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A historian of medical futures looks back

Yale Medicine Magazine, 2021 Issue 167


Professor Joanna Radin, PhD, was 17 when the Kings Park Psychiatric Center closed in her Long Island hometown. Since its founding in 1885 to alleviate overcrowded city asylums, the massive hospital grew with and came to define the town. Eventually it too was overcrowded, its occupational therapies replaced with lobotomies and shock treatments. Radin remembers growing up playing on the asylum’s grounds, seeing the derelict buildings through the trees from her bedroom window. Friends’ parents worked there; certain patients were well known around town. “It was normal, almost. The idea of mental illness wasn’t a fiction,” she said. “It was a reality for the town. Kings Park was a company town. Instead of a mill we had an asylum.”

From her upbringing on the boundary of this now empty monument to our country’s biomedical secrets to what most would conceive of as a classic haunted asylum fantasy, grew an insatiable curiosity about the wisdom of science fiction in relation to biomedical infrastructure; the violence of the past and conceptions of the future; the forms of communications central to good science; and the nature of innovation.

Radin is an associate professor of the history of medicine and teaches across disciplines. She is the author of Life on Ice (University of Chicago Press, 2017), a book about American scientists’ efforts to collect and stockpile frozen blood samples from indigenous communities around the world; and co-editor with Emma Kowal, MBBS, PhD, an Australian medical anthropologist, of Cryopolitics: Frozen Life in a Melting World (MIT Press, 2017). Radin has a new project forthcoming—a look at the history of American science through the work of physician-turned-author Michael Crichton, MD.

From Kings Park at the tail end of the Cold War, Radin devoured books and films about unwieldy scientific leaps like Crichton’s Jurassic Park and Westworld, which conveyed the message that science will produce monsters. She attended a summer camp at Cold Spring Harbor Laboratory, where at 10 years old, she was encouraged to think about the futures latent in DNA. Later in life she learned that the lab had been the epicenter of the American eugenics movement, and many of the patients at the Kings Park asylum had been subjects of experimentation by its scientists.

“It's this nexus that I've only made sense of after a career in the history of science and medicine,” she said, “that helped me realize there were all of these potent, very real, terrifying, but also powerfully optimistic forms of horror and hope and hype swirling around my childhood, which I osmotically absorbed.”

A question central to science’s tug of war with power, she tells her students, is the identity of those who makes the future. How do we inherit ideas about innovation? “If you look into history, some of the most powerful and important innovations are not always the most expensive or sexy.” Mold, for example, disrupted the world of biomedicine when a mold called Penicillium rubens proved to be the source of the first major antibiotic. But Radin is particularly preoccupied by freezers.

She was attracted to freezing because unlike gene sequencing, for example, freezing is rather ordinary. “Looking at mundane technologies allows us to see different ways of understanding innovation,” she said. Cattle breeders, she found, were working with freezer technology to preserve sperm in order to standardize variation. But the human biologists and epidemiologists Radin was paying attention to wrote to the cattle breeders to learn how they might adapt cold storage to preserve variation across human groups.

“This was such an object lesson in the history of technology,” she said. “It's not that technology tells us what to do; technology is developed by people who decide what to do with it.”

Then came the cheek swab revolution, 23andMe, and our obsession with Who We Are, all made possible by freezers full of genetic material from indigenous people across the world—ephemeral material considered a resource for the unknown future. “I just got so fascinated by the kind of perversion of that thinking, the kind of colonialism, the hubris, and the lack of consideration for the lives and ideas of the people whose bodies were being collected for science.”

The history of frozen blood also reveals insights into our present crisis. A focus on the cutting edge, she said, considers only having a safe and effective vaccine, but not how that efficacy is achieved; upon whose bodies it is tested; and who is shut out from access. “It's not a coincidence that the pandemic has come along with the Black Lives Matter movement and calls for efforts to rethink our institutions and the place of expertise within them.” To that end, she has been working with colleagues in the Infectious Diseases Section and the Department of Genetics at Yale Medical School, which invited her to collaborate on curriculum to address issues of racism in the training and practice of medicine.

It’s easy to see this crisis as emblematic of the one facing science writ large: how—and particularly whether—science is communicated or trusted. Radin has watched with dismay as the Trump administration eroded faith in the CDC and disregarded the knowledge and needs of clinicians. Faith in science—and simple technology, for that matter, PPE, mundane paper technology—beyond the shiny solution of a vaccine, could have profoundly mitigated this crisis.

For Radin, lately everything comes back to Crichton, whose fiction shaped the way many think about the promises and perils of technology. It matters what stories we tell about science and technology. Crichton’s tales of science gone amok influenced a generation … but how can we learn to love our monsters, to better care for our creations and each other?

Radin’s inquiries have returned to the Kings Park asylum of her upbringing, those huge and now empty buildings. She plans to write about the place to understand the relationship between eugenics and ideas about what it means to be free in a way that can help us navigate the present. “There’s so much silence,” she said. “I grew up looking at these buildings and not knowing the secrets they contained.”

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