Historians and Doctors: Getting the Facts Straight

by Bob Schoone-Jongen.

Agent Joe Friday with the text "Just the Facts, Ma'am"“Just the facts, ma’am.” Popular history says that for years Sgt. Joe Friday (LAPD, badge 714) intoned this refrain as he gathered clues and information to solve each case. The perpetrator always finished the show looking guilty as sin, while the faceless narrator recited the catalog of charges and the sentence. The facts, and justice, prevailed, once again. “My name is Friday, and I wear a badge.”

Some people would like to think that history should be “just the facts,” a catalog of events in chronological order, with no insights or interpretation provided. Unfortunately history’s facts are not fixed stars. Instead they are shards of glass in a kaleidoscope shifting into new configurations as the cylinder turns. Circumstances will pull events out of the accumulated pile and set them before us to be seen in a new context. The old events take on a new look. Some headline or personal experience will shift the old shards to create a new picture with a new focus, and a different background.

I like to stress this historical fact (yes, ma’am, that’s all I need) throughout the semester, especially in classes inhabited by non-history majors. It provides a useful reminder that as life moves along, our views of the past change. While some events will remain prominent for a long time, others will lose their importance–maybe for good, or maybe just for a while. Forgotten facts will sudden re-emerge in this same process.

My recent medical problems certainly shifted the shards for me. Doctors and nurses have been crowding out the immigrant stories and statistics that usually dominate my view of vision. In looking at what medical people do, I have noticed a tension between those who catalog symptoms and expect to diagnose maladies “by the book” and those who cling to the older notion that experience and intuition should be the default setting for treatment. I know that that loud thudding sound you may be hearing is nuance crashing to the floor; but hear me out and I will pick most of them up before this is finished, and we will sterilize them before reattaching them to just the facts I want to highlight for now.

two young men in surgical scrubs in an operating room.

Dr. Charlie Mayo, left, and Dr. Will Mayo. Source: http://www.mayoclinic.org (Click the picture for more.)

The Mayo brothers were great medical cataloguers. Will and Charlie first learned medicine by traveling with their father to isolated Minnesota farmsteads to visit his patients. Broken bones, childbirths, lacerations, old age, childhood diseases, the Mayos saw them all, and treated them all. And then there were the cases that defied the common medical wisdom of the time. How should those patients be treated? Somewhere along the line the brothers hit upon the idea that treatment would be vastly improved if doctors could consult a catalog of symptoms. The more extensive the catalog, the more accurate the diagnosis. Theoretically, the catalog could become so large that in time there would be no symptoms that could not be found in their collection of just the facts. With that catalog of knowledge, the Mayo brothers built a clinic, and a reputation for being able to treat the most difficult of medical conditions.

William Osler quizzing a student at Johns Hopkins Hospital, 1902 or 1903.

William Osler quizzing a student at Johns Hopkins Hospital, 1902 or 1903. Source: NIH US National Library of Medicine (Click the picture for more.)

Sir William Osler, a contemporary of Will and Charlie Mayo, also believed in having the medical facts at his disposal as he patrolled the wards at Johns Hopkins University Hospital in Baltimore, with his medical interns in tow. Coincidentally, Osler came to the attention of the medical world with an article he published during the 1880s—the topic endocarditis, the condition that has laid me low this fall. He insisted on something else beyond the facts. He taught his students that each patient was a person with an individual history. He also believed that doctors could improve their diagnostic skills with a firm grounding in the classics, books that would teach them how to both see life in a larger context and analyze each case. In Osler’s medical world, experience rooted in the facts was the essential ingredient in good medical care. No two cases were exactly identical, since no two people were exactly identical.

Good history, like medicine, requires informed intuition. Analogues and algorithms certainly come in handy when there is information to collect, quantify, and catalog. But these essential ingredients are inherently unreadable, until they are processed into decent prose. This requires analysis, thought, editing–intuitive stuff that the historian brings to table. Dates, locations, quotations, and personalities are the symptoms historians measure to diagnose historical questions. The stories are the cures. And as with doctoring, the historical cures are never complete. There are always side effects, either immediate or long term, that keep us occupied, intrigued, and employed. Time will inevitably reshape the picture and call the cure into question. What looked like good medicine one hundred years ago looks primitive today. Historical conclusions that looked so certain in era of the Mayos and Osler, now look quaint, at best. Time has taken a toll on both medicine and history, and improved them, at least in our own eyes.

I have never considered myself the sort of person who wore a lab coat while doing my work. But maybe I have been, without realizing it. Historian as diagnostician–that’s something to think about for a spell. Getting the facts right so the prescription will be effective, or at least do no harm, should be the historian’s version of the Hippocratic Oath, something to separate reputable practitioners of the historian’s craft from quacks and charlatans.

That reminds me of one more fact. Sgt. Joe Friday never said his most quoted line. And that’s a historical fact.

Robert Schoone-Jongen is in his eleventh year at Calvin College, working with student teachers who hope to become high school and middle school social studies teachers. His historical interests are immigration, American social history, and the presidency. 

About historicalhorizons

The blog of the Calvin College History Department
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