-what-should-be-permitted-geneva-october-20-21-2009/ (14.08.09)
24. Maher, Brendan (2008). Poll results: Look who’s doping. Nature, 452, 674-675

I’ve just begun my ph.d.-project here at Medical Museion. Titled ”A genealogical study of the concept of successful aging and its relation to the idea of human enhancement”, the project is financed by the new Center for Healthy Aging at the Faculty of Health Sciences.

Below is the first part of the project description concerning the notion of successful aging. In two following parts I will first introduce the possible relation between successful aging and human enhancement, and then my attempt to narrow the project to cognitive aspects of ageing and cognitive enhancement. Comments to one or all three parts are much appreciated.

The genealogy of the notion of ’successful aging’
At present there is much focus on the notion of successful aging (healthy aging, optimal aging) in Denmark and other developed countries. The increasing life expectancy of the population in combination with low birth rate and low rate of immigration gives rise to both political and economic concerns about the future maintenance of the living standards for an aging workforce. The increasing number of elderly people gives rise to new demands for developing new knowledge about how individuals can live a healthy life and remain healthy, even in old age.

The notion of ‘successful aging’ is not new. It can in fact be traced back to at least the 1960’s and became ubiquitous in the field of aging research in the 1980′ and 1990’s [1][2][3][4][5]. The dissemination of the notion is connected to a development trend in aging research, whereby scientists gradually changed their understanding of aging as a research object for gerontological/geriatric research. From primarily being concerned with the treatment of diseases in later part of a life course to an increased focus on disease prevention and to a broader public health oriented approach to aging involving several different scientific fields, also beyond the biomedical sciences [4][6], cf. [7].

The aim of this project is to undertake a genealogical study[8][9] of the development of the notion of successful aging from the increased focus on prevention in the middle of the 1980’s until today. The literature on the subject is sparse, consisting of a few short chapters with an overview of the historical development of age research, cf. [6][10]. A more detailed historical study of this development based on the primary literature (scientific articles, textbooks, policy documents, etc.), is supposedly going to produce a deeper and better understanding of the notion of successful aging, which in turn will help qualify the current scientific and public discussions about the prevention and treatment of age-related diseases. The study will thus hopefully also help identify some of the conditions that may influence future understandings of what ‘successful aging’ is and the ways in which the future research in the field might develop.

References:
1. Williams, Richard H., and Wirth, Claudine, G. (1965). Lives through the years: styles of life and successful aging. New York: Prentice-Hall.
2. Rowe, J. W. and Kahn, R. L. (1987). Human Aging: Usual and Successful. Science, 237: 143-149.
3. Rowe, J. W. and Kahn, R. L. (1998). Successful aging. USA: Pantheon Books.
4. Baltes, P. B. and Baltes, M. M. (1990) (eds.). Successful aging: Perspectives from the behavioral sciences. Cambridge, UK: Cambridge University Press.
5. Bond, L. A., S. J. Cutler, and A. Grams (1995). Promoting Successful and Productive Aging. Thousand Oaks, CA: Sage Publications, Inc.
6. Amstrup, K og Poulsen, I. (2007). Geriatri – en tværfaglig udfordring. København: Munksgaard Danmark.
7. Kirk, H. (2008). Med hjernen i behold – Kognition, træning og seniorkompetencer. København: Akademisk Forlag.
8. Villadsen, K. (2006). Genealogi som metode: fornuftens tilblivelseshistorier. Kaspar Villadsen & Ole Bjerg (2005) (eds.). Sociologiske metoder: Fra teori til empiri i kvalitative og kvantitative studier. Frederiksberg: Samfundslitteratur.
9. Foucault, Michel (1992). The archaeology of knowledge. London: Routledge.
10. Bengtson, V.L. and Schaie, K.W (1999) (eds.). Handbook of Theories of Aging. New York: Springer Publishing Company, inc.

The 15th biannual conference of the European Association of Museums for the History of Medical Sciences (EAMHMS) will be held at the University of Copenhagen, 16–18 September, 2010.

This year’s conference focuses on the challenge to museums posed by contemporary developments in medical science and technology.

The image of medicine that emerges from most museum galleries and exhibitions is still dominated by pre-modern and modern understandings of an anatomical and physiological body, and by the diagnostic and therapeutical methods and instruments used to intervene with the body at the ‘molar’ and tangible level — limbs, organs, tissues, etc.

The rapid transition in the medical and health sciences and technologies over the last 50 years — towards a molecular understanding of human body in health and disease and the rise of a host of molecular and digital technologies for investigating and intervening with the body — is still largely absent in museum collections and exhibitions.

As a consequence, the public can rarely rely on museums to get an understanding of the development and impact of the medical and health sciences in the last 50 years. Biochemistry and molecular biology have resulted in entirely new diagnostic methods and therapeutic regimes and a flourishing biotech industry. The elucidation of the human genome and the emergence of proteomics has opened up the possibility of personalised molecular medicine. Advances in the material sciences and information technology have given rise to a innovative and highly productive medical device industry, which is radically transforming medical practices. But few museums have so far engaged seriously and in a sustained way with these and similar phenomena in the recent history of medical sciences and technologies.

The contemporary transition in medical and health science and technology towards molecularisation, miniaturisation, mediated visualisation, digitalisation and intangibilisation is a major challenge for the museum world; not only for medical museums, but also for museums of science and technology, and indeed for all kinds of museums with an interest in the human body and the methods for intervening with it, including art museums, natural history museums and museums of cultural history.

Contemporary medicine is not only a challenge to exhibition design practices and public outreach strategies but also to acquisition methodologies, collection management and collection-based research. How do museums today handle the material and visual heritage of contemporary medical and health science and technology? How do curators wield the increasing amount and kinds of intangible scientific and digital objects? Which intellectual, conceptual, and practical questions does this challenge give rise to?

The meeting will address questions like (but not limited to):

• How can an increasingly microanatomical, molecularised, invisible and intangible (mediated) human body be represented in a museum setting? Does the post-anatomical body require new kinds of museum displays?
• How can museums make sense of contemporary molecular-based and digitalised diagnostic and thereapeutic technologies, instrumentation and investigation practices in their display practices?
• How can museums make use of their older collections together with new acquisitions from contemporary medicine and health science and technology?
• What is the role of the visual vs. the non-visual (hearing, smell, taste, touch) senses in curatorial practice and in the public displays of contemporary medical science and technology?
• What can museums learn from science centers, art-science event venues etc. with respect to the public engagement with contemporary medical science and technology? And, vice versa, what can museums provide that these institutions cannot?
• How can museums draw on bioart, ‘wet art’ and other art forms to stimulate public engagement with the changing medical and health system?
• How does physical representations of contemporary medicine in museums spaces relate to textual representations in print and digital representations on the web?
• How can museums integrate emerging social web technologies (Wikipedia, Facebook, Twitter, blogs, etc.) in the build-up of medical and health exhibitions?
• What kind of acquisition methods and policies are needed for museums to catch up with the development of contemporary medical science and technology, especially the proliferation of molecular and digital artefacts and images?
• What kind of problems do museum encounter when they expand the acquisition domain from traditional textual, visual and tangible material objects to digital artefacts (including software, audio- and videorecordings, and digitally stored data) and non-tangible scientific objects.
• How can participatory acquisitioning, crowd-sourcing, wiki-based methods, etc. (‘museum 2.0’) be employed for the preservation and curation of the contemporary medical heritage?
• How can curatorial work in museums draw on medical research and engineering and on academic scholarship in the humanities and social sciences? And, vice versa, how can museums contribute to medical teaching and research and how can their collections stimulate the use of physical objects in the humanities and social sciences?

The conference will employ a variety of session formats. In addition to keynotes and sessions with individual presentations of current research and curatorial work there will also be discussion panels and object demonstration workshops.

We welcome submissions from a wide range of scholars and specialists — including, for example, curators in medical, science and technology museums; scholars in the history, philosophy and social studies of medicine, science and technology; scholars in science and technology studies, science communication studies, museum studies, material studies and visual culture studies; biomedical scientists and clinical specialists; medical, health and pharma industry specialists with an interest in science communication; engineers and designers in the medical device industry; artists, designers and architects with an interest in museum displays, etc.

We are especially interested in presentations that involve the use of material and visual artefacts and we therefore encourage participants to bring illustrative and evocative (tangible or non-tangible) objects for demonstration.

The meeting will begin on Thursday 16 September (noon) and end on Saturday evening 19 September, 2010.

100-300 word proposals for presentations, demonstrations, discussion panels, etc. shall be sent before 28 February 2010 to the chair of the program committee, Thomas Soderqvist, ths@sund.ku.dk.

A meeting website for registration and hotel bookings will be established in early January 2010. A number of hotel rooms will be prebooked.

Programme committee:
Ken Arnold, Wellcome Collection, London
Robert Bud, Science Museum, London
Judy Chelnick, National Museum of American History, Washington, D.C.
Mieneke te Hennepe, Boerhaave Museum, Leiden
Thomas Soderqvist, Medical Museion, University of Copenhagen (chair).

Local organising committee:
Anni Harris, Bente Vinge Pedersen, Carsten Holt, Morten Bulow and Thomas Soderqvist, Medical Museion, University of Copenhagen.

For further information about the academic programme, please contact Thomas Soderqvist, ths@sund.ku.dk. For practical information about travel, accommodation, etc., see http://www.mm.ku.dk/sker/eamhms.aspx, or contact Anni Harris, konference2010@sund.ku.dk after 4 January 2010.

The conference is hosted by Medical Museion; further information will be posted on the museum’s website (www.museion.ku.dk) and on this blog.

One of the challenges for a museum of medicine intent on collecting recent and contemporary medical artefacts is to get an overview of the historical development of medical instruments, medical technological systems and the medical device industry.

Trade shows and their catalogues (published or online) are excellent sources. But memoirs and reminiscences of people who have been engaged in the trade show business can also be useful —  they add a more personal perspective to the dry historical data, they are more fun to read than catalogues, and you can probably construct a useful picture of trends by piecing their more or less idiosyncratic stories together.

Take for example Wolfgang Albath, a pioneer in laboratory medicine and one of the founding organisers of the world`s largest medical trade show, MEDICA in Düsseldorf,. He has just summarized, shortly, his view of some of the important trends in the last 40 years of medical hospital technology (in the 12 Nov online issue of European Hospital):

Medica trade show 1974

In summary, his view of the recent history can be described in three words: mechanisation, automation and digitalisation. When MEDICA started (in Karlsruhe) in 1969, it focused exclusive on laboratory diagnostics. Most lab analysis were then carried out manually and in pretty small series.

One of the few automatic systems was the Technicon Auto-Analyzer, introduced around 1960; for a contemporary evaluation of it, see here): “Based on a system of continuous flow analysis [the Technicon AA] revolutionised lab diagnostics and paved the way for analysers to work through organ-specific parameters in batches”.

In the 1970s came immunofluorescent techniques for detecting auto-antibodies and infectious agents, and in the 1990s advances in molecular biology opened new diagnostic opportunities at the picomolar level.

Iinformation and communication technology has not only made possible automation in the clinical lab, but all kinds of hospital practices. The first patient monitoring systems, which are now taken for granted in intensive care and neonatal unit, were introduced in operating rooms and wards in the mid-1960s. In the clinical laboratory, computer development made possible large-scale diagnostic tests in the 1970s.

Another area which depends heavily on IT  is radiology and medical imaging. In the 1960s “the triumph of real-time ultrasound diagnostics began”; in the 1970s came the CT-scanner; the first digital image archives, radiology information systems and laboratory information systems arrived in the mid-1980s; about the same time came MRI, and in the 1990s PET. 3D reconstructions of CT, MR and ultrasound images also became possible in the mid-1990s.

Surgery too has undergone enormous technological changes; eg., keyhole (laparoscopic) surgery began in gynaecology in 1969; the first keyhole gallbladder removal was performed in 1985 and in the early 1990s keyhole surgery in the abdomen. And then there is laser technology which has “lit up the medical sky” for 30 years, not least in ophthalmology, where doctors hardly cannot imagine work without lasers today.

While we are waiting for the sequel to Joel Howell’s seminal Technology and the Hospital: Transforming Patient Care in the Early Twentieth Century (Johns Hopkins University Press, 1996), reminiscences like Albath’s are among the best ways to get an overview of the complexities of the recent history of medical technology. I haven’t made a systematic search for memoirs and reminiscences of similar kinds — but I’m convinced there are many out there, although they can be difficult to find.

(Btw, for a useful academic course syllabus for the history of medical technology, see here).

Last year we had a discussion on this blog (see here and here) about whether objects ‘talk’ — no, they don’t! But do they ’die’?

The UCL-based Autopsies group (associated with Film Studies) suggests they do. The group runs a cultural studies project called “Autopsies: The Afterlife of Dead Objects” to explore this morbid issue. Here’s how they reason about the ‘death’ of objects:

Just as the twentieth century was transformed by the advent of new forms of media—the typewriter, gramophone, and film, for example—the arrival of the twenty-first century has brought the phasing out of many public and private objects that only recently seemed essential to ‘modern life.’ What is the modern, then, without film projectors, typewriters, and turntables? How has the modern changed as trolley cars disappeared and hot air balloons were converted into high-risk sport rather than the demonstration of national pride in science and a crucial tactical mechanism of wartime? But what will our twenty-first century entail without mixmasters, VCRs, or petrol-driven automobiles? Does the ‘modern’ in fact program the death of objects? What is the significance of death for things that live only through such a paradoxical program of planned obsolescence? How can cultural historians and theorists participate in the reflection on the ends of objects, from their physical finitude to the very projects for their disposal, the latter increasingly of concern with the multiplication of things that do not gently decompose into their own night.

In other words, what the Autopsies project actually tries to do is to reflect on the life course and ultimate fate of the material things we associate with ‘modernity’ — and dressing this up in the metaphor of ‘death’.

The ’death’-metaphor might be useful. For example, I guess you could say, in some cognitively productive sense, that science, technology and medicine are huge modern technoscientific systems for the production of dead things. Because the perpetual quest for creativity, innovation and progress, by definition as it were, continuously kills off ideas, concepts, theories, methodologies, instruments and practices of the near past, turning them into a dead objects — dead scientific objects, dead technologies, dead medical instruments, dead diagnostic procedures and dead therapeutical regimes. The killing of living objects and parallel production of dead objects is an inherent necessary side-effect of the innovation machinery. 

I don’t think the ‘death’ metaphor radically changes the way I look at objects. But it nevertheless introduces a slightly different angle to the way I understand science, technology and medical museums — from being repositories of cultural heritage, they can be seen as graveyards for dead scientific, technological and medical objects.

And for some reason I like the idea of conceptualising medical museum objects as ‘dead objects’ better than the notions of ‘talking objects’ and ‘evocative objects’ (that said, ‘madeleines’ is my favourite metaphor).

(thanks to Haidy Geismar for the tip about the Autopsies project)

Laboratory equipment for rats or mice have begun to fascinate me more and more. Not in the way the rat guillotine was fascinating, but more in the way of how lab equipment can show so many things about biomedical practices, contexts and knowledge production.

The picture above is from an article in the October issue of The Scientist, which Thomas has referred me to, called ‘Lab Toys – How does cage enrichment affect rodents?’. It is a really interesting article (as he knew I would think) about, well, lab toys – and their consequences for lab practices.

For instance the article illustrates one of the aspects about the use of laboratory animals that you seldom think about: the everyday life in the lab where humans and animals interact. Rats, for example, are not only instrumentalized in an experimental setting but must also, like any other domesticated animals, be cared for and nurtured. And offered toys. As the article describes there is a growing interest and market for this special kind of lab equipment, combined with a growing concern about animal welfare both in public as well as in a biomedical research context.

Another often overlooked aspect (seen from the humanities, at least) about biomedical laboratories that the article shows, is the amount of creativity involved, not only in coming up with new experimental setups, but also in designing facilities for animals. Innovative lab workers apparently do a lot for the well being and the shaping of lab animals’ environment using simple things like cardboard or shreded paper.

The article also had some more critical points about lab toys.

In the 1940s, the famed neuropsychologist Donald Hebb decided to bring home one of his experimental rats, letting it run free in his house and play with his children. The increased variety in the animal’s environment compared to a small bare cage, he found, improved its ability to learn. Psychologists since then have examined the effect of environment on cognitive processes such as learning, fear and addiction.

This and other examples are given to illustrate the fact that the living conditions of lab animals — from materials used for nesting, gnawing or hiding, to temperature and access to other animals — affect their behaviour, stress level, immune system and physical condition. Wheels, gnawsticks and hiding places can therefore in a more or less subtle way influence the results of the experiments the animals are used in.

So if you want to know if your lab’s results are comparable to the results from other labs you have to take these aspects into account and maybe even standardize your lab animals’ living conditions (just like the standardized units, setups or even what you could call standardized mouse like the oncomouse that are used today). As the Dutch researcher Vera Baumans says in the ‘Lab Toys’ article: “The effects of different types of enrichment are often strain-specific and gender-specific, and are even sensitive to the statistical method used in any given study”.

Allthough this is only a relatively small part of the field of modern biomedicine, the living conditions of laboratory animals can, in this way, reflect many of the central aspects constituting the field. One important aspect shown in the lab toys discussion is the way medical sciences attempt to manage complexity by creating controlled lab settings.

But it also becomes clear that the laboratory is a setting for animal and human interaction beyond a simple ‘exploiting the animals’. It is a setting where you cannot separate lab practices from their political and social context — in this case in the form of regulations and concerns for animal welfare. And as the article ends by pointing out, the investment in animal welfare made by Pharma companies like Novo Nordisk can also have a positive effect on the image of these companies as moral entities.

Unfortunately, we don’t have any laboratory toys in the collections of Medical Museion, but they would definitely be items worthy of a museum exhibit. Imagine a rat toy and a rat guillotine next to each other to illustrate some of the paradoxes and themes in recent biomedicine. More lab toys on display, please!

Part of the fun of being involved in a medical museum these days is that the notion of ‘biomedicine’ is so much broader than traditional medicine and health care taught in faculties of medicine and health science.

As a university institution for biomedical science communication we are, by default as it were, confronted with some of the most fundamental issues in the world today. Financial crisis, atomic weapon threats and global warming  aside — the rapid technical development in biology and biomedicine raises some pretty hefty social, political and ethical questions which we, as a museum, can hardly avoid dealing with if we want to stay just minimally atuned to the world around us.

Take the issue of synthetic biology. Forget about the potentials benefits and risks of stem cell biology, nanotech, gene therapy, and so forth. Synthetic biology — the design and construction of new biological systems not found in nature, for example, constructing living cells from simple molecules (proto-cells); creating new biological systems based on biochemical pathways not found in nature; etc — is potentially more powerful, not least for medical therapy and human enhancement. 

Is it safe and secure? Well, of course it isn’t! In yesterday’s issue of Public Service Review: Science and Technology, Markus Schmidt, who leads the SYNBIOSAFE project at the Organisation for International Dialogue and Conflict Management, raises some of the problems involved in the development of synthetic biology:

With the availability of genetic sequence information available on the internet and outsourcing of DNA synthesis to specialised synthesis companies, we are facing the risk that some person with malicious intents might place an order for pathogenic genes.

But there is always two sides to new technologies. In the future, more and more people will probably be able to construct new biological systems (read: democratic technology). Already, the annual International Genetically Engineered Machine competition in Boston invites students from all over the world to construct new biologies. And there are several DIY biotech groups who want to get the techne out of the laboratory, to bring it to the people. Such democratisation of synthetic biology might, as Schmidt rightly observes, lead to a creative revolution similar to that we have seen in the computer industry and the internet. Imagine synthbio 2.0 — love it or hate it.

Schmidt’s institute is only the last in a row of initiatives to discuss the safety and the political, governance and ethical issues involved in synthetic biology. Two years ago a report from the J. Craig Venter Institute discussed the governance problems associated with synthetic biology, and last year a report from the International Association of Synthetic Biology proposed a number of technical solutions for improved biosecurity. And there are several other initiatives around — enough to fill the agenda of a future-looking medical museum.

Schmidt’s analysis is expanded in M. Schmidt, A. Kelle, A. Ganguli-Mitra and H. de Vriend, eds., Synthetic Biology: The technoscience and its societal consequences (2009); there is also a 55 min video here: SYNBIOSAFE: Synthetic biology and its social and ethical implications.

Last week, Computerworld carried an interview with futurist Ray Kurzweil, who predicts that in 30 or 40 years from now nanomachines will travel through our bodies, repairing damaged cells and organs, effectively wiping out diseases:

The full realization of nanobots will basically eliminate biological disease and aging. I think we’ll see widespread use in 20 years of [nanotech] devices that perform certain functions for us. In 30 or 40 years, we will overcome disease and aging. The nanobots will scout out organs and cells that need repairs and simply fix them. It will lead to profound extensions of our health and longevity

What’s interesting is not whether the prognosis is right or wrong, naïve or realistic. Like all med-tech forecasts it probably better reflects our own time than it predicts the future.

What’s interesting is that it is said by Kurzweil. Or more generally speaking: Much forecasting about health and longevity comes from people in the computer and IT world, whereas medical doctors rarely indulge in such frivolous mental activities (see also the earlier ‘What makes the human enhancement movement tick?’ post). Why are IT people more wedded to the idea of enhancement and longevity than medical and health scientists are?

Yesterday, I asked one of our business partners, who attended the opening of our new exhibition, Primary Substances: Treasures from the history of protein research, last Friday what he thought about it.

“I thought it was fino”, he replied, and added:

I like old instruments and packings — it reminds me of Jules Verne and it’s a pretty big subgenre that you can find on the web under the label Steampunk http://steampunkworkshop.com/lcd.shtml

That’s an interesting comment.  I’ve never thought about semi-old scientific instruments in terms of steampunk before (had heard about steampunk, but didn’t really know what it stands for).

Our collection of medical and medicotechnical instruments and devices is pretty big. It’s particularly strong on instruments made in the industrial (steam and electricity) era; less so on 17th-18th century objects and late 20th century ones (although we’ve begun acquiring lots of instruments from the last decades as well).

I guess this means that Medical Museion is full of medical steampunk. I just learned from the Wikipedia article on steampunk that the main difference between it and cyberpunk (which I’m much more familiar with) is that steampunk is generally much less dystopian.

Isn’t that what characterises medical technology as well? It’s much more utopian than dystopian (you would never try to destroy the world with the help of an electromechanical ECG machine, would you?).

Sounds like we’ve got a theme for our next public exhibition: Medical Steampunk! Much better topic than the history of medical instrumentation (yawn!).

After the large-scale renovation of its permanent collection in 2005, the Hunterian Museum in London has expanded its outreach programme under the leadership of senior curator Simon Chaplin.  Today, the museum opens another new temporary show,  “Sci-Fi Surgery: Medical Robots“.

Running until 23 December, the exhibition displays the world of medical robotics. Things like the Probot (1991), a robot designed to aid prostate gland surgery; Freehand, a robotic camera holder for keyhole surgery; mini-robots designed to make their own way around the inside of the human body; the prototype Robotic Camera Pill (2005); and the ARES Robot prototype (2009) which requires patients to swallow up to 15 different modules which then re-assemble inside the body into a larger device that can carry out surgical procedures.

The exhibition will also feature medical robots from sci-fi: from the 1920s ‘Pyschophonic Nurse’ to Japanese Manga and Anime, raising the question  to what extent scientists are inspired by the representation of medical robots in films, books and comics.

It doesn’t come as a surprise that the exhibition has been funded by, among others, The Japan Foundation and The Japan Society.

Sci-Fi Surgery: Medical Robots events including anime and film screenings, discussions and robot family workshops.

Sounds like a great show — I cannot attend the opening — but it looks a must for the annual London trip.

Medgadget believes there is a good reason why their blog mainly covers medical devices and technologies coming from the United States, namely the great American healthcare system, “equipped with the latest technologies, smart doctors and clean hospitals … a system that delivers unbelievable technologies to help patients day in and day out”.

“There must be a reason”, they add, “why we almost never see anything interesting coming out of France, Greece, Spain, Italy, or most other European countries (Germany being the clear exception)”.

Medgadget asks this rhetorical question as an argument against the Obama administration’s health care plan. But besides the pros and cons of Obamacare, I wonder if the claim is really true. Is the US really the motor of medical device innovation? Do Europeans not produce any interesting medical technologies?

Historically, this is of course an outrageous claim. Brought up in technologically innovative Sweden and now living in a small country (Denmark) with a plethora of small and large medical device companies, I intuitively know it is plainly wrong. And I can easily substantiate my intuition with a lot of anecdotal evidence — Coloplast and Oticon in Denmark, Gambro, Getinge and Elekta in Sweden, just to name a few.

The combined annual production value of the Danish and Swedish medical device industries is around 90 billion DKK (~15 billion USD). In the light of a total population of around 15 million this is a pretty impressive achievement. (And note that these are countries with strong national health care systems!)

But I must confess that I don’t know if this high productivity is the result of innovations of the past. Is the innovation rate still high? A 2007 report from the Royal Institute of Technology, the Karolinska Institute and Karolinska University Hospital indicates that many of the most important Swedish innovations are 30-50 years old and that there are signs that the rate of innovation is declining. Maybe the situation is similar in Denmark? That would make Medgadget’s claim somewhat less outrageous.

But that said I believe there are more obvious reasons for why Medgadget almost only covers medical devices and technologies coming from the US, namely the fact that the editors are situated in the US, that they are thus familiar with US industrial culture, have a tendency to follow American websites, and (most importantly) cannot read the current of daily tech news published in Danish, Swedish and other European languages. In other words, Medgadget’s medical device universe is nationally myopic.