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From atom-splitting to mind-healing

I had to miss a session on The Two Cultures, at last month’s Literature and Science conference in Oxford, because I was myself speaking in a parallel session (see previous entry).

Never having read CP Snow’s original 1959 lecture before, I did so, and was struck by several things which seem to have been filtered out in the huge amount of media and academic commentary it has spawned over the last five decades.

Barely having made a few opening remarks, Snow the promoter of science and scientists puts the boot in to ‘literary intellectuals’ by saying that uncritical admiration for fascist sympathising poets such as WB Yeats, Ezra Pound and Wyndham Lewis was an important cause of Germany’s extermination program in the Second World War.

Well, I happen to have looked at some rather large books on the historical causes of the Holocaust recently, and they did not mention Yeats, Pound, Lewis, or any other poets. That doesn’t necessarily mean that Snow was wrong, of course, but his judgement does not seem to have ‘stood the test of time’.

When he talks about scientists, Snow mostly mentions physicists, such as the atom-splitting Nobel-Prizewinning Rutherford, who he had known personally. Perhaps that just reflects how the wider role of science was discussed in the 1950’s, but it’s interesting that having mentioned the Holocaust and its causes, Snow does not make any point about the very dodgy biological and medical science of Nazi Germany, or the rather less dodgy (and also quite often Nobel-Prizewinning) biomedical science which meant that Britain had little resembling an extermination program itself.

I’m fairly sure that Bad Science, rather than allegedly Bad Anglo-Irish-American Poetry, was more prominently in the minds of those who thought up the Final Solution. To some extent this relies on hindsight, as it was only in the 1980s and 1990s that the British Historian Michael Burleigh more fully outlined the importance of German biomedical eugenics, sterilisation and ‘euthanasia’ of the mentally and physically disabled, as necessary steps which then led to racial genocide.

And as euthanasia (or ‘euthanasia’, as the medically-dominated pressure group Care not Killing might still write it) is very much part of today’s public biomedical discourse, I think that a proper updating of Snow’s Two Cultures argument about ‘literary intellectuals’ would have to properly take account of the general shift of public interest in science, away from atom-splitting and towards …(allegedly) disorder-mongering mental health professionals, perhaps?

Asylum History 1, Recent History 0

 

Last month’s radio programme about lobotomy (1) is interesting because it slightly departs from the usual historical scripts, which are: evil psychiatrists used lobotomy as a destructive form of social control, or well-meaning but weak ones rubber-stamped the decisions of others, such as Nurse Ratched in One Flew Over the Cuckoo’s Nest.

It emphasises that the inventor, and two of the main promoters of lobotomy were in fact not psychiatrists. Politician and neurologist Egas Moniz started the ball rolling. Then, American neurologist Walter Freeman, and the British surgeon Sir Wylie McKissock, both continued to do thousands of operations despite evidence for uncertain therapeutic results.

Historical radio and TV programmes about the bad aspects of the old asylum system (which I don’t advocate returning to, but will say it was always underfunded) are often a means, I think, of deflecting attention from current NHS mental health failings. Other occasional broadcasts about the mental health systems of second- or third-world countries generally have the same function.

At least this one is a little different. However, it seems to me that there is a clear parallel between lobotomy and another kind of invasive operation for a serious behavioural (and often psychiatric) disorder today.

Although obesity surgeons are not household names (yet), there has never been a proper trial of gastric banding or the more serious procedure of partial gastric reduction, despite thousands of operations being done annually (2). The rush to surgery is delaying the development of new non-surgical treatments, and the application of at least one recently developed and partially tested treatment (for obesity-linked ADD / ADHD).

The programme-maker did not draw attention to this obvious parallel. Was he or his boss warned off by England’s Department of Health, which for much of the last decade had surgeons both as chief medical officer and as a health minister? Or was it (perhaps more likely) BBC self-censorship?

BBC journalists don’t themselves seem to believe, any more, that the “licence fee” protects their independence because it is supposedly “not a tax”. But they continue to resist the suggestion that their work should be subject to the Freedom of Information Act.

So ordinary patients who have experienced poor results, infections or other complications from bariatric surgery, may never be able to discover the extent of any such BBC collusion. The same goes for relatives who, following one of the thankfully few deaths directly caused by bariatric surgery, may take a retrospective interest in how this surgical descendant of lobotomy was promoted.

 

 

(1) http://www.bbc.co.uk/iplayer/episode/b016wx0w/The_Lobotomists/

(2) See my previous pieces on obesity: https://drnmblog.wordpress.com/category/obesity/

Drafted 2nd December; final version 8th December

Another Nobel for Cambridge University

 

One of my past teachers is to be awarded the Nobel Prize for Medicine today.

Professor Robert Edwards, who developed In-Vitro Fertilization, gave an annual series of seminars on embryology to about a dozen Cambridge students specialising in physiology. I was a member of the 1982-3 class, when Edwards was a prominent public figure; not only as a scientist, but also because of his decision to publicly discuss the ethical aspects of IVF in a very proactive way.

Unlike other aspects of the course, where we did experiments on rats, pigs, cats, and ourselves, there were no “practicals” in embryology. So the seminars were, to be honest, a bit dry and theoretical. The realities of fertility only became apparent when I was a clinical student in obstetrics and gynaecology, a couple of years later.

But on one occasion, Professor Edwards’ partner, the pioneering obstetrician Patrick Steptoe, came to tell us about the early days of IVF in Oldham, and we heard also about how they overcame opposition from the various establishment bodies of the day. The scientist and the clinician both loosened up and brought the subject, appropriately enough, to life.

 

 

Published at www.DrNM.org.uk on 10th December 2010; transferred to DrNMblog.wordpress.com on 9th October 2011

The Call of the Bottle

 

Books “should, like alcohol, dissolve barriers”, according to the literary academic and journalist John Sutherland, who explored the early history of Alcoholics Anonymous (AA) in a short programme last week on Radio 4 (1).

But for some people (including Professor Sutherland himself, sober only through two decades of attendance at AA meetings) alcohol has the opposite effect: “drinking recreated the conditions of childhood. Solitude; myself alone” (2).

Of these two apparently contradictory explanations for excessive drinking (alcohol dissolves interpersonal barriers; alcohol creates an interpersonal barrier), the first has been widely held for decades. “Social anxiety” was seen as a cause of alcoholism (3), and a problem in itself, well before pharmaceutical companies supposedly invented it in the 1990’s (4).

Anyone with the slightest interest in English Literature is likely to have read at least one of Sutherland’s reviews, books, or introductions to classics by authors such as Wilkie Collins and Anthony Trollope. They are invariably well-organised and structured, with a light touch but not at all “dumbed-down”, so achieving their aim of engaging academics and the general reader.

Alcoholics Anonymous has the reputation of having a rather black-and-white view of addiction. This is probably helpful, even necessary, for many people with severe problems, especially those in the early stages of “recovery”.

But this academic abstainer is not afraid to explore complexity or uncertainty. For example, in his Introduction to Jack London’s ‘Alcoholic Memoirs’, he suggests that the “chronic boozer” London later brought his own alcohol intake under control “easily enough”, and then continued to drink in part “socially”, but also because of the creative possibilities gained from alcohol withdrawal (not intoxication) (5).

Therefore, for anyone looking to remove or reduce moderate or mild addictions, a period of solitude spent reading Sutherland’s extensive works is highly recommended, and is unlikely in my view to have any harmful effects.

 
(1) Available on the BBC’s iPlayer only until 14th November: http://www.bbc.co.uk/iplayer/episode/b00vr78f/The_AA_Bible/

(2) Both quotations are from Professor Sutherland’s British Council Biography: http://www.contemporarywriters.com/authors/?p=auth519D1A75056591DEA5JxLj47A89F

(3) http://www.ncbi.nlm.nih.gov/pubmed/4394734

(4) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60470-5/fulltext

(5) The whole Introduction can be read with Amazon’s “Look Inside” facility. The book’s full title is John Barleycorn: ‘Alcoholic Memoirs’.

This post was published at www.DrNM.org.uk on 12th November 2010, and transferred to DrNMblog.wordpress.com on 7th October 2011

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