Programs in Medical Classics

UCLA Programs in Medical Classics is a series of presentations designed to enhance an appreciation of the links among famous medical writings, clinical practice, basic research, and humanistic scholarship. Six times a year these meetings bring together a convivial group of individuals of scholarly tastes—both from the community and from UCLA faculty, students, and staff—for a lecture and an opportunity to discuss and examine texts and topics that embody the history of medicine, as well as the relations of medicine to broader cultural settings.

Programs convene at 6:00 p.m. in the UCLA Faculty Center

Program for Fall 2005

25 October 2005

A Plague on All Our Houses: Once and Future Epidemics of Chronic Diseases
Stephen Leeder, M.D.
Professor of Public Health and Community Medicine; and Director, The Australian Health Policy Institute, University of Sydney

Introduction by Steven P. Wallace, Ph.D.
Professor, UCLA School of Public Health; and Associate Director of Public Service, UCLA Center for Health Policy Research

Heart disease, stroke, mental illness and cancer strike principally in developing nations. This year, in China, 3-5 million deaths will occur from stroke and heart disease. One third of deaths from heart disease in developing countries occur among workers.  Dr. Leeder will discuss the rise of these disorders, their causes, our surprising failure to confront them globally, and—more encouragingly(!)—what we can do about them.

Printable PDF version of October 2005 announcement

6 December 2005

The Arts of Healing and the Arts of War: the UCLA Medical School’s Atomic Energy Project, 1949-1959
Janet Farrell Brodie, Ph.D.
Associate Professor and Chair of History, Claremont Graduate University

Introduction by Esther F. Hays, M.D.
Associate Dean Emerita, and Professor of Medicine Emerita, David Geffen School of Medicine at UCLA

Dr. Brodie will explore a significant but little studied aspect of the history of American medicine after World War II: the interconnections between atoms for peace and atoms for war. Physicians and biomedical scientists in the developing fields of nuclear medicine, radiology, and radiobiology straddled with apparent ease in the postwar decades what in earlier eras had been regarded as a firm line between war and peace as they contributed to the development of the atom’s military as well as civilian potential. She examines this through a case study of the “atomic energy project” that was funded for over three decades at UCLA by a semi-secret contract with the Atomic Energy Commission. Stafford Warren, the first dean of the UCLA School of Medicine, negotiated the contract and directed the atomic energy project in its first decade. Many early medical school faculty participated in the atomic energy project in ways that they believed furthered medical knowledge and in ways useful to officials planning America’s defensive and offensive capabilities in the nuclear era. Dr. Brodie’s talk examines the impact of such sponsored, often classified, research on postwar medicine.

Printable PDF version of December 2005 announcement

Program for Winter-Spring 2006:

History of Medicine and the Brain

Tuesday, 24 January 2006

Revisiting the Emergence of Brain Death, Reconsidering the Uses of Bioethics
Gary S. Belkin, M.D., Ph.D.
Department of Psychiatry, New York University School of Medicine

Introduction by Rabbi Micah Hyman
Interfaith Chaplain, Spiritual Care Department, UCLA Medical Center

In a 1968 Report, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death promulgated influential criteria for the idea and practice known as “brain death.” Before and since the Committee met, brain death has been a focal point of dispute—with a characterization of the Committee and brain death as a morally deaf and self-serving pursuit of expanded transplantation, furthering a broader historical characterization of bioethics as a necessary antidote of moral expertise. This paper looks at the Committee and finds that these historical depictions and lessons drawn from them need some serious rewriting. Entertaining different possibilities as to the motives and historical circumstances behind the Report it famously produced and practiced, it furthermore may point to not only different histories of the Committee, but different perspectives on the historical legacy, and failures, of bioethics as a discourse through which to address anxieties about medicine.

Printable PDF version of January 2006 announcement

Tuesday, 7 March 2006

Reinventing Neurosurgery: Harvey Cushing's Earliest Contributions to Successful Brain Surgery
Samuel H. Greenblatt, M.A., M.D.
Professor of Clinical Neurosciences (Neurosurgery), Brown University

Introduction by Robert G. Frank, Jr., Ph.D.
Professor of Medical History and History, Geffen School of Medicine at UCLA

At the turn of the twentieth century - in the year 1900 - the outlook for the surgical practice that we now call neurosurgery was utterly dismal. Mortality rates for brain tumor operations were 50% or more, and there were legitimate claims that the large majority of patients did not benefit from surgery, whether or not tumors could be located and removed. In retrospect, we can see that the primary reason for this unhappy state of affairs was postoperative brain herniations, either fatal brain shifts within the skull or “fungations” (extrusions) of brain tissue through the surgeons’ scalp and skull openings, which led to fatal meningitis. At the time, no one knew that the solution to the problem was only a few years away, in the earliest research and clinical work of a promising young American surgeon named Harvey Cushing (1869-1939).

Among historians of neurosurgery, there is general agreement that three essential technologies were needed to begin the modern era: anesthesia, antisepsis/asepsis, and cerebral localization. William Macewen used all three when he did the first modern craniotomies in Glasgow in 1879. There is also general consensus that Cushing was the single most important figure in the ultimate success of neurosurgery. But the three technologies had been available and in use for two decades before Cushing started, so exactly what did he do that was so crucial?

Cushing made several early advances, but Dr. Greenblatt will argue that his fundamental contribution was the addition of a fourth technology, which made intracranial surgery clinically effective, rather than just feasible. By understanding the problem of raised intracranial pressure (ICP) - and teaching himself to control it - Cushing was able to bring neurosurgery’s horrific mortality rates for tumors into a reasonable range (10-15%). He did this in four rapid and overlapping stages: (1) research on ICP with Theodor Kocher in Bern, Switzerland (1900-1901); (2) application of the experimental lessons to acute, mostly traumatic cases in his early years on the faculty at Johns Hopkins (1901-1904); (3) application of the conceptual and technical lessons about acute ICP to the chronically raised ICP in tumor cases (1903-1905); and (4) accumulation of enough tumor cases (180) by 1910 to have convincing statistics.

However, by 1920, when Cushing was neurosurgery’s acknowledged international leader, his achievements were so numerous that the crucial significance of his first contribution was not appreciated. Then, as now, neurosurgeons have simply assumed that we ‘always’ knew about the importance of ICP and its control. Not so! Harvey Cushing made us who we are - a distinct profession - by teaching us the fundamental lesson of ICP and its control.

Printable PDF version of March 2006 announcement

Tuesday, 11 April 2006

Capturing Movement Disorders, from Drawing to Digital Image
Genevičve Aubert, M.D., Ph.D.
Professor of Neurology, Cliniques Universitaires Saint-Luc (Brussels, Belgium)

Introduction by Jan-Christopher Horack, Ph.D.
Adjunct Professor of Critical Studies/Moving Image Archives Studies, UCLA; Curator, Hollywood Entertainment Museum; and Editor, The Moving Image

Movement disorders are neurological diseases characterized by distinctive static postures and deformities as well as a gamut of involuntary movements. For neurologists, reliance on visual observation remains an essential diagnostic step. It is not surprising, then, that medical communications concerning these neurological disorders have depended particularly on artistic, photographic, and cinematographic documents.

The starting point of Dr. Aubert’s research was the discovery of the original nitrate films made by Arthur Van Gehuchten (1861-1914), professor of anatomy and neurology at the Catholic University of Louvain. Van Gehuchten was an avant-garde teacher, eager to adopt new visual aids. In 1905, he began to film neurological patients. He made extensive use of this technique to demonstrate clinical signs, illustrate neurological diseases, and document functional evolution following surgery. The unique collection of moving pictures he built for teaching purposes has miraculously survived, and serves as an important archive of neurological diseases and their manifestations prior to the advent of modern therapies. The original nitrate films (more than two hours long) have been restored by the Royal Belgian Film Archive, where they are the oldest Belgian films.

Besides Van Gehuchten’s exceptional set of films, a few other iconographic documents in the field of neurological disorders will be highlighted. Drawings, sculptures, photographs and films illustrating chorea, dystonia, Parkinson Disease and parkinsonism—one of the most dramatic sequelae of encephalitis lethargica—will be discussed, along with key figures in these achievements including Charcot and Richer, Kleist, Van Bogaert, and Sacks.

Printable PDF version of April 2006 announcement

Printable PDF version of April 2006 reading
(T.H. Weisenburg. "Moving picture illustrations in medicine" Journal of the American Medical Association, 1912, v. 59 no. 26, pp. 2310-2312)

Tuesday, 23 May 2006

Benjamin Franklin and Medical Electricity
Stanley Finger, Ph.D.
Professor of Psychology and Neuroscience, Washington University, St. Louis

Introduction by Joyce Appleby, Ph.D.
UCLA Professor of History, Emerita

Benjamin Franklin was deeply involved with whether electricity might have medical utility. In this context, he conducted electrical experiments on people with palsies, especially those caused by strokes, to see if it could restore movement. During the 1750s, he recognized that it was not the miraculous cure it was hoped to be for the palsies and presented his findings in a letter to the Royal Society. He was much more successful, however, when it came to treating hysteria with electricity, and he and Jan Ingenhousz were the first to propose trying cranial electricity with melancholics. This presentation will examine these and other facets of Franklin's "clinical trials" with medical electricity.

Printable PDF version of May 2006 announcement