The current era of medicine is undoubtedly fascinating. Major breakthroughs in cancer treatment, CRISPR gene editing, the use of artificial intelligence and machine learning in the medical field, and the response of medicine to the COVID-19 pandemic continue to demonstrate that the medical field is one of innovation, creativity, and cutting-edge research. While it is easy to get swept up in the excitement of the future, our history is just as fascinating and shouldn’t be ignored. The history of medicine is one that is comprised of many highs and lows — from centuries of fascinating discoveries and accidental breakthroughs to tragedies and disasters. While our history is undoubtedly interesting to learn about, it is very rarely something students are introduced to or even consider worth studying. So why is learning about history worth it to us in this modern era of medicine?
During my second year of medical school, I was lucky enough to have a professor that found a way to incorporate small lectures about major medical historical breakthroughs at the end of his pharmacology lectures. He told us about the fascinating creation of the first smallpox vaccine by Edward Jenner, the unfortunate tale of Typhoid Mary, Joseph Lister’s antiseptic principles, and the gutsy experiment of Dr. Barry Marshal, who drank H. pylori to prove that it causes gastric ulcers. While these were interesting stories in and of themselves, the biggest takeaway I had was a greater understanding of the foundations of medicine. Learning how something was created or discovered in the context of its historical importance gives one a much deeper appreciation for the significance of these otherwise common medications and medical practices.
With a greater appreciation for history came an increased curiosity during my time in medical school. As many say, the first two years of medical school are like drinking from a fire hydrant; the amount of information one needs to learn is immense and often intimidating. Finding memory devices is key to helping one remember what often feels like minutiae. For me and many other learners, stories can often help to shine light on the human aspect of science. Learning about Phineas Gage’s unfortunate accident with a tamping iron helped me to remember the role the frontal cortex plays regarding personality. Similarly, while learning about Boerhaave’s syndrome I discovered that the syndrome was first described by Herman Boerhaave in 1724. He observed the case of Baron Jan van Wassenaer, a grand admiral of the Holland fleet, who induced vomiting after eating a feast and subsequently developed left-sided chest pain and died within 24 hours. These stories helped me put a face to the science, and the often-emotional narratives provided a memory device with which to better recall these facts. This has been supported in a recent meta-analysis which found that narratives are more easily understood and recalled than expository texts.
However, the most crucial reason why we should all learn about the history of medicine is to acknowledge the tragedies and stories of those who have been mistreated and learn from the mistakes of our past. Certain populations, including people of color, women, Indigenous persons, and persons persecuted during war times have suffered from unethical experimentation, racial injustice, and general mistreatment under the medical system. In addition to the well-known abuse of Black men in the Tuskegee syphilis study, there is also the example of the horrific medical experimentation done on predominantly Black inmates at the Holmesberg Prison in Philadelphia between 1951 to 1974. Researchers under the direction of University of Pennsylvania dermatologist Albert M. Kligman used these men to test cosmetics, detergents, and deodorants. These trials also included phase one drug trials, inoculations of radioactive isotopes, applications of dioxin, and various experiments for the Army and CIA which left these men in excruciating pain and often had long-term health effects. This is just one example of many in which certain populations have been treated unjustly and used by the medical system without their consent. These injustices still have an impact on how these communities view clinicians today. In fact, a 2020 nationwide poll by the Undefeated and the Kaiser Family Foundation found that 7 in 10 African Americans believe that people are “treated unfairly based on race or ethnicity when they seek medical care.” Understanding these narratives provides context for this mistrust, allows us to acknowledge the dark chapters in our history, and pushes us to be culturally, ethically, and socially aware.
The importance of studying the history of medicine was championed before in 1913 by Dr. Eugene F. Cordell, historian and physician, in his presidential address to the Medical and Chirurgical Faculty of the State of Maryland. Dr. Cordell argued that studying the history of medicine “increases knowledge, gratifies natural and laudable curiosity, broadens the view, and strengthens the judgment.” Dr. Cordell believed that the history of medicine is a fundamental area of study that should not be neglected, but rather emphasized as a key component of the medical curriculum. But in our current era in which medical knowledge doubles at a rate of every 73 days, incorporating a medical history course in the official medical curriculum seems unrealistic. Many have already argued that medical education needs to be expanded to include medical ethics, narrative medicine, social justice, and policy topics. While one option is to incorporate some pieces of major medical history into other courses to bolster student memory as my professor did, the other option is to simply emphasize the importance of curiosity and self-learning as it pertains to history.
There are so many ways to learn about the history of medicine in one’s own time. The most important and easiest thing anyone can do is to simply take the time to look up interesting historical tidbits about what they are learning. For example, a quick Google search regarding the history of Addison’s disease takes one into the life of Thomas Addison, who discovered pathologic changes in both suprarenal glands in patients who presented with weakness, irritable stomachs, and strange changes in skin color. For those that have more time, books like the “The Emperor of All Maladies,” “The Immortal Life of Henrietta Lacks,” and “The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution” are fascinating ways to get a deep dive into these topics. In addition, podcasts like “Bedside Rounds,” “Poor Historians Podcast,” “Disease Death and Doctors,” and many more can be thrown on in the background while doing chores or driving. I know that many will roll their eyes at the idea of having to learn more when it comes to medicine. But history is not obsolete and shouldn’t be treated as such. Knowing the foundations of our field, understanding the human aspect of the why’s and how’s of medicine, and acknowledging the mistakes that have been made in our past makes us better clinicians.
What's something interesting you've learned about medical history? School your peers in the comments.
Ruchi Desai is a current first year internal medicine Resident at UT Southwestern Medical Center. During her free time she loves to read, listen to podcasts, and learn as much as she can about the world. She is a 2021–2022 Doximity Op-Med Fellow.
Image by N. Savranska / charactervectorart / Shutterstock
