Author Archives: Jenna Healey

About Jenna Healey

PhD Candidate in the History of Science and Medicine at Yale University.

Going Global

As Ebola spreads outside the confines of West Africa, public health officials have declared the epidemic to be a crisis on a global scale. Peter Maurer, president of the International Red Cross, described the outbreak as “a global health catastrophe…an epidemic of global dimension and a global threat.” While there is much to be said about the politics of these statements (as well as the public health response to Ebola more generally), it is Maurer’s constant invocation of the “global” that interests me most.


Within the history of science, medicine, and technology, we are experiencing our own turn towards the global. Over the past few years, global history has emerged as a theme in CFPs, at conferences, and in recently published scholarship. Back in 2012, my department introduced a History of Global Health class which attracted a large number of enthusiastic undergraduates. This trend towards global history is also reflected in the job market. Based on a very unscientific survey of recent job postings, the number of advertisements requesting a candidate with a global research focus has jumped from 16% to 29% between 2011 and 2014.*

What is driving this trend? Is global just the newest label for non-Western history (in the tradition of comparative history, international history, transnational history, or “America and the world”)?  Or is global history a qualitatively different enterprise?
Image from Kenneth Lu via Flickr

A cynical interpretation of the trend is that “global history” is the product of a troubled job market. As universities tighten their purse strings, the number of permanent academic positions has shrunk considerably. When a department is able to secure the funds for a tenure-track position, it seems prudent to select a candidate that is as versatile as possible. From a budgetary perspective, this means being able to teach a wide variety of classes across a number of different geographic regions. A global historian that can fulfill many of the department’s teaching needs is more useful that a specialist who can only teach a narrow range of classes. Of course, it might also be that universities recognize the growing demand for coursework that provides a global perspective on history, and are orienting their hiring towards that end.

While fiscal politics play a part in shaping the job market, I think that the global turn runs deeper than that. The intellectual energy emanating from the field is palpable. Whenever I hear a talk or read new literature that engages with global histories of science, I begin to think about my own work differently, asking how I can move my research beyond its national confines. Our turn to the global is certainly informed by our own contemporary moment when epidemics become “global catastrophes” and information travels around the world in a single tweet. Living in a globalized world, we seek to historicize it.

The challenge then, is how to go about the process of doing global history. The global history of science, technology, and medicine encompasses topics as diverse as the politics of global health, the development of global technology networks, and the impact of globalization on scientific practice. What do these studies have in common, other than telling stories that transcend national borders? Is there a methodological approach that binds them together?

I am certainly not the first to ask these questions. Several historians of science, medicine, and technology have thoughtfully reflected on the “global turn” and what it means for our discipline. Historian of medicine Warwick Anderson has written extensively in what we could call the history of global health. In an essay published this month, Anderson reviewed the recent historiography in the history of global health and suggested that the most important contributions have been written not by historians, but by anthropologists. This is because anthropologists pay close attention to local contexts – a seemingly strange virtue in a search for the “global.” Anderson goes so far as to say that “the most compelling accounts of global health manage to localize medical interventions: they examine the messy and often confusing, even conflicted, interactions of foreign doctors and aid-workers, domestic and traditional health practitioners, and their patients.”

Anderson’s claim for the importance of locality in global history runs through his other writings on the subject. In an essay published back in February in the Social History of Medicine, Anderson critiqued historians’ emphasis on global “flows,” what he cheekily refers to as the “hydraulic turn.” By embracing the language of “flow,” he argues, historians begin to take globalization for granted, treating it an inevitable historical narrative instead of a process that requires its own analysis and historicization.

The issue of movement is a common thread running through other methodological discussions of global history. Fa-Ti Fan identified “circulation” and “trade” as the two methodological pillars of global STS. Stuart McCook recently suggested the method of “following” an object – whether it be material, textual, or biological – as it moves around the world. Sujit Sivasundaram, on the other hand, encourages historians to cross-contextualize their sources to better understand how both Western and non-Western subjects approached the natural world at any given moment. Sivasundaram’s call to cross-contextualization strikes me as similar to Anderson’s praise of the anthropologist. Both insist on careful and thorough local study that maps the complexity of encounters as they happen on the ground.

The tension that emerges from these discussions is a battle between flow and focus, between moving and standing still. Even if people, ideas, and technologies are always moving around the world, it is only by taking a snapshot that will we understand how global flows influence local realities. In all likelihood, both kinds of studies will be essential for historians tackling the enormous task of writing the history of the world.

* Based on the job listings on Academic Jobs Wiki (http://academicjobs.wikia.com/wiki/Academic_Jobs_Wiki)
* Check out the Isis focus section on “Global Histories of Science,” published in March 2010, as well as well as Isis focus section from December 2013, “Global Currents in National Histories of Science: The “Global Turn” and the History of Science in Latin America.”

What Difference Does a Chromosome Make?

This feature is cross-posted on Cosmologics, an online magazine project of the Program for Science, Religion and Culture at the Harvard Divinity School.

Back in May, the NIH announced their intention to draft new policies to address gender bias in preclinical research. The majority of model organisms and cell lines used in preclinical research are male, a bias that obscures potentially significant differences between the sexes. Sex, the NIH argues, should be treated as a fundamental variable in biomedical research. By revamping inclusion and reporting policies, the NIH hopes that sex-based differences will be identified earlier in the research process.

Image from TZU-YEN FU via flickr creative commons.

This policy change is not without precedent. In 1987, the NIH changed its grant guidelines to require equal numbers of women and men in clinical research. Before this moment, clinical trial participants were almost exclusively male. This preference for male bodies was justified by the argument that females’ constantly cycling hormones would add too much noise to experimental data, making it more difficult for researchers to observe the effect of the intervention being studied.

Douglas Fields, a neuroscientist at the NIH, published his critique of the NIH’s new policy in last month’s Scientific American. In his article, Fields laments that the new policy is “about politics, not science.” Twenty years ago, when the inclusion of women in clinical research was first proposed, many scientists made the same complaint. Today, by Fields’ own admission, there is “no debate” about the importance of ensuring diversity among clinical trial participants. As the gradual acceptance of clinical inclusion policies show, the ideals of “good” scientific practice change over time, a process that is inevitably political.

Fields’ critique is two-fold. First, he argues that implementing the new policies will result in unnecessary and wasteful expenditures. Second, he contends that including both male and female research subjects in every study will produce unacceptable levels of experimental variation.

Let’s look at the issue of variation first. According to Fields, the reason why most preclinical researchers conduct single-sex experiments is that including both sexes would increase variation while simultaneously cutting sample size in half. This would make it more difficult for researchers to detect significant differences between the experimental and control groups. Fields rejects the explanation that researchers favor male animals and cells because they exhibit less hormonal variation. He does not offer an alternative explanation, however, for why a majority of single-sex experiments use only male animals.

The way around the problem of variation, it would seem, would be to increase the overall number of test subjects, so that there is a sufficiently large number of animals or cells of each gender. The larger sample size would smooth out the variation so that researchers could still detect significant differences between experimental conditions. Alternatively, researchers could perform separate statistical analyses on male and female populations, which would be useful in identifying the differences between these populations. Let’s say, for example, that female rats react positively to a candidate drug, but male rats do not. That seems like essential information to have before a drug advances into human clinical trials.

Back to Fields’ primary objection: experiments with larger subject pools cost more money. I think that Fields is probably right, even if Janine Clayton and Francis Collins insist that inclusion “need not be difficult or costly.” The NIH policy of preclinical inclusion may add to the already substantial cost of biomedical research. Is it worth it? That depends on what one thinks the goal of preclinical research should be. If we want experiments that are cheap, clean, and produce unambiguous results, then perhaps we should stick to a single-sex model. But if we hope to gain insight into how a patient’s gender (among other biological factors) might play out in a clinical situation, inclusion seems necessary—even if it comes at a cost. Fields actually suggests that using both male and female animals could cut down on laboratory costs, as labs could breed costly transgenic rats instead of purchasing new ones. And this week, the NIH announced 10 million dollars in “administrative supplements” to encourage gender balance in projects already funded by the agency. It seems that if the scientific community wants to make inclusion a priority, additional resources and solutions are available to ease its integration into preclinical research.

Fields accepts that sex difference is an important object of biomedical inquiry. In lieu of mandatory inclusion policies, he suggests earmarking NIH funds for researchers for whom the study of sex difference is a major focus. This forgets that sex differences often crop up in unexpected places—from processes of cellular death to the effects of daily aspirin on heart disease. The NIH policy need not transform every study into a major investigation of sex differences. But if scientists aren’t on the look-out for sex differences in their own research, how will we know where to look? Inclusion policies will provide new leads for researchers who want to delve deeper into the mechanisms behind sex-based variation.

I do, however, have my own reservations about expanding inclusion policies to include preclinical research. My main fear is that such policies will encourage us to see sex-based difference where none exists, or where such a difference would be irrelevant for clinical practice. I am convinced that biological sex can be can be an important variable in the study of a variety of biomedical phenomena. But I also imagine that there are many instances in which variation between the sexes is negligible—and that’s ok. Another danger of lionizing biological difference is that we might neglect the cultural factors that influence sex differences at the clinical level. We need to maintain a flexible understanding of the relationship between biological sex markers (either gonadal or chromosomal) and the lived experiences of all genders.

I also admit that I am less convinced about the necessity of inclusion at the cellular level than among laboratory animals. Maybe this is because sex difference at the cellular level boils down to an X or a Y, which bears little resemblance to the complex manifestations of sex or gender at the organismal level. Maybe it is because I am uncomfortable with personifying cells that are bought, sold, or left to divide in perpetuity, even though I know those cells once came from a human being with a gender identity of his or her own. Historian Hannah Landecker’s work on the HeLa cell line has shown how the racial identity of the donor has been projected back onto the cells themselves, often in highly problematic ways. For example, scientists wrote of HeLa’s tendency towards “miscegenation” through the aggressive contamination of other cell lines. By focusing on the sex of the cells (or even animals) we study, will we be able to avoid slipping into gendered language? How might our projection of gender onto cells change the way we think about or study them?

Only time will tell if the NIH’s new policies will enrich our understanding of biological differences between the sexes. There is a fine line, however, between appreciating sex differences where they do exist and expecting that biological sex will shape every aspect of clinical practice. Thinking critically about the ways in which sex factors into preclinical research is a necessary first step in ensuring that both women and men benefit equally from the fruits of biomedical research.

Bringing Together #histSTM and #FergusonSyllabus

In late August, historian Marcia Chatelain started the twitter campaign #FergusonSyllabus as a response to the unrest in Ferguson, Missouri following the death of 18-year old Michael Brown at the hands of local police. For Chatelian, an Assistant Professor of History at Georgetown, #FergusonSyllabus was a way for teachers and scholars across the country to crowdsource ideas about how to address the events of Ferguson in their own classrooms. Rather than ignore such a pivotal moment, and all of the racial tensions it brought to the surface, participants in #FergusonSyllabus were committed to engaging with these issues head on. The tragedy sparked conversations about the historical roots of white supremacy, discriminatory housing practices (such as redlining), and systemic economic and educational inequality, all issues that have shaped the contemporary urban landscape in St. Louis as well as in cities across the country. This experiment in academic crowdsourcing produced a diverse list of sources – historical, literary, musical, and artistic – that provide rich context for the struggles facing the people in Ferguson today.

In the weeks since, the #FergusonSyllabus campaign has lost steam, along with the mainstream media coverage of the events in Ferguson (although protests continue). As the semester gets busier, it feels that the urgency of the #FergusonSyllabus moment is already fading away, pushing aside the issues that Ferguson had forced to the surface. But #FergusonSyllabus remained in my thoughts as I read two major pieces of history related news this week. 

The iconic slogan of Ferguson protestors


The first was this editorial, by American Historical Association director James R. Grossman, about the controversies surrounding the introduction of “revisionist” history into American high school curriculum. Tension emerges between those who believe high school history should be a patriotic celebration of American accomplishments, versus those who think students should be taught to think critically about the more disturbing episodes of American history. Can we imagine selections from the #FergusonSyllabus being incorporated into high school as well as college curriculums? I think it is worth thinking about how these kinds of conversations can happen at every level of education, and not just among those who have the privilege of sitting in a college classroom.

The second was this interview, linked to in our Weekly Roundup, that reveals how very old ideas about inherent (read: biological) racial difference have been inscribed onto seemingly objective medical technologies. Author Lundy Braun  (a professor of Africana studies and medical science at Brown University) explains how the spirometer – a machine that measures lung capacity – was designed to adjust for race of the patient. The design of the spirometer draws on a centuries old belief that African-Americans have a lower lung capacity than whites do. Such ideas have been passed on uncritically, cited as scientific fact and integrated into medical practice so seamlessly that many physicians are not even aware of the instrument’s racial dimensions.

Although I did not contribute to the original #FergusonSyllabus, the Grossman article and Braun interview inspired me to think about the ways in which we, as historians of science and medicine, might contribute to this conversation. I am a strong advocate for the integration of history of science and medicine with American history more broadly. Thinking about the history of science and medicine as a field apart from American history, as many historians do, is to the detriment of both fields. Science and medicine do not happen at the fringes of society. Scientific and medical ideas about race have been repeatedly deployed to justify the enslavement, segregation, and oppression of African-Americans and other racial minorities. It is also essential to understand how modern health disparities have their roots not in biology, but in decades of discriminatory policies that prevent entire communities from accessing health care.

In this spirit, I suggest four history of science and medicine books that would appear on my #FergusonSyllabus. There is a strong bias towards the history of medicine because so much excellent work in the social history of medicine has addressed these questions head on. I would love to hear from readers in the comments: What would your picks be?  How they might we envision the history of non-medical science and technology, broadly construed, as fitting into this conversation?

My list, in no particular order:

1. Susan Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (University of North Carolina Press, 2009)

An instant classic and an obvious choice for this list. Not only does Reverby provide the authoritative account of the complex history of the Tuskegee syphilis trial, she traces how stories and memories about the trial continue to circulate in African-American and biomedical communities. Reverby takes the collective trauma of Tuskegee very seriously, even for those who were not directly impacted by it. The stories we tell about Tuskegee matter just as much as the facts of the case. The last section of the book, Traveling, explores these many afterlives of the Tuskegee trial.

2. Steven Epstein, Inclusion: The Politics of Medical Difference (University of Chicago Press, 2007)

Epstein’s book really gets at the tension between biological explanations of racial difference, on one hand, and the very real health disparities created by segregation and poverty, on the other. For many years, clinical researchers used white, middle-aged men as their primary research subjects. As a consequence, white, male bodies became the standard to which all other bodies were compared. It also meant that drugs in clinical trials were not accessible to anyone who didn’t fall into this category. This changed in the early 1990s, when activists called on the NIH to require clinical researchers to recruit a diverse subject pool that included both female and non-white subjects. This inclusionary impulse, however, runs the danger of reinforcing our belief in racial essentialism, without grappling with the fact that many supposed racial differences are social, not biological, in origin.

3. Jim Downs, Sick From Freedom: African-American Illness and Suffering and during the Civil War and Reconstruction (Oxford University Press, 2012)

Reconstruction is perhaps the era of history most maligned in traditional historical narratives. It is also a time period which has largely been ignored by historians of medicine. Downs recounts the devastating consequences of emancipation for the health of many freedpeople, as they were left to contend with the fallout of the Civil War with few resources and limited access to medical care. Severe epidemics of smallpox, cholera, and yellow fever, not to mention malnutrition and exposure, crippled communities of freedpeople trying to establish themselves in Southern society.

4. Rebecca Skloot, The Immortal Life of Henrietta Lacks (Broadway Books, 2011)

Perhaps this is a controversial choice, as it is one of the most dynamic stories of late 20th century medical history as told by (gasp!) a journalist. Skloot recounts the story of the HeLa cell line as created from the tumor of Henrietta Lacks at Johns Hopkins in the 1950s. Lacks was a young black woman living in Baltimore when she passed away from cervical cancer, and her family had no idea that biological material removed from her body would go on living without her. What I think Skloot does so well here is to capture the uneasy relationship between Henrietta’s family and a biomedical giant like Johns Hopkins. Skloot’s emotional engagement with members of the Lacks family hammers home the irony if the HeLa cell line generating billions of dollars in profit (and countless medical breakthroughs) while Lacks’ children are unable to access the most basic medical care. It is a eye-opening contrast between world class, high-tech biomedicine and the atrocious or non-existent level of care only a few blocks down the road.

What books would appear on your #FergusonSyllabus?

Laughing at Smallpox

Back in July, something pretty serious happened. On July 8, 2014, the CDC made a chilling announcement: six vials containing the smallpox virus were discovered in the back of a freezer in a NIH laboratory in Bethesda, MD. The vials were discovered when a researcher cleaning out the lab pulled them out of a cardboard box. Nobody had any idea that they were there.

Smallpox. It’s serious.
CDC Public Health Image Library
The CDC reacted to this serious discovery in an appropriately serious manner. After the authorities were alerted to the existence of the variola-labelled vials, the CDC immediately took possession of the samples and brought them to a high-security laboratory in Atlanta. After testing the contents of the vials, the CDC invited the World Health Organization (WHO) to witness their destruction. A few weeks later, the CDC confirmed that the vials did indeed contain smallpox, and that the material in at least two of the samples was capable of infecting humans. Disaster was averted, but only narrowly.

And yet, something funny happened when the CDC announced this wildly terrifying discovery. The internet, and in particular the twitterverse, found the whole situation to be rather…hilarious.

July 8 will be remembered on the internet as the day of the smallpox joke. Now, smallpox-related comedy is an odd genre (to say the least), and it will be the topic of my blog post today. Although I won’t always be joking about deadly diseases here at AmericanScience (which should come as a relief to the rest of the team), I will be writing about the cultural and social dimensions of biology and medicine.

Before this summer, my exposure to smallpox humor was limited to the wildly inappropriate “smallpox blanket” card one can play in the irreverent game Cards Against Humanity (If you don’t know what I’m referring to, you can check it out here).  In my experience, the card is usually played to great effect, eliciting a combination of horrified laughter and disapproving gasps. And far as the game goes, this is generally the point.

As English actor Peter Ustinov once observed, “Comedy is simply a funny way of being serious.” Humor is a universal human mechanism for confronting the issues that make us the most uncomfortable. As a historian, I’ve always found jokes to be useful sources for understanding a given culture. In the instance of Cards Against Humanity, the smallpox blanket card invokes the long and violent and history of the European colonization of Native Americans – and that makes most people pretty uncomfortable. And so the academic (read: humorless) side of me can’t help but wonder: What are the anxieties driving this particular wave of smallpox humor? Why is smallpox humor even a thing?

Based on my observations, here are a few ways you can laugh at smallpox:

1. A Disease of History
I admit that my own reaction to the SmallpoxVialsFiasco2014 was generally sarcastic. Sometime between hearing the news (while in very close proximity to Bethesda, I might add) and picking my jaw up off the floor, I turned to social media to express my incredulity:


My sarcastic reaction was not uncommon. Twitter filled up with comments that were some variation on “Oh, no big deal, I JUST FOUND SMALLPOX IN A FREEZER”:




These flippant comments were a reaction to the dissonance created when you juxtapose an act as mundane as cleaning out one’s freezer and with the horror of discovering samples of a deadly human virus that is not supposed to exist (according to the incongruity theory of comedy). No way around it: the scenario in which one opens up a cardboard box and finds smallpox in it seems inherently ridiculous.

But this is only because we live in a post-1980 smallpox eradication world. I can’t imagine anyone having the same reaction to a story in which a scientist stumbles upon a box of diphtheria samples, for example. And there is evidence to support this – in the month of July, the CDC had two other serious incidents in which samples of anthrax and H1N5 avian flu were left unsecured. It was also confirmed that the box that contained the vials of smallpox also contained 300 other vials holding dangerous infectious agents. None of these incidents inspired the same incredulity, or fear, that the smallpox discovery did.

Smallpox wields special power not only because it is so deadly, but because it feels so out of place in our modern world. Smallpox is a disease of history. Its story has been relegated to textbooks and fading vaccination scars (and the John Adams miniseries on HBO). It may have dramatically shaped our past, but it has no place in our future. To be so sure that humans have banished smallpox from the face of the earth, only to find it carelessly stuffed into the back of the freezer, is humbling and horrifying at the same time.

Cue the nervous laughter.

2. Oh The Incompetence!
Some jokes were aimed at the supreme incompetence of the NIH/FDA/CDC/IRS/the White House/Obama, take your pick. To be fair, the discovery of decades old samples of smallpox in an unsecured federal laboratory does not exactly inspire confidence. It was a perfect opportunity to get in a dig at inefficient bureaucracies:




I highly recommend this piece in The New Yorker that imagines a memo sent to NIH maintenance staff after the incident. After reassuring staff that there (probably) aren’t any other deadly pathogens “lying around the facility, tucked behind hedges on the grounds or stacked like cordwood in the common areas,” the supervisor suggests a few precautions that should be taken (Just in case! Probably unnecessary!) What follows is an inane list of bureaucratic instructions, ranging from using a wet floor sign to signal the discovery of deadly neurotoxin to leaving the Ark of Covenant untouched if one happens to come across it.

Beyond poking fun at bureaucracy, the piece is also reacting to complaints made by NIH workers that they were not notified when the vials were found. Fortunately, no workers were harmed during the incident. But one can imagine workers being evacuated for much less than the discovery of a Tier 1 infectious agent.

Lastly, this comic appeared in the Chicago Tribune on August 5, after the CDC announced that two physicians infected with ebola would be transported back to the United States for treatment. Fear of this new deadly scourge collided with outrage over the smallpox incident and claims of incompetence on the part of the CDC. If the CDC can’t keep track of diseases we’ve eradicated, how can we trust them with new biological threats?

3. Vaccination Wars
A gem to emerge from this wave of smallpox humor was the parody twitter account, @NIH_Smallpox, created in honor of the vials themselves. Turns out that tweeting from the POV of long-lost vials of smallpox is a goldmine of comedic material:


Only 24 hours after its creation, however, the NIH_Smallpox account was temporarily suspended for making disparaging comments about celebrity anti-vaccination crusader Jenny McCarthy. But the vials (and others) managed to get in a few good shots at the anti-vaccination camp first:





I found this one to be a tad peculiar, because a) we no longer vaccinate against smallpox b) strategic vaccination against smallpox (in the military, for example) is highly controversial. Smallpox is one of the few cases in which the risk of accidental infection through vaccination potentially outstrips the risk of contracting the disease in another situation. More than anything, these jokes show the intensity with which the vaccine debate is still raging in the United States.

4. Saving The Best For Last
What is my very favorite smallpox joke, you might ask? Without a doubt:


I do love a good pun.

If you’re interested in more smallpox jokes (because, who isn’t?), check out this great compilation (which I can’t take any credit for) by @tarahaelle .