December 2007

Our collection and display activities are again and again putting the issue of aesthetics on the medical museum agenda. How do we handle the ‘aesthetic dimension’ of medical objects in curatorial practices?

I came to think of this question again when I read yet another laudatory review of Sansernes Hospital [Hospital of the Senses] by renowned Danish architect journal editor Kim Dirckinck-Holmfeld and professor Lars Heslet, former head of the intensive care unit at the Danish National Hospital (Rigshospitalet), published by the Danish Architectural Press a few weeks ago.

The basic claim of this lavishly illustrated coffee-table format book is that it is high time to throw out the predominant brutalist functionalist architecture that has dominated hospital environments of the last 40-50 years. It should be substituted, the authors suggest, with a new kind of aesthetically more pleasing design concept. One that can contribute to the well-being of both patients and employees.

And it’s not just a dream: Over the last ten years Lars Heslet has raised millions of Danish crowns from private foundations to put artwork in the wards of the intensive care unit at The National Hospital and to change the clinical soundscape with the help of music and the sounds of nature.

‘Riget’ (world famous through Lars von Trier’s movie The Kingdom) is perhaps not the worst hospital I’ve seen in the brutalist category. Even so, the authors have a strong case and they are thereby joining a growing international movement against functionalist hospital architecture. This is a frequently discussed topic on the web (for example here) and is a political issue even in some developing countries: “In the last decade healthcare architecture has undergone a dramatic shift from crisis intervention to healthcare maintenance, by rejecting the sterile look of medical edifices and creating a more humane, warm ambience for the patient,” writes a Mumbai-based commentator in the Indian Healthcare Mangagement newspaper in 2000.

Common sense speaks in favour of the authors’ proposal (there even seems to exist some clinical studies that support the claim that aesthetically pleasing hospital design has positive therapeutic effects). So I’m all in favour, of course.

That said, however, the campaign for aesthetically pleasing hospital settings raises the interesting issue of what one might understand by the ‘aesthetic dimension’ in a hospital context. Most of what I have read on the topic is about changing the physical spaces of the hospital (wards, hallways, cafeterias etc.) by adding aesthetically pleasing artistic elements. That is, the ‘aesthetic dimension’ is usually thought of in terms of extra-clinical architectural elements and artworks (paintings, soothing music etc.), but doesn’t really enter the core of clinical practice itself.

Again, I’m not against nicer hospital buildings, tranquil hospital gardens and beautiful artworks. After all, I’d prefer lying in my hospital bed contemplating a ceiling that looks like that by Michaelangelo in the Sistine Chapel rather than staring on a dirty ventilation system. But this widely spread understanding of hospital aesthetics — as a change in the hospital environment — distracts from a more inclusive view of aesthetics as a pervasive dimension of all clinical structures, objects and practices.

By restricting our interest to the aesthetic power of hospital spaces, for example by means of new architectural structures and pleasing artworks, one risks missing the fact that all everyday clinical objects and practices –the ultrasound apparatus, the defibrillator, the syringes and tubes, the bed, the linen, the bodies and gestures of the doctors and nurses, and so on — have intrinsic aesthetic powers.

All these things have aesthetic appearances that relate to our senses — not just the visual, of course, but all the senses: the taste of prescription drugs, the smell from the coffee wagon, the sounds of monitors and beepers, the tactile experience of the bed cover, the cold sensation of the exploration jelly, the choreography of consultant as he/she enters the ward, the gory feeling of having a palpating finger inside one of your body openings, and so forth.

In other words, every detail of the clinic provides a firework of aesthetic impressions — even without a single piece of art on the walls. True, the sensuous qualities of the hospital can be vastly improved by focusing on the aesthetics of the environment — on architectural extras, paintings and glass mosaics — but one shouldn’t forget that the most overwhelming aesthetic dimension of the hospital lies in the nitty-gritty details of everyday clinical objects and practices.

So, to get back to the issue of handling the ‘aesthetic dimension’ of medical objects in curatorial practices, I believe that a heightened awareness, among curators, of the ubiquitous aesthetic dimension of everyday clinical objects and practices will have consequences for the way these objects are turned into museum objects after they have been cassated from hospitals.

Why? Because 1) acquiring, curating and registrating an always-already aesthetic object is a very different museological practice than 2) acquiring, curating and registrating an alleged ‘non-aesthetic’ object and later attributing aesthetic qualities to it, for example when it is put on display.

If (as I suggest) all clinical objects and practices are aesthetically permeated, they will remain so throughout all steps in the curatorial process, and not only when (or if) the exhibition curator decides to ascribe aesthetic qualities to them.

Academics write, want to write, have to write. Sometimes we cannot, and often we have excuses for not doing it. Therefore there are plenty of guidebooks about how to write and how to write frequently. Honestly, I just love these kinds of books. Like people who like cooking cannot resist the temptation of buying yet another cookbook, like gardeners who stock-pile books about gardening, or like DIY-folks who collect a library of DIY-manuals.

The latest book in my writing self-help pile will be psychologist Paul Silvia’s How to Write a Lot (published by the Am. Psychol. Assoc., 2007) which has been recommended by quite a few reviewers, including the group behind the blog Academic Productivity (see review of Silvia’s book in this post).

(thanks to Gustav for bringing the link to Academic Productivity. Brothers in arms we are …)

Speaking about good academic writing habits — Zenhabits has an excellent post titled “How to Actually Execute Your To-Do List: or, Why Writing It Down Doesn’t Actually Get It Done”. Lots of good tips for all of us who let our writing be disturbed by emails, phone calls — and blog RSS feeds!

Today The Scientist is presenting the winners of the first Laboratory and Video Web Site Awards. They started with 60 nominations (out of tens or hundreds of thousands of lab web sites on the net), then a select group of judges short-listed ten top sites — and now the winners have been chosen.

The result is intriguing! Most of the judges preferred an overcrowded and difficult-to-navigate marine biology website with tons of different features (moving images, cartoons, touristic animal photos, etc.). The editors of The Scientist chose a somewhat more sophisticated perception biology site — and the readers voted for this one:

NyborgLab Online it says — but otherwise not much indicates that this is the site of a serious lab that focuses on “the function of the HTLV-1-encoded Tax protein and its role in transcriptional activation and leukemic transformation” and has a decent publication record. Could as well have been an ad for Levi’s, or Nyborg’s new album (or movie).

What’s intriguing about the readers’ choice of ‘Best of the Web’ is that it epitomizes two growing tendencies in the biomedical and biotech world.

One tendency is the focus on the individual principal investigator (PI). For several years, department websites have been subdivided into the lab websites of their individual PIs (i.e., the senior researchers above the postdoc level who run a lab with a grant from a major funding body). And such labs are almost always named after the PI’s (last) name: Johnson’s lab, Chandrasekhar’s lab, Xing’s lab etc.

This use of last names for lab web sites is an indication, I believe, of the strong individualistic character of biomedical and biotechnological research (at least in the university sector; pharma och biotech company labs is a different matter). And the NyborgLab web site underscores the point by displaying professor Jennifer Nyborg prominently as cover scientist — in a relaxed jeans jacket, her slightly blurred fingers indicating dynamic leadership.

The other tendency is that these flashy web sites is an indication of a rapidly increasing need for marketing and branding in the biomedical and biotech world. It is not enough to present content only. Laboratories (PIs, departments, universities) are competing for scarce resources from federal, state, and philanthropic funding agencies. Of course (hopefully?) intersubjective and disinterested peer-review plays the major role in selecting worthy projects for funding. But, web visibility surely helps!

(The title of this post is of course a pun on Erving Goffman‘s classical The Presentation of Self in Everyday Life, 1959)

One thing is the haptic qualities of medical things. Another the olfactory. Many medical things smell, some are smelly. Yet another dimension of the curatorial life we ought to pay more attention to!

I was reminded of the olfactory dimension this morning when I glanced through the last batch of posts from the H-SCI-MED-TECH-list. One of the posts, from medical historian Margaret DeLacy, describes “a very strange and unexpected problem” with her library copy of Geoffrey Cantor’s otherwise excellent book Quakers, Jews and Science (Oxford UP, 2005): “The book stinks. Literally! A very strong chemical smell wafts from the pages when you open the covers”.

Margaret borrowed another copy from the University of Wyoming (American academics can enjoy an excellent interlibrary loan system!), but the problem remained: “it smells equally strange”.

It makes it nearly impossible to read the book. I can’t figure out whether this resulted from too much bleach being used on the paper or too much fumigation with pesticides when the book was in the Oxford University Press warehouse, but the book smells just like the pesticide shelves of our local garden store. Is an aberration of my own or has anyone else ever experienced this problem? Is it limited to this one edition of this one book? Has anyone noticed a problem with other OUP books from that year? Any suggestions? Electronic versions don’t seem to be available for this title. Amazon lists a paperback ed. but evidently it was never issued as no copies seem to be available.

Margaret has had an unusually bad experience indeed. But the phenomenon of smelly books is not that uncommon. Books always smell, of course, more or less, but in many cases they do so quite distinctly. I’ve also experienced books that emanated such strong odours that I felt it disturbed the pleasure of reading.

Vice versa, some books just smell so good! One of my best book smelling experiences is the 1960s multi-volume edition of Josef Stalin’s Collected Works from Foreign Languages Press in Beijing. You can say many bad things about the literary and political qualities of the ideas expressed in these collection of (mainly) talks — but not about the olfactory quality of the binding! I sometimes wonder if the Chinese publishers deliberately used a specially designed fragrance to attract readers to the old dictator’s wicked ideas. 

So the smell of books is one of the qualities of their presence as things. Wonder if book historians pay attention to this? Or maybe the olfactory qualities of books wane over the years so that it doesn’t really matter for a book historian. Today, Stalin’s Collected Works may be less attractive than they were in the early 1970s. And Cantor’s study of how the British Quakers and Anglo-Jewish community engaged with science in the 17th through 19th centuries may loose it’s pesticide odour over time.

(Added 13 Dec.: The H-SCI-MED-TECH list is flooded with good suggestions for solving Margaret DeLazy’s problem: the most frequent one is to use a ‘book deodorizer’. Never heard of this basic intellectual support product before — but one learns something every day 🙂

Open access on-line publishing has eventually reached the field of history, philosophy and social studies of science, technology and medicine (HP&SofSTM). It’s the Institute of History & Philosophy of Science & Technology at the University of Toronto that hosts the new free-access on-line journal Spontaneous Generations. First issue is just out.

The journal — together with a growing number of open access/on-line journals — is powered by Open Journal Systems (OJS), a journal management and publishing system that is developed by the Public Knowledge Project consortium. An awesome initiative!

(And by the way: the first issue of Spontaneous Generations contains a number of focused discussion papers on ‘Scientific Expertise: Epistemological Worries, Political Dilemmas’ by Michael Lynch, Steve Fuller, Stephen Turner, Stephen Bocking, Ben Almassi, Aaron K Martin, Edgar A Whitley, Palmira Fontes da Costa, and James Hull.) 

I’m nurturing a crush on lab-on-a-chip technology! I’m browsing issues of the journal Lab on a Chip,

(cover and inner cover of LOC, vol. 7 (9), 2007)

reading about all possible kinds of technologies of miniaturization for chemistry, biology, medicine and bioengineering.

My favourite topic is biomolecular motors, like bacterial flagellar motors (which cannot be used in vitro on a chip yet), kinesin linear motors, DNA motors, etc. Much of it is futuristic, of course: “Thus far”, says a recent review article, “the use of molecular motors as onboard devices for chip-based platforms is fairly limited” (D. Spetzler et al., ‘Recent developments of bio-molecular motors as on-chip devices using single molecule techniques’, Lab Chip, vol.7: 1633 – 1643, 2007).

But such sobering evaluations from the pundits cannot really curb my imagination. In my fantasy, I put a variety of biomolecular motors onboard hybrid material chips and implant them in the transhuman bodies of the future, where they do all kinds of microfluidic tricks, pumping signaling molecules around artifically grown organs, and so forth.

I don’t think I’m alone having such futuristic fantasies. Maybe lab-on-a-chip technology is a kind of bio-Meccano for the 21C ‘transhuman imagination’ (cf. Keith Ansell-Pearson, Deleuze and philosophy: the difference engineer, 2002, p.194).

Meccano, the classic assemblage toy kit, invented in 1901 and manufactured from 1908,

trained the modernist creative mind. (Not at all like Lego, the soft, plastic unit-size cubicles designed for kids at a time when modernism was already waning). Meccano was a serious kit, made for teenagers and grown-ups alike who dreamt of a utopian mechanized industrial civilization. Generations of mechanical engineers grew up with Meccano.

I’m eagerly waiting for Dolomite, Microfluidic ChipShop, Micronit Microfluidics and other lab-on-a-chip manufacturers to produce the 21st century counterpart of the classic Meccano for the garage biotech amateur market.

Blog (and other) writers could learn from Doris Lessing, whose Nobel lecture (alas, she’s not coming to Stockholm) was released a few hours ago:

Writers are often asked, How do you write? With a processor? an electric typewriter? a quill? longhand? But the essential question is, “Have you found a space, that empty space, which should surround you when you write? Into that space, which is like a form of listening, of attention, will come the words, the words your characters will speak, ideas – inspiration. If this writer cannot find this space, then poems and stories may be stillborn. When writers talk to each other, what they ask each other is always to do with this space, this other time. “Have you found it? Are you holding it fast?”

(from nobelprize.org)

I wonder — could it be the case that this particular attentive, listening space which Doris Lessing is talking about is actually destroyed by the hyperlinking-frantic blog medium?

I think it would be worthwhile to think a little more about ephemera in a contemporary biomedical context (cf. yesterday’s post + Jessica’s and Mike’s comments to it).

The term ‘ephemera’ (n. pl. of ephêmeros = short-lived) is often used by collectors for documents that were produced for the moment and not for long shelf-life: posters, recipes, advertisements, pamphlets, postcards, stamps, labels, etc. Ephemera have always been favourite objects of collectors; e.g., in a medical history context the William H. Helfand collection of proprietary health pamphlets and his collection of pharmaceutical trade cards are famous, and have been shown in several temporary displays, e.g. the exhibition ‘Here Today, Here Tomorrow … Varieties of Medical Ephemera’ at the National Library of Medicine in 1995.

Biomedical material culture also has its durables and its ephemera. A hundred (or even just fifty) years ago, most laboratory utensils were constructed from durable materials and were made to last. One was supposed to wash them, sterilize them and use them over and over again. Our collections are filled with such durables, made of brass, glass, stainless steel, hardwood, ceramics, etc.

Today’s laboratories, on the other hand, are filled with short-lived things made of plastic to be used for the moment. Lots of disposable plastic items: cups and caps, centrifuge tubes, suction catheters, syringes, culture flasks, cover slips, urine collection bags, vials, gloves, petri dishes, etc. etc., to be used once and then thrown out. To the extent that contemporary biomedicine could be described as an ephemeral culture.

To the material ephemerality of the lab could be added a documentary ephemerality, for example in the form of web-based electronic publications instead of books and bound journal volumes. And even the laboratory itself is becoming ephemeral and disposable: whereas the traditional lab has concrete walls, floors, benches and centrifuges, lab-on-a-chip technology represents the ultimate ephemeralization of the biomedical lab space (Richard Buckminster Fuller seems to have used the term ‘ephemeralization‘ in a somewhat different sense).

So I would like to see a collection and exhibition of biomedical ephemera — not of tradecards and pamphlets, but of Eppendorf tubes and plastic tubings mixed with lab websites and felt-tip pens.

I’ve followed Jessica JoslinPalmer’s blog Bioephemera for a while. I’m fascinated by her pictures and meandering thoughts. Many of her posts are inspiring for medical exhibition work (but she’s rarely to the point).

Eventually I found the answer in a February 2007 post, where she writes that Bioephemera is “straddling the awkward rift between biological specimen and art object, and doing so with grace and charm”. There you are! Self-characterisation sometimes hits the nail right on its head!

I wish, though, Jessica could raise herself above the charming stuff now and then and write more about ephemera as an analytical category  — close to curiosities, anecdotes, etc. — for making sense of the contemporary biomedical/biotech world.

Yet another wish-I-were-there seminar organised by the History of Medicine Divsion at NLM (NIH), namely on 12 December, when Peter Keating (U Quebec, Montreal) shall speak about “Who’s Minding the Data? A History and Sociology of Data Monitoring Committees in Clinical Cancer Trials”. Here’s Peter’s abstract:

Modern biomedicine is based on a number of novel institutions and practices running the socio-technical gamut from third-part payers to molecular biology. In order to function, these institutions and practices require a degree of formal and informal regulation that themselves form a spectrum from tacit conventions to legal mandates. In this we contribute to our ongoing investigation of these institutions and the forms of objectivity they generate by examining the emergence and development of DMCs and by discussing some of the issues and problems raised by this novel form of regulatory objectivity.

The seminar takes place in the Lister Hill Visitor’s Center on NIH Campus @ 2-3.30pm. Maybe they will video-record the seminar? Just to remind you all: Peter is co-author (with Alberto Cambrosio) of Biomedical Platforms (2003), one of the books that inspired our own research programme.