Saturday, 20 July 2013

Head Wounds, Hippocratics and the NHS



Abdera General Hospital, 700 BC

I celebrated TWO PhD students getting through their vivas by twisting my ankle and applying my head to the pavement outside King’s College London on the Strand.  Twenty hours in University College Hospital with severe concussion and a bloody eyebrow left me mystified by modern medicine.  After 'only' five hours’ wait in Casualty a kind doctor made sure I had a bed on a ward and told people in shades of aquamarine to give me various medicines, victuals and tests, most of which NEVER transpired. At one point a nice man turned up with a wheelchair to take me to Ophthalmology, but said He Didn’t Know Where the Clinic Was and Could I Show Him. Since I had an eye bandage but no contact lenses, I was unable to oblige.
Concussion is strange. On Thursday I felt happy and thought God was calling me. On Friday I wondered whether the blow to my right frontal lobe might have had an unexpected therapeutic effect on my morale. And this morning I suddenly figured out the solution to a brain problem that has been besetting me for weeks.
 
I have drafted a 'public-facing' book called The Ancient Greeks 1600 BC to 400 AD, but the Philosophy chapter has been criticised by one of the editors for being too ‘abstract.’  Modern readers, apparently, can’t cope with questions like ‘is the world of ideas in our minds prior to the material world we can perceive?’ or ‘what is the difference between holding an opinion about something and knowing it for a fact?’ Until this morning I have been at a loss how to dumb down the Greeks for the contemporary reader, but the blow to my head seems to have clarified everything. I rewrote the chapter in two hours, and without ever using the words ontology and epistemology!
Location of Abdera in Thrace
The process reminded me that a woman with a head injury has recently changed the history of ancient medicine, itself a factor in the invention of science and philosophy. Advanced head surgery was performed on the thirty-year-old’s injured cranium at Abdera in northern Greece—the city that gave the world the brilliant thinkers Democritus and Protagoras--by the middle of the 7th century BC.  
The remains of this patient show that complicated surgical procedure on bones of the skull, including trepanation (the removal of a disc of bone to allow the extraction of damaging bone splinters) was already in use before the first philosophers and more than two centuries before the sophisticated treatise On Head Wounds, attributed to the physician Hippocrates, was written in around 400. The intellectual approach of the Hippocratic treatises, and their concern with inference, evidence, cause and effect, without recourse to supernatural causes, was one of the godparents of the Greek ‘miracle’.
Abdera Excavations
But as I think about that woman’s cranium I can’t help wondering about her treatment. Did she ever get her painkillers and water, her ancient equivalents of antibiotics and tetanus, or have her vital signs observed? Could her porter find the way to Ophthalmology?  We must assume so, since she lived for another twenty years. I am going to be fine, but my ‘disappearance’ in the hospital bureaucracy means that this is more by good luck than good management. It is a sad day when I would rather be treated in Abdera General Hospital in the late archaic age than in the British National Health Service of the twenty-first century.

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