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A Prize for Ilana Löwy, and other extraordinary events at the Biennial Conference of the European Association for the History of Medicine and Health, Utrecht, the Netherlands, 1-4 September 2011

Report by Steven Palmer; photos by Wieke Eefting

I came to Utrecht trying to keep my expectations realistic.  I’d had such a good experience at the EAHMH meeting in Heidelberg two years earlier, and didn’t want to be unfair to the successor by asking too much of it.  Sometimes at a conference you happen to be in the right frame of mind to appreciate the presentations and engage the place and people, and everything comes up roses.  But it’s not the case with most academic meetings, rewarding though many are in their own way.  Heidelberg was exceptional, in part because it was my first encounter with the EAHMH constellation and I was enchanted, in part because I’d decided on a whim to blog it, “semi-live”, in the spirit of the news scribbler covering an event, and this led me to engage on a fresh level, and think about the nature of conferences per se.  But I discounted the temptation to blog Utrecht, again to avoid trying to repeat an experience or measure this one against that.  Let the gathering reveal its own dynamic, I told myself, and suggest its own genre.  It didn’t take long.

A certain classical character had already been suggested in the conference theme, “Body and Mind in the History of Medicine and Health”; in the host institution, Universiteit Utrecht (f. 1636) and its Descartes Centre for the History and Philosophy of the Sciences and the Humanities; and in the venue itself, an old town on the Vecht with a long history of trading in goods and ideas, its historic streets resonant with the Dutch golden age.  The postcolonial and global health leitmotif of the previous conference had suited Heidelberg: despite the putative age of the university there, like the city it is essentially a 19th-century reinvention whose conflicted significance was found in the age of nation-states, empires and post-empires.  Utrecht goes back further than that, and the call to the Cartesian dance of body and mind invited us to reconsider some of the original puzzles and dynamics in the modern history of medicine.

Frank Huisman welcomes us to the conference

From the moment we stepped into the Academy Building beside the impressive Dom for the welcoming reception it was clear that there were no ghosts in this machine, and that any such classicism would not be austere.  On the contrary, the laid-back charm, light touch and ecumenism of conference organizer and EAHMH president, Frank Huisman, professor in the history of medicine at Utrecht, was already the guiding spirit incarnate -- in the relaxed atmosphere, in the easy practical manner of the students helping out with registration, and in the great good humour of the welcome.  A friendly photographer, Wieke Eefting, immediately started documenting the conference, and it looked like her pictures would be worth waiting for – as so clearly they were.

 the Young Cartesians (left-to-right): Robin van Ingen, Wouter Verberne, Noortje Jacobs, Shoko Vos

I soon run into two Brazilian historians I’d first met in Heidelberg, Ana Carolina Vimieiro Gomes and Juliana Manzoni Cavalcanti, and – a good sign of the energies present in the room – both are thriving: Ana Carolina, a post-doc when she presented in Heidelberg, has since won a professorship in Ouro Preto at the Universidade Federal de Minas Gerais; Juliana, a recent MA two years ago is now pursuing doctoral studies at Giessen. 

Juliana Manzoni Cavalcanti (left) and Ana Carolina Vimieiro Gomes

And soon after that I am able to raise a glass to Rich McKay, who’d I’d seen in Heidelberg give a stellar talk on the ideology of AIDS epidemiology from his dissertation-in-progress, and toast Dr. McKay’s ESRC post-doc at King’s College, London.  Indeed, as in Heidelberg, there is an inspiring youthful presence at this meeting – a contingent of impressive graduate students from the UK (among them, Victoria Bates, recipient of an honourable mention in the student paper competition for “‘Early Ripe, Early Rotten’: The Body and Mind in Early and Precocious and Delayed Sexual Development, 1850-1914”), and others from Norway (including Magnus Vollset, recipient of said prize for “Medical Models of Leprosy, Polices and the ‘Leper Mind’”), France, the Netherlands, Spain, Germany, the Czech Republic, Italy, Greece and beyond (the Americas and New Zealand!).

Magnus Vollset accepts the prize for best student paper

Before long, another great coincidence: I meet Paula Michaels and see on her name tag that she is from the University of Iowa, a place I spent two of the most rewarding, if temporary, sojourns of my academic life, attracted there by the great intellectual historian of Latin America, the late Charlie Hale who I wish was still with us.  The most recent time, in 2000, I’d just missed Paula who was on a research leave (though I’d made good friends with the person who was replacing her!).  People I almost met – people I long since should have met – people I now get to meet -- this will be, for me, the hallmark of Utrecht: scholars of shared or complementary sensibilities, perhaps in search of one another without knowing it, finding themselves under the same roof.

Wendy Kline (left) and Paula Michaels

As I sit watching people file in for Jacalyn Duffin’s evening keynote (a full house, I’m relieved to find, as I’d promised her this association was all about solidarity), I see Francisco Javier Martínez Antonio from Spain.  However did I miss him on the program?  Here is someone with whom I’ve had two tantalizing -- and altogether too brief -- intellectual encounters since a first chance run-in ten years ago – and I will finally get to talk with him (after realizing a couple of years ago when a friend told me I had to read “this amazing article” – which turned out to be by Paco – that unbeknownst to me he had been working the flipside of my Cuban project, reconstructing the imperial health apparatus of Spain in the 19th century).  During a coffee break I rudely buttonhole Christoph Gradman, who I’ve never met, to tell him that his brilliant book on Koch’s medical bacteriology, Laboratory Disease, published in English translation last year, has made me completely rethink, with new confidence, my work on Cuban laboratory science in the late Spanish empire.  By interrupting his conversation I get to meet Pratik Chakrabarti who is doing fantastic and fundamental work on the case of Indian bacteriology in a colonial context, which has intriguing parallels with the Cuban case I’d never thought of.  Pratik not only does me the honour of Googling up a recent article of mine on the Cuban stuff, he reads it and gives me a generous critical evaluation at the next day’s first coffee!

Jacalyn Duffin answers questions after her keynote

After embarrassing myself by almost collapsing from jetlag on Anne Kveim Lie during a lull in the Boerhaave Museum proceedings, I find that she too has spent a lot of time in Cuba and, like me, had her life transformed by the mind-bogglingly selfless generosity of friends made there.  I happen to sit beside Bill Leeming on the bus coming back from the museum, and gradually realize that he is the expert on the history of Canadian medical genetics who was so unusually kind and forthcoming to an MA student of mine who sent him an e-mail out of the blue looking for advice and bibliography for his project on genetic screening in Montreal.

(left-to-right) Anne Kveim Lie, Kaat Wils, Bill Leeming

I could go on, and actually I will.

It was an epiphany to hear Annemarie Mol’s conversational, breath-taking keynote lecture revisiting themes from The Body Multiple, her (I now realize) path-breaking work on disease as process.  Very cool to see Ana Carolina Gomes’ Brazilian futurist biotypology body images from the 1930s.  Fortunate to witness one of the most polished lecturers of our time at the top of her game: Jacalyn Duffin’s lively and witty and much appreciated 'after dinner' talk on the better and the worse of teaching medical history to Med students – her disarming and down-to-earth delivery making accessible a depth of thinking on this subject (as on so many others) that few if any have ever attained.  Wonderful to have as a moderator, Heiner Fangerau, whose pithy observations between papers brought sessions together and kept them ticking.  Pleasantly surprising to become the audience for a theatrical – or perhaps rather anatomico-amphitheatrical – performance piece at the Boerhaave Museum on the history of pedagogical dissection by Andrew Cunningham (playing himself) with inspired supporting work from a rambunctious troupe of actor-curators channelling commedia dell’arte.

Courtesy Boerhaave Museum

And lucky to be at a fine panel on psychoprophylaxis (popularized in the US as the Lemaze method) and natural childbirth, featuring Paula Michaels’ keen work on debates over psychoprophylaxis in its place of origin, the Soviet Union; a lucid and crafty paper by Marilêne Vuille on the way French medical discourse around Lemaze located pain in women's bodies; Ema Hresanová's snapshot of the status of psychoprophylaxis in Czechoslovak obstetrics in the 1960s (the setting making me recall Daniel Day-Lewis’ inscrutable grin from The Unbearable Lightness of Being); and an engaging talk by Wendy Kline on the home birthing movement in the US during the 1970s.

Kline prefaces her paper by telling us that she had been discussing home birthing at a restaurant that morning with Hermine Hayes-Klein, a midwife visiting from the US (who also attended the panel), when a woman from England came over to their table to tell them, in no uncertain terms, “Could you please not talk about childbirth during breakfast!”  Hilary Marland, discussant on the panel, assures the audience that the English woman in question was not her.  After the session, in the foyer, there is talk about childbirth all through lunch.

Annemarie Mol

These are just some of the moments that stayed with me, and that mark my own route through this luminous gathering.  With up to six panels going on at any one time, the permutations were – well, Descartes no doubt could have figured out how many possible routes through the conference there were, though perhaps even his pal Pascal would have had trouble calculating the possible experiences of the collective, especially if the multiple differential routes of body and mind are factored in.

But of course I have not done all the participants justice with this description.  To those whose talks and talk I missed, I can only say that, while I truly did miss them, I feel they must have been similarly rewarding because the surrounding buzz in communal moments was to my ear quite harmonious.

Drift 21

Which returns me to a point of departure, for I think, still giddy from Frank Huisman’s Utrecht potion at the reception the night before, we were somewhat taken aback by the depth, the cast of characters and the musicological conundrum of Floris Cohen’s keynote kickoff, “Body and Mind: Descartes’ Opening Gambit”.  In fact it was a playful exploration of Cartesian philosophical and institutional politics, some centuries earlier, in the same site we now had the privilege to stride, and it set an erudite, open and humanistic tone for all that followed. Speaking of musicology (and there were more musicians in his audience than Professor Cohen perhaps realized), my one criticism of the conference organization – which I was compelled to pass on to Frank Huisman – was that, while we were all told of our full access to state-of-the-art digital projection equipment, we were not informed that every conference room would be rigged out with a piano.  Had we known this, I feel sure that many would have introduced a musical component into their talks – perhaps even a little soft shoe?

H. Floris Cohen after his keynote

Even so, the presentations I attended were rich in performance and artistry: Émile Nelligan, the tragic modernist poet of Québec at the heart of Johanne Collin’s paper; the sad princess, Marie Fortunée d’Este, whose fabulous melancholia was rendered so beautifully by Aurélie Chatenet-Calyste; the great Sterne, evoked to ironic effect by Marilina Gianico in her exploration of the confluence of literary and medical understandings of the “English malady”; Audrey Hepburn’s meningitka, reverentially introduced into Yuri Zagvazdin’s colourful examination of meningitis in Russian folk etiology; and Donato, “the king of magical hypnotists,” whose troubling performances spanning the world of entertainment and academic medicine were so nicely woken from historical slumber by Kaat Wils.  The combined papers of the conference were a rich tour de monde, and did what contemporary medical history does so well: not so much debating the terms of the mind-body puzzle, as articulating and enacting a “unified understanding of people and their illnesses”, to quote from Roger Smith’s final, and nicely placed keynote appeal.

Roger Smith and company

Utrecht was at its best these four days, I suspect.  Leaving Drift 21, the light and airy Humanities building in the old town where the conference sessions were held, we drifted ourselves along magical streets humming with purposeful cyclists and medieval canals filled with postmodern light and chatter.  The sun shone, and the cafes and restaurants spilled onto the streets with vibrant students in early semester, all their dreams still true. 

It was well into the conference, while I was munching on a pleasant raisin bun during a coffee break, that Pratik Chakrabarti passed by with some news. “Did you see?  Ilana Löwy’s here.”  And so she was.  It was extraordinary, as she wasn’t listed on the program.  I took another bite of the bun and it exploded with marzipan – my favourite.  From body to mind, the thought arose that here was a metaphor for the conference itself: a fresh and unpretentious invention that constantly delivered unexpected delights.

Scientific board members, Alex Mold (left - also EAHMH Secretary) and Fernando Salmón

The final business meeting of the association contains much good news about an organization that is doing very well and fulfilling its mission.  The EAHMH has brought to life a new book series in medicine and healthcare from a historical perspective, in conjunction with Belgium’s Brepols Publishers (manuscripts now being solicited for peer review by EAHMH editorial board).  And the scientific board of the association has also worked hard to maintain one of the flagship journals of our discipline, Medical History.

Jonathan Simon, EAHMH Treasurer

After acknowledging the seven excellent graduate student papers that were in competition and choosing two for special recognition, Frank Huisman has the enviable outgoing presidential task of presenting the inaugural Book Award for the best medical history monograph published in the four years preceding the EAHMH biennial conference (I note that among his many tasks other than serving as EAHMH president and conference organizer [!], Huisman has managed to define a new book prize, find funding for it and serve on the jury [!!]).  The prize, which comes with a nice cheque for € 3,000 courtesy of the Dutch Stichting Historia Medicinae and the German Robert Bosch Stiftung, this time considered books published from 2007 to 2010 inclusive on any medical history topic concerning Europe or Europe’s relationship with the wider world (edited volumes, as well as works with two or more authors, were not eligible).

The jury - consisting of Professors Anne Hardy, Robert Jütte and Huisman – was unanimous in conferring the 2011 EAHMH Book Award on – well, I’ve given it away already, but at the time it was suspenseful – Ilana Löwy’s Preventive Strikes: Women, Precancer, and Prophylactic Surgery (Johns Hopkins University Press, 2010).  Lowy’s award-winning book concerns the 20th century battle against cancer, with a focus on preventive diagnostics regarding breast and ovarian cancer, and its implications for the lives of women.  Reflecting the jury’s deliberation, Huisman describes Löwy’s analysis as a metaphor for modern medicine – for modern life even – a book about “the tragic consequences of the malleability of life in a secular risk society.”

As Huisman puts it for the assembled members of the association:

“The strength of this book lies in its demonstration that the medicalization process is by no means a conspiracy of doctors against patients. The ‘cancer script’ – as Löwy calls it - is a co-construction evolved by surgeons, pathologists, insurance companies and women. While the diagnostic categories they use are unstable, their framing of cancer has dramatic consequences for the lives of individual women.  As such, this story may be read as a comment on the tragedy of the human condition.”

His well considered summary of this book’s enormous contribution to the history of medicine and science – a contribution that itself rests on a body of work that has ranged across much of the world and taken on questions as diverse as the visualization of parasites, the Atlantic culture of bacteriology and tropical medicine, and the history of the philosophy of medicine – also quotes from Löwy’s own conclusion.  “The desire to transform precancer into a stable diagnostic category can be compared with earlier efforts to stabilize a diagnosis of another ‘dread disease’, with deep social and cultural resonances: the history of the Wassermann reaction for the detection of syphilis”.

He calls our attention to the fact that this latter history was written by the Polish physician and philosopher of science Ludwik Fleck, and concludes his elegant laudatio, and invites Dr. Löwy to the podium, by saying that “with this book on what Löwy herself calls the ‘lumpiness’ of today’s oncological practice, she may come to be perceived as the Ludwik Fleck of our times.”

There is vigorous and sustained applause.

A delighted and deeply moved Ilana Löwy accepts her prize with eloquence, modesty and grace.  She honours the memory of Olga Amsterdamska, a Dutch friend and colleague recently passed away, who first introduced her to the work of Fleck.  This was at a time when, as a neophyte historian of science with ten year’s experience of the bench, Löwy found that what was then traded as cutting-edge work in the field did not speak to her way of understanding research practice or thought process.  She acknowledges that Fleck’s work had set her on her way, though Dr. Löwy is quick to distance herself from the presidential comparison, instead likening her relationship to Fleck to that of the proverbial mortal standing on the shoulder of a giant.  Well, perhaps, but as one of many who is trying to get their footing while standing on Ilana Löwy’s shoulders, I must say that she certainly looks a giant to me – and a rather restless one at that.

It is hard not to feel that we are in the presence of greatness.

The presentation of this award crowns a wondrous gathering in Utrecht, and reaffirms the meaning of what we do, and the reason we sometimes must do it together, in person, in colloquia – not only in mind, but also in body.  We all endorse the sentiments of Fernando Salmón, who thanks Frank Huisman for presiding over the Utrecht meeting with an easy good humour that rubbed off on everything and everyone in rare combination with a respect for formalities that only made the proceedings more profound and altogether human.

Still there are more wonders to come!  The first is the election – by unanimous vote of the membership – of the new president of the European Association for the History of Medicine and Health, Laurinda Abreu, professor in the history of medicine at the University of Évora.  Professor Abreu accepts humbly and inspires confidence in assuming the responsibilities of office.  Most urgent is to rehearse the theme of the next EAHMH conference that will be hosted, as per association tradition, in the president’s neck of the woods.  With Europe teetering on the brink, Abreu’s initial proposal is to conjure a meeting around the theme of “Risk and Catastrophe in the History of Medicine and Health”.  Yes.  I like it, and the feeling seems unanimous.  And what better places to think out loud and exchange ideas and findings about risk and catastrophe (or anything else really for that matter) than Évora or Lisbon, one of which will be the venue for the next conference?  You have big shoes to fill, Professor Abreu, but the good thing is that you can change shoes, as long as the new ones are big, too.

Laurinda Abreu, President of the European Association for the History of Medicine and Health (2011-2013)

So if you think you have something to say about the history of medicine and health, if you think you have something to confer about, come and join the great conversation of this radiant society: the EAHMH will meet again in Portugal in September 2013.  Maybe we will talk to each other there – I hope so – because I will not miss it for the world.

And, if I may, one last time ... thanks, Frank.  The conference was, after all, a classic.