Biomedicine in museums

My blood pressure rose this morning when I read Google CEO Erik Schmidt’s rebuttal of Rupert Murdoch’s attack on Google (published 1 December as an op-ed in Wall Street Journal, of all places).

Not because he strikes back at the old newspaper dinosaurs. I don’t mind, I hardly read paper media any more. The reason for my momentarily increasing pulse rate is Schmidt’s opening lines: “It’s the year 2015. The compact device in my hand delivers me the world, one news story at a time […] the device knows who I am, what I like, and what I have already read (my emphasis).

I don’t actually mind about the privacy thing. There is too much info for the new Leviathan to crunch already, so I don’t care about the surveillance problem. What really irritates me is the idea that a search machine is supposed to deliver “what I like and what I have already read”. Fine, if I opt for that possibility — but I also want to be able to opt out. Sometimes I browse to find what I know I want to find — but often I browse to find something I didn’t know I wanted to find — something that shakes me out of the expected. I want to be surprised!

It’s like falling in love: meeting someone you’ve never dreamed of. It’s like science: detecting phenomena you never expected. It’s like visual art: viewing the world in a totally unanticipated way. It’s like literature: exploring news ways of putting human experience into words.

I’m not the only one who wants to opt out; the problem has been raised several times before. But the fact that Google’s CEO unwittingly repeats the old formula for web search in his 2015 vision scares the hell out of me. Enough to put me in a state of alarm this otherwise tranquil Tuesday morning in Copenhagen, where the climate meeting has just begun only two kilometers from where we live.

One of the challenges for a museum of medicine intent on collecting recent and contemporary medical artefacts is to get an overview of the historical development of medical instruments, medical technological systems and the medical device industry.

Trade shows and their catalogues (published or online) are excellent sources. But memoirs and reminiscences of people who have been engaged in the trade show business can also be useful —  they add a more personal perspective to the dry historical data, they are more fun to read than catalogues, and you can probably construct a useful picture of trends by piecing their more or less idiosyncratic stories together.

Take for example Wolfgang Albath, a pioneer in laboratory medicine and one of the founding organisers of the world`s largest medical trade show, MEDICA in Düsseldorf,. He has just summarized, shortly, his view of some of the important trends in the last 40 years of medical hospital technology (in the 12 Nov online issue of European Hospital):

Medica trade show 1974

In summary, his view of the recent history can be described in three words: mechanisation, automation and digitalisation. When MEDICA started (in Karlsruhe) in 1969, it focused exclusive on laboratory diagnostics. Most lab analysis were then carried out manually and in pretty small series.

One of the few automatic systems was the Technicon Auto-Analyzer, introduced around 1960; for a contemporary evaluation of it, see here): “Based on a system of continuous flow analysis [the Technicon AA] revolutionised lab diagnostics and paved the way for analysers to work through organ-specific parameters in batches”.

In the 1970s came immunofluorescent techniques for detecting auto-antibodies and infectious agents, and in the 1990s advances in molecular biology opened new diagnostic opportunities at the picomolar level.

Iinformation and communication technology has not only made possible automation in the clinical lab, but all kinds of hospital practices. The first patient monitoring systems, which are now taken for granted in intensive care and neonatal unit, were introduced in operating rooms and wards in the mid-1960s. In the clinical laboratory, computer development made possible large-scale diagnostic tests in the 1970s.

Another area which depends heavily on IT  is radiology and medical imaging. In the 1960s “the triumph of real-time ultrasound diagnostics began”; in the 1970s came the CT-scanner; the first digital image archives, radiology information systems and laboratory information systems arrived in the mid-1980s; about the same time came MRI, and in the 1990s PET. 3D reconstructions of CT, MR and ultrasound images also became possible in the mid-1990s.

Surgery too has undergone enormous technological changes; eg., keyhole (laparoscopic) surgery began in gynaecology in 1969; the first keyhole gallbladder removal was performed in 1985 and in the early 1990s keyhole surgery in the abdomen. And then there is laser technology which has “lit up the medical sky” for 30 years, not least in ophthalmology, where doctors hardly cannot imagine work without lasers today.

While we are waiting for the sequel to Joel Howell‘s seminal Technology and the Hospital: Transforming Patient Care in the Early Twentieth Century (Johns Hopkins University Press, 1996), reminiscences like Albath’s are among the best ways to get an overview of the complexities of the recent history of medical technology. I haven’t made a systematic search for memoirs and reminiscences of similar kinds — but I’m convinced there are many out there, although they can be difficult to find.

(Btw, for a useful academic course syllabus for the history of medical technology, see here).

Seed is running a series of monthly portraits of workbenches of interesting people (like Oliver Sacks, a renowned bat expert, an industrial designer, etc.)

The latest portrait, published in yesterday’s online issue, is the lab bench of Martin Chalfie, one of the three who won a medical Nobel last year for the discovery of green fluorescent protein (GFP).

The image on seedmagazine.com is interactive (of course) — that is, you can blow up details with accompanying texts.

Nifty, but …. what struck me when I first saw the image was that Chalfie’s lab bench doesn’t look authentic. Take a look at the magnified version below — it is way too neat and tidy! It looks like the photographer has cleaned up and arranged everything in orderly fashion before shooting the image.

Then I read the caption to the small glass bottles detail on the shelf above the microscope — it explains why:

I have to admit, I haven’t done a lot of experiments recently. I spend most of my time in my office next door, working on papers or talking with post-docs about their studies.

That’s the fate of most senior scientists — and Seed doesn’t seem to have realised that this fact corrupts the authenticity of the image. The difference between a used and not-so-much used lab bench is subtle. But it is there. Maybe they could have presented it as ‘the dead workbench of Martin Chalfie’ instead.

So, please, in the forthcoming issues, let’s get some images of lab workbenches that reflect some real lively untidy 24/7 lab work.

(thanks to Bertalan Meskó for the tip about Seed‘s article; that said, however, Bertalan wrongly, in my view, believes that the image “lets you look behind the scenes of the workbench of a famous and successful scientist”. That’s exactly what it does not — it’s lets you see pure surface, no behind.)

Gott exempel på forskningsformidling som tilfredsstiller alle nyhedsverdens krav på “lige her og nu!” reality show: The Brain Observatory ved University of California San Diego viser på streaming video hvordan de laver histologiske tyndsnit af hjernen af en patient. Og de gør det altså lige nu.

Patienten (som kaldes H.M) led af alvorlig amnesi. Efter hans død blev hjernen frosset ned og er — lige nu — ved at blive skåret i tynde skiver i en helorgans-mikrotom i en lang session som vil vare ca. 30 timer og som slutter en gang i aften. Hele proceduren bliver altså streamet, se her.

Så her langt var de kommet kl. 9.30 da jeg lavede en screen-dump:

Fascinerende histology-live! Og fascinerende eksempel på forskningsformidling som lever op til “lige nu”-syndromet. The Brain Observatory gør det primært for at skaffe penge til deres forskning. Så det er led i en reklamekampagne.

The Brain Observatory at UCSD is right now showing the slicing of the brain of an amnesic patient into histological sections on streaming video.

The whole brain of the dead patient (called H.M.) was frozen to -40C and is now being sectioned in a whole-organ microtome during one continuous session that they expect will last about 30 hours. After sectioning the brain they will do ex vivo MRI and so called blockface imaging, and will of course store all the histological sections. The whole sectioning process is streamed on video and will end later today. Watch the live video here.

This is as far as they came at 9.30 am today when I made a screen-dump:

Fascinating histology live!

(thanks to Alex for the tip)

We have just recruited Morten Hillgaard Bülow as a PhD candidate. The three-year stipend is financed by the new interdisciplinary Center for Healthy Aging at the University of Copenhagen. The Center was established last year with a budget of 300 mill. DKK for a five-year period — and a smallish amount of the total will be used for studies of healthy ageing science communication in a museum context here at Medical Museion.

Morten’s project is titled “A genealogical study of the concept of ’successful aging’ and its relation to the idea of ‘human enhancement'”. More specifically, the project will investigate how the notion of ‘successful aging’ has been understood and defined in the field of neuroscience over the last decades, and how ‘successful cognitive aging’ has played together with discussions about the possibility for so called ‘cognitive enhancement’. Morten will present the project in our seminar series in January and more details will also appear here on the blog.

By the way, Morten is not a newcomer to Medical Museion. Four years ago he spent a couple of months with us as part of his studies in history and philosophy at Roskilde University (where he earned his MA last year) to work out a ‘value strategy’ for us. Welcome back to Medical Museion, Morten!

(soon I’ll present our new postdoc — stay tuned!)

Nu ligger Medicinsk Museion godt nok ikke under Kulturministeriet (som KU-museum hører vi under Videnskabsministeriet) — men det gør jo ikke kulturminister Carina Christensens udspil (se dagbladet Politiken idag) mindre interessant.

Ministeren mener kort sagt at hvis folket ikke vil komme til museerne, så må museerne ud til folket. Kunsten og kulturarven skal ud på gader og torve, ind i indkøbscentrene og ud på friluftsbadene — eller der hvor folk nu tilfældigvis befinder sig i deres hverdag.

Grundlæggende synes jeg at det er en glimrende måde at tænke kulturarvsformilding på. Selvfølgelig skal museernes samlinger og udstillingstilbud ud og luftes! Vi skal ikke vente på at folk kommer ind i templet, men ligesom Jesus skal vi være der, hvor folket befinder sig (man kan drage mange interessante analogier mellem kirken og museerne!).

Ligesom en del andre museer (Trapholt m.fl.) har vi prøvet at lave en del udstillinger tættere på brugerne. For to år siden var vi med til at lave en udstilling om Rigshospitalets historie i forbindelse med deres 250-årsjubilæum. Den blev placeret i indgangshallen og blev set af tusindevis af ansatte, patienter og pårørende hver dag igennem flere måneder.

Vi har også eksperimentet med udstillinger på Bella Center. Da 5000 europæiske anæstesilæger var på kongres i København for to år siden kunne de se en kulturhistorisk udstilling inde på messeområdet — halvdelen af dem kom forbi vores 100 kvm i løbet af de to dage kongressen varede. Det var ikke mindst den grønne, frygtindgydende jernlunge fra polioepidemien i København i 50-erne som trak — men også den gamle flaske med curare!

Og vores seneste udstilling — om proteiner i historien — er placeret midt i vandrehallen på Panum, mellem undervisningslokalerne og kantinen, hvor mange hundrede studerende og ansatte går frem og tilbage hver dag. Hvis vi havde stillet den op i vores fine gamle museumsbygning i Bredgade ville den have haft et langt mindre publikum end  i det halvoffentlige rum på Panum.

Og så videre. Der findes altså allerede museer som i praksis lægger kulturen ud til brugerne. Og vores erfaring er, at det giver rigtigt god mening at tage museet ud, der hvor folk befinder sig. Det har været succesfulde udstillinger både for os på museet og for brugerne — og for institutionerne som har huset dem. Ren win-win-win! 

Samtidigt skal vi huske på at det ikke er uproblematisk. Man skal kende sin målgruppe, man skal arbejde meget tæt sammen med brugerne. Risikoen ved at bringe kunsten og kulturen ud til indkøbscentre og sportsanlæg er at museumsvirksomheden overgår i fladpandet oplevelsesøkonomi. Man kan nemt komme at tænke i “antal kunder i butikken” istedet for at se brugerne som kvalificerede, engagerede deltagere i et fælles langsigtet kulturarbejde.

Jeg tror at den nu højaktuelle diskussion om brugerinvolvering og museum 2.0 vil være et bedre udgangspunkt end den oplevelesøkonomiske tankegang. Når vi vil bringe kunsten og kulturhistorien ud til folket, så skal vi ikke primært gøre det for at tjene penger eller bidrage til det samlede eksportværdi — men for at skabe bred forståelse for vores historie og folkelig beredskab til at håndtere fremtiden. Det er brugerinvolvering og brugerstyret museumsinnovation det handler om, ikke oplevelser som Handelshøjskolen i København opfatter dem.

At the last weekly staff lunch meeting we had a short discussion about the notions of ‘topical’ and ‘timely’ exhibitions. A ‘topical/timely’ (Danish: aktuel) exhibition is one that relates to current social or political events, like for example showing a climate exhibition here in 2009.

One argument in the discussion was: Aren’t topical/timely exhibitions exactly what university museums by definition ought to avoid getting involved in? If university museums are by definition elitist — because universities are by definition elitist, as we discussed in a couple of earlier posts (here and here and well summarised by Adam here) — then their job is not primarily to create topical/timely exhibitions (even though this is an absolutely worthwhile thing to do) but rather to create exhibitions that set the agenda for what will become topical/timely. That is, one would expect university museums to be in the lead museologically, because the rest of the university has (at least in its self-understanding) taken on the role to be cognitively leading.

In a sense this is quite trivial. Going beyond what is topical/timely is what drives not just the world of science and scholarshíp but also much of the world of music, visual arts, literature, film making, fashion, etc. Neither scientists nor artists are content with creating knowledge or works of art that are topical/timely; they want to create new and so far untopical/untimely conceptual worlds, new data, new procedures, which are by definition untimely when they appear.

But many museums — especially, and paradoxically, university museums — still behave as if they stand outside the world of scholarship and creative arts. They want to cater for the current taste rather than change the taste.

And here comes the conondrum: the quest for untimeliness seems to be problematic for us who believe in the positive value of the notion of ‘museum 2.0’ (participatory museum). I mean, how can you wish to restructure the museum with its collections and displays into a user-driven institution while at the same time promoting the creation of new and unseen museum visions and practices? Can you do both without becoming a schizophrenic museum? And generally speaking, how do museums handle the tension between being avantgardish and being populist.

Som de fleste sikkert allerede har hørt i radioen her i aften, har Medicinsk Museion, efter lange forhandlinger med en anonym giver i Køge, erhvervet en unik samling af glasampuller, indholdende oldgamle farmakologiske præparater. Samlingen, der betegnes som ‘alternativ’, består ifølge registranten af en række ekstremt væskedrivende naturlige (ikke kemiske!) stoffer og bør derfor indtages i meget, meget små mængder (helst i homoeopatiske mængder eller mindre, dvs. som negativ vægt). Da vi åbnede en af ampullerne i museets baggård for en time siden for at kontrollere indholdet blev skydækket umiddelbart mærkbart fortyndet og da vi senere gik ind på DMIs radar, kunne vi se at det daglige regnområde over Sjælland havde formet sig i en stor cirkel rundt om et tørlagt København, med Medicinsk Museion i centrum. Der behøves næppe andre beviser for disse naturpræparaters fænomenale virkning.

I haven’t been around natural history museum DNA researchers for a while. So I didn’t know there is actually an -omics discipline called ‘museomics‘ — “the large-scale analysis of the DNA content of museum collections”. It’s not a joke, they (the Center for Comparative Genomics and Bioinformatics at The Pennsylvania State University and others) mean it seriously :-).