Would you Rather See a Surgeon Today, or in the 1700s?Kristina Schaufele reflects on historical biases in medicine and the need to understand the past for progress in patient care and addressing disparities.
Would you rather see a surgeon today, or in the 1700s? Hopefully your answer is a resounding “Today!”, similarly to how us Huang Fellows responded to Dr. Jeff Baker’s first question upon our arrival in the Rubenstein Rare Book Library. While we were taken aback by the apparent simplicity of this question, as Dr. Baker reveals, it represents the critical role of history in medicine. I have found that we don’t often think of medicine in the context of the past, but rather the future: improving our health, predicting outcomes, and developing new procedures. Moreover, we commonly reflect that more time equals more scientific progress. Dr. Baker encourages us to realize that how we perceive human anatomy and the practice of medicine has shifted over time, and challenge the conception that progress is linear.
At least to me, the human body had seemed relatively constant and objective in the context of human history. After all, revolutionizing our technologies – from the printing press to the iPhone – and supersizing our structures – from the water well to the Empire State Building– seemed like drastic changes in comparison to the average human height increasing 10 centimeters over the past two centuries. It was difficult for me to imagine how we perceive and utilize medicine could have changed significantly in comparison. Yet historically, medicine included more than treating what we see as our physical human anatomy. Charting human anatomy and caring for patients often included metaphysical beliefs and the perceptions of the doctor.
In fact, the medieval tradition of medicine revolves around a more intangible concept of health: hubris, a term used to refer to the intrinsic, natural balance of our bodies. If you were sick, it meant your hubris was out of balance, and a doctor would be entrusted to return your body to its natural hubris. This was typically measured by fluid production; Dr. Baker proudly demonstrated various filters, oddly shaped cups, and blood-letters designed to support doctors in this role.
Progressing into the 16th century, doctors began to create and utilize anatomical illustrations that resembled works of art. One of the most famous textbooks of Renaissance anatomy, De humani corporis fabrica (1543), contained detailed pictures of a surgeon excavating a human body and drawings of human skeletons in remarkably flamboyant and playful poses. One skeleton was hunched over with their hand fingering a human skull, seeming to ponder human existence. While medicine had progressed at this point to include anatomical depictions, Dr. Baker stressed that the human body was being painted as a mechanical work of art. These physicians did not break the body down into the strict biological language that we see in textbooks today.
What shocked me was that as the practice of medicine developed into the 18th and 19th centuries, its structures favored the aims of the doctor over the needs of the patient. As an enthusiastic pre-med student, I had originally perceived these two goals as reconcilable. After all, isn’t the most intrinsic tenant of medicine to help people? Yet as dissections became popularized to understand anatomy, doctors began to exploit the imprisoned, poor, and generally underprivileged. The 18th century featured a period of “body snatching” for medical dissection, which encompassed plundering corpses from prisons and executions. During the French Revolution, the government gave control of the hospitals to the doctors, effectively expanding their ability to perform dissections on the corpses of the poor. As Dr. Baker remarked, France became “a great place to be a doctor, but an awful place to be a patient.” As doctors began to connect physical symptoms and classify disease, they also began to overwhelmingly objectify patients to do so. Although our understanding of anatomy was progressing, I would not call this period one of progress.
These methods of classification turned uglier as anatomical measurements of the brain were used to justify cognitive ability, especially to disparage racial minorities and women. Dr. Baker displayed a diagram labeled Types of Mankind, which used the size and shape of skulls of different races to claim that each race originated from a distinct ancestry, and in turn justify white superiority. While our lesson with Dr. Baker ended in the 19th century, we know that racial discrimination has persisted in healthcare, as demonstrated by notorious events like the Tuskegee syphilis study and the general apprehension of health professionals by marginalized groups.
Although human anatomy and the principles behind medicine seem to be objective, our investigation with Dr. Baker revealed how biases can be inflicted into these processes. It astounded me that historically, medical anatomy didn’t have to involve seeing what was physically there. I had previously found advancing anatomical study and improving healthcare as inextricable goals, but the reality is that surgery revolutionized our understanding of physical anatomy before improving patient wellbeing. As an aspiring surgeon, I find it important to point out these misconceptions in medical history. The public good of anatomical discovery does not justify disparaging the needs of an underprivileged individual, medicine is not always an objective science, and finally, scientific progress is not linear. Before we rush ahead into the future of medicine and scientific discovery, it is important to recognize how these practices emerged, and that the path we are embarking upon is truly propelling us forward – not just forward in time.
Kristina Schaufele, Huang Fellow ’26
Kristina is a first-year student from Atlanta, GA, pursuing a major in biology and a minor in computer science on the pre-med track.