Diagnosing History

I'm pleased to host this guest post today from Samuel Brown, a physician, biomedical researcher, and (to boot) a talented historian, and author of the fascinating new study In Heaven as It Is on Earth: Joseph Smith and the Early Mormon Conquest of Death (Oxford University Press, 2012). Below, he reflects on his work as a physician and a historian, and the nature of the "calling" of these two enterprises.

Diagnosing History

by Samuel Brown

When I started college in 1990, I was filled with excitement about scholarship in the humanities. I particularly loved the idea of Classics, with its mix of language and ancient history. But as the first semester wore on, I couldn’t escape the feeling that God had a different path in mind for me. I had no desire to be a physician, saw it as selling out the life of the mind, something upper-middle-class people did in order to be self-employed. But the call to medicine seemed undeniable to me, so I ultimately relented. I did, in a bit of homage to the biblical patriarch Abraham (Genesis 18:20-33), negotiate with God over the structure of my undergraduate career and ended up majoring in Chomskyan linguistics en route to medical school. Even as a linguistics major, I considered a PhD in religious history several times near the end of college, but I always grudgingly heeded the call back to medicine. (I finally wanted to be an academic physician in my second year of medical residency, much to my relief.)

I have great admiration for professional historians, for their discipline, their rigorous empathy for their subjects, their love of ideas and narrative and method. I often experience holy envy when I converse with friends ensconced within the traditional humanities academy. But I am happy in my career as an academic physician, researching cardiovascular physiology and caring for patients with life-threatening illnesses. I prefer the stress of life-or-death decision-making at the bedside to the ennui of untangling undergraduate prose when I am not actively researching physiology.

My main job and chief priority is quantitative research on the ways the heart, lung, and blood vessels interrelate in order to maintain life in the face of severe infection. In this biomedical research, I think constantly about causal inference and association, confounding and counterfactuals. Skepticism is natural and vital to these endeavors, and I feel great satisfaction in my career as a biomedical researcher.

It is hard, though, having once imagined myself as an academic humanist, to practice medicine and research physiology without wondering about the big issues. Not just ethical problems with the distribution of medical care but reflections about the human struggle to maintain (or is it create?) sanity and to make sense of the world. I wonder about the ways we as patients and physicians create narratives to interpret lived experience. Perhaps most powerful and frightening for me as a young physician were the emotions that arose when individuals, despite our best efforts to the contrary, finally passed from life. I wondered what people thought of their religious systems at those moments, watched the ways those systems often failed to provide the support I hoped they would. And from those ruminations—combined with my awareness that Mormon angels were not traditional angels—came a book project that grew over several years into In Heaven as It Is on Earth. The book reinterprets early Mormonism and explores beliefs about death in early national America, especially in the groundswell of anti-Calvinism that encompassed fringe groups like Mormons and increasingly mainstream groups like the stunningly successful Methodists. The book also reflects my conviction, broadly sympathetic to the Lived Religion school of social history, that religion is most interesting when it is most relevant to participants, when they apply it, test it, stretch it.

I find that my experience as an academic physician provides both advantages and disadvantages as I approach cultural history. I know that cold exposure does not cause pneumonia and emotional stress or ambition does not itself cause early death. But I must remind myself that historical subjects believed that these common problems were causally connected. I know that in general association is not causation, but I must remind myself constantly that historical actors constantly developed and followed inaccurate causal models. In many respects the responsibility of the historian is to elaborate the details of these causal models without necessarily dismissing them as epidemiologically groundless. Skepticism is not always the correct response to a particular document or set of documents, not if the goal is understanding the people who created them.

I believe in the vital symbiosis of biomedical research/practice and cultural history. Different participants will have complementary skills to bring to bear on problems of relevance to all.  My medical work is enriched by my relationships with historians and their craft, and I hope that my historical work is enriched by my experiences as a physician and researcher. I am grateful for the opportunities I have had to know and respect scholars across a variety of disciplines.