Medicine as History: A Conversation with Historian of Medicine Dora Weiner

Professor Dora Weiner's fields of scholarly inquiry include the social and intellectual history of eighteenth and nineteenth century medicine and psychiatry, and the history of professions and institutions.  She has published widely, in French and English, on the history of public health, the nursing profession and the politics of health in eighteenth and nineteenth century France.  Dr. Weiner has been a professor of the medical humanities with an appointment in the UCLA Department of Psychiatry and Biobehavioral Sciences since 1982.  She also teaches seminars on "The Historic Roots of the Healing Arts" and "Madness in the Enlightenment" within the university's Professional School Seminar Program and Honors Collegium.

What initially motivated you to study history, and medical history in particular? 

Since my family was Jewish and I was born in Germany, my family and I fled from the Nazi regime to France.  At age thirteen I found myself in the wonderful city of Paris and attending a Paris lycée.  The lycées in France have a curriculum that is decided on by the Ministry of Education, so it reflects the idea of what leading educational circles view as essential to the image of France.  My studies were extensively focused on French history and especially on the central event of modern French history-the French Revolution.  I also loved discovering Paris as a young girl and found it to be a wonderful adventure.  My love of Paris and the strong focus that the lycée placed on France later drew me to complete my dissertation on nineteenth-century France, and from then on I found myself focused on the medical history of France.

After the Germans attacked France in 1940, my family and I moved to unoccupied France, and then my father obtained transit visas so we could travel to Cuba.  Finally, after two years in transit, we arrived on U.S. soil in Kansas City.  From there, I was able to win a scholarship to Smith College, where I veered towards history and ended up graduating magna cum laude in 1945.  I was then awarded a scholarship to Columbia University where I studied under Jacques Barzun and completed a dissertation with him on the nineteenth-century historian Ernest Renan.  It was at this point of my studies on nineteenth-century French history that I became interested in medical history.  I was specifically intrigued by the scientist and rebel Raspail, who not only was a pioneer in exploring cell theory and communicable diseases (particularly as they affected poor people), but who also stressed that hygiene for the poor ought to be a main mission for medical scientists to pursue.

Your past books, The Citizen-Patient in Revolutionary and Imperial Paris,Raspail, Scientist and Reformer, and Comprendre et Soigner: Philippe Pinel, 1745-1826: la medicine de l’esprit reveal your strong focus on France.  What drew you to center your medical studies on France?

I had come into frequent contact with the French Revolution due to the fact that it affected many aspects of French culture, social and intellectual life.  It was this exposure and my studies on Raspail that helped me choose what would be the central theme for all my future research:  whether the rights of man which were proclaimed by the revolution in 1789 should not include the citizens’ right to healthcare.  It is this theme that my book The Citizen-Patient in Revolutionary and Imperial Paris focused on, and it is the same theme which has led my research and teaching to follow in a similar direction of investigating problems and consequences of health issues.  This comparable thematic direction has led me to my current research, which looks at the relationship between France and South America, and especially Peru, from the point of view of the modernization of medicine and of medical education.

What have been some of the most rewarding findings during your research?

The event that stands out the most to me is one of the many days I had spent in the archives digging up information when, by chance, I discovered a document that the literature has long told us existed but nobody had ever seen.  It was a document written in the early 1790s by the administrator of the ward for mentally ill men at Bicêtre Hospice called “The Observations of Citizen Pussin on the Insane.”  The famous physician-in-chief at the Salpêtrière Hospice, Philippe Pinel, requested that the administrator send to the Minister of Internal Affairs this observational medical report on the St. Prix ward.  That is why I found it, by chance, in the minister’s correspondence.  The document raises the unsolved problem of who originated the humane but firm methods of managing the mentally ill that came to prevail in France and which was emulated throughout the Western world. 

Do you think the historical study of medicine has come a long way?  What do you think have been some of the greatest advances in understanding this area of history?

The answer to this question offered at UCLA at the moment is puzzling.  On the one hand, the medical school faculty seems uninterested in teaching about or researching the history of their profession.  On the other hand, interest among the student population has surged; the registration in my survey course dealing with the history of medicine has suddenly tripled to 180 students!  There does not seem to be an obvious explanation for this sudden increase, but nonetheless it is great to see a newfound interest among students in this subject.  As for some advances in the history of medicine, there certainly have been new directions emerging, along with massive new evidence being examined.  The writing of the history of medicine has advanced and expanded as social issues have been raised by historians who were not necessarily trained as physicians.  With the social interests of these historians, new concepts in the history of medicine were being investigated such as nursing, hospitals and their patient populations, epidemic diseases and their impact on the population, and social responses to disease, particularly among the poor.  Since the field of inquiry among historians of medicine has broadened into social history, there have been greater research advances in these new areas of interest.

What areas in medical history do you feel lack the most research?

Unfortunately there is insufficient emphasis on foreign developments and on comparative studies. 

Have you felt that more graduate students are becoming more interested in the historical study of medicine?

What I have noticed with great interest is that among the student population, there is a sizeable contingent of young men and women who think of medically-related careers in fields as diverse as social work, nursing, dentistry, hospital administration, and services for people with disabilities such as deafness, blindness, or certain types of mental illness.  For all such fields of professional activity, an acquaintance with their historical development provides an enriching perspective.

You are not only an accomplished historian but also a professor at UCLA.  What do you feel are the greatest obstacles that you deal with as a professor?

I think that obstacles I deal with come more from the outside, because as a member of UCLA’s distinguished History Department, and with an appointment in the Department of Psychiatry and Biobehavioral Sciences, I see opportunities all around me rather than obstacles.  The main problem now facing UCLA is obviously the budget cuts, which have imposed very serious problems not of our own making.  As for teaching, the large number of undergraduates enrolled in my lectures makes it hard for me to get to know them on the personal basis that I have found to be so wonderful with my graduate students.  Undergraduates also are more puzzling in the sense that there are a handful of really interested and engaged students, but also a considerable number of students who do not seem primarily committed to the acquisition of knowledge.  However, I do realize that many of these students have to work a considerable number of hours because of the financial problems which loom large in many of the undergraduates’ lives, and also because of the recent fee hike which has caused more financial tensions for these students.

What advice would you give to current undergraduate students who are contemplating pursing their PhDs in history?

I have one unconventional comment to make which is addressed to the women in the student population who are considering pursuing PhDs in history.  I know that many women are concerned about whether they will be able to conciliate a career with having a family.  I can only say that yes, it is not only possible to have a career and a family, but it is hugely rewarding as well if you have a family that supports your efforts.  I am sustained in this opinion as I have not only experienced a fulfilling marriage to an outstanding clinical neuroscientist – and we raised three successful sons, now a lawyer, a doctor, and a reporter turned author – but I am also now actively involved in the challenges and rewards presented by my seven grandchildren.  I hope that my life can be encouraging advice to young women students.

What qualities do you think are essential for history students who are considering the possibility of spending their lives researching? 

For those students who are looking to pursue their history PhDs and to spend a great deal of their lives researching, my advice would be for them to acquire the tools for research as early as possible.  Nowadays, this means not only possessing extensive computer skills but also mastering the foreign languages that their research may require.  It is simply not possible to make sense of archival documents if one is not thoroughly familiar with the language of the document.

You have commented on how issues in our current healthcare debate in the United States reflect the basic issues that spawned the concept of healthcare in Revolutionary France.  How is this historical connection important in understanding and dealing with healthcare issues today?

My main astonishment concerns the fact that the French dealt with these issues two hundred years ago and yet here we are facing the same issues today, and having great difficulties in coping with them.  The healthcare issues of Revolutionary France and the United States are very similar in the sense that France’s National Assembly was rife with clashing interests among its members, and that the U.S. Congress is also currently dealing with a similar clash of interest among its representatives.  In France, the Poverty Committee that wanted to develop a safety net for the poor was at odds with the Health Committee, headed by Doctor Guillotin, which wanted to look out for professional interests.  So can we learn from them?  Yes, we need to go beyond this clash of interests and establish measures that honor the obligation of a democratic government to fulfill the citizen-patient’s right to healthcare.  Expensive?  Yes.  But necessary.