23 February 2011

When Did Government Support of Neurology Research Begin?

Government patronage of full time biomedical researchers was largely without precedent in Interwar Britain. The full time clinical investigator was rare. Young doctors often conducted research towards their higher medical degree (MD), which in part established their reputations as practitioners in a special area of medicine. From there, however, it was rare that these doctors continued clinical investigations. Their time was almost wholly given over to hospital medicine with the ultimate goal being private practice.

Thus it was often and widely remarked that many of the most important discoveries in British medicine had occurred during long unrecognized evenings of labor, often taking place in dark basements or other poor facilities that served as ad hoc laboratory space. While such rhetoric obviously served to fashion a heroic narrative about the advance of British medicine, it also spoke to the reality that research facilities in medicine, as well as funds to support them, were rare indeed.

It appears that Britain’s first full time clinical neurological researcher was Edward Arnold Carmichael, Director of the Medical Research Council’s Clinical Neurology Research Unit at the National Hospital, Queen Square from 1933-on. Carmichael’s career perhaps best exemplifies the challenges to creating government positions for biomedical research. In the absence of precedents, no one was entirely certain how achievement and excellence in research performance could be measured. That problem haunted Carmichael and his unit throughout his career. It is a problem that seemingly remains a commonplace even today. Carmichael's strategy might be described as the "publish or perish" attitude. He became editor of Kinnier Wilson's Journal of Neurology and Psychopathology which he renamed the Journal of Neurology and Psychiatry. That organ became the default place of publication for research conducted in his unit.

When did government supported neurology research develop in other countries? Were there earlier precedents in Britain? Questions like these remain to be answered. But they point to the larger problem of definitions: what precisely counts as neurological research? Haymaker and Schiller tried to answer this question in their Founders of Neurology, but letters in their archives indicate that the definitions were not obvious to them. Nor should they be for us.

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