Samantha Clarke

 “The medical profession is the world’s greatest fraternity: wherever a doctor may go in civilized society, he is welcomed by his fellow doctors… As disease itself is no respecter of national or racial differences, so the doctors in their humane service do not respect them… Though methods of treating injury and disease may differ in different lands, the aim is everywhere the same – the mitigation of human suffering, the saving of human life. On that humane purpose is firmly based the vast brotherhood of the doctors of medicine.”
-Walter Cannon

Every historian who has ever given me guidance on archival research has emphasized the value of serendipity (thanks to the archivists who have accrued, sorted, cared for, and catalogued the documents, and to whom I am forever indebted as a historian) in the archives.[1] I’ve taken this advice as an excuse to procrastinate by reading through five years’ worth of journals that, quite frankly, have very little to do with my dissertation. I study poliomyelitis in postwar divided Germany, and came across the American Review of Soviet Medicine while looking for East German and Soviet scientists’ research on polio vaccines. Spoiler alert: the journal does not have any useful articles on polio vaccines. Instead, what follow are my initial observations about how terribly wrong Walter Cannon was about the firm foundation of the “vast brotherhood of doctors of medicine.”

In the inaugural issue of The American Review of Soviet Medicine (ARSM) printed in 1943, Harvard physiologist Walter Cannon referred to the medical profession as “the world’s greatest fraternity.”[2] Cannon opined that physicians’ commonalities transcended state borders and international politics. While most medical historians will concede that physicians’ groups hold a privileged position in society, we are divided about whether doctors’ collective values transcend state lines. Some medical policy researchers, such as Michael Karlsson, K. Grill and S.O. Hansson, adhere to Peter M. Haas’ theoretical conception of “transnational epistemic communities,” where doctors have a shared knowledge base and foundational beliefs, regardless of national context.[3] Alternatively, sociologist Sydney Halpern discusses “indigenous morality” whereby actors are “embedded in communities that frame moral issues” – these communities are dictated by individual states’ histories and policies about healthcare, health insurance, and ethics.[4] Though it only lasted five years, ARSM gives a glimpse into Soviet-American medical relations from 1943 to 1948, showing that, even before political-ideological differences severed the connection between doctors in the two countries, the two groups of doctors were not as unified as Cannon and others might have liked to believe, and imbalances in perceived and real power were already visible.

ARSM, though short-lived, was not an exercise in futility or the invention of a radical, unimportant sect of society. The journal was started by the American-Soviet Medical

H.E._Sigerist_1934
H.E. Sigerist, 1934. Bulletin of the History of Medicine, Band II (1934), No 10, 584. Wikimedia Commons. 

Society, under the leadership of medical historian and director of the Johns Hopkins University Institute of the History of Medicine Henry E. Sigerist.[5] Sigerist was highly respected for his expertise on socialized healthcare systems. He worked with Saskatchewan Premier Tommy Douglas on Douglas’s Medicare proposal in 1944, and even appeared on the cover of Time magazine in 1939, the same year as Eleanor Roosevelt and Winston Churchill.[6] He was far from a crackpot leftist, as Senator Joseph McCarthy and the fiercely anti-socialized medicine American Medical Association would later portray him. The journal itself was the result of an agreement in 1943 between the Soviet government and the United States Department of State to share information on “certain aspects of medical research of mutual interest.”[7] This decision came in the context of the Grand Alliance during World War II, and would quickly break down after the Armistice was signed. Nonetheless, the journal enjoyed significant readership during its tenure, and, using the revenue from the journal, the editors were able to create a large library of Soviet medical literature.

Inherent in the format of the American Review of Soviet Medicine was American doctors’ belief that they were in a position to judge whether Soviet research was important and/or correct. In the first two years of the journal, American doctors expressed frequent surprise at how well Soviet medical research has developed. Wilder Penfield quipped in 1943 that “the discovery that the Red Soldier is receiving such satisfactory surgical treatment is apparently as surprising… as the evidence of military efficiency on the part of the Red Army.”[8] Despite Penfield’s positive assessment, later correspondents relished opportunities to emphasize Soviet medical researchers’ lack of technology and mechanized equipment, as well as unfounded therapeutics like treating shock with an intracisternal injection (i.e. injected into a patient’s spine) of potassium phosphate.[9] As well, even more positive accounts of Soviet medicine carry a tinge of Mariah Carey, such as one article which praises Soviets because “They know our work far better than we know theirs.”[10] American visitors were simultaneously surprised Soviets were not stuck in the Stone Age, but emphatic that the USSR had not yet advanced to match the expertise and mechanization of their American counterparts, and therefore positioned themselves as the pinnacle of progress in medicine.

A major wrench in Cannon’s plan for an international fraternity of physicians was the large number of female physicians in the Soviet Union. Sigerist had already remarked on this trend in his 1937 standalone book, Socialized Medicine in the Soviet Union, and in 1943, Michael B. Shimkin noted that of 19,550 medical researchers at 223 research institutes, 60% were female.[11] Even more startling (and appalling) to American observers, women physicians accounted for half of the physicians in the Red Army and

Lina_Solomonova_Stern_(1878-1968)_(12484743704)
Lina Stern. Acc. 90-105 – Science Service, Records, 1920s-1970s, Smithsonian Institution Archives. Wikimedia Commons. 

were often required to do hard labour on the front lines.[12] Nonetheless, female medical researchers faced a glass ceiling in ARSM. Female army doctors were described by Americans as “tall and gaunt” or “stocky and sturdy” – contravening norms of femininity.[13] When speaking generally about healthcare professionals, American reviewers without fail use male pronouns when discussing “doctors” and female pronouns when discussing “nurses”. Few publications came from female researchers, and though the journal frequently featured brief biographies on well-known Soviet physicians, only one woman was profiled. That woman, Lina Stern, discoverer of the blood-brain barrier, was described in the biography as “an attractive and very lively woman.”[14] The biographies of men did not contain assessments of their physical appearance.

What emerges from the American Review of Soviet Medicine is not an inspiring story of two groups of individuals coming to support and accept each other just the way they are, to form an epistemic community to push for the best health for all individuals regardless of ideological background. Instead, it is a story of limitations: financial, political, and gendered. By January of 1948 Henry E. Sigerist was forced to conclude his transnational experiment, citing low readership due to “reasons which are so obvious that we need not elaborate on them.”[15] He also retired from his position at Johns Hopkins University. The United States of America and the Soviet Union entered into an era of mutual distrust which even new international organizations like the World Health Organization could not bridge. This period of intense isolation would last until the USSR re-joined the WHO in 1955.

The other unfortunate part is that this story, while interesting and novel, does not quite fit into my dissertation. For one thing, it’s not about polio and for another, it doesn’t have much to do with Germany. What I plan to do instead is to write an article examining medical journals designed to target transnational audiences in the postwar period, which are not as rare as you might think. For example, the American Medical Association published Medical Service, distributed globally by the U.S. Department of State to “give doctors… the world over the benefit of the latest U.S. medical developments,” which just reeks of exceptionalism.[16] As well, in 1956, German physicians published the first edition of German Medical Monthlyin English, a “natural common language,” to restore German doctors’ reputations after their participation in medical atrocities and genocide during the Third Reich.[17] Doctors used these medical journals to spread a curated representation of their nation’s medical research, giving a glimpse into how they viewed their own national role in this (imagined) transnational epistemic community. I’m rather excited to procrastinate on my dissertation project and explore these themes (sorry supervisors!).

 

Samantha Clarke is a PhD candidate at McMaster University, specializing in Cold War medical history and international relations. Her dissertation examines how the fight against poliomyelitis fit into international and transnational relations between divided Germany and its occupiers between 1947 and 1965. She completed her B.A. (Hon.) at McMaster, and her MA at Western University. In her free time, Sam grows too many plants and feeds them to her rabbit.


NOTES

[1] The secondary literature on ARSMshows I am not the only one who experienced a moment of serendipity upon finding the journal. Richard E. Kerber notes “Research is an exercise in serendipity” at the beginning of his very brief article, “A USA-USSR Experiment in Medical Journalism: The American Review of Soviet Medicine” in American Communist History

[2] Cannon is best remembered for coining the term “fight or flight.” Cannon, qtd. in Henry E. Sigerist, “On American-Soviet Medical Relations,” American Review of Soviet Medicine5.1. (1948): 5.

[3] Michael Karlsson, “Epistemic Communities and Cooperative Security: The Case of Communicable Disease Control in the Baltic Sea Region,” Journal of International and Area Studies 11.1 (June 2004): 79-100.; K. Grill and S.O. Hansson, “Epistemic Paternalism in Public Health,” Journal of Medical Ethics 31.11 (November 2005): 648-653.

[4] Sydney A. Halpern, Lesser Harms: The Morality of Risk in Medical Research (Chicago: The University of Chicago Press, 2004), 9.

[5] According to Walter J. Lear, the American-Soviet Medical Society contained liberals, pro-peace political independents, and, of course, “staunch supporters” of Soviet communism. Walter J. Lear, “Hot War Creation, Cold War Casualty: The American-Soviet Medical Society, 1943-1948,” in Making Medical History: The Life and Times of Henry E. Sigerist, ed. Elizabeth Fee and Theodore M. Brown, 259-287 (Baltimore: The Johns Hopkins University Press, 1997), 263.

[6] Obligatory reference to Canada: accomplished.

[7] A. Baird Hastings and Michael B. Shimkin, “Medical Research Mission to the Soviet Union,” ARSM3.5 (1946): 453.

[8] Wilder Penfield, “The Recent Surgical Mission to the USSR,” ARSM1.2 (1943): 169

[9] Stuart Mudd, Robert Leslie, Mrs. Stuart Mudd, “Our Visit to the USSR,”ARSM4.1 (1946): 95.; Hastings and Shimkin, “Medical Research Mission,” 465.

[10] “Society News and Notes,” ARSM4.4 (1947): 375.

[11] Henry E. Sigerist, Socialized Medicine in the Soviet Union(New York: W.W. Norton, 1937).; Michael B. Shimkin, “Medical Education in the Soviet Union,” ARSM1.2 (1943): 475-476.

[12] “Women Physicians at the Soviet Front,” ARSM2.6 (1945): 566.

[13] Penfield, “The Recent Surgical Mission,” 170.

[14] Henry E. Sigerist, “Lina Stern,” ARSM 1.1 (1943): 560.

[15] Henry E. Sigerist, “Editorial,” ARSM5.3 (1948): 162.

[16] Charles P. Arnot, “Amerikadienst (US Information Service),” OMGUS Weekly Information Bulletin 168 (August 1949): 5. PSA: if you ever find yourself in a position to name a journal, please don’t name it something so mundane that makes it unGoogleable.

[17]“Mission Statement,” German Medical Monthly 1.1 (January 1956): 1.

 

Cover Image: “Nurse attending wounded in Soviet military hospital,” 1962. Wikimedia Commons.