Reflections on Past Conversations: Impactful Narratives

After all these years, I have begun to explore the idea of pursuing a doctoral degree, specifically in history. The goal would be to write a comprehensive historical narrative on the development of Space Medicine from the late 1940s to the present time. So before I actually take the next step, I enrolled in a graduate-level class here the University of Cincinnati to see if I really want to delve into this. The course has a seminar-like structure with lots of reading, guest speakers, and of course writing. The focus is on the history of medicine. Every two weeks I submit a four-page essay based on the assigned readings.

The first three readings were (1) Nieslen’s manuscript, “The Perils and Promises of Disability Biography,”¹ (2) a book entitled “Ohio Under COVID: Lessons from America’s Heartland in Crisis,”² and (3) a chapter, written by Elliot “Cincinnati,” which was focused on bioethics related to radiation experiments conducted at my university in the 1960s.³ While these three readings are not focused on telemedicine, they align with technology, innovation, leadership, biography, and intent to provide care for patients.

In Nielsen’s manuscript, she lays out a cogent argument of the utility of developing historiography and scholarly work as a historian’s tool. She incorporates her work on researching Helen Keller, Franklin Roosevelt, and Dr. Anna Ott as examples. In each of these, oral history and biography are key elements in understanding how individuals with disabilities have been portrayed and cared for in historical context. Within our discipline of telemedicine and telehealth, historical biography is highly relevant; in previous editorials, I have mentioned this. Looking at the past, helps us understand the future. This of course makes perfect sense. However, I can assure you that many of the submissions from around the world to this journal do not reference the work from the past. For many, it is like it never happened, or what they are reporting on is new, and never before presented. This does a disservice to our scholarly sojourn.

In Bashshur and Shannon’s book, History of Telemedicine, they layout a comprehensive history of how the field was developed and grown to what it is now.⁴ Yet, a lot has happened since its publication in 2009. Furthermore, nearly three decades of this journal provide a strong foundation from which to spring forward. I recall a conversation several years ago about young engineers who were discussing quarantine issues on samples being brought back from the moon. In the audience was the individual who actually developed the protocols for the Apollo samples. In response to his commentary, the young engineers quipped, “we have better technology now.” While this may be 100% true, the issue is that they did not look at the past, nor talk with anyone remotely involved.

Another assigned reading in my class was a book on COVID-19 and Ohio. It provides an interesting set of thought-provoking essays and research articles on such subjects as leadership, education, racism, disability, and ableism. In my own conversation with Dr. Amy Acton, the Ohio Department of Health Director under Governor Mike DeWine, she indicated the rapid growth of telemedicine and telehealth in Ohio and its utility. The focus of some of the chapters was on leadership and government overreach. As we have seen both in the COVID-19 pandemic and the 1918 pandemic, leadership was driven by personal opinions and not evidence. One might say the evidence was constantly changing, but it was evidence nevertheless. Once Dr. Acton was no longer involved, the governor appointed an individual who did not have the same clinical background and COVID-19 cases increased.

Elliot’s chapter, in “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No” was focused on the Department of Defense-funded radiation experiments conducted at the University of Cincinnati by Dr. Eugene Saenger. Over a period of 10 years or so, he conducted full-body irradiation experiments on terminally ill cancer patients. During this period, informed consent evolved, but the patients were unaware of the consequences of their participation in these experiments. It was a whistleblower that brought the experiments to light, and they were eventually cancelled.

The goal was not to highlight the books or the events but to illustrate the relevancy and importance of oral histories. In my own work, I have had the opportunity to capture the stories and lessons learned from those early pioneers. Oral history is important; it can stimulate design; it can stimulate growth and of course stimulate change. There are hidden pearls of wisdom in those who came before us. Listen intently and learn from them. When we reflect on the past, we learn from it. It will open your eyes.

What Is in This Issue

This issue contains an excellent review article on teledentistry as wells as a number of poignant articles on disparities, perspectives, and five articles on COVID-19. These manuscripts come from Brazil, Germany, Hungary, Israel, and the United States.

As we approach the 30th year of this journal, please be mindful of the changes we have seen in this field and the challenges we continue to face in providing our patients and providers with empirical evidence, strong and dedicated leadership, and ethical approached to health care.