Engaging Fellows: Richard Barnett

Dr Richard Barnett

The Wellcome Trust’s first ever Engagement Fellows came into the Trust a couple of weeks ago to record a conversation about their different experiences in engaging the public with medicine and its history.

Following Dr Richard Barnett’s interview with Dr Kevin Fong last week, we asked Kevin to interview Richard – academic medical historian and author of Medical London and the newly published Dedalus Book of Gin – about his own path from UCL medical school to Engagement Fellow.

KF:         What brought you [to UCL Medical School] and what caused you to swerve?

RB:         I always had two strands in my life and interests, right from the earliest age: I was fascinated by science and technology and steam engines and the human body and all the kind of things that spark your interest when you’re only five or six years old. But at the same time, fascinated in writing and poetry and history. My parents aren’t doctors, we’re not a medical family, but there’s a connection to a very famous forensic pathologist, a chap called Keith Simpson. He wrote a book called ‘Forty Years of Murder’ – his autobiography – which I read at a very impressionable age when I was seven or so and just fell in love with it. I mean, it’s exactly all the kinds of things that would excite a seven-year-old.

KF:         Sorry, did you just say you read a book called ’Forty Years of Murder’ aged seven years old?

RB:         Yes, who wouldn’t pick up a book with that title?

KF:         My son’s six and he’s reading ‘Biff, Chip and Kipper’.

RB:         I don’t think I picked up every nuance of the book but it was a thoroughly exciting book and Simpson really was a wonderful storyteller. He grasped what one could fashionably call the ‘Sherlock Holmes’ aspect of medicine: the fact of discovery, the idea of deducing a person’s history and circumstance and the facts of a death from a lot of rather unpleasant bits and pieces. And it just seemed the most exciting thing in the world, and since I had no familial models for how to be a writer or anything like that, medicine seemed like a very sound, secure career.

So medicine, as I initially thought of it, was as a stepping-stone on the way to becoming a pathologist. But then of course you go to medical school and realise that it’s a very much deeper and wider subject in itself, it’s not something that you can just do as a route through to something else in that way.

Pathological romantic

KF:         And do you think, looking back, that you were after something other than medicine then? I mean, it sounds like you were caught up in the romanticism of the way that story was told and the history and the –

RB:         I think most children are captured by the romanticism of some thing. If you have a drive to do something at a young age, whether it’s train driver, forensic pathologist or astronaut or whatever it is, it’s not because you love the nitty gritty of it, it’s because you have a romantic image of what you’re doing. Looking back, I think it was the storytelling aspect married with the sort of rigour and discipline that science offered: I loved the way that those two things seemed to come together for me in forensic pathology. And, jumping ahead a little bit, those are exactly what I found in history of medicine. I think that’s why the discipline was so appealing when I first encountered it.

KF:         At what point did you think that medicine might not be the ideal career for you?

Light micrograph of a branchial cyst and 'The Scarlet Sunset' (detail) by JMW Turner

RB:         I did the preclinical and enjoyed it, actually. It’s a funny thing to say in some ways, but it’s a very aesthetically enjoyable business, the beauty of histology: you can look at things that look like Turner sunsets down a microscope, or seascapes. And what I love is the way that it marries the aesthetic appreciation and the ability to stimulate the imagination with the fact that this is telling you something really profound about the way the human body works. And I loved the – it sounds rather macabre to say it – but I loved dissection: it was such a privilege to be able to go into a room with a group of other students and just explore the human body. It’s not something you can ever do in any other – well, any other legal context anyway.

So there was much I loved about medicine but over time, I became dissatisfied in ways that I found very difficult to put my finger on. It’s the oldest cliché that there is about medical schools that they select well-rounded people and then proceed to flatten them, and I saw that happening to my friends and to myself and I didn’t like it. Fortunately, just as that was happening I got an opportunity quite out of the blue to come and do some research work with Michael Neve at what was then the Wellcome Trust Centre for the History of Medicine. And that was the beginning of a friendship which has lasted to this day. Michael was a deeply inspiring tutor and showed me that a lot of the questions I was starting to ask about medicine were actually best answered in the frame of history of medicine.

So I did the intercalated BSc History of Medicine, found a lot of other like-minded people who were slightly dissatisfied but couldn’t really work out why, and just absolutely loved that year. Not only did we do the history of medicine stretching back to Hippocrates and beforehand, but we also did the history of evolution, we started to look at critiques of modern medicine and to look at some of the ways in which you didn’t have to swallow medicine whole, as it were; that you could take the edifice of modern medicine and critique it.  And after finishing that year there was no way on earth I was going to go back and be a doctor. I tried for about six months and was plunged straight into a surgical rotation up at the Whittington, which crystallized for me very clearly that this was not what I wanted to do.

Monastic order or military? Listen to Richard and Kevin discussing their experience of medical school.

A window on the history of culture

KF:         So you go away, you do your PhD in the history medicine –

RB:         Masters degree History of Medicine; PhD History of Medicine. All the time thinking that this would just be a way into straightforward academia, but all the time at the same time knowing that there was something else niggling away in the back of my mind that I didn’t quite have a finger on. I spent some time writing; I spent some time as a musician. None of that got quite to the heart of what it was I was trying to do.

Richard's 'Blood and Guts' walking tour of London, July 2008

And it was during my PhD that I started to do, in a very small and scrappy way, bits and pieces of public engagement. It was the classic thing at first that somebody had volunteered to do a guided walk – they were ill, so I picked up their notes, ran down and did it. And in a very, very small way, it was the light bulb coming on over the head going, “Ah, this is what we’re supposed to do with this knowledge and this idea about how the world works and this perspective on history, is actually start to communicate it”, because it’s such a vivid powerful subject: everybody has a body, everybody is sick sometimes, everybody has to confront the prospect of death in their lives, everybody pays their taxes to pay for the health service. Medicine, and the history of medicine, is this wonderful window onto the entire history of culture.

There’s one very narrow and reductive view of the history of medicine, which says that it is the history of doctors and the history of surgeons and the history of their ideas. And that view rightly has been very strongly critiqued and criticised over the last generation. There’s lots of people it leaves out; there are lots of perspectives it doesn’t include. It tends to tell very naïve, triumphalist stories about the progress of surgery and the progress of medicine – not that those things are necessarily wrong but you need other perspectives and other dimensions. And what I loved was the idea, as I said, that you could tell every story, you could tell a story with history of medicine that would open up new perspectives on people’s bodies and the city that they walked through and the lives that they lived and the lives that their ancestors and maybe the life that their descendants would come to live.

Epiphanies: Richard describes his own public engagement ‘epiphany’ and the thrill of sparking an interest in others.

Fellow and anti-Fellow

KF:         I don’t know what it’s like on the history side, about how people feel about the sorts of communication that you do, but certainly we’ve still got a little way to go in medicine yet, before you can see that communicating the things that we do, so that people understand what we do and why we do it, is almost as important as doing it.

RB:         There’s more of a tradition in the humanities of scholars writing books. So there is a slightly more a priori sense that there is an audience out there to be communicated with. But I think there is exactly that same sense that the true work of scholarship is primary research and even teaching is – it’s not looked down upon but it’s seen as secondary to that.

KF:         Well it’s seen as a distraction from the business of doing the research.

Richard talking about gin at an event in Wellcome Library, Jan 2012

RB:         Yes, and I’m afraid that being a contrary person, I always found the bits round the edge far more interesting than the bits in the middle. So it was teaching, engagement and writing for the public that grabbed me. And the impulse for me fundamentally comes from the fact that it’s really enjoyable. I love doing this, it’s great to be up in front of an audience or writing for them, and it’s great to engender that feeling of curiosity and it’s great when somebody takes exception to it as well. There’s nothing better than a good argument with somebody who’s got their own view and maybe you convince them, maybe you don’t, but it’s great to have inspired, and perhaps even infuriated, somebody to the point where they want to take you up on something.

KF:         That’s true. The thing I wanted to finish off with was that I remember when we were appointed [to the Engagement Fellowships] and I thought, “Gosh, if you were looking for my anti-character, it’s probably Richard Barnett” – in terms of your interests, you know: I’m out there looking at cross star fields wondering where we will next boldly go and –

RB:         And I’m in the library.

KF:         Well, steeped in the history of this thing and my knowledge of history is woefully poor, but –

RB:         I’m not so good on star fields myself.

KF:         But I’ve realised that the thing that links them is they’re both explorations, aren’t they?

RB:         It’s a funny thing. There’s been a lot of work in the history of medicine recently, and in history generally, about imperialism and about Western explorers. And the conclusion of this is, basically, that when Westerners go exploring, people get hurt: generally powerless people, they get enslaved, they get killed, they get driven off their lands, they get told they weren’t here first. So the word ‘exploration’ raises the hairs on the back of my neck a little and I go, “Well, what if we just make all the same mistakes that our imperialist ancestors made?” But it’s difficult not to use these metaphors of travel: it’s a voyage, it’s an exploration, it’s a journey. It has something of that quality to it but I’d say I’m a kind of slightly troubled explorer, as it were.

KF:         Troubled or otherwise, you’re probably still an explorer.

RB:         Well, we all are, I’m sure.

Kevin and Richard have guest-curated an event at the Royal Institution tomorrow night (28 February): ‘From iron lungs to intensive care’ will investigate the history – and future – of intensive care.

Applications are open for the second year of Wellcome Trust Engagement Fellowships. See our website for more details – the closing date for preliminary applications is 30 March 2012.

Image credits: Wellcome Images; Tate Collection (Turner painting)