Literary Medicine’s Daily Dose: Featuring Richard Barnett

Welcome to Literary Medicine’s Daily Dose, companion to the Fiction Reboot!

Today, I am pleased to feature Richard Barnett, the voice behind the Sick City podcasts! A medical historian, teacher, poet, and researcher, Richard is currently a Wellcome Trust Engagement Fellow.

Welcome, Richard!

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BIO

Richard Barnett dropped out of medical school in London to become a historian. He has taught the history of science, medicine and evolutionary theory at the universities of London and Cambridge, and was a judge for the inaugural Wellcome Trust Book Prize. His writing has appeared in Strange Attractor, The Lancet, The London Magazine, Time Out, The Natural Death Handbook (fifth edition, 2012), and he received the 2006 Promis Prize for poetry. His first book, Medical London: City of Diseases, City of Cures, was published in 2008, and was a Book of the Week on BBC Radio 4. He is currently a Wellcome Trust Engagement Fellow, and an Honorary Research Fellow in the Department of Science and Technology Studies, UCL. He spends his time writing, walking, talking and broadcasting his way around the history of life and death in London.

You can follow Sick City on Twitter: @SickCityProject and @doctorbarnett

Interview

1. Like so many medical humanist academics, I work most often between fields rather than in one particular research niche. Could you talk a bit about how you perceive your recent work (Sick City, Natural Death, any other you would like to mention)? How did you come to these projects?

It used to be said that opera was the greatest form of art, because it brought all other arts – dance, music, theatre, painting – to their highest states. For me, the medical humanities are the opera of academia. One of the great joys of working in the medical humanities is being able to leap across boundaries and make new connections – not only between disciplines, but also between the world of scholarship and the public sphere. I’m just coming into the second year of a Wellcome Trust Engagement Fellowship, which has provided a fabulous opportunity to devote myself full-time to public engagement work, and in all the world there’s no better place to start teasing out the relationships between the personal and the political, the body and the mind, the inner and the outer worlds. I think of myself as primarily a medical historian, and in its recent incarnations the history of medicine is fundamentally interdisciplinary – a loud and always-packed coffee-house at the crossroads of the arts, the humanities, and the social and biomedical sciences.

All of my projects have begun as chance encounters in this coffee-house, and I’ve been very, very lucky in the people I’ve worked with, the places in which I’ve been able to study and teach, and – most of all – simply being in the right place at the right time. When I was becoming disillusioned with life as a medical student, for example, I was extremely fortunate that UCL happened to have one of the world’s leading history of medicine departments, where I could spend some time and work out a different way of approaching all the questions I had. And my interest in public engagement came, initially, from wanting to overcome the incapacitating stage-fright I suffered until my mid-twenties. Writing and leading guided walks, starting to feel at ease in front of an audience, even learning to take pleasure in performance and telling a good story – all of this gave me the confidence to teach, and to share my questions with the world beyond the college gates.

Likewise, my first major public engagement project, and my first book – ‘Medical London’ (2008) – was the result of being the right person in the right place at the right time. I was writing up my PhD and, simultaneously, searching for a new project to take me as far away as possible from the history of pain relief in childbirth under the NHS. At the same time Wellcome Collection wanted to commission a new popular history of medicine, and so I got to collaborate with Mike Jay, freelance historian extraordinaire, and Mark Pilkington of Strange Attractor Press. We made a genuinely beautiful object – a slip-cased set of maps and books, with artwork by Ali Hutchinson of Deer Wolf Wolf – and my essays on London’s history were read as a Book of the Week on BBC Radio 4. ‘Medical London’ has given me what may (if I’m lucky) turn out to be both a passion and a career: writing and talking about life, death, health, disease and the body in London’s history.

2. I am intrigued by the concept of Natural Death, not only because it seems a more environmental policy but also because it bears affinity to historical approaches to interment. Has your work on these physical aspects affected your psychological approach to death? Given that grief is one of our most primal emotional responses, do you think natural death offers more to the psyche than the science of preservation and decay?

 It’s funny you should put it that way. I turned thirty a couple of years ago, and suddenly mortality is beginning to bite a little. Not so much a new and vivid awareness of death itself – growing up, I witnessed a fair amount of death in my family, and as a medical student one is encouraged to develop a rather mordant sense of humour about it – but a sense that, as Philip Larkin put it, ‘most things may never happen: this one will’. Existence is not unlimited, and – well, to quote Larkin once more, ‘we should be careful of each other, we should be kind / While there is still time.’

Death is so central to the ways in which we live, and it seems to me that all culture can be read as the response of human beings to two deeply unsettling discoveries. First, the realisation that other people exist, and have minds and inner lives too, just like us in some ways, but profoundly unreachable in others. And second, the realisation that we’re mortal, that we won’t be here and thinking and feeling for ever. If you want to name the one thing that separates us from animals, it’s this awareness of the deep limitations on our existence. All creatures are in some senses trapped within themselves, and all creatures will eventually die – but we know it, and we have to live with it.

When you teach the history of medicine death is always loitering in the background, and my thoughts on this subject have been sharpened by writing a chapter for the new edition of the ‘Natural Death Handbook’ (fifth edition, 2012). Ru Callender – an undertaker working in Devon, and one of the most remarkable men I’ve ever met – asked me to write an essay unpicking the relationship between death and medicine in Western culture. The idea of ‘natural death’ is not about everyone expiring in pastoral splendour on a heap of rosemary in the middle of a wood. Rather, it’s about working together to provide dignity and agency in dying – whether that death takes place in a cutting-edge hospital or a tiny cottage.

When we encounter death in modern life, many of us find that modern biomedicine, while it has become expert in prolonging life and minimising physical pain, has also tended to silence, separate and isolate the dying, and likewise has made grief into something solitary and faintly embarrassing. There is no reason, absolutely no reason, why all the palliative benefits of modern medicine should not be provided in a setting which also allows the dying and their companions to draw the story of their life to a dignified, apt and natural conclusion. Whatever we think makes for a ‘good death’, we cannot expect one ourselves if we are not prepared to participate in the good deaths of our friends, neighbours, relatives and lovers. As our lives become longer, and our declines become slower, this will become a pressing question for us all.

3. I am, of course, a huge fan of the Sick City Project (having appeared on the talks myself!) The history of medicine, reaching to make connections to the modern, living human on the streets of London is necessarily a humanist undertaking. Can you say a bit about the impetus of this project?

History of medicine is certainly a humanist undertaking, but also (at its best) a democratic one. Good public engagement makes history open to all. It gives people a handle on their own histories and the wherewithal to hold science and medicine to account, to ask awkward questions about the way things are and how they came to be. By telling stories about things like life, death, health, disease, and the body, it reminds us of how much we hold in common: we all have bodies, and they all go wrong, and yet one of the truly inspiring things about human history is the astonishing variety of ways in which we’ve come to understand the pleasures and perils of the flesh.

There’s a rather lazy assumption amongst some academics that what ‘the public’ want from historians of medicine is gory stories and nothing more. Working with many different groups over the last seven or eight years has shown me that there’s an enormous appetite (and aptitude) out there for a more sophisticated take on medicine and its history – one that weaves the big ideas of historiography around places, people and stories. How, for example, could Foucault’s work be used to tell a new and politically potent kind of story about London’s ancient hospitals, workhouses and prisons? To do this you need both a grasp of the scholarly issues and a sense of how to bring them to life, how to make them gripping. This is the idea at the heart of the Sick City Project – the first major initiative to come out of my Engagement Fellowship.

The Sick City Project has two strands: Sick City Talks, a series of podcasts in which I interview some of the fascinating folk who work with London’s history, and Sick City Walks. Having built up an archive of more than twenty walks – exploring everything from revolutionary medicine in Clerkenwell to global science at Greenwich – I wanted to find a new way to make them available. So over the next year or so I’ll be adding self-guided versions to the Sick City Walks app (produced by Joanna Rahim of The Galton Lab and Will Tinsdeall of BCS Lichfield, and with graphics by Joanna Walsh, aka Badaude). This is a web app, so you don’t need to download it from an app store – just point your phone or tablet’s browser to www.sickcity.co.uk.

Those of us who work in engagement are sometimes reluctant to admit this, but public engagement is the most enormous fun. My job is writing and talking about the city I love, from the most exciting and illuminating perspective that scholarship has to offer. And a few times a week I get to go out and perform for all kinds of people in front of the greatest stage-set in the world – the City of London. In some ways, my working life has more in common with a one-man theatre company than with traditional academia, and I love it more than I can get across in words. Come on a walk with me, and you’ll see what I mean.

4. Finally, as someone who writes fiction as well as research, I am interested in your poetical work. I know we have joked often about setting aside time for the Sublime Academic (in the Romantic/Gothic sense)–but how do you balance the creative impulse with research? And where might these threads lead you in future?

 Well, the terribly boring and quotidian answer to your first question is that I get up early, make a pot of tea, and force myself to spend an hour or so reading or writing or rewriting poetry before I get on with the history. Otherwise it simply doesn’t happen. If I do this – and I don’t always, he typed shamefacedly – the structure and rhythm of the poetry usually makes a good warm-up for the different kinds of discipline required for academic work. An odd and rather practical distinction is that almost all my prose writing is done on a laptop, but the poetry – or at least the early drafts, in which the form and the content are still slugging it out – seems to demand longhand.

I don’t write overtly historical poetry or – God forbid – ‘poetical’ history, but the two do seem to spring from a single impulse. Poetry and history share the common currency of memory, and both are concerned with the ways in which our histories frame the momentary passage of our consciousness. Whether you think that ‘art is our chief means of breaking bread with the dead’, as Auden put it, or you share Eliot’s vision of poetry and prayer as a kind of communion with history, or you think with Wordsworth that poetry ‘takes its origin from emotion recollected in tranquility’, you find that Anglophone poets have so often returned to the idea of poetry as a historical enterprise – ‘memory-work’, as a psychoanalyst might put it. In my own writing, this emerges as a recurrent obsession with the sea, as a symbol of memory and particularly the unconscious – what surrounds us, what we have emerged from, what we will return to, and what strange and grotesque creatures may appear when we go out beyond the shallows.

And I think this speaks to something deeply imbricated in the collective life of our country. To the extent that we have a genuine and meaningful national identity, it is one fashioned from the chunks of history that litter our landscape, our politics and our minds. Like all national stories, this tale of ‘Britishness’ has the potential to be both liberating and infantilising. Poetry and historical enquiry are both tools with which we hack away at this moss-covered heap of stones – our patrimony – and see what, if anything, remains alive within it. Roots can be shackles, and perhaps the last words should go to James Joyce: ‘History, Stephen said, is a nightmare from which I am trying to awake.

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