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Centre for the History of Science, Technology and Medicine

Communicating Medicine: Objects and Objectives

Ray Macauley is a PhD student at CHSTM. His PhD research is on visual representation of scientific knowledge and interdisciplinary approaches to interstellar communication c. 1959–1977, with particular reference to NASA's Pioneer plaque and Voyager record. He has worked as a Clinical Support Worker in Critical Care at Manchester Royal Infirmary. He was previously a postgraduate research student and Research Associate in the Department of Psychology at the University of Manchester and worked on sensorimotor coordination and phenomenology of presence in immersive virtual environments. Here he adds his thoughts on the question:

What does "curate" mean when speaking of objects reflective of the recent history and present of medicine? A conference report?

The workshop provided ample evidence that participants are both au fait and more than willing to actively engage with complex issues, more commonly associated with recent theories, empirical studies and concomitant discourse among researchers in fields such as the history of STM and STS. Papers and discussions at the workshop addressed issues such as reflexive approaches to the history of medicine, authorship and transformation of historical narratives, rhetorical aspects of visual representation, notions of objectivity, and the interdependency of material practices, public discourse and agency in production and authentication of scientific knowledge. 

An example of how some of these issues inform the work at the Copenhagen Museion was encapsulated in Søren Bak-Jensen’s perceptive paper in which he outlined his concerns about the recent formation of a ‘gap’ between ideas held by members of two identifiable social groups - historians and curators of medicine on the one hand and health care professionals on the other – with regard to recognizing recently outmoded and contemporary biomedical devices as material objects that are of historical significance and suitable for collection, preservation and public display. Similarly, Susanne Bauer’s paper highlighted practical and intellectual challenges associated with recent endeavours to curate biomedical software, ordinarily used by physicians in everyday practice as a predictive tool in epidemiological risk assessment and to support decision-making with individual patients in clinical settings.

Whilst these, and other, papers at the workshop provided valuable insights into conceptual issues and attendant practical issues concerning initial identification, acquisition and display of biomedical objects as exhibits in medical museums, the interdiscplinarity, rationale and goal of the curatorial process was, at times, unclear. For example, I would have liked to know more about the consultation process and interaction between professional curators, exhibition designers, scholars in the field of HSTM and, importantly, health care practitioners and patients. It appears that the knowledge, experience and opinion of professional clinicians, particularly doctors and surgeons, are acknowledged and integrated in representations of biomedicine and displays in medical museums, but to what degree are medical engineers, specialist nurses, laboratory technicians, equipment suppliers, medical illustrators, individual patients and patient groups, for example, incorporated within the curatorial process? Is creative input and feedback from members of such groups during conception, design and revision of museum displays or installations of any significance to museum curators and co-workers in academic fields of research related to HSTM and public engagement with STM?

Efforts to display and communicate the history of contemporary biomedicine in and through material artifacts such as laboratory instruments and software, run the risk of overlooking how and, importantly, why a particular tool is used in a specific context by healthcare professionals. For example, blood gas analysers are a fundamental tool for monitoring critically ill patients in intensive care units, but acquisition and display of one of these devices in a medical museum - even if accompanied with a clear and concise explanation of how it works and what it’s used for - would not necessarily convey the historicity of these objects or reveal that they are part of a complex assemblage comprised of machines and human actors. Further, I doubt whether many healthcare professionals know exactly how a blood gas analyser works – they don’t need to. Instead, they rely on technicians and medical engineers to acquire the requisite knowledge and skills to select, set-up and maintain blood gas analysers and multitude of other biomedical devices. Nevertheless, specialist nurses and anaesthetists do know how to operate, interpret and, crucially, perform subsequent tasks on the basis of results inscribed on slips of paper that the gas analyser produces; the visible traces or inscriptions produced by biomedical devices are constitutive of meaning for healthcare professionals and, ultimately, patients and relatives too. For the majority of intensivists and other professional clinicians, the device itself and the precise manner in which it works is less significant than what it affords in terms of purposive action or decision-making, and how it is used in conjunction with a diverse range of biomedical instruments that effectively mediate or facilitate co-operative work and communication between professional healthcare staff involved in direct patient care.

During the workshop papers and discussions, I wondered precisely how (or should) contemporary academic research on HSTM and curatorial practices coalesce and make available innovative contexts and opportunities for public engagement with science, medicine and biotechnology in and through public display of material objects? And in what sense do theories and practices associated with recent academic research, museology and curatorship translate, problematise and combine in productive ways, including effective means to reflect on the role of museums in the production and authentication of knowledge and portrayal of scientists, for example, as both producers and users of technology?

Francis Neary’s presentation focused on the argument that Latour’s notion of ‘agency’ is suitable as a conceptual tool with regard to informing curatorial practice and scholarly analysis of material artifacts as objects that embody meaning within networks comprised of machines and humans. Specifically, he argued that medical devices are constitutive of meaning and mediate purposive activity between different actors and heterogeneous groups such as biomedical engineers, surgeons and patients. Some workshop participants objected to what was understood as the attribution of agency to non-human objects on the grounds that material objects such as artificial hip joints simply don’t have the capacity to talk or make conscious choices (I suspect that some of these misgivings are related to competing definitions of the term ‘agency’).

Other participants at the workshop suggested alternative analytical tools that would allow conceptual re-orientation and distancing from traditional reliance on narratives in constructing displays, and promote increased awareness of more diverse and valid approaches to museolgical practice and international scholarship in HSTM. Thomas Söderqvist, for example, suggested that a more productive interaction between curators and academics will result from a greater emphasis on identifying the necessary and sufficient conditions for accentuating the ‘presence-production’ of an object on display. In certain respects, the analytical concept of ‘presence’ advocated by Thomas is as problematic as Latourian notions of agency, when applied to curatorial practices associated with the display of objects in medical museums. The notion of presence is notoriously difficult to define, convey and reproduce in a consistent or predictable manner. It is difficult to see how analytical distinctions between ‘presence-production’ and ‘meaning-production,’ can help to explain or facilitate our understanding of the relationship between the perception of material objects and the social production of meaning. Further, it’s unclear why there needs to be a programmatic shift in curatorial focus and practice to accommodate the macro- and micro- entities that are effectively invisible to the human senses and yet intrinsic to the supposed convergence of biomedical technologies and information technology, for example. Invisible entities have been a staple ingredient of STM for centuries; experiments on the elasticity of air during the seventeenth century, theories of ether in physics and experiments on the origins of various diseases and human afflictions have routinely been attributed to entities that cannot be directly perceived by humans. From the papers and discussions at the workshop, it is not entirely clear why a convergence of technologies in the twenty-first century is an ‘acute’ problem that will result in an increasing number of imperceptible entities or scientific objects, requiring a shift in conceptual approaches, theoretical frameworks and curatorial practices in order to render these objects in material, public and intelligible forms.

On balance, the contributions and discussions at the CHSTM workshop provided a valuable and tantalizing glimpse of intellectual tools and practical techniques that show great potential for interdisciplinary approaches to conceiving, curating and analysing museum displays of material objects, which convey knowledge about STM and encapsulate medicine as a manifest, social and historically embedded practice.

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