[AAHM_Clio_Project] medical history is a serious subject of study

[Howell, Joel]

Good question – before answering let’s stipulate that some high profile medical journals routinely obtain high-quality peer reviews and publish superb medical history (Annals of Internal Medicine comes to mind). Others publish excellent history at times, but at times succumb to the temptation of assuming that a high-profile researcher or clinician must also be a competent historian.

But there’s also a lot of drek.

Why?  Answer is multifactorial and could include (but not be limited to):

·         Failure to appreciate that history is a learned discipline, which takes specialized training, and not just a senior figure’s reminiscences of what life used to be like.

·         Nor is it a date or an event.  (From which one gets the sort of introductions described by Alessandra – “This phenomenon was first described by Hippocrates around 400BC.  Osler also commented on it in 1902.  But we didn’t really understand what was going onto until research in my lab last week.”)

·         Unfortunate tendency to believe that having an MD makes one an expert on anything, including history.

·         Desire to use history as hagiography.

·         Belief that history is kinda like journalism, and in any event finding its way into the journal not as a scholarly contribution but just as filler. (Manifest in some journals by placement of history not as “original research” but in some other section.)

·         Lack of submissions from historians + editors’ real desire to include some history in the journal – if they don’t get it from historians they’ll get it from somebody else.

·         Fact that some history is written in ways that make it nearly damn near unintelligible to nonhistorians.

·         Reward structure in some departments that de-emphasizes value of articles in medical journals (though that emphasis is reversed in other departments).


What should we do?  Neither a hall of shame nor a standard letter to the editor are likely to be useful (whereas a letter pointing out issues with a specific paper might be).  While the most egregious examples will be obvious to all, there are lots of examples of senior figures writing articles that, while not in any sense historical analyses, offer a good deal of useful primary source material for later work. While it’s irritating to see them held up as examples of good history, going after them is not likely to do us any good.

The answer, IMHO, is more real history throughout the educational process, and more interactions with medical journal editors.  Editors of top tier journals really do want to publish good stuff, by and large. David Jones and Jeremy Greene have been encouraging this group to submit papers to NEJM.   Less top tier journals are often receptive to the opportunity to publish good history, if that is made clear to them.

From: AAHM_Clio_Project <aahm_clio_project-bounces at histmed.org> on behalf of Jackie Duffin <duffinj at queensu.ca>
Date: Sunday, July 10, 2016 at 2:21 PM
To: "aahm_clio_project at histmed.org" <aahm_clio_project at histmed.org>
Subject: [AAHM_Clio_Project] medical history is a serious subject of study

Dear All

An interesting question comes from Alessandra Foscati a colleague in Italy…below.

With her permission I forward it to you all.

I sent a reply with some of my thoughts for why this happens in medical publishing.
.
But it would be interesting to hear what others have to say ….
Or if you too have had the peculiar experience of having your brilliant, pathbreaking work ignored.

And more importantly for our Clio Initiative…what can we do about it?

A hall of shame for offending journals?
A standard letter to editor when we notice it?
More real history in medical education and residency?

Explanations for Alessandra — and all thoughts welcome!
Please copy Alessandra in your replies.

Happy summer!

Jackie


From:    alessandra foscati <alessandra.foscati at GMAIL.COM<mailto:alessandra.foscati at GMAIL.COM>>
Subject: medical history is a serious subject of study

Dear  all,

a little question. Why do serious medical  periodicals, with respectable impact factors and peer review, often permit the publication of articles of history of medicine that are so naive (to use an euphemistic expression)? Is there no serious peer review by historians in medical periodicals?

It seems not.

I think it is damaging and insulting to serious scholars of medical history.

As I see it, physicians often use history at the opening of an article starting with a picture and then leap immediately to conclusions connected to current medical knowledge. Or they start with the tale of a miracle, using a casual source without dating it or using any philological interpretations or providing any references,  and so on.

I have just read a very recent example in Journal of Vascular Surgery.

Even if the periodical is dedicated to the medicine, I think that articles and parts of articles regarding medical history deserve to be seriously written and controlled.

Sorry for my outburst.

Alessandra

Alessandra

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