For thousands of years, the treatment of illness involved some combination of superstition, trial-and-error, inadvertent torture, and just plain dumb luck. A treatment counted as effective if the patient survived.
Whatever doctors were doing before the middle of the 19th century, it’s hard to consider it medicine – certainly not by the standards of the 150 years or so since the advent of local anesthesia. Physicians have understood the principles of antisepsis for about as long, while aspirin was synthesized only in 1897. We are spoiled. Not for us the clinical technique of Theodoric of York -- the medieval practitioner Steve Martin used to play in a "Saturday Night Live" sketch – whose treatment for every condition included the draining of excess blood.
Comforting one patient’s mother, Theodoric reminds her of how far the healing arts had advanced as of 1303: “Why, just 50 years ago, they thought a disease like your daughter's was caused by demonic possession or witchcraft,” he tells her. “But nowadays we know that Isabelle is suffering from an imbalance of bodily humors, perhaps caused by a toad or a small dwarf living in her stomach.”
Insofar as Theodoric and his colleagues brought any book-learning to their practice, it came from the pen of the Greco-Roman philosopher and physician Galen, born circa 130 A.D. in what is now Turkey. Susan P. Mattern, a professor of history at the University of Georgia, does not exaggerate in calling her biography The Prince of Medicine: Galen in the Roman Empire (Oxford University Press). His posthumous career was, if anything, one of almost regal authority.
An earned authority, just to be clear about it. Galen had an ego the size of the Empire itself. He never tired of pointing out the abject ignorance of other physicians, and was prone to quoting tributes by illustrious people to his own erudition and skill. It is not charming. But Mattern shows Galen to have been tireless as both a practitioner and a scholar -- and his output of treatises, case histories, popular textbooks, and editions of Hippocrates and other medical authors was astounding. “The most modern edition of his corpus runs to 22 volumes, including about 150 titles,” writes Mattern, “and is one-eighth of all the classical Greek literature that survives.”
Tireless in his efforts to accumulate, compare, and synthesize the recorded medical knowledge of previous centuries, Galen also conducted a great deal of anatomical research (including animal vivisection) to test the theories of the day. In his 20s, he did the second-century equivalent of a residency as the physician-on-call to the gladiators of his hometown. A standard treatment for open wounds was to bathe them in hot water, followed by a plaster made of boiled flour, which Galen reports as totally ineffective – crippling, when not lethal. By contrast, he “soaked linen cloths in wine and placed the folds on the wounds,” the biographer says, “covering the cloths in soft sponges which he moistened day and night.” Whether or not the technique saved the lives of all the gladiators in his care during his first year (so Galen claimed) he definitely understood the antiseptic property of alcohol.
Opening a practice in Rome, he distinguished himself in the constant, cutthroat battle of reputation among physicians, both for his skill in diagnosis and treatment and his erudition. He seems to have been acutely sensitive to changes in a patient’s pulse and body temperature. “Long before laboratory testing,” Mattern writes, “he examined urine and feces, sweat, sputum,” and “vomit, pus, and blood for color, texture, viscosity, and sediment.” Galen’s case histories show he “scruitinized his patients’ faces for signs such as change in skin color or the shrunken eyes of wasting or extreme dehydration.” And he knew how to interview patients about their history and symptoms with more finesse than you can expect from one HMO that I could name.
Mattern stresses that Galen was also an exemplary product of Hellenistic culture – urbane, deeply familiar with Greek philosophy and literature as well as the medical authors, and capable of writing in either a matter-of-fact or a high-flown style as the circumstances required.
She notes that we have no evidence that Galen bothered to learn the language of the Empire. He wrote in Greek and did not cite Latin authors, and his reputation took root among the aristocracy, for which familiarity with Greek was the sine qua non of intellectual sophistication. Medical science in particular was a fashionable topic, and a number of Galen’s works were composed as memoranda or instructional guides for the amateurs in his entourage.
The audience for Galen’s work was not limited to the scroll-buying public. He had also learned the arts of oratory and debate practiced by the sophists -- and his encounters with other physicians were brutal rhetorical showdowns, as were his lectures on anatomy, during which slaves held down monkeys and livestock as Galen and his opponents cut them open to demonstrate their points.
Much of it was done in the street. At one point while reading the book, I got an image of the Prince of Medicine crossing paths with the adherent of some medical philosophy he opposed -- the Empiricists, say, or the Dogmatists -- and performing dissection battles while surrounded by their respective crews (students, patients, slaves, aristocratic fanboys, etc.) as well as random passers-by. Like break-dancing, in togas, with gallons and gallons of blood.
It did not hurt Galen’s reputation that he had inherited considerable wealth and could refuse payment for his services. He disdained the very idea of practicing the divine art of Asclepius (the god of medicine who had visited Galen’s father in a dream to provide vocational guidance on the boy’s future) for money. This, too, had its rhetorical side: it meant he could cast aspersions on doctors with more worldly motivations than pursuit of the pure good of healing.
In his writings, Galen expressed reluctance at being summoned by the emperor, Marcus Aurelius, to serve as court physician. He accepted, of course (it was an offer he couldn’t refuse) and was also retained by the succeeding emperors. Mattern suggests that there may have been more to his professed misgivings than thinly disguised braggadocio. Whatever the boost in prominence, the position also meant less autonomy.
Self-aggrandizing as Galen’s devotion to medicine may have been at times, the biographer calls him “a surprisingly pious man,” fascinated by the “cumulative and overpowering evidence of an intelligence at work” in the animals he dissected in hopes of understanding the human anatomy. This made him one of the more appealing pagan thinkers for adherents of the three major monotheistic religions, who translated them into Hebrew, Latin, and Arabic. A number of his works have survived only because Islamic scholars translated them, although it’s entirely possible that the original Greek texts may yet resurface. As recently as 2007, Galen’s treatise “On the Avoidance of Pain” – long presumed lost in any language – turned up in a Greek monastery.
His biographer points out how unfortunate it is that Galen never challenged the medical value of bloodletting – a practice that continued for so long that historians have wondered if it perhaps have had therapeutic value in treating something, though it could prove fatal when done with a shaky hand.
“While it is perhaps wrong to blame him for failing to break from a tradition that his followers, including the great physicians of the Islamic Middle East and of the European Renaissance and Enlightenment mostly did not question,” writes Mattern, “one wishes he had turned his scorn on this therapy” instead of on the “three-day fasting cure” promoted by some of his peers. “For while Galen did not invent bloodletting, he had the power to consign it to oblivion.”
Maybe he did change his mind, but history lost the memo?
It’s been a few weeks since "The Heart of the Matter," the congressionally ordered report on the state of the humanities and social sciences, was issued by the American Academy of Arts and Sciences. And while there is little to object to in the actual text, which brims with veracities on the importance of education and good citizenship, the smarting hasn’t stopped.
In The New York Times alone, we heard from three pundocratic naysayers. David Brooks, a member of the commission, bemoaned the collective suicide of the humanities professoriate, Verlyn Klinkenborg lamented the decline and fall of the English major, and Stanley Fish excoriated the report itself for its "bland commonplaces" and "recommendations that could bear fruit only in a Utopia" (and as a Miltonist, he knows that’s not the world we live in).
There have been valiant attempts to parry this latest volley of gloom regarding the "crisis of the humanities."
But even if "our classrooms remain packed," that still leaves the population at large. And there, a basic contention remains unanswered: the, by now, self-evident truth that the humanities are a "public relations failure" (Fish ventriloquizing Klinkenborg). Humanists are just no good at explaining why their work matters. No wonder, then, that the public has little use for their efforts.
The marketing problem is such a commonplace in the debate, it goes virtually unremarked these days. But to me, it raises a very basic question: why is it the job of a humanist to be her own advertiser? Other creative types have managers, agents, and publicists for that task, to say nothing of film studios, theaters, galleries, and museums – infrastructures, in other words, that allow them to focus on what they do best.
What would such an institution look like for humanists? As it happens, I help lead one. The Chicago Humanities Festival, which I serve as artistic director, is the largest organization of its kind in the United States. In fact, we were name-checked as such in "The Heart of the Matter," praised for our success in "inviting academics and artists to share their passions and expertise with new audiences."
We’re in our 24th year of doing so. Our annual fall festival features about 100 events, always organized around a theme. Attendance is around 50,000, with hundreds of thousands more consuming our content digitally. Not your average public relations failure, we like to think.
But how do we do it? How do we get thousands of people to come out to hear humanities professors lecture?
It’s really quite simple: we treat our presenters as stars and our events as performances.
It’s probably best to think about this mode of operation in contrast to your typical university programming. Sure, those lectures are free and open to the public. But how would that public even know? Dreary leaflets on campus bulletin boards aren’t likely to draw general audiences. Nor would such crowds feel particularly engaged by often dry and specialized presentations. (I should hasten to add that in my other life as a university professor, I can get quite excited about an earnest announcement circulating on a listserv; but then again, I’m already sold on the product.)
Everything we do at the Chicago Humanities Festival is designed to break those kinds of barriers. We write tantalizing copy for our events, place our ads in all the local media, and hustle for coverage in those same publications.
And we make sure that our featured talent appears in the best light possible. We think about stage sets and backdrops and fuss endlessly with our sound systems. Even more importantly, we spend a huge amount of time thinking about the best way to showcase a speaker. Is the great Harvard historian we invited known to go on and on when lecturing? No problem, we feature him in conversation with that gentle, yet firm journalist who has a deep passion for his subject. Is there worry about the density of a speech on continental philosophy? We coach the presenter in the joys of multi-media.
When it all works out, we get big, expectant audiences who, after basking in the erudition of our speakers (and asking sometimes stunningly insightful questions), can’t wait to come back for more.
This isn’t so different from the way other cultural organizations operate. Let me take an example from the world of opera, another domain whose utility could seem suspect in the glare of neoliberal scrutiny. When soprano Anna Netrebko was scheduled to make her Chicago debut in the 2012-13 season, it brought shivers of anticipation to local opera fanatics. But for a good chunk of Lyric Opera’s patrons, she was just a Russian-sounding name. It was the task of the company to create the appropriate excitement for her bow as Mimì, to say nothing of providing her with all the theatrical props needed for an optimal performance. The result: a sold-out run and something approaching collective hysteria (of the good kind).
Why should it be so different for humanists? Sure, in the academy we recognize folks like Julia Kristeva, Frans de Waal, and Maria Tatar as stars (to mention three of the speakers who will join us for this fall’s festival on Animal: What Makes Us Human). But just like your average opera diva, they need a bit of professional marketing and a decent production to find and captivate their audience. As a performing organization in the humanities, that’s our job. And after 24 years, we know how to do it.
Matti Bunzl is artistic director of the Chicago Humanities Festival and professor of anthropology at the University of Illinois.
If you were a casual reader of American newspapers, you would think that the fate of the humanities was in doubt. Polishing off a 30-year-old critique, most famously offered by Allan Bloom in 1987’s The Closing of the American Mind, an acerbic corps of doubters – David Brooks of The New York Times is in the vanguard -- wonders if scholars of literature have lost their way, substituting politically chosen texts for classics, stripping away the basic function of the humanities, defined gloriously as: to help us make sense of our world. Enrollments are down, they note, which means that students are shifting their efforts into the sciences, or business, or technology. The doubters want us to believe that the wonderful dreamers who once taught at Chicago or Penn or Yale are, sorrowfully, gone.
This skeptical cohort is often partnered with another, angrier, and more politically active group, which questions whether a college degree is even worth the money these days. Hack the degree, they say. Take a MOOC. If you have to go, enroll at Stanford, or choose your major based on your starting salary after graduation. This platoon of nail-biters and shouters asks us – the big "us," that is, our fractious national family – to distrust the words of tenured radicals, to seek an end to administrative bloat, to treat higher education, basically, as a commodity.
As many have noted – Michael Bérubé and Scott Saul foremost among them – this is all generally hogwash. The humanities remain popular with students, and the great bulk of student credit hours in the humanities are still generated by courses that discuss Important Events or Great Books or Big Thinkers. Much of the decline in enrollments can be attributed to long-term trends – for instance, changes in the gender distribution of majors as universities open doors into STEM fields for students, or the rise of new interdisciplines that eat away at our notion of what counts as the core of the humanities. Professors still love their subjects, even if they don’t wear tweed and even if some of them are women or people of color, even if they sometimes look different, dress different, talk with accents, come with different histories, and sometimes even use foreign languages in the classroom. Great lectures are still given, by "star" faculty and wandering adjuncts alike. Students are still inspired, even if they read William Faulkner alongside Toni Morrison.
I’m in lockstep with Bérubé and Saul, but I also think we need to continually reframe this conversation, to focus in on the single greatest threat to higher education: the defunding of public colleges and universities and the consequent overemphasis on revenue through student credit hours. The threat to the humanities – really, to higher education comprehensively – isn’t caused by a loss of passion or direction or focus, as Brooks and his chorus of doubters want us to believe. Or about bloat in the administrative middle.
It comes from the transformation of the day-to-day interactions between students and faculty, a transformation that is ensured by an emphasis on vast classes, big draws, and throngs of students. And that emphasis flows – in a straight and narrow line – directly from the declining state contributions to public universities and, more abstractly, from our recent consensus that profit alone is the surest measure of importance. It is great that Harvard University wants to pour more money into the humanities, but such an investment is meaningless, really, if every place that isn’t Harvard, or Yale, or Princeton has to trim and cut in one corner to build and grow in another (let alone to cover the skyrocketing health care costs of employees).
Who am I to contribute to this conversation? I should not be here today. I should be silent, or muted, or fixed in the background, a security guard or a mechanic or a grocery clerk – noble professions, I know, but not generally featured in conversations like this one. There was nothing inevitable about my present social position. Indeed, if you were a gambler, you’d have wagered against me. I am no David Brooks, you see. But I am just as much a creature of the humanities.
I was a screw-up, a wastrel, washed-out and adrift for a long time. And headed to nowhere-in-particular very slowly. A generally lackluster youth from a small, forgettable town, I was a C- student at the end of high school, trending down and not up. I enrolled -- at my mother’s loving insistence -- at a big public university, signed up to major in political science, and bombed out fast and hard, earning a 0.5 GPA in my first semester.
With my failure thus well proven, I moved out to a trailer park at the dusty, quiet, southern tip of New Jersey’s Long Beach Island, and went to work in a used bookstore. I rode my bicycle, drove an old station wagon, grew my hair long, drank Miller Lite in tall, dark bottles, smoked Camel cigarettes, and genuinely enjoyed my early hermitage.
The institution that saved me from this enthralling vagabondage wasn’t a church, or a gang, or prison, or the family. It wasn’t football or baseball or basketball. It wasn’t "America." I didn’t read Kerouac. I didn’t hear an inspirational speech on television. It was a small place, Richard Stockton College, tucked away in the Pine Barrens, perhaps the simplest and most basic expression of our belief in an educated adult citizenry. I signed up – not knowing what I meant to do, really – and then showed up, ready for absolutely nothing.
My saviors weren’t clerics or wardens or coaches. They were teachers. They wore mismatched socks, drank coffee by the gallon, and loved ideas, evidence, and debate. They weren’t generalists but specialists, with hard-earned knowledge about medical science in Scotland, or library readership in the early Republic. I couldn’t tell you anything about their politics, but I could paint you a richly detailed portrait of their presence at the head of the classroom. From what I could see, they lived cheaply, responsibly, and haphazardly, drawing sustenance from the material of their research, which they shared, twice or three times a week, with a group of 35 or so history majors, mouth-breathers all. These strange masters of the blackboard, drove cars just like mine, except that theirs were filled with random slips of paper and wildly strewn books and file folders. They gave extraordinary, dazzling lectures, even though much of the time, I could not understand anything they were saying. They were a live cliché.
I wish I could say that their job was easy, that I turned myself around, figured it out, and bootstrapped my way back to the right track. The truth is, I was hard work, just like everyone else. In red ink, they implored me to rewrite and rethink. In a cascade of office meetings and hallway conversations they pored over my paragraph formation, transition sentences, basic grammar and syntax.
They didn’t see anything special in me, of course, because there just wasn’t anything special to see. They merely believed that this was what they should do for everyone who walked into their classroom. They had seen thousands of people before I arrived, and they would see thousands after I was gone. They weren’t naïve or wide-eyed, and they didn’t imagine themselves as heroic or romantic. They were professional. And, when I look back on the last 20 years of my life, it wasn’t their lecture material that made the difference. It was the time they spent with me outside of class.
Of course, I was lucky. I was born in 1970, at a moment when most states believed in adequately funding higher education. I grew up in a place that had an enhanced system of public universities and colleges, all staffed with well-trained, research-focused faculty, people with published expertise in a specific field, with a dedication to craft. And I went to school and college at a time when professors – and schoolteachers more generally – were respected for their role in civil society, and trusted to patiently instruct and constructively challenge slack-jawed young men and women like me.
Raised in the idyllic world of yesteryear, I honestly never once thought to measure my education – or my intelligence, or my civic worth – by my starting salary after graduation. I had been making $78 a week at the bookstore, borrowing money for college, and charging meals and gas and cigarettes on a credit card. I just assumed that this pattern would continue forever. Even now, I am surprised that I didn’t just keep working at the bookstore, didn’t just keep shivering my way through the cold, lonely winters and hot, busy summers of what is colloquially known as “LBI,” didn’t just keep grifting my way to a full stomach.
When it comes to higher education, I’m not nostalgic for the way things used to be. I’m indebted to those who came before, to those who made this current "me" possible. I’m unhappy that we can’t do the same here and now for others. And I think the problem is quite clearly not about escalating salaries or administrative expansion.
Long after my redemption, I spent nine years teaching at a public university. For most of that time, I was running an interdisciplinary program at the very heart of the humanities. We were charged to grow an "honors-style" major, with small classes, lots of writing, and intense faculty and student interactions. In short, to create the experience of a small liberal arts college -- an experience I know well – within a 35,000-student university. Our capacity to grow was the result of a clever administrator, who – in the face of a statewide budget freeze – added on an additional fee for incoming students, and used that vast pot of money to shift growth toward the emerging interdisciplines. But this "honors-style" dream was chipped away slowly by the annual news reports of state budget cuts. We were pressed to create bigger courses, to put "fannies in the seats." We ended our enhanced foreign language requirement because it kept our major count down. We were encouraged to open up our enrollments, to create a big survey course at the front end of the major, a course that became so large that we had to trim off the writing requirement and give multiple-choice exams. We spent hours on assessment data, all required by the state higher education board, and less and less, as a consequence on students.
Not surprisingly, some of us left, hoping to find somewhere else something rather like what we’d experienced as young adults, some place where we could do for every student what had been done for us.
Wherever we are now, the stakes, for all of "us," in this higher education debate are high. Few students are ready, right at the start, to be inspired by a lecture on Plato. Most need help taking notes, or forming a thesis statement, or just thinking hard about anything. Still, every time a university has to add 500 students to the freshman class to make up for a budget cut without also hiring faculty, and every time an administrator – typically, a good person trying to save an institution – has to ask for a significantly larger lecture class without having the funds to beef up the support structure for students, we make stories like mine less likely.
When we describe the lecture as a delivery mode, as a site for Great Thinkers to Expound on Big Ideas, and not as the public expression of hundreds of miniature conversations in which one or two students work through material, and expression, and form with a single person, and we don’t emphasize the equal importance of those behind-the-doors sessions, we do damage to the representation of great teaching. We make it possible to believe that "big" is better. Without those conversations, it isn’t just the humanities that gets shortchanged – it is all of us.
Today’s jobs might not be yesterday’s, but they still require the ability to write and speak clearly, to analyze evidence and form opinions, to solve problems with research, to reach an informed opinion and to persuade others, through a presentation of logic or facts or material, that your opinion is worth their attention. This is what higher education is supposed to do. Fulfilling this mission requires an attention to scale, and a commitment to making it possible for faculty and students to work together closely. In the big and small publics – the great post WWII laboratories of social mobility, from which Brooks and his cohort are so greatly distanced – we simply can no longer teach these skills or create this scale of interaction. And if these centers of gravity fail, everything else will, too.
This should make ordinary Americans angry. It used to be that my story could be your sons' and daughters' story, but not any longer. Don’t blame the teachers in the classroom, though. They still work as hard as they can – they still drink too much coffee, still drive beat-up cars, still occasionally mismatch their socks – to deliver sparkling lectures, to rouse students to believe in the passionate study of humanity, to expand their intellectual horizons. And they try very hard to work closely with students in need, students with talent, and students who seem to want more. Don’t blame the administrators either. Most of them are simply trying to stave off the very worst consequences of this transformation. Blame the folks with the budget ax. And blame those who vote them in.
Matthew Pratt Guterl is professor of Africana studies and American studies at Brown University.
This essay is as timely as it is unlikely. Timely, because many studies have correlated economic crises, such as the one corroding the academic job market as well as so many other career prospects, with a rise in domestic abuse. Unlikely, because I am far from the type of person whom one would expect to chronicle personal experience in this area.
None of the stereotypes apply. I am a professor at a respected university with what many people (not just my mother) would describe as an international reputation in her field. The product of a white, upper-middle-class professional household, I seldom heard my father raise his voice to my mother -- his raising his hand would have been inconceivable. Their marriage was perhaps not one made in heaven, but neither was it an instance of cruelty by any stretch of the imagination. And I did not and do not have a pattern of involvement with abusive partners; indeed, for the past 22 years I have enjoyed a very happy and stable relationship with a compassionate and supportive man.
I had thought I had every reason to anticipate a happy and stable relationship in my erstwhile marriage as well. My ex-husband and I shared many cultural interests and were anticipating careers in the same field within the humanities, with similar pedigrees and similarly strong academic records. By chance my career, however, started more smoothly than his, despite his impressive credentials and abilities, indeed gifts. I finished graduate school a year before he did in the ‘70s — shortly after the precipitous decline in the job market -- and obtained a tenure-track appointment while he was completing his dissertation. We then moved for compelling personal reasons, and I was fortunate enough to find an academic position again, but he did not do so.
My ex-husband had slapped me once early in our marriage when, because I had not understood and hence had not followed his instructions during a household repair, a small amount of water fell on him. I was shocked, but I viewed the episode as an aberration. It was not.
That event suggests that the recurrence of such abuse cannot be wholly blamed on his not having a job. And after all, many unemployed people do not descend into such behavior, while many who are guilty of it hold stable jobs. Nonetheless, the timing persuades me that my ex-husband’s not obtaining the sort of position he had hoped for contributed significantly to the recurrence of wife-beating. For shortly after we had moved and I, but not he, held an academic appointment, physical abuse started again. He pinched, shoved, and hit me with some regularity over a period of about a year. Not by any means the most violent wife-beating, but quite enough, thank you, to leave significant black-and-blue marks on one occasion and less visible scars on the others. The physical abuse was accompanied by persistent belittling remarks. Throughout all this, my ex-husband continued to appear in public as a charming and highly educated gentleman and a courteous husband. I later learned that this Jekyll-Hyde scenario is a common symptom of pathologies like his.
Why did I put up with it? Barely able to believe that this was happening between people like us, I made excuses for him, justifying his behavior as a regrettable but understandable response to his unemployment, which was clearly all the more difficult for him because I had an attractive job in the same field. The contrast between his public and private behavior made it harder to confront the events squarely, as did the ways the situation sapped my own self-confidence. Like many victims of domestic abuse, I began to blame myself, not realizing that although I had made real mistakes, such as occasional tactless remarks, they neither explained nor justified this physical and emotional maltreatment.
Moreover, like many wife-beaters, he repeatedly seemed to repent. On the several occasions when I finally resolved to leave, he admitted that situations for which he had blamed only me were in fact in large measure his responsibility, and he promised to get therapy. These apparent reversals were, I was to discover, as much a pattern as the violence itself, and the therapy never materialized.
His career not only got back on track but flourished after that year of unemployment — a good though temporary job one year, a tenure-track job the next, the publication of a well-received book by a leading press, and so on. The physical abuse stopped shortly after he gained those academic positions, though the emotional analogues to it did not, and for that and many other reasons I finally, belatedly, got a divorce.
What I learned is relevant to anyone, man or woman, suffering domestic abuse.
Realizing that stressful circumstances outside the home -- and one's own behavior -- may have contributed to tension is a very different matter from excusing the behavior or shouldering all the responsibility oneself. Distinguish compassion from submission: it's healthy to understand the financial pressures that might bring out this type of violence in some individuals, but no one should accept its continuation. Be alert to connections between the physical and verbal, recognizing that physical abuse often merely goes into remission or resurfaces as verbal wife-beating. Apologies and promises need to be backed up with concrete and reliable evidence for believing that change will occur.
But one step must precede and accompany all of these: Avoid the temptation to excuse or deny the abuse by saying, "This isn't really occurring, and it will stop any minute because things like this don't happen to a professional couple like us." They can. They do. And, sadly, in this academic job market, they will.
The author of this piece, who asked to remain anonymous, is a tenured professor.