Janet McCalman

Ten Years of Health & History

This issue of Health & History celebrates two things: first the tenth birthday of the journal itself, and second the distinctive role of the physician-historian in the history of medicine. Furthermore, the two are intimately related. Health & History emerged from the partnership of physician-historians and professional historians that had made the Australian Society for the History of Medicine a lively scholarly community for more than two decades. Looking back over the published collections of papers from past conferences, a wide range of work emerged that began to build a tapestry of the history of medicine within Australia and explored topics of wider interest to medically-minded historians and historically-minded physicians.	1
However, many physician-historians felt frustrated by the lack of a more regular source of publication and exchange of ideas and the growing body of specialist historians of medicine were keen to connect Australian and New Zealand scholarship with the global history of medicine community.	2
The leader who emerged to make this happen was Warwick Anderson, a physician not long returned from graduate school and post-doctoral experience in the history of medicine in the United States. His original conception was to produce an Australian variant of the Bulletin of the History of Medicine and it was he who settled on the name Health & History and edited the first issues. When he returned to the United States, the editorship fell to myself, but the Melbourne operation was hampered by lack of time and editorial experience.	3
With the move of editorship to Hans Pols in Sydney, Health & History has flourished. Hans' connection with the History Cooperative has solved the problem of free electronic access and integrated the journal with the international scholarly community. I also wish to congratulate Hans and his team on the imaginativeness of their editing and the increasing richness of each issue's contributions. This issue celebrating the physician as historian is no exception: the subject matter contributed by this issue's cast of physician-historians ranges from animal medicine (which Virchow argued was on a continuum with human medicine), psychiatry (suicide), history of a specialist area of medicine in Australia (paediatrics), indigenous health and human rights in a global frame, medical biography and women in medicine, and finally, scientific medicine with an article on the early years of nuclear medicine in Victoria.	4
However, the marriage of history and medicine, historical expertise with medical expertise, has not been without tension. This occasional marital disharmony can be found everywhere that physician historians and general historians interact. It has caused problems within the Wellcome Trust in the United Kingdom, and has seen some international conferences divide into the 'real historians' and the 'medical antiquarians.' Sometimes, the physician-historians have withdrawn altogether as medieval and early modern historians appear to have captured the field entirely for the humanities.	5
Each side is jealous of their professional standards: of correct understanding of biological processes and medical knowledge; of acceptable standards of evidence and appropriate sophistication in the explanation and interpretation of historical contexts. Yet each side needs the other because few are able to combine expertise in both, and those few who do so, internationally—the physicians and scientists who have undertaken a second training in history—are often the natural leaders of the field.	6
Even so, from the historian's perspective, the richer the historical training, the better the historian and too specialist a focus in graduate school on the history of a discrete field—such as medicine, or psychiatry, or a branch of science or technology—can limit a scholar's range. However, as with all branches of expertise, knowledge has expanded so much in the last half century that it is now difficult to be a convincing generalist.	7
The scholarly world, along with the scientific world, is increasingly turning to interdisciplinary and multi-disciplinary collaboration to tackle complex questions that no one discipline can comprehend on its own. If non-physician historians are to venture more confidently into modern, scientific medicine, then many will need to do so in collaboration with physician-historians. Similarly, physician-historians can benefit from a partnership with disciplinary experts.	8
That said, the physician-historian is still a special and precious beast. Medicine itself, in particular in the clinic, demands the full cognitive repertoire: to put it colloquially, using every part of the brain. The study of medical humanities in medical school is needed more for the stimulation of different ways of knowing, thinking, and communicating, than it is for the actual content of the subjects. Clinical thinking is also inherently historical. Health and disease in individuals and populations are historical processes that happen over time and space. The progress of illness in the patient is mapped with a history. Clinical knowledge is all about accumulated historical observation and the critical reading of literature. Physicians are inevitably historical thinkers, collecting evidence over time that is framed by both current formal knowledge and what the surgeon-historian Christopher Lawrence has called 'incommunicable knowledge,' and then finding meaning in that accumulated, structured evidence.	9
The study of history in general, and history of medicine in particular, further trains the physician in the understanding of human disease and suffering, of its therapeutics and finally its human and moral significance. It is a privileged perspective on human affairs, and the more that physician-historians can share that with the rest of us, the better we shall all be.	10

University of Melbourne

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