OUR KEYNOTE SPEAKERS

JEREMY GREENE: RUDOLF VIRCHOW LECTURE

Johns Hopkins University

How Medicine Becomes Trash: Healthcare Waste as Environmental Crisis

The modern medical enterprise is distinctively wasteful.  This may seem to result inevitably from the hazardous nature of medical substances, whose infection risk, chemical toxicity, or radioactivity and accordingly requires more extensive techniques of waste handling.  Yet only 15% of global healthcare wastes fit this specialized profile.  The remaining 85% are simply materials that have been built to be disposable rather than reusable:  a staggering volume of single-use items that emit toxins and carbon dioxide when incinerated, give off methane and other greenhouse gases while decomposing in landfills, or, if they escape these two fates, float on the surface of the oceans.

It was not always this way.  In a relatively short period of time, we have naturalized the use of single-use masks, single-use surgical drapes, single-use plastic syringes, single-use surgical tools, and single-use diagnostic tests, all wrapped in multiple layers of single-use plastics—and then forgotten there was ever any alternative.  In this keynote, Jeremy Greene traces the links between environmental history, the history of technology, and the outsized role that the global healthcare sector now plays in contributing to climate change and plastic waste.  Greene the recent crisis of COVID-waste as a window into the broader infrastructure of engineered wastefulness in modern medicine and its differential effects across rich and poor nations on a global scale, and rich and poor neighborhoods on more local scales.  Only through historical analysis, he argues, can we work to unseat medical waste as a natural category and reconsider it as the outcome of a set of value decisions we have made in the past, and can change in the future.  

BIO 

Jeremy A. Greene, MD, PhD, is the William H. Welch Professor of Medicine and the History of Medicine, Director of the Department of the History of Medicine, co-Editor-in-Chief of the Bulletin of the History of Medicine, and founding Director of the Center for Medical Humanities and Social Medicine at the Johns Hopkins University School of Medicine, where he also practices internal medicine at a community health center in East Baltimore.  In addition to scholarly publications, he is a regular contributor to clinical and public health journals including The Lancet, The New England Journal of Medicine, and The American Journal of Public Health, and his work has appeared in popular publications including Slate, Forbes, The Atlantic, and The Washington Post. In his several books, Prescribing by Numbers: Drugs and the Definition of Disease (Johns Hopkins University Press, 2007), Generic: The Unbranding of Modern Medicine (Johns Hopkins University Press, 2014), and The Doctor Who Wasn’t There: Technology, History, and the Limits of Telehealth (University of Chicago Press, 2022), Greene’s research explores how the complex social, cultural, and economic histories of medical technologies impact present day medical knowledge and clinical practice. Greene’s work has been supported by grants from the National Science Foundation, the National Institutes of Health / National Library of Medicine, the  Norwegian Research Council, the Andrew W. Mellon Foundation, the Laura and John Arnold Foundation, and the Greenwall Foundation.  His current research project, Syringe Tides: Disposable Technology and the Making of Medical Waste is supported by a 2023 Guggenheim Foundation Fellowship. 

JULIA IRWIN

Louisiana State University

Relief, reform, and realpolitik: International medical humanitarianism and the messy politics of U.S. foreign disaster assistance

In her keynote lecture, Julia F. Irwin explores the links between the history of disasters, the histories of medicine and health, and the complex politics of global humanitarian relief. Catastrophes caused by earthquakes, tropical storms, floods, and other natural hazards, as Irwin will discuss, must be understood as comprehensive medical and health crises. Aid to disaster survivors, by extension, has often focused on ameliorating the physical and mental harms that such catastrophes precipitate. Yet, disaster aid has never been purely altruistic. Historically, it has also functioned as a valuable instrument of foreign policy, a tool for promoting the diplomatic, strategic, and economic interests of donor nations.

To illustrate these points, Irwin presents case studies of U.S. responses to multiple disasters in East Asia and Central America during the early twentieth century. While highlighting the centrality of medicine and health to American foreign disaster assistance efforts, she also analyzes the messy politics and power dynamics that underpinned these humanitarian operations. In the wake of these crises, as she will discuss, American humanitarians found auspicious opportunities to exert medical influence, exercise biomedical power, and promote the United States’ image as a benevolent nation. By thinking more critically about the medical and political histories of disasters, Irwin emphasizes, perhaps we can improve our collective responses to future global crises.

BIO

Julia Irwin is Professor of History at Louisiana State University. Her research focuses on the politics of humanitarian assistance in 20th century U.S. foreign relations, international history, and the history of medicine, in the context of both armed conflicts and disasters stemming from natural hazards.

Her first book, Making the World Safe: The American Red Cross and a Nation’s Humanitarian Awakening (Oxford University Press, 2013) is a history of U.S. foreign relief efforts in the early 20th century, particularly during the First World War and its aftermath. Her second book, Catastrophic Diplomacy: U.S. Foreign Disaster Assistance in the American Century, will be published in 2023 by the University of North Carolina Press. Catastrophic Diplomacy examines how the U.S. government, U.S. military, and American voluntary organizations responded to sudden disasters in other countries during the 20th century, with a focus on humanitarian emergencies caused by tropical storms, earthquakes, floods, and other natural hazards. Investigating the messy politics and complex power dynamics associated with these relief and reconstruction operations, the book analyzes the use of foreign disaster assistance as a tool of U.S. foreign policy.

She has also published more than twenty journal articles and book chapters on the histories of U.S. foreign aid, international humanitarianism, and medical relief. Her work has appeared in such journals as The Bulletin of the History of Medicine, Isis, Diplomatic History, Nursing History Review, and the Journal of American History, and in volumes published by Oxford and Cambridge University Presses and Georg Editeur. Recently, she became a founding editor of the Journal of Disaster Studies. Aimed at disaster researchers across the humanities and social sciences, this international journal seeks to advance interpretive theory, methods, and empirical research on hazards, disasters, and humanitarian governance globally.