COVID-19 Portfolio: Scholarship

IT WAS THE mid-1970s, and medicine’s so-called golden age was beginning to lose its luster. The pharmaceutical industry was booming, a sure sign to some that the medical profession had sold its soul — if it ever had one to begin with — to big business. Indeed, that was what Ivan Illich, a Catholic priest and philosopher, charged in a damning, if arcane, attack on what he called the “iatrogenic” culture of medicine: its healers’ tendency to bring forth harm.

Illich did not believe physicians were intentionally trying to hurt their patients. Rather, he blamed the system in which they practiced, one that was oriented toward a dispassionate embrace of science at the expense of humility and humanity. As a spiritual thinker, Illich held a deeper concern that doctors had become cogs in an institutional machine that robbed them of the ability to adequately address human suffering. In 1975, Illich’s takedown of the profession, Medical Nemesis, became a nonfiction best seller.

Caring for Capitalism

Ebola’s ability to travel has been well publicized, but there is another story: one of immobility. In West Africa, research materials that contribute to improving knowledge about the disease such as blood samples and patient records have been trapped or entangled in the “hot zone.” In some circumstances, the virulence of such materials appears to pose a risk to biosecurity that may be greater than their ability to help mitigate that risk. In times of uncertainty, fear may trump established policies about how to manage the flow of people, information, and research materials. For instance, while the World Health Organization (WHO) has been opposed to travel restrictions to ensure continued circulation of health workers, the home institutions that employ such workers may choose to impose such restrictions. In such cases, prevention is seen as a preferable alternative to quarantine should health workers return with infection. Yet, physicians and health workers who have been able to travel between makeshift treatment camps in Africa and the resource-rich laboratories and medical centers in the Global North have been frustrated to realize that perceptions of the intensity of the hot zone functions to freeze the otherwise relatively fluid channels of global biomedical infrastructure.

Frozen by the Hot Zone

The Nature of Fear and the Fear of Nature from Hobbes to the Hydrogen Bomb

“Why Did They Die?”

After the atomic bombing at the end of World War II, anxieties about survival in the nuclear age led scientists to begin stockpiling and freezing hundreds of thousands of blood samples from indigenous communities around the world. These samples were believed to embody potentially invaluable biological information about genetic ancestry, evolution, microbes, and much more. Today, they persist in freezers as part of a global tissue-based infrastructure. In Life on Ice, Joanna Radin examines how and why these frozen blood samples shaped the practice known as biobanking.
 
The Cold War projects Radin tracks were meant to form an enduring total archive of indigenous blood before it was altered by the polluting forces of modernity. Freezing allowed that blood to act as a time-traveling resource. Radin explores the unique cultural and technical circumstances that created and gave momentum to the phenomenon of life on ice and shows how these preserved blood samples served as the building blocks for biomedicine at the dawn of the genomic age. In an era of vigorous ethical, legal, and cultural debates about genetic privacy and identity, Life on Ice reveals the larger picture—how we got here and the promises and problems involved with finding new uses for cold human blood samples.

Life on Ice

During World War II, polio epidemics in the United States were viewed as the country’s “other war at home”: they could be neither predicted nor contained, and paralyzed patients faced disability in a world unfriendly to the disabled. These realities were exacerbated by the medical community’s enforced orthodoxy in treating the disease, treatments that generally consisted of ineffective therapies.

Polio Wars is the story of Sister Elizabeth Kenny – “Sister” being a reference to her status as a senior nurse, not a religious designation – who arrived in the US from Australia in 1940 espousing an unorthodox approach to the treatment of polio. Kenny approached the disease as a non-neurological affliction, championing such novel therapies as hot packs and muscle exercises in place of splinting, surgery, and immobilization. Her care embodied a different style of clinical practice, one of optimistic, patient-centered treatments that gave hope to desperate patients and families.

The Kenny method, initially dismissed by the US medical establishment, gained overwhelming support over the ensuing decade, including the endorsement of the National Foundation for Infantile Paralysis (today’s March of Dimes), America’s largest disease philanthropy. By 1952, a Gallup Poll identified Sister Kenny as most admired woman in America, and she went on to serve as an expert witness at Congressional hearings on scientific research, a foundation director, and the subject of a Hollywood film. Kenny breached professional and social mores, crafting a public persona that blended Florence Nightingale and Marie Curie.

By the 1980s, following the discovery of the Salk and Sabin vaccines and the March of Dimes’ withdrawal from polio research, most Americans had forgotten polio, its therapies, and Sister Kenny. In examining this historical arc and the public’s process of forgetting, Naomi Rogers presents Kenny as someone worth remembering. Polio Wars recalls both the passion and the practices of clinical care and explores them in their own terms.

Polio Wars

Epidemic Histories