Foreword

Historical enquiry and understanding our past

Colin Holmes
Adjunct Professor of Nursing, School of Nursing Sciences, James Cook University, Townsville QLD

PP: 101 - 105

Article Text

The nature of history and its credentials as a discipline have long attracted sophisticated and passionate discussion. A sense of urgency was introduced in the 1980s, when postmodern criticism of the dominant traditions first appeared, and the sometimes bitter disputes as to representation, objectivity, truth, standpoints and ideology, morals, textuality and method, to name but a few, have been fuelled by a belief that the integrity and future of history and historians is at stake. However, my own experience in clinical and academic nursing settings has been that historical inquiry is dismissed not so much as theoretically problematic, or ill-conceived, or methodologically flawed, but rather as irrelevant. My own enthusiasm for history is often met with, ‘Look, it's all in the past and you can't change it. You should do something useful!' Although these comments are not based on complex philosophical arguments, the question ‘Why bother with history?' is surely logically prior to, and more fundamental than, those which dominate the former debates.

One reason for concern as to the value of historical inquiry may be the Anglo-American obsession with utility, and the deeply ingrained belief that the value of any scholarly inquiry must be judged according to its ‘products', which ideally should be measurable, subject to copyright, and have immediate practical application. The antithetical view - that scholarly inquiry can be worthwhile for its own sake - has long since disappeared from academe, squeezed out by a business model of education in which productivity takes precedence over intellectual activity. For its part, nursing has never enjoyed the emphasis on intellectual activity which once defined the university.

In Australia and the United Kingdom, by the time the preparation of nurses moved from the hospital training school to the higher education sector the introduction of managerialism was already underway. Today's student nurses know only the business model, and consider themselves to be purchasing the required set of carefully proscribed clinical knowledge and skills. For the academic staff, productivity is measured not only in relation to satisfying the student-customer but also in terms of scholarly publications, research income, and research outcomes that have a direct influence on clinical practice. The paper by Walker and Holmes (2008) in the present issue illustrates one way in which this emphasis of the pragmatic over the esoteric, of clinical skills over intellectual ones, was legitimised and reproduced via the textbooks used in the years prior to nursing's entry into higher education. Developing in such an ethos, it is hardly surprising that nurses have rarely participated in the construction or interpretation of the history of their discipline, and that it has so long been at the mercy of eulogists, mythmakers and patronizing outsiders. In Australia, serious study of the history of nursing, midwifery and associated subjects continues to be a marginal activity, poorly supported by the academy and the profession, and the literature is consequently fragmented and vestigial.

This neglect suggests one of the reasons for undertaking historical inquiry and taking history seriously: because it is otherwise ignored and lost altogether, or is left in the hands of those who would carelessly or deliberately misrepresent the past. This was eloquently expressed in the work of Geoffrey Elton (1967), for whom the study of history was a search for truth, and for which no further justification was required. If the Holocaust had not been studied in depth by historians, Deborah Lipstadt's (1994) defence of her reputation in the case brought against her by Holocaust denier and anti-Semite David Irving may not have succeeded, and future generations would have totally misunderstood what was perpetrated by the Nazis. Furthermore, the case turned on Irving's credibility as an historian and upheld the integrity of historical scholarship: the major finding was not that he misinterpreted the data, but rather that he simply did not adopt the standards of scholarship that are required of a genuine historian. He falsified data, ignored data which did not support his arguments, and interpreted data without regard to alternative explanations. The court concluded that he was motivated by a desire to discredit Jewish accounts of the Holocaust and to glorify members of the Nazi regime, and that this overrode any commitment to academic standards (Eaglestone 2001).

By way of a further illustration of the importance of historical scholarship, consider the old psychiatric hospitals. Historians rarely turned their attention to these before the 1980s and with their closure, an understanding of this remarkable aspect of our social history might have been forever beyond reach; but the closures sparked a massive detailed literature telling the fascinating stories of the institutions and their staff and patients. This has provided a counterweight to the sensationalist reports as to everyday life in those places, on which popular opinion tended to rely, and has perhaps helped moderate some of the ill-informed negativity that attaches to mental disorder and the psychiatric system, not least among health professionals themselves. They have also introduced a note of caution to those commentators who have taken the erudition and complexity of Foucault as a social theorist and philosopher as entailing accuracy as an historian. The notion of ‘truth' has, of course, been widely reconstructed or dismissed by contemporary philosophers, and this is not the place to defend a particular version, but we may say with Elton (1967) that history offers an opportunity to construct truthful accounts of the past and to expose those that rely on falsehoods.

This in turn suggests another reason for history: that it has the potential to reconstruct our views of the present and the future. Elton's (1967) dismissal of this as ‘whiggish' notwithstanding, our attitudes, beliefs and decisions today are surely based on more or less conscious reflection on what has happened in the past. Knowledge of the Holocaust teaches us, for example, that there are legitimate grounds for compensation and the recovery of stolen possessions, that there is a need for healing, remembrance and memorialisation, and that fear and anger at the sight of neo-Nazi activity in Europe is well-founded. Of course, we may ignore or reject historical knowledge, and historians may believe with Elton (1967) that the only reason for history is the light it sheds on the past rather than what it suggests about the present, but although it is not infallible and we can be misled, what better guide does a person have as to the outcome of any sequence of events than experience? The knowledge acquired through previous experience, through knowledge of the past, forms our view of the world and enables us to successfully navigate our way through life.

Critics of this suggestion often equate it with the view that history can predict the future. Although it is a matter of fact that knowledge of the past often helps us predict the future, and this is the basis of the scientific method, human history is not an exact science, so at best it can only suggest likely outcomes or, more usually, alert us to possibilities. Another criticism of this view is that all situations are complex and unique, and that the relevance of history recedes with the passage of time, since the factors involved become so different. However, if this were the case, then there would be no lessons to learn from ancient philosophy, literature or arts, and the great works of the past could be consigned to the flames; the plays of Shakespeare, and the myths, legends and literature of the past would not speak to us as they do; the great wonders of the world would teach us nothing, we would not marvel at Macchu Picchu, nor care how the Iceni lived in ancient Britain; archaeology and history programmes would not be among the most watched programmes ever made for television. What makes these relevant for us today is not only that they help map who we are and from where we have come, but our sense that they tell us something about the human race.

This brings us to another rationale for historical inquiry, best expressed by the British philosopher, Robin G Collingwood (1946) who argued that its purpose is to increase human self-knowledge: its value is that it teaches us what human beings have done and thus ‘what man (sic) is'. The recent trend toward constructing histories in terms of personal stories, and to examining the interplay between individuals, their social contexts and the larger events in which they are caught up, certainly contributes to such knowledge. The biographical element teaches us what human beings are capable of, their strengths and weaknesses, the nature of the human condition. This biographical element in historical scholarship was once restricted mostly to the great figures of the past, inevitably men, often military or political leaders, but today embraces ordinary people. We want to understand what everyday life was like for past generations of ordinary people like ourselves, rather than for the towering figures of history. We are no longer satisfied with glorifications of eminent people; we want to know what they were ‘really' like, warts and all.

Thus, Nightingale continues to fascinate us not because of her impact on contemporary nursing as such but because of who she was: because of her humanity in which a range of personal qualities - petulance, arrogance, determination, altruism, commitment - vie for expression and are met in a single individual struggling to overcome the prejudices of her day. How much more fascinating she has become now that the romanticized accounts of the past have been leavened with the iconoclastic ones of recent years, in which she ceases to be idealized and becomes truly human. This is not to suggest any commitment to an essentialist view of human nature, but simply to claim that history enlarges our understanding of what it means to be human. Nor does this interest in individual lives and their context indicate any concession to methodological individualism, or entail any stand as to the relationship between individual action and social change. Notwithstanding the efforts of Anthony Giddens, Margaret Archer and other social theorists, the agency-structure debate, like the nature- nurture debate, remains alive and well. Rather, the study of individual lives is one way in which Collingwood's (1946) claim that history increases self-knowledge can be realized.

Neither is it just the biographical element which can achieve Collingwood's (1946) purpose: as we view the great events of history, the minutiae of domestic life, the great artefacts and remains of past civilizations, and the great works of literature and art, their authors may be entirely anonymous to us and yet they too bespeak the spirit of humankind. They tell us what human beings can achieve, they speak of our common humanity, and they may remind us that despite his proud warning to the powerful to look on his works and despair, all that remains of Shelley's Ozymandias is ‘two vast and trunkless legs of stone, standing in the desert'. Returning to the example of the Holocaust, historical scholarship also teaches us about the darker side of human life, how readily we can be persuaded to transfer our anger and sense of injustice to an identifiable ‘other', to dehumanize people and ultimately to collude in their destruction. It tells us about the extremes of courage and caring, but also of cruelty and evil, of which ordinary people are capable.

So, why study history? Along with idealists such as AO Lovejoy, we could answer quite simply ‘for its own sake', and refuse to deal in the coin of the neo-pragmatist culture from which the question proceeds, but let us concede a little ground to the demand for outcomes. History - that is the written history produced by historians rather than the past itself - has a unique place in human life. It is the vehicle for understanding and appreciating the human situation as it has developed and evolved over time, and without it we cannot claim to understand our culture, institutions or practices, but most importantly we cannot claim to know ourselves or to understand what it is to be fully human.

To understand ourselves and our field of nursing practice, we must consider its history. The papers in the present issue cover a wide range of topics relating to nursing, midwifery and education in Australia and New Zealand. Many readers with experience as paediatric nurses will recall the days when children's wards were colourless, impersonal and frightening, and visiting was restricted to immediate family at fixed times. Few nurses today would know that the dramatic change was initiated largely as a result of the pioneering work on maternal attachment, and subsequent lobbying, by British psychologist John Bowlby, described in the paper by Jeanette Wood (2008). The paper by Wendy Madsen (2008) addresses the much neglected and undervalued work of the school nurse, and identifies a number of political and scientific influences, including racial hygiene and the ‘White Australia' policy. She notes that the school nurse had a difficult role to negotiate, given the legitimate claims of parents, teachers and education and health departments to be the key stakeholders. This was compounded by the various expectations that were conferred on the nurse by State and Federal policies.

The rather convoluted history of the professionalization of midwifery in New Zealand is carefully documented in the paper by Jane Stojanovic (2008), and it is interesting to set this alongside the practice of rural or ‘backblocks' nursing in pre-war New Zealand, described in the meticulous paper by Pamela Wood (2008). The professional, practice and political problems which confronted nurses in the early days, and the organisational and attitudinal problems associated with the new role, are reminiscent of those faced today by Nurse Practitioners in developing countries. Still in New Zealand, the tensions between psychiatric and general nursing during the period 1939-1959 are explored by Kate Prebble and Linda Bryder (2008). Echoes of these tensions also reverberate today, and the authors leave us with the question of how mental health nursing should be perceived in the contemporary context of a female-dominated profession. We might also consider how the notion of the ‘mental' should be conceived, in the context of a health care system increasingly dominated by a biogenetic model of health and illness.

The paper by myself and Kim Walker (2008) has already been mentioned, and takes a critical look at a number of key student texts that shaped the thinking and attitudes of nurses in the period 1910-1969. It argues that these texts sustained a cycle of thought and practice which uniformly idolized clinical skills and excluded intellectual ones, and which highlighted the personal qualities of the nurse and their responsibility for the quality of care but failed to acknowledge systemic or political factors. These themes resonate with early curriculum policy in South Australia, as described by Mayumi Kako and Trudy Rudge (2008), who show how a more reflective and better theorized approach to nurse education, attendant upon the move to the higher education sector, potentially contributes to a more secure professional identity.

The resources now available via the web, and particularly through the gradual digitization of old and rare texts and documents, have added a new and exciting dimension to historical research, and brought it within reach of those for whom it is not normally a professional activity. It is my genuine hope that the papers in this special issue will prompt others to study the history of their discipline, whether it is in order to challenge or confirm the existing literature, or to take a first step into a completely unstudied area. It is an exciting, rewarding and revealing journey!

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