May 2019

OUTSIDE THE OR

Ophthalmic historians share why they look at the past


by Liz Hillman EyeWorld Senior Staff Writer

“History is part of our heritage and our perspective on what we do. When we lose touch with it, we lose touch with where we’ve been, the mistakes we should not repeat, what good things we should try to remember.”
—Michael Marmor, MD


“Nothing is esteemed of consequence but that which contains something new. But in catching at the new, how often we risk losing that which is old, well-grounded and far better.”
—Eugene F. Cordell, MD1

Why do baby boys wear blue? This question from one of his children led George Bohigian, MD, down a research trail that would ultimately get him interested in various topics of ophthalmic history. He learned that people, especially in Middle Eastern and Mediterranean cultures, used to wear blue beads because it was thought to ward off evil. In these cultures, Dr. Bohigian explained, blue eyes were unusual and thus thought to be evil.
From there, Dr. Bohigian became interested in symbols in medicine and ophthalmology. Rx, for example, is thought by some to come from the Eye of Horus, the Egyptian symbol of healing. OS, the abbreviation for left eye, stands for ocular sinister because the left was thought to be the evil side, Dr. Bohigian said.
At the 2019 Cogan Ophthalmic History Society meeting, Dr. Bohigian presented on the symbol of medicine: the staff of Aesculapius with one snake coiled around it. Dr. Bohigian called this the true symbol of medicine but explained that the caduceus, which has two snakes coiled around and a set of wings, a symbol of the god Hermes, is often confused as such. Aesculapius was a Greek demigod healer, and the snake in ancient medicine was of interest due to its ability to shed its skin and regenerate.
“Past is prologue, as Shakespeare said, because the stuff in history gives you a guide to the future; also, it gives you appreciation of the present,” he said.
For Michael Marmor, MD, an interest in medical/ophthalmic history goes back to college where his advisor was a historian of science and where he majored in mathematics because it had the fewest requirements of the sciences and left him time to explore courses in the arts, history, and humanities.
“History is part of our heritage and our perspective on what we do. When we lose touch with it, we lose touch with where we’ve been, the mistakes we should not repeat, what good things we should try to remember,” Dr. Marmor said.
Dr. Marmor said his historical interests are in scientific ideas—how the retina works, how the eye as a whole works, how the eyes of animals work—and history of the arts.
“It takes us out of our shells and into the world of why we do some of the things that we do,” he said, adding, “arts that interface with ophthalmology are of special intrigue.”
Dr. Marmor recalled one of the first topics of ophthalmic history that he addressed professionally. It was in the 1970s when he was new at Stanford and his neighbors were political scientists who studied President Woodrow Wilson. President Wilson had a hemorrhage in one eye while he served at Princeton University, which led some critics to “read into all sorts of ominous signs into an ophthalmic event (likely a vein occlusion) that is not rare in people with vascular disease,” Dr. Marmor said.
“I began to talk about this with my colleagues to clarify the history,” Dr. Marmor said, adding later, “I’ve taken the time [to research topics in ophthalmic history] when I thought there was something important to say. In Wilson’s case, it was to correct false implications about whether he had strokes early in his career, which I doubt.”
Dr. Bohigian said medical/ophthalmic history was not part of his medical schooling or training, but it’s something in which he thinks more programs are showing interest.
“Now many of the universities and medical schools have courses on the history of ophthalmology. It’s becoming more popular,” he said. “I think people want to know what’s behind the current facts and how things came up. … Present medical students and residents may not have a lot of time to look up the past, but it gives you a feeling that we’re connected, and it’s also a kind of guide to the future.”
Dr. Marmor said he has tried to encourage an involvement with history and the humanities in medical school but recognizes that it is difficult for medical students to find time to integrate awareness of the humanities. Still, that doesn’t diminish its importance.
“Humanities are important to make well-rounded doctors, and well-rounded doctors are better doctors. … It makes for physicians who are more than just technicians,” he said.
Studying medical history gives you a “sensitivity to the origins of the ideas that drive you professionally,” Dr. Marmor said. “You might find that a discovery you thought was new was actually discussed a century ago, and that makes you more critical.”
In terms of the arts, he said, “you have knowledge about the eye, how it works, and how you can treat it. This may help you understand a painter or help you to treat someone who is a musician and is losing vision … or may give you a better appreciation in the visual wonders of different artists when you put this knowledge into context.”
Studying medical history, Danny H.-Kauffmann Jokl, MD, said gives students an appreciation for those who had a vision for how something could be done differently in the field and who persevered to see that vision through to completion. It provides an appreciation for how “the things we take for granted have evolved,” Dr. Jokl said.

About the doctors

George Bohigian, MD

Professor of clinical ophthalmology
Washington University School of Medicine
St. Louis

Danny H.-Kauffmann Jokl, MD
President
Cogan Ophthalmic History Society
Associate clinical professor of ophthalmology
Columbia University
Medical Center
New York

Michael Marmor, MD
Professor emeritus of
ophthalmology
Stanford University School
of Medicine
Stanford, California

Contact information

Bohigian
: g.bohigian@gmail.com
Jokl: dhj6@cumc.columbia.edu
Marmor: marmor@stanford.edu

Reference

1. Cordell EF. The importance of the study of the history of medicine. Med Library Hist J. 1904;2:268–82.

Financial interests

Bohigian: None
Jokl: None
Marmor: None

About the Cogan Ophthalmic History Society

The Cogan Ophthalmic History Society was originally founded in 1988 by David Glendenning Cogan, MD, as the American Ophthalmic History Society. It was renamed in honor of Dr. Cogan, an ASCRS Ophthalmology Hall of Fame inductee, after his death. The society meets each year, and participants present papers on ophthalmic medical history.

Ophthalmic historians share why they look at the past Ophthalmic historians share why they look at the past
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