On Biography and the History of Medicine

Dr Fallon Mody is a historian of medicine and Metascience researcher at the University of Melbourne. In this interview with PhD candidate Samara Greenwood, produced for the HPS podcast, Dr Mody discusses the use of biography as a historical research tool, including in connection to her own work investigating the role of migrant and refugee doctors in shaping urban and regional medicine in early twentieth-century Australia.

Listen to the interview by clicking on the arrow below, or read the transcript.

 

Hi again from all of us at the HPS Podcast!

I’m Samara Greenwood, and today I’m talking with Dr Fallon Mody, historian of medicine and Metascience researcher, on the topic of biography as a research method in history of science.

For non-historians, scientific biography is likely thought of as a straightforward retelling of the life history of a celebrated individual, like Albert Einstein or Marie Curie. However, historians are finding that biography as a research tool for better understanding our past is better put to a broader range of valuable uses.

For example, Fallon has used group biographies in her own research to investigate the role of migrant and refugee doctors in shaping regional medicine in Australia during the early twentieth century. In this interview, Fallon draws our attention to the range of ways biography can be used as a valuable research tool, especially in recovering important stories of women, Indigenous people, and non-elites in the history of science.

Hi Fallon, welcome to the HPS Podcast!

Thank you! Thanks for having me.

So could you tell us how you came to history and philosophy of science?

I actually think it’s probably a fairly standard story in that I was doing a bachelor of science, majoring in genetics. I’d picked genetics because that was when the human genome project was in the news and it seemed like genetics and biotechnology was going to be the future of science and scientific inquiry. And I thought, yes, that’s what I’m going to do.

In the process of studying genetics, I found increasingly that actually the questions I was interested in fell into this kind of weird and wonderful area of study I had never heard about called History and Philosophy of Science. I was studying at the University of Melbourne and realised that I was quite lucky because we’re one of the few universities in the world that actually have an HPS department.

It was through that I discovered biotechnology and society, which covered a lot of really interesting and contemporary topics in science and technology studies and I didn’t look back.

What are your research areas now?

I’m an historian of medicine, particularly twentieth-century medicine, and I’m broadly interested in the structures and practice particularly of primary healthcare in Australia. But, in the last four or five years, I’ve also found a secondary interest, if you like, that combines my HPS training with what is an emerging area of science called metaresearch or metascience, where we’re looking at the ways in which we can improve the rigour or the integrity of scientific practice in ways that are done in partnership with or in collaboration with scientists.

So you’re a historian of medicine primarily. What did you find so interesting about research in that area in particular?

I’m an unusual historian of medicine in that I’m not interested in eighteenth- or seventeenth-century medicine. I’m actually interested in the ways in which you can understand really mundane topics like medical manpower and how global historical events can disrupt the flows, including of medical professionals, and what the implications are, for example, for patient or citizen experiences of healthcare.

To give you an example, World War Two is considered to be one of the biggest disruptors of the flow of medical professionals, owing to events that happened in central and continental Europe.

That had huge ramifications in terms of the ways in which medical knowledge flowed and the ways in which hospitals and GP clinics were staffed.

Australia was one of the recipients of a lot of migrant doctors or refugee doctors, and that’s had flow-on effects or legacies, including in the way in which we structure healthcare.

For example, if you want to understand Australia’s position as the second or the third most prolific hirer of migrant doctor labour, even today, the roots of those understandings can be found in the post-World War Two era.

So turning to our central topic: what is something about history of science you believe would be of interest to a broader audience?

I’m going to answer this in a bit of a cheeky way, in that I think broader audiences are already interested in this, because it’s possibly one of the most marketed areas of science history – and that’s biography.

It has this really strange position because biographies, broadly construed, not just in science or medical history, have a huge market.

As a result, in academic circles, people who use biographical methods tend to occupy a really divisive place in their respective communities. So, biography has a really controversial place as an academic methodology.

And, so, I think it would be really interesting to a broader audience to understand some of that, but also to understand the really unique ways that biography or biographical methods can be used in order to gain unique and different insights into any given research topic because of the nature of the method.

Particularly if you want to diversify your viewpoints, it gives you an opportunity to go beyond the very thing that has both vilified biography, but also is its greatest strength, which is that it gives you perspectives that are often hidden or invisible or marginal in traditional historical records.

Let me give you an example of that. Women, Indigenous peoples, non-elites – they are the hardest to find in preserved written archival records. And so biographical methods, including collective biographical methods, are often ways in which to recover insights into, for example, lived experiences of people who have traditionally not been documented because they weren’t considered to be important, or have been documented, but in really piecemeal ways.

So you’ve got to be inventive or read an archive across the grain in order to tease out those fragments of the past and put them together to form a picture of whatever it is that you’re researching. You can compare it to why people are wary of biography – that’s because, particularly in the history of science, there were these traditions of writing biographies of great white men or of a great idea that was often had by a great white man.

Then, there was a real turn within our discipline of not wanting to do that, but that came at the expense of the potential of biography as an academic research tool. You can find this long conversation about ‘why it’s bad’ and ‘why it’s good’ – to be really kind of simplistic about it.

Absolutely. And so you’re saying that by reframing biography in this certain way, by drawing out ways that it can be used to an advantage in academia – we can better see how it can be used.

Yes, that’s right. In preparation for this interview, I was thinking about influential scholars who’ve had similar ideas and the one that I pulled out was Michael Polyani, who said in 1962 that historians ought to pay attention to ordinary workers in the scientific community. He said, and I’ll quote here, “the example of great scientists like Einstein is the light which guides all workers in science and we must guard against being blinded by it”.

Really, it’s about the different ways in which you can think about and understand any given historical episode. Biography’s a really powerful tool if you want to explore a concept or a movement or whatever it is in a way that captures the everyday or the ordinary.

And that’s been used to really great effect in a lot of different ways outside of what traditionally pops in your head when you think about biography and you think, oh, Einstein or Feynman or whoever. There’s actually a lot of really interesting work that’s been done that uses biography, but in ways that are not well understood.

Have you used it in your own research?

I have and I suppose that’s why I’m waxing lyrical about it! Of course I have a bias.

I used biography in that collective sense. I was interested in the careers and the lived experiences of migrant doctors who came to Australia between pre- and post-World War Two.

That actually gave me some really fascinating insights into, for example, the ways in which bias and structural discrimination was embedded within legislative and regulatory frameworks. And that’s not a common way that you might think about what biography might reveal. But that’s exactly the sort of thing that it does reveal because you take a group of people who, at an individual level, might not be a significant enough actor to warrant their own kind of sweeping biographical study, but when you put them together, it actually allows you to say something really significant and new about a point in time in a way that hasn’t been understood before.

And in a way that’s perhaps more relatable than a whole lot of statistics?

Well, absolutely. I think that necessarily, particularly if you are researching twentieth- or twenty-first-century historical actors, and you have the opportunity to interview them, it brings in the component of oral history as well. Again, that’s really important, particularly if you’re working with, for example, in Indigenous communities where you have a traditional of oral retelling and that’s the core of how memories are passed on across generations.

But oral histories also allow voices that haven’t been documented to be brought into relief. Women are a great example of that – particularly, for example, professional women who, while they were practising, would have been very reticent and careful in how and what documented evidence they left behind. But as a retired older person might actually be more comfortable and more willing to provide some of that insight on reflection in a way that you will only capture if you actually go out and talk to them.

Absolutely. It’s nowhere else in the records other than in these memories.

The other thing about biography is that it tends to give you the ability to really pull evidence from a lot of different places. So, you’re not just tying yourself to a particular set of archival records, or you’re not tying yourself to reading or interpreting those records in traditional ways. It allows you a level of flexibility. But I will owe that that flexibility has also led itself to dubious practices. So that’s why it’s remains controversial – like people who use biography to develop psycho-biographies or retrospectively analyse key historical figures to make sweeping claims.

And when you were practising it yourself, were there certain things that you kept to the front of your mind about being careful not to do?

That’s a really good question. I think I wanted to champion the voices of people who I felt had been marginalised in the historical record. And so one of the things that I was really careful not to do was to have this really binary view of the people I was researching as either victims stripped of agency or pioneers or heroes who fought against a thing and won. That was really important to do because if I did that, I would be falling into the types of practices that people are rightfully wary of when you deploy biography. And so I had to keep reminding myself that people who were discriminated against had agency. In similar ways, people who might have been thought of as pioneers or heroes – actually, they were flawed. It was important to centre that. That was my guiding principle, if you like.

And so why do you feel this topic in particular would be of interest to a broader audience? You’ve mentioned some things, but are there other things you can talk about?

There are, and I might do that kind of in combination with some examples to make concrete what I’ve been talking about in the abstract.

So I’ve talked about the ways in which biography gives voices to people, and I think there are some fabulous examples – including of Australian histories – that do exactly that.

Really close to home, Janet McCalman wrote this phenomenal history of the Royal Women’s Hospital called Sex and Suffering, in which she used a combination of patient records, but also available biographical details to really bring to life the ways in which women experienced, particularly birth, for example, at the Royal Women’s, at a time where the centrality of patient experience was diminished and somewhat ironically, male doctors dominated in terms of who your medical service provider was.

I think one of the most compelling chapters in Sex and Suffering includes this insight into what migrant women’s experiences in post-World War Two Australia were like. If you were an Italian or a Greek woman giving birth, not only were you encountering all of the gender bias against you, but you also encountered language barriers, and then also cultural barriers in terms of what you traditionally expected when you gave birth compared to what was the social norm here.

Staying in Australia, another really interesting example of biography was the way in which Rod Home [NB: the correct author is Rod Buchanan] used it in his traditional biography of Hans Eysenck who was a psychologist, a very famous English psychologist, who it turned out had actually basically used fraudulent data. The result of Rod’s work, for example, has seen – finally, after decades of lobbying – retractions of Eysenck’s work – which, again, is a form of correcting the scientific record and is an example of the ways in which biography, when done well, can actually have these really interesting and diverse impacts on how you understand the scientific past.

Were there any other good examples that you wanted to talk about?

In history of medicine, at least for me, at the time that I was going through, one of the most admired works was Medical Lives in the Age of Surgical Revolution. It was a type of prosopography, which was a systematic uniform biography done by Marguerite Dupree and Anne Crowther. It looked at Lister, who you may know from Listerine, but effectively Lister had this, what we now understand to be, this pioneering idea about the role of cleanliness in hospital environments and how that might actually prevent the transmission of disease.

At the time, it wasn’t a necessarily well received idea, but Lister’s students who went to all parts of the British Empire, took this idea and were his apostles, if you will. What Medical Lives does is it does this prosopography that shows Lister’s legacy writ large. It’s a fascinating example of the use of this uniform biographical tool to understand something that we take for granted today – that you have to keep medical operating theatres sterile or you have to wash your hands. I feel perhaps I’m triggering people when I say that post-pandemic! But, you know, these taken-for-granted ideas weren’t necessarily always taken for granted and someone had to push this through. This particular book was a really fascinating use of collective biographical methods to demonstrate the long legacy of Lister.

And in your own research, what were some of the interesting insights that you found? I’m especially interested in the ones that you didn’t expect to come across…

Actually, I think the thing that I didn’t expect to come across, and which I think has been probably one of the most insightful things that I ended up making as my own tiny, tiny contribution, was understanding the extent to which migrant doctors shaped the structures of rural and regional medicine, particularly in Australia.

Now today, we know this because a lot of migrant doctors – in order to not compete with Australian trained doctors – are sent to regional areas on what’s now referred to as a 10-year moratorium. But in the period that I was researching, there was just this fundamental opposition to even registering these doctors, let alone allowing them to practise because of the very same kind of underlying notion, which is if we train doctors in Australia, it is Australian-trained doctors who ought to have the first right to practice. But of course, as medical practice became more lucrative and populations in Australia increased, doctors’ willingness and desire to leave urban centres like Melbourne or Sydney and go out to regional areas was diminishing. What you actually found is that the migrant doctors who somehow managed to get themselves registered – actually, this was an available niche. So, what you have are urban communities who are broadly suspicious about immigrants in general, but also immigrant doctors. Then, to compare, you have a lot of country communities who went, actually, this is an opportunity for us to get a really valuable set of skills into our community!

Having a doctor who was resident meant that you didn’t have to drive for 50 minutes on bumpy roads in the middle of winter to get to the closest country town to access primary care, even sometimes specialist care. It was that combination of the extent to which migrant doctors found themselves shaping regional, broadly construed, medical structures, but also the ways in which country communities advocated for this. They overcame some of the prejudices because of what it meant, which was access to a high status service that they really valued.

You found through these biographies that this was a common story?

Precisely, yes. So I looked at about 500 to 700 doctors in total, and then I did a subset of doctors. I did every single doctor who held a qualification other than one from Britain or Ireland. What I consistently found was that they would spend a large proportion of their medical career on arrival and after finally being able to get registered to practice often in country areas and second to that, often in migrant-dominant suburbs – so, Footscray and Sunshine and Brunswick, when they were not as hip as they are today, where again, Australian-trained doctors had the luxury of rejecting them as places they would want to set up practice.

This repeated pattern that you get out of just literally mapping careers of doctors gives you a sense where, actually, if you take a step back and look at it more holistically, what you’re actually seeing is that, for example, for a period of 30 years, immigrant doctors effectively filled these gaps. And then you fast-forward to today, and that’s the basis upon which access to primary healthcare in Australia is predicated, the ability to import migrant medical labour to fill gaps where Australian doctors won’t. And so, what I did was effectively this pre-history of what we experience in our contemporary medical systems today.

Oh, that’s fabulous! Was there anything else you wanted to add in?

That’s a very good question, Samara. Hmm. Only to say this, if you are going out into a bookshop and looking for something to pick up, to actually look for interesting biographies. There are biographies of diseases – for example, one that I was recently looking at, is a biography of migraine as a concept, which is fascinating.

And when you’re thinking about figures that are really popular ones, like Darwin for example, to actually go, well, let’s look at what people are saying about it more recently. In the case of Darwin, what you actually find is that biographies of Darwin are considered now more an insight into broader scientific cultures of the time. So historians, at the very least, have gone from remembering Darwin as this genius figure to thinking of Darwin as a conduit into understanding all of the different contemporary actors who influenced Darwin’s work and how he’s just an icon for a broader kind of scientific moment. And I think that’s a really interesting thing to think about.

The HPS podcast is hosted by Samara Greenwood and produced by Samara Greenwood and Indigo Keel.

Resources mentioned in this interview:

  • Janet McCalman, Sex and Suffering: Women’s Health and a Women’s Hospital (Melbourne University Press, 1995)
  • Rod Buchanan, Playing with Fire: The Controversial Career of Hans J Eysenck (Oxford University Press, 2010)
  • M Anne Crowther and Marguerite W Dupree, Medical Lives in the Age of Surgical Revolution (Cambridge University Press, 2007)
  • Katherine Foxhall, Migraine: A History (Johns Hopkins University Press, 2019)
  • Janet Browne, Charles Darwin. Volume 2. The Power of Place (Vintage Digital, 2010)