2009 Society for Medical Anthropology Conference: Reflections on the Future of Anthropology

In his plenary session entitled Five Questions on the Future, Harvard anthropologist Arthur Kleinman capitalized on the 2009 Society for Medical Anthropology Conference’s theme of Medical Anthropology at the Intersections to speculate on the future of the discipline.As he reflects on the field of anthropology, which had lacked theory, ethnography, and strong ties to public health and medicine, Harvard anthropologist Arthur Kleinman celebrates the accomplishments made by his contemporaries by saying, “My generation has made medical anthropology what it is today.” However, he is now looking to the future of the discipline, saying it must re-examine itself as a field.During the 2009 Society for Medical Anthropology Conference at Yale University, Kleinman capitalized on the theme of Medical Anthropology at the Intersections in his plenary session entitled Five Questions on the Future. Casting the conference itself as a kind of intersection, Kleinman not only lauded its size and diversity, but asserted that it marked a pivotal moment in which medical anthropology must re-evaluate its central questions.     

2009 Society for Medical Anthropology Conference: Changing Anthropology,Changing Society

Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University.Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University in New Haven, Connecticut. The conference, Medical Anthropology at the Intersections, drew an international audience of more than 1,000 scholars.In her opening remarks, program Chair Marcia Inhorn noted that medical anthropology has been interdisciplinary since its inception. This assertion was supported at a roundtable discussion, Founding Medical Anthropology and the Society for Medical Anthropology, which featured four of the field’s founders.Asked to identify the factors that led to the development of medical anthropology, the panelists emphasized the role of changes in the practice and landscape of medicine in the late 1950s and early 1960s in the United States. According to Hazel Weidman, who helped spearhead the Society for Medical Anthropology, medical personnel sought social scientists’ guidance in the new clinical environments created by the increasing involvement of U.S. physicians in global development work and by the community-oriented approach to mental health encouraged by the Community Mental Health Act of 1963. The novel inclusion of lifestyle as a determinant of health at this time also played a role, according to Clifford Barnett. Norman Scotch, author of a 1963 review that had helped define medical anthropology as a field, noted that physicians at the time were very interested in the possible applications of the social sciences to medicine [1,2]. Joan Ablon recalled that this emphasis on application led some academic anthropologists to dismiss the medical anthropologist as a “handmaiden to the doctors.” Despite such resistance, interest in medical anthropology as a sub-field was clearly growing among anthropologists. When Weidman helped organize the first gathering of medical anthropologists at an anthropology conference in 1967, attendance was twice what was expected. Panel organizer Alan Harwood noted that the Society for Medical Anthropology transformed its newsletter into a professional journal, Medical Anthropology Quarterly, in 1983. According to Inhorn, the society has 1,300 members today.For the panelists, medical anthropology’s potential for application makes it a compelling scholarly pursuit. As Barnett stated in explaining his decision to work in anthropology: “If you know how a society works, you can change it.”     

2009 Society for Medical Anthropology Conference: The Intersection of Anthropology and Medicine as Portrayed in Paul Farmer’s Photo Album

Paul Farmer, physician, anthropologist, and author, spoke at the 2009 Society for Medical Anthropology Conference at Yale University in September.Medical anthropology is a very young field, only approximately 50 years old. The underpinnings of medical anthropology have been around for some time, but as a discipline, the burden to ensure that it continues to flourish and grow belongs to future generations of students and scholars. However, future generations of medical anthropologists cannot carry the field forward unless they examine the teachings of previous teachers and scholars. By narrating his own story, just as he so frequently narrates the intricacies of Haiti [1], Paul Farmer, physician, anthropologist, and author of Pathologies of Power: Health, Human Rights, and the New War on the Poor [2], displayed a parallel between the stories of his own past with that of medical anthropology.At the 2009 Society for Medical Anthropology Conference at Yale University in September, Farmer began his aptly titled presentation, Photo Album, with a discussion of his introduction to medical anthropology while an undergraduate at Duke. He stumbled upon medical anthropology quite by chance as an ambitious pre-med who was interested in taking every course that had the word “medical” in its title. He credited many people, including Patricia Pessar, Arthur Kleinman, and Linda Garro with aiding the development of his ideas and perception of the world and teaching him to use medical anthropology not only in passive observation, but in the active practice of medicine. You “don’t have to be a faculty member to teach,” stressed Farmer. Some of the most important lessons to learn come from the poor, to whom few listen.Farmer believes that listening can form the work we do. He honed his listening skills, which are used in anthropology in an ethnographic context, after his first night in an emergency room, when he saw that many minor cases were brought in solely because individuals had no other outlet for treatment. Being a good listener allowed Farmer to understand the full impact of a 1981 slavery case involving migrant workers in Florida. It was this skill of listening that enabled Farmer to understand and tell Haiti’s story, as well as understand the intricate web that exists between privilege and privation. Just as the line between medical anthropology and primary care is often blurred, the “bracing connection between privilege and privation” becomes even more apparent the longer one spends studying both extremes.This is a vantage point Farmer was particularly susceptible to, given his trips from Haiti to Harvard and back again. Listening to his patients in Haiti and the United States would allow Farmer to draw parallels of inequality and injustice that exist for the impoverished in both places. The only difference between the United States and Haiti is that eventually many impoverished individuals in the United States will wind up in somewhat adequate medical facilities. In the story of global economics, Farmer said, “Good things get stuck in customs and bad things get traded freely.” A practicing physician may easily note that inequalities between the rich and poor are not unique to the United States or to Haiti, but what, Farmer asks, can anthropologists say about this division?The cursory glance through Farmer’s photo album ended with a picture of friends whom he fondly termed “the structural violence mafia” and anthropological ideas regarding unequal access to health care. While at first, the portion of anthropology that dissects the structures of violence seems isolated from medical anthropology, those structures of violence institute the vast inequalities that cause medicine to seem inaccessible. Farmer also stressed that “how we think about social theory influences global health.” Work in Haiti taught Farmer firsthand about the phenomenon of blaming the victim [3]. To understand this entrenched system of structural violence fully, an intensive bio-social analysis must be undertaken. Structural violence results in a system in which the victims are blamed, empowering those who suppress the victim while inhibiting the victim’s access to health care. Pointing fingers at the vulnerable is illustrated by the fact that Haiti is often blamed for the introduction of AIDS into North America [4,5]. Farmer stressed not only the inherent trauma of structural violence, but Carolyn Nordstrom’s ideas on violence having a distinct tomorrow [6]. The perpetual cycle of structural violence enables this concept of violence having a clear future with the inherent cultural systems that allow for violence remaining stagnant while the individuals entrapped within the system change.Beyond this concept of structural violence is that of structural healing [3]. Though structural healing is a new phenomenon being examined by anthropologists, it provides a balance to structural violence with the idea being that there are certain societal standards that are either in place or can be introduced that allow for an alleviation of the suffering caused by structural violence. While Farmer’s discussion of the path that led him to his current position was inspirational in itself, the sharing of his story is of even more importance because he has been a teacher to so many. His story reinforces the idea that even though structural violence has a definite past and future, so do medical anthropology and the idea of structural healing. Thankfully, medical anthropology may be used as a relatively new force to combat structural violence. Farmer’s speech may have been unexpected in its autobiographical content, but perhaps the main point is that the intersection between medicine and anthropology can be seen not as a single point but a line that runs the full length of each of these disciplines. We all have a distinct responsibility to not only hear but to listen and learn, not to just passively observe, but actively understand. It is with this listening and acting, that future medical anthropologists can bridge the gap between social sciences and practical medicine.     

Abraham Flexner and the development of the Yale School of Medicine

Abraham Flexner first toured the Yale University School of Medicine in preparation for his report of 1910, but it was just the beginning of his relationship with the school. While his review of Yale in his report was generally favorable, he mentioned several shortfalls that needed to be improved to make the school acceptable. Throughout the next twenty-five years, Flexner worked with Deans George Blumer and Milton C. Winternitz to improve the school's finances, infrastructure, and quality of education through his work with the Carnegie Foundation and General Education Board Flexner has been given great accolades for his work on medical education for the country, but little mention is made of him at Yale, even though he was one of the most influential figures in the development of Yale in the last century.     

Abraham Flexner and the development of the Yale School of Medicine. 1999

Abraham Flexner first toured the Yale University School of Medicine in preparation for his report of 1910, but it was just the beginning of his relationship with the school. While his review of Yale in his report was generally favorable, he mentioned several shortfalls that needed to be improved to make the school acceptable. Throughout the next twenty-five years, Flexner worked with Deans George Blumer and Milton C. Winternitz to improve the school's finances, infrastructure, and quality of education through his work with the Carnegie Foundation and General Education Board. Flexner has been given great accolades for his work on medical education for the country, but little mention is made of him at Yale, even though he was one of the most influential figures in the development of Yale in the last century.     

The Anthropologist as Geologist: Howitt in Colonial Gippsland

The paper discusses A.W. Howitt's position as an amateur of science in colonial Gippsland, and explores connections between his geological and anthropological endeavours. Two contexts contributed to the kind of anthropology he did. and the kinds of works he wrote. One is the point on the trajectory of the colonial history of Victoria when Howitt joined it and began his researches. The other is the moment in the development of anthropology when he and his sister Anna Mary Howitt began to read and correspond about the discipline, and he began to correspond with other practitioners. Geology was linked to Howitt's anthropology in two ways: through his working life in Gippsland, and in models that informed the evolutionary paradigm within which his anthropological research and writing were situated.     

THE THREE G's Meeting the Invertebrate Cell Culture Pioneers: Goldschmidt, Gaw, and Grace

It was my good fortune to meet personally the three invertebrate cell culture pioneers,Richard Goldschmidt,Zan-Yin Gaw,and Thomas D.C.Grace (Fig.1).In 1951 I met Goldschmidt at a symposium in Cold Spring Harbor,but I only knew that he was a prominent geneticist.I had no idea about his insect cell culture work at Yale University and daily contacts with Ross G.Harrison.In 1959 Zan Yin Gaw in Wuhan successfully cultured monolayers of silkworm cells for more than one year.I reported his breakthrough achievement at the 11th International Congress of Entomology in Vienna in 1960,but his work was completely ignored outside China.In 1982 Gaw invited me to Wuhan where he told me that he studied in the United States in the 1930s,working as postdoctoral scientist at the Rockefeller Institute,where he was daily meeting William Trager,and later at Yale University in the Osborn Laboratory,where he was inspired by Harrison.T.D.C.Grace worked in my laboratory at Rockefeller University during 1957 and 1958,then returned to CSIRO in Canberra,Australia.     

Dr. Haifan Lin. Interviewed by Han Lee and Rachel Rosenstein

Dr. Haifan Lin is professor of Cell Biology at Yale University, where he studies the mechanism of stem cell self-renewal in fruit flies, mice, and human cancer cells. Recently named director of the Yale Stem Cell Center, Dr. Lin has made seminal contributions to the stem cell field, most notably his demonstration of the stem cell niche theory using the fruit fly model, his discovery of the PIWI/AGO gene family that is essential for stem cell division in diverse organisms, and his recent finding of a group of small RNAs called PIWI-interacting, or piRNAs, which may play a crucial role in stem cell proliferation and germline development. Dr. Lin’s work on piRNAs was recognized by Science Magazine as a top scientific breakthrough of 2006. Recently, the Lin lab has begun exploring the role of these molecules in stem cell division and oncogenesis.     

"C.-E.A. Winslow and the early years of public health at Yale, 1915-1925"

C.-E.A. Winslow was the first chairman of the Department of Public Health at the Yale University School of Medicine. This paper considers the development and changing agenda of his department, the structure of Yale University, and the maturation of public health as a discipline. Winslow's successes and failures are discussed as they relate to Yale and external societal influences.     

His Own Synthesis: Corn, Edgar Anderson, and Evolutionary Theory in the 1940s

Tracing the contributions of Edgar Anderson (1897--1969) of the Missouri Botanical Garden to the important discussions in evolutionary biology in the 1940s, this paper argues that Anderson turned to corn research rather than play a more prominent role in what is now known as the Evolutionary Synthesis. His biosystematic studies of Iris and Tradescantia in the 1930s reflected such Synthesis concerns as the species question and population thinking. He shared the 1941 Jesup Lectures with Ernst Mayr. But rather than preparing his lectures as a potentially key text in the Synthesis, Anderson began researching Zea mays -- its taxonomy, its origin, and its agronomic role. In this study, Anderson drew on the disciplines of taxonomy, morphology, genetics, geography, anthropology, archaeology, and agronomy among others in his own creative synthesis. Though his maize research in the 1940s represented the most sustained work of his career, Anderson was also drawn in many directions during his professional life. For example, he enjoyed teaching, working with amateurs, and popular writing. This revised version was published online in July 2006 with corrections to the Cover Date.     

Q & A. [interview

Joel Rosenbaum was born and grew up in Massena, New York state, on the St Lawrence River border with Ontario, Canada. He received his undergraduate and PhD degrees from Syracuse University, and a Masters Degree in high school biology teaching at St Lawrence University. His PhD work was done with the protozoologist, George Holz Jr, and his post doctoral research on cilia and flagella was at the University Of Chicago with Frank Child and Hewson Swift. He has been at Yale University for 37 years where he has taught Cell Biology. His research has been on the synthesis and assembly of the proteins of cilia and flagella, showing that the flagellar axoneme assembles at the distal tip and that detachment of the flagella upregulates the genes for flagellar proteins. More recently his group has shown that this tip assembly process is facilitated by a rapid kinesin and cytoplasmic dynein-mediated motility underneath the flagellar membrane called ‘intraflagellar transport’. He is a runner with more than 20 marathons under his belt.     

The Life and Work of Marquis Robert de Wavrin,an Early Visual Anthropologist

This article traces the life and work of Marquis Robert de Wavrin de Villers au Tertre (1888–1971), a Belgian explorer and ethnographer. While fragments of his oeuvre are familiar to scholars of South America, he is almost completely unknown in historical studies, and largely forgotten within anthropology too. Here we will explore his filmic work as well as its contribution to the history of visual anthropology. While de Wavrin’s work cannot be divorced from the discipline’s colonial and Eurocentric heritage, we show that his visual record provides notable historic insights and merits further scholarly attention.     

The birth of chemotherapy at Yale. Bicentennial lecture series: Surgery Grand Round

Chemotherapy, one of the mainstays of cancer treatment today, was pioneered at Yale during World War II. Last year, two Yale surgeons, Drs. John Fenn and Robert Udelsman, sought to unearth the mystery surrounding the discovery of chemotherapy and its first use at Yale. The first chemotherapy patient is known only as JD in the literature, and without a name, date of birth, or medical record number, a search for his record seemed futile. However, persistence coupled with sheer fortune led them to JD's chart, where they found information that differed from previous accounts. The riveting personal story of JD, an immigrant patient with lymphosarcoma, was revealed for the first time by Drs. Fenn and Udelsman on January 19, 2011, at a special Surgical Grand Rounds celebrating the bicentennial of Yale School of Medicine.     

Knowledge from the Margins: W. Montague Cobb's Pioneering Research in Biocultural Anthropology

W. Montague Cobb became the first African American to receive a doctorate in physical anthropology in the United States (1932). He was also among the first U.S. physical anthropologists to demonstrate a commitment to biocultural integration and racial equality in his research. Nonetheless, very few European American physical anthropologists responded to or utilized Cobb's work. This continued after bioanthropology took on a more biocultural focus in the 1980s, some 50 years after Cobb's first studies of this kind. In this essay, I highlight Cobb's research and writing from the first decades of his career to illustrate his contribution to developing biocultural perspectives in physical anthropology. As a result, I hope to move Cobb from the margins to the center of discussions about methodological and theoretical developments in bioanthropology over the past 30 years.     

Elihu Yale and the medicine he promoted: the government general hospital and Madras Medical College, India

Much has been written about the philanthropist Elihu Yale and his life in the Americas and England, where he spent his beginnings and end. Less publicized is his life in India, where he spent the majority of his adult life and where he raised his family. A major contribution of Elihu Yale to medicine in India was his promotion of a local hospital in the major Indian trading port city of Madras. This essay briefly describes the history of that hospital and the medical college that grew out of it.     

My early days in photobiology with Philip Hanawalt

Phil and I started our careers on somewhat similar scientific paths. I had an undergraduate degree in physics from Swarthmore College and a Ph.D. degree in physics from Yale for research in the field for ultraviolet spectroscopy. Phil received an undergraduate degree in Physics from Oberlin College, joined the Yale Physics Department in 1954, and transferred to the new Biophysics Department in 1955. We began our interactions then by virtue of the fact that Phil had to take a Laboratory Course in Experimental Physics, one part of which was spectroscopy in which I was the instructor. One of my principal interests was in the effects of different wavelengths of ultraviolet (UV) radiation on proteins, viruses and bacterial cells. So what was more natural than for Phil to dream up a Ph.D. research project to investigate the effects of different wavelengths of UV on macromolecular synthesis in Escherichia coli. I became his mentor with expertise in UV, whereas he did most of the microbiological/biochemical work. Thus began a collaboration and a communicating friendship, the latter going on for 50 years. That communication was essential in elucidating some of the important steps in nucleotide excision repair-a field in which Phil is a pre-eminent scholar and investigator.     

Capitalist Philanthropy and Russian Revolutionaries: The Jesup North Pacific Expedition (1897-1902)

This review of the Jesup North Pacific Expedition, still the most important expedition in American anthropology, gives an idea of the goals and hazards of fieldwork around 1900, the pitfalls of international research, the tensions between anthropologists and host populations, the careers of early anthropologists, the role of private philanthropy, and the character of anthropology at the turn of the century. Franz Boas was the Expedition's linchpin. His organization of the Expedition, the way he handled problems, and his personal concerns reveal aspects of his view of anthropology and some of his basic attitudes.     

Edmund Beecher Wilson, Class of '81

Edmund Beecher Wilson was born in Geneva, Illinois in 1856.He attended Antioch College, the University of Chicago, Yale,and Johns Hopkins (Ph.D. 1881). Most of his professional lifewas spent in the Zoology Department of Columbia University togetherwith his close friend, Thomas Hunt Morgan. They were dominantfigures in developing the Chromosome Theory of Heredity. Wilsonbegan his professional life as a conventional 19th century biologiststudying problems of systematics, morphology, and phylogeny.Soon he became a key figure in the newer experimental disciplinesof embryology, cytology, and heredity. He is remembered todaylargely for his superb synthesis of these three fields in TheCell in Development and Heredity. He died in 1939.     

An interview with Dr. Frank Slack on his highly cited paper published in Cell Cycle

Frank Slack received his B.Sc from the University of Cape Town in South Africa, before completing his Ph.D in molecular biology at Tufts University School of Medicine. He started work on microRNAs as a postdoctoral fellow in Gary Ruvkun’s laboratory at Harvard Medical School, where he co-discovered the second known microRNA, let-7. He is currently an Associate Professor in the Department of Molecular, Cellular and Developmental Biology at Yale University. The Slack laboratory studies the roles of microRNAs and their targets in development, disease and aging.     

Harvey Cushing's ghosts: death and hauntings in modern medicine

The passing of Yale School of Medicine's 2010 Bicentennial occasions a moment of reflecting on the past, present, and future of medical education and research at Yale and beyond. Last June, a ribbon-cutting ceremony inaugurated the opening of the Cushing Center in the Cushing-Whitney Medical Library. Named after Harvey Cushing, an early 20th-century neurosurgeon and former Yale College alum, the dual education/exhibition space now houses hundreds of gross brain specimens constituting the Cushing Tumor Registry. Originally a personal collection, Cushing donated his numerous medical specimens, photographs, and other medical relics from his deathbed, relinquishing the brains to Yale only under the condition that a suitable space be erected to preserve the many specimens. Some 70 years later and after nearly being destroyed, Cushing's wish is fully realized: The once desiccated, hidden brains have been painstakingly restored and are now on view in the Cushing Center. The brains express Cushing's singular and spectral worldview as a surgeon, artist, athlete, soldier, book collector, and historian.