#42 Dr Leah Kaminsky

The Anatomy Education Podcast is supported by the American Association of Anatomists. The American Association of Anatomists is a scientific membership organization with the mission of advancing anatomical science through research, education and professional development. For information on its range of membership options, scientific meetings and grants funding portfolio, please visit www.anatomy.org. Welcome to the Anatomy Education Podcast. Hello again everyone and today it is my real pleasure to welcome Dr. Leah Kaminsky from Melbourne, Australia to the podcast. There is a physician and a ward winning writer. Leah, how are you doing today? It is a bit chilly in Melbourne, I hear. A tad yes. Well I probably barmy by your standard, 10 degrees. Yes, so in the UK we are having a bit of a heat wave which personally I think is just unnecessary. I think having temperatures, you know, anything north of 25 degrees Celsius that is. I will be evaporating after this podcast. It was interesting because when I was talking to you initially, you were busy snuggling up with a blanket which 9 degrees is a perfect temperature. Anyway, let's not talk about the weather. Thank you once again for coming onto the podcast. Really, I came across this piece on the BBC website. I was a little bit of a conversation on Twitter between some anatomy educators that I know about the use of eponyms, which is really interesting in an anatomy education specifically and the wider world which we can talk about. And you spoke on that piece about the use of eponyms in the female pelvis. You can talk about that in some detail and some other things. You are actually a doctor by training. So what kind of got you into this line of work? I'm a GP, I'm a family physician. And I don't remember wanting to ever do anything else. Very old, true, stickers. I just really loved science and also loved humanities and so it seemed a perfect blend. I've always liked language. So I guess, yeah. And then as I was a medical student, I was really fascinated especially in anatomy classes about how everything was named. Especially they still use mnemonics in anatomy. Timothy Dathvex, all nervous housewives and some other more salubrious ones. Yeah, that was the band by now. Well, you kind of let the students know that exist. But perhaps you don't explicitly put them into workbooks. But it's usually the rude ones that helps them to remember them. Yeah, well, I think they're pretty useful. But I also introduced you as an award-winning writer. And you write, you've got numerous books out there as well. What's kind of theme of those books? I've been writing my whole life, even as a medical student, that's sort of what my pocket money was at my school. But I call myself genre fluid. Okay. I've started off writing short stories and poetry. And whatever they gave me, I wrote medical articles. I worked as a journalist. I drew a lot from my medicine. But fiction is my love. And so I'm now about to, my second novel is about to come out soon. So I guess, yeah, and I think one feeds the other. I'm just so privileged. I get walking poems and stories coming into my clinic every day. And a recent book called The Waiting Room. So it's not my debut novel. So just, I can put a link on the show notes so people can go away. And they can, they can find your website. And they can have a look at the book and a couple of links to see where they can perhaps go and purchase the book. But before we kind of talk about the whole idea of epilimps and stuff, just what, what's that book about? Because it's been really, really quite successful. It's had modest success. Yes. Thank you. It only took me 30 years to write. But The Waiting Room. So is it based on medicine? It is. It's, well, the protagonist is a doctor. The first thing anyone ever asks me is this an autobiographical book. And then when I write a nonfiction book that's actually memoir, they say, "Have you made all this up?" So it draws on, I, it's got a lot of thematics around it. And one of them in particular is about the notion of waiting in our lives and how we sort of wait for life to happen. And this deals a lot with war and, and, and ordinary lives of people within war-torn environments or situations like that. I don't want to give too much away. Of course, of course. And like I say, I can put some links on the show next to people who can go find out more about that. Is it that interest in, in writing and that interest in science and medicine that kind of flagged up the use of eponyms? How did we get into writing a piece with the BBC on, on eponyms? Gosh, well, I, I guess it's sort of late nights on Google a lot of the time that I fall down the rabbit hole. I'm very interested in narrative and in language as a writer and as a doctor. And I'm not really sure where it came from, where all my ideas come from. Again, I sort of stumble across things and then I start thinking about them. They kind of compost in my brain. And, and I started thinking about what we call, what we call things and how we name things. And, and initially started with me taking a walk, taking my dog for a walk around the block. And I live in Melbourne in a very suburban area where a lot of the street names are named after indigenous first peoples. And so using a language that's actually sadly died because we've, you know, been atrocious to our indigenous people. And I thought to myself, well, that isn't that wonderful. We're honoring the original inhabitants of these, of this land. And yet on second thought, I thought, well, are we honoring them? We've, we've actually taken it away from them. And what's the point of it's almost like ironic or that these street names with nice little sort of white suburban streets carry such such a dark narrative. And then I came home, I don't know where that all went, but basically started looking up meaning of words and it led into then me coming back to what I know, which is medicine and anatomy, which I did do that well at. I mean, because I couldn't remember things. It was like, you know, how London taxi drivers used to have to learn all the streets. It was called the knowledge, I think, or so. And anatomy always felt a bit like that to me. Sorry. That's okay. That's okay. That's okay. So I wondered whether I would have remembered it better. Had it made sense to me that it didn't just have to be the sphincter of body and who the hell, where the hell was that and what was it? Well, that's interesting because we just touched on the sphincter of Odie as an example before we, before we hit the red record button. And obviously thinking that we may talk about the sphincter body, I went to the well-trusted encyclopedia on the internet and found out quite a lot about Dr. Rigero Odie who in 1887 at the tender age of 23 discovered this sphincter that was associated with the juadine. But you're right. What does the sphincter of Odie mean to anyone? Really, it's not very descriptive and the epato pancreatic sphincter gives students a lot more information about what we're looking at. Yeah. If you said to me, where's the sphincter of Odie now? And I haven't sort of, you know, come across it in a couple of years. I wouldn't know. But when you say a epato pancreatic sphincter, I know where that is. It gives me more knowledge as a name and it's more useful to me. I mean, I guess, and then I started sort of looking at all these eponymous names and starting with atlas, you know, the first sphincter and correct me if I, you know, I did get a sup exam in anatomy. So please correct me, James. The first cervical vertebra that supports the head was named after Atlas, the Titan God, I think he was a God of some mythological dude, and who held the world on his shoulders and I thought, "Well that's just such a metaphor. Gods are holding up hell, entire anatomy." And then I thought, "Well, so areblocks." And I understand where that all comes from, but I don't have an answer. But my job as a writer is to question. And so it just occurred to me, "Well gosh, we're just populated by. " And then it kind of, you know, I honed in on the female pelvis and said, "No, I don't want to do that." Well, how many blocs are hanging around there? - Yeah. - And, and tons. And I've had hate mail, by the way, since then I'd got came out. - Really? - Oh, totally, yes, yes. - On what basis? What? - Well, one person even complained about the fact that I was named after, I have a biblical name, Lea, which means in apparently in old Hebrew, weary cow. I was a bit horrified to find out. He said, "How appropriate for you to be named that, because you're not honoring all these people who've put such hard work in and you were probably named after some patriarchal, biblical, you know, patriarch from the Bible. It just went on and on. I just got these, I got very complimentary emails and people who thought I'd raise some very important issues, but others that just, I guess the world's divided into people who love epinems and people who hate epinemes is what the take over message I've learned." - Well, very interesting. - Yeah, I often think about certain things and that's an interesting one, 'cause I often think, why do people care enough to read this piece perhaps? And then actually make the next step, which is to find your email address, 'cause your email address is not on the BBC website. So they'll have to do some sort of searching to then find out just as I did. - I guess I take it as a compliment. - Yeah, I suppose. - I suppose. But why do people care enough to go away and write kind of abusive emails to people? Yeah, fascinating. Well, obviously epinemes really raise a lot of emotion. I mean, we are by nature as humans, relentless taxonomists. I mean, my dog doesn't distinguish between, I don't know, what his tin food is called, which tin is which and what it's name is and who it's named after. But humans, I think need to name things, obviously. - Yeah. - And it's not just an anatomy. You look up at the stars and everyone's stuck their name on that and all right throughout science, every bacteria has an eponymous name. And that in itself is not so much a problem, but I think for me, what I started wondering was, do we deserve, you know, just eponymous naming deserve retrospective kindness from us, from a historical sense, or should we be throwing unreserved censure at these mainly blocs, sorry, because of the age, just deciding that they're gonna kind of pee on that tree and that's theirs. And conquer that kind of continent of the body, all that part, that their little sort of neck of the woods. And the more I looked into it, the more a lot of these names were actually named after people that didn't deserve, weren't there in the first place to name it. You know, there was somebody that was overlooked and the headhunter got to name it. And we can talk about a few examples of that that you have brought up as well. - So a lot of the attributions sort of lack the historical basis in the first place. - Yes, so they've been distorted through time anyway. So actually you've been away from the actual, actually what happened, but let's-- - And in a way, James, so that's actually best case scenario, but then when it comes to, you know, quite nasty links, for example, to card carrying Nazis, that have stamped their names on different diseases or things that were that research grew out of very dark experimentation. - Yeah, sorry. - And it's okay, we could talk about that now, really, I suppose, because a recent example of that is the use of clover cells. So clover cells are a cell type found in bronchial epithelium and they were kind of discovered by a German anatomist, Max Clower, using tissue that was obtained from executed prisoners during the third rite and he was a signed up kind of Nazi party supporter. I know recently the-- - He's the chair of a natomy at Leapseek University. - Yes, yes. - And he was using the material from executed prisoners as he's so. - Yes, and a card carrying Nazi. - Yeah, so clearly there is a certain degree of uncomfortableness in using those people to name various things and actually it's been changed now to club cells, I think. - Oh, really, I didn't know that. - Yeah, it's clover cells and now-- - Yeah, and now you're called club cells. But even that, I'm not sure on the origin of club, what they actually are are bronchialar exocrine cells. Now this can come to a point that we spoke about, yeah, again before we pressed a big red record, but if you're a medical student or your histology student or you're someone that's learning about this sort of stuff, then actually a cell known as a bronchialar exocrine cell tells the students so much more about what that cell actually is. It's located in the bronchials, it's exocrine, which means it's a crete something which is gonna be lost through natural waste as opposed to endocrine, which goes into the blood system. And it tells the students exactly what that cell type is. So there's a balance there in supporting the students, like we said about the apatopancreatic strenght. - I guess the scientific terms, the more descriptive, informative terms of a more of a mouthful, there is a bit of a kind of romantic ring to something called a clara cell. But there was an article recently that came to light in the New York Times about Asperger. And Asperger syndrome, and Asperger again, had a very dark, third-rife history. - Yes. - And medicine and anatomy are littered with these epidemics. So I hear. So it's interesting, isn't it? Because you have those structures that are named after various things, be it a Nazi perhaps. But actually, you have rarevious other diseases like Parkinson's disease. Now, what else would you call Parkinson's disease nowadays? You know, Parkinson's disease has become kind of more than the person. Well, you know, Parkinson's is a really interesting dude. And he actually. First, this is back in the 1800s, he named it the shaking palsy. But he was a real renaissance man. This guy, he was a paleontologist, studied fossils. But also plotted to, in my reading, which he's a wonderful thing, plotted to assassinate King George III. My British history is not that great, he was one of your mad ones, I think. And he was going to sit in the theater and fire a poison dart at him from a popcorn. It's a good old Parkinson's. - Yes. - Yes. - Very colorful background. - And there's Huntington's disease, there's Addison's disease. There's so many of them, which I wonder. I suppose where you draw the line in wanting to change eponyms to reflect a more scientific basis, you think of things like Calvin and Boyle's Law and Hertz. I was named after predominantly men, but that becomes so rooted in our language. - Yeah. So one of the emails I got was arcing up because, and basically said, "Mrs Kaminsky." (laughs) When you've worked hard enough to discover something unique and made a difference in the world, then and only then will you have a right to have something named after yourself. I guess people feel that having something named after a scientist or whatever, or an explorer or whatever means you're giving, you're honoring that person and you're giving them credit. And I can understand that. But we kind of float and I talk about this in in the article, Lera Borodetski, who's a very well-known linguist, I chatted to her about it. And she was saying, "Well, these eponyms are innocuous when you don't know what they mean." Well, when you're just talking about, you know, I don't know, - Well, there's that. - Down syndrome, let's say. - Yes. - But you don't know the background of the person. It's just a word. And so it's harmless. But once you start looking behind the veil and you understand that down was actually the superintendent at the Royal Earlswood asylum for idiots in Surrey and was looking after people with Trisomi 21 and quote, said, "They might be a throwback to the Mongolian type." This is, we're looking at the mid 1800s. And then the term Mongolism was coined for Down syndrome. Well, I'm thinking, why don't you just ditch the lot? 'Cause that's just so laden. Why not? just call it, try Sony 21. Why does he have to have, and you're looking, we're kind of applying the morality of contemporary morality, the politically correct version of here and now, with the retrospective scope, looking at these guys and condemning them for what probably was run of the mill stuff in those days. An example, I think it was last year, don't quote me on it, but Sims, who was called, who was coined the father of modern gynecology in America, had a statue, that went, we used the Sims speculum, we used the Sims position for examining in gynecology, he had a statue dedicated to him in Central Park, and if you google that, there were huge protests condemning the fact that this man without consent used women of color to do all sorts of horrific examinations, experiments without anesthesia, and there was such a huge protest that they actually took down the statue, a bit sort of saddam, the same stuff, and moved it to the cemetery where he was buried, and no longer is there. So, it is, it's difficult because it's very difficult to have these conversations without there being a kind of overarching political agenda, and rather, you know, on a nice, friendly podcast, we don't necessarily want to get into these conversations, but there are clearly kind of political connotations and repercussions about the balance of trying to, to try and cleanse history, and to change history, or to sense the history, and to, you know, you can still, I suppose, criticize what went on the past, but there's a balance between understanding and accepting and criticizing it when it on the past, and actively trying to remove it, and it's where does that apply, you know, things like Parkinson's and hurts and calvin, and various things are so ingrained into our society. And again, talk about that. What Paradisky was saying, and I think what really impressed me, what she said is that these, you know, the eponyms that don't hold out actually kind of will die, the death they deserve to die. So that if, if, if, you know, society understands what's behind some of these eponyms and, and realise, and doesn't, as a whole, we don't think that that's kind of applicable anymore. Then it will, it will die out. The more innocuous ones, we're not going to be so bothered with. Yeah, yeah. But there's, if we just look at your, your piece on the BBC, where you focus on the female pelvis, there's the philopian tube. Now, I never teach my students the philopian tube, because what does philopian mean? Whereas if you call it the uterine tube, well, it's a tube associated with the uterus, and therefore it makes so much more sense for a student to understand what that is, like Bartholing's gland. Well, who's Bartholing is Bartholing some sort of structure? Well, it doesn't, that word Bartholing doesn't mean anything when you start talking about the vestibular gland and various things, and it gives it a location, it gives it a place, it gives an anatomical landmark, which helps the students to learn that, that content in a lot more context. So, Jens, I'm wondering, you know, I haven't been in anatomy school for a long time, and I'm wondering, is that a trend? Are you just sort of a maverick in that, or is that a trend with students? Because I know every day, you know, when I get specialist letters or radiology reports in a clinical setting, I'm still reading about Bartholing's gland and philopian tubes and pouch of Douglas and blah, blah, blah. Well, I'd like to think I'm a maverick and leading the way here, but I'm not, and if you look on the on the Twitter page, that, you know, a group of anatomy educators, a popular one, on Twitter, there is, you know, there's been quite a rich conversation actually on the YouTube channel. What's your handle? I'll have to follow that one. What's your Twitter handle? So, the Twitter handle for this is a Nat Edu podcast, but if you, and I'll tweet, tweet out about it afterwards, and there's various other people on there that have commented, commented on this, and we can perhaps start that conversation again based on what you've said. But there was, I think it's so cool what you're doing. Well, I think it's interesting, because I think the medical students, they clearly, in my opinion, like the idea of it being called a uteroine tube or whatever, which gives it is anatomical understanding, but I think some of them quite like the history of it, of that this structure was named after a person, and therefore it's got a certain level of importance, perhaps. And I think some of the older clinicians in the workplace will tend to refer to structures by their epidem, rather than their anatomical, because that's how they were trained. So I suppose there's a balance there between teaching the students the anatomical version. But making them aware that there are the epinems, because they may well encounter them later on when their surgeon talks about the page of Douglas. Well, what is the page of Douglas anatomically? I wanted to just ask you also about, we're talking about epinems, but what about language that is laden like the word for vagina? I was quite shocked to learn from my linguist friends that that actually comes from the Latin for a sheath, for a covering of a sword. And I mean, you know, that's, that's pretty interesting. There are lots of words like, you know, clitoris comes from to shut away from Lake Greek. So there are words that aren't eponymous terms that are anatomical terms that are actually quite laden with negative or patriarchal connotations, that I wasn't aware of, until I started sort of trawling through. No, and it's not something I was particularly aware of either. And I don't think the podcast is supposed to work, but you ask me questions. I'm not sure I know the answers to that question at all, but it does reflect a period of time when things were named with a much more patriarchal kind of view of the world, I suppose. And so that that terminology does skew male? Yes, because you write in the piece the way language and it's masculine or feminine kind of way it's named can mean different things to people. I think there was something in the piece about kind of architecture as well. Yeah, well, also in different languages. Gillard Suclamen, who's a professor of linguistics here at University of Adelaide, pointed out to me there were words like bridge that in a language, there are languages where bridge has a feminine gender, I don't know, large bridge sort of thing. And then there's another one in another language and I can't quote which language is it is. It has a masculine gender and studies have shown that the one has the masculine gender, a lyrd bridge, let's say, for argument purposes. People look at them as strong and sturdy. Lyrd bridge is sort of seen as elegant and beautiful and graceful. So I people say that people said to me, well, you know, it's just a name. What's in a name? It doesn't really influence your thought patterns. And that's the question, do they? And I think if you do build an awareness of what's behind the language, I think it does reflect your thought patterns. Yeah. Yeah, well, I'm not sure I have the answer. So those questions are to I don't think any of us. But I think it's important to ask the questions. I think it's important not to just take it for granted. These are the names. I've used these our whole lives, eponymous or whatever the Latin, the great and not actually reflect on it. Yeah. Yeah, there was a section in the piece where you wrote about hysteria. And that has that was kind of used in a very it was pointed towards towards females, wasn't it? It comes from the word the great word for uterus which was hysterica. And we all have heard about, you know, the mental disorder that women had for a long, long time, everything was put down to hysteria. And that came from ancient times. But the the Greeks were the ones that were saying that getting married was going to be a cure for hysteria because the uterus was particularly prone to wandering. Anyway, what was most fascinating out of that old exploration of hysteria was the treatment for it. But in the 19th century, which I actually wasn't aware of. that the treatment for hysterical ladies was a genital massage performed by their physician and they were cues going out the door. And basically these women were going to have orgasms with their doctors. And that garnered the development, that led to the development of the mechanical vibrator to save the poor doctors withering hands. So it's a funny story. What period of time was that? 19th century. Wow. Yeah, hysterical. That was the treatment for hysterical ladies. They were given paroxysms by their doctors. I mean, horrific, what do you think of it today with the retrospective scope? Yeah, but also interesting that I suppose the women went along with this. Oh, I would chew darling. If they were coerced or it just comes back. It comes back to that judging that work that went off in the 18th and 19th century with the way in which we view the world today. And how far we go along judging and condemning or yesterday's kind of science and what was going on with what we think and what we believe today. I'm not sure it's a question we know the answer to, but it's definitely a good question that's worthy of discussion to bring it into the consciousness more of people. So they're more aware of the history. I think that's the most salient point here, James, that you bring up now, is to bring it into our consciousness. I'm finishing a novel that's coming out next year, which is examining the group of, we're a bit off topic here, but it's sort of on the same plane. A group of Nazi scientists that were sent to Tibet by Himmler to explore the origins of the Iron Race, because they threw out Einstein's theory of relativity and the scientific platform of the Third Reich was something called Velt Eisler, which is world ice theory, so that the building block of the universe, this was an accepted scientific platform in those days, and very popular, was the ice crystal, of course. So the moon was made of ice, and I think if you don't question these things with the retrospective scope, I mean, it's happening now, the pseudo science, the fake facts. I think taking things at face of value goes against the grain for me as a writer and as a position, I guess. It's interesting, because it has provoked a fair bit of conversation it really has, which I suppose is a really good thing from the piece you wrote on the BBC to have this conversation, and there's so many different strands to it. There's the simple how best to teach students these words, so they can support them in knowing what they need to know. Keeping various eponyms like Parkinson's or Calvin or Hertz that have become so ingrained in our culture. And we touched on Down syndrome earlier and Mongolism. But I wonder what would happen if we did start calling it, try semi-21, because people know what Down syndrome is now, don't they? And it's so ingrained, and then you change it, and people are going to not know what you're talking about perhaps. Well, that comes down to education. And just because they know what one thing is doesn't mean that it can't be changed. For example, this conversation is happening now with Asperger's, trying to divest of that eponym. But I think language evolves and language changes. And I don't understand my teenage kids nowadays. I'm not allowed to use the word groovy anymore. That's just so not cool. So I don't think it's bad to jettison languageism isn't relevant now. But I think it needs to be a thought through conscious process, especially if it is language that is laden and kind of reinforces gender bias or misogyny or racism or any of the above. Just to go back to your work as a GP, how do you find or how do you use epinems when you talk to patients? Probably badly. I'm just wondering from a kind of, you know, it's very well, isn't it? Us and Atomists talking to each other, and I reach out and talk to you about it. And we're talking about these things that actually, maybe a large proportion of the general public are just completely oblivious to what epidem is perhaps. But so was I as a doctor? I mean, I used terminology day in day out that I didn't know that Gramstein is named after some guy. Or did I until I was there? Oh, well, there you go. Look it up. Yeah. You know, I'm using this terminology all the time to read, Oslo's notes, Rantkin, I don't know, that I don't even think of people's names. Yes. So it's just been a fascinating kind of awakening for me. And now I'm just kind of obsessed with trying to, you know, looking up, oh, who was that named after? Yeah. Now that's a good, and I suppose Wikipedia is a good source of that information, isn't it? You know, let's give Wikipedia some credit. A lot of my, my own preparation for this was, oh, that's interesting, because actually on Wikipedia you have a list. You have a list of epidem from medical epinisms related to Nazi members. You have a whole list of medical epinems that are related to disease and various things. So it's actually a nice little exploration. And on the show notes just, just while I'm just talking about that, I can put a couple of papers actually, which are based on a BMJ, a British medical journal discussion, where there are people argue, yes, and no for the use of epinem, which is, which is really interesting. And there's also a paper on there, which I can find about clara cells, and how they had that discussion. I think it's the European Journal of Respiratory or something, something like that. But I'll put it in. I came across a wonderful terminology. It's called epon, it will not be our reprenounce. Here we go. Epinema philia, as opposed to epinema phobia. So I don't know which camp. I'm kind of somewhere in the middle, I think. Yeah, I just think it's nice to have this discussion. I think it's nice to have this discussion. And just like we say, to bring this sort of thing into people's consciousness, so they can just think about things a little bit more. But it sounds to me like anatomists are kind of a bit more woke than clinical folk to all of this, because as I said, you know, I've got all these reports that I've brought home that I'm kind of going through now. And I could just flip through them and you will see so many eponymous names on them. It's just part of the daily stuff. I think it is. I think it is. Okay, Leah. Thank you very much for coming onto the podcast and for sharing. Thank you for inviting me. No problems at all. No problems at all. Thank you for sharing some thoughts and ideas, some insight, some background, and some really interesting. And you are on Twitter, so if people want to treat you or to find out more, then they can. Only nice things. Of course, yes. Yes. Speak on. Let's not delve into the origin of your name anymore. I think we've put that to the point I have. Oh, God. So you can follow Leah on Twitter via using the Twitter handle @LiaCAM. So, AlieHK8M. And I'll put a link on the show notes to your website, so people can go and find out a bit more about you and have a look at the rarest books that you've written. So Leah, thank you very much again for coming onto the podcast. Thank you, James. It's been fantastic. No worries at all. And until next time, cheerio.