75th stories: Excellence attracts – Roy Porter at the Wellcome Institute
To mark the 75th anniversary of the death of Henry Wellcome and the founding of the Wellcome Trust, we’re publishing a series of 14 features on people who have been significant in the Trust’s history. In our third piece, medical historian Bill Bynum looks at his former colleague Roy Porter, who was for years a linchpin of the Wellcome Institute for the History of Medicine.
Flamboyant yet unassuming, brilliant and generous, Roy Porter (1946-2002) was the shining star of medical history through the 1980s and 1990s. Indeed, he was one of the greatest medical historians of his generation. Extraordinarily prolific, he wrote and edited more than 100 works on subjects that ranged from patients to madness, quackery to gout. And as he appeared often on radio and television, he brought medical history to a wide public.
The Wellcome Institute for the History of Medicine at University College London, where Roy shone from 1979 to 2001, was the legacy of Sir Henry Wellcome’s enormous collections of books, manuscripts, pictures and artefacts. Although much of the collection was dispersed to other museums, the books and manuscripts remained as the Wellcome Library and were joined by academic historians. This union contributed greatly to the development of the field of medical history, which has now grown to be one of the most vibrant fields of history in the UK.
Early medical history
Doctors have long been interested in medicine’s past. One of the Hippocratic tracts is called ‘Ancient Medicine’, and Galen (129-c.216), the most influential doctor for more than a thousand years after his death, saw himself as consolidating the Hippocratic legacy. The ‘Divine Galen’ was still a force until the 17th century, so his works were lovingly translated and commented on. Indeed, modern medicine owes much to the transmission and recovery of ancient texts.
This concern with the past was vibrant and creative. Because ancient authors still had things to say, it was about the present as much as the past. Through the 17th century, ‘history’ still meant ‘description’, so histories of medicine had little historical dynamism. This began gradually to change, and the first ‘history of medicine’ by an English author, that of John Freind (1675-1728), had some sense of the difference between the ancients and the moderns, of which Freind was one.
British doctors continued to interest themselves in the history of their discipline, but through the 19th century, most serious medical historical work originated in Germany. By then, ‘history’ had acquired its modern implication of ‘development’, and older authors had retreated to the status of inspiration or the occasional clinical pearl, but they were no longer authorities guiding medical practice. A number of massive German monographs surveyed the development of medicine from antiquity to modern times, and several institutes of the history of medicine were established.
The most important of these was that in Leipzig, where Karl Sudhoff (1853-1938) was the director. He was an academic in both the best and worst senses of the word: authoritarian and pompous, but also a serious scholar who sought to impart high standards on the new academic discipline. His successor was a Swiss, of a completely different stamp. Henry Sigerist (1891-1957) was a man of great charm, linguistically gifted, liberal and with a vision of medical history that still inspires. As Germany lurched towards Nazism, Sigerist felt alienated, and went to Johns Hopkins, where his institute provided the seed for the discipline in the USA. The chair had earlier been offered to Charles Singer (1876-1960), the pivotal figure in Britain.
Singer was the first academic historian of medicine in Britain. Singer’s wife, Dorothea, herself a distinguished historian of science and medicine, was independently wealthy, which allowed the Singers the luxury of book collecting and independence. For two decades, Charles Singer taught at UCL, but his teaching duties were light and the couple could spend much of their time in their fine home in Cornwall. Whereas Sigerist was the man who introduced the social dimension to medical history, Singer was a more traditional intellectual historian of medicine, science and technology. Both Singer and Sigerist were remarkably productive, able to write with equal ease about antiquity and the modern world, and all points in between. Their work still has solidity and relevance, and their friendship is movingly captured in their ‘Correspondence’, shortly to be published as a Supplement to ‘Medical History’.
The Wellcome Institute
Singer and Sir Henry Wellcome did not get on very well, and even after Wellcome’s death in 1936, Singer felt that he was not allowed adequate access to the treasures that Wellcome had collected. It would have been appropriate for the Wellcome Trustees to have endowed a Singer Chair in the History of Medicine at UCL, but at least that institution was the place they chose to begin officially to support an academic discipline in the field. Before 1965, when the initiative was first discussed, most history of medicine grants had been made to libraries. Libraries do need support, but they also need scholars to exploit their riches.
By then, the treasures of the Wellcome Library were freely available, due especially to the vision of its Librarian, F L N Poynter (1908-1979). Under Poynter, the Library became part of the Wellcome Institute, which consisted of Wellcome’s Museum and Library, with a handful of scholars employed to work on the collections. The Museum was then housed in 183 Euston Road, and in 1964 Poynter became Director of both Library and Museum, renamed the Wellcome Institute.
One of the academic staff was Edwin Clarke (1919-1996), a neurologist who had been sent by the Trust to the USA to further hone his skills in medical history. (I just missed him when I was a medical student at Yale, where he taught for a term.) Clarke was the beneficiary when the Trust decided to invest in academic history of medicine, and the Sub-Department of the History of Medicine was created in the welcoming Department of Anatomy. The Trust’s idea, a good one at a time when universities were relatively expansionist in their philosophies, was to seed a post for five years, with UCL agreeing to take it on at the end. This initiative was soon followed by similar ones at Cambridge and Oxford.
Clarke established a teaching and research programme at UCL, as well as at the Royal Free Hospital Medical School, then a separate institution. His core staff remained small: himself, a secretary and a research assistant, although Jonathan Miller became an honorary research fellow. He also built up a fine research library, now sadly dispersed. Clarke had an outstanding personal library, and he once told me that there were times when he had trouble finding money for a new pair of shoes, but that he could always find the money for the books he wanted. Poynter retired in 1973, and Clarke succeeded him as the new Director of the Wellcome Institute. I had just finished my PhD at Cambridge, and was fortunate to be appointed as the head of the Sub-Department at UCL.
Clarke went back to the Wellcome Institute at the time when the Trustees had decided that Henry Wellcome’s museum specimens were better displayed in a site likely to attract more visitors, and the Institute was subsequently moved to the Science Museum in South Kensington. As the museum objects were beginning to be moved, a new structure was proposed for the Institute: instead of a Library and a Museum, it ought to consist of the Library and an Academic Unit. What better way to exploit the Trust’s commitment to academic enquiry than to have the Wellcome Building the centre of teaching and research in the discipline? A ‘Scheme of Association’ between the Trust and UCL was agreed in 1976, whereby the Sub-Department, as it was still called, would be the nucleus of the Institute’s Academic Unit. UCL would make the appointments and promotions, and the Wellcome Trust would foot the bill. It was a minor miracle, given the status of UCL and the richness of the Wellcome Library, and the erudition of its staff.
The Director of the Trust, Peter Williams, was determined that the Unit expand only as and when a new post could be justified. In retrospect, it seems ambitious that we asked for a position in the social history of medicine. I could easily justify it now, but I do not remember how we argued for it then. It was certainly not designed merely to attract Roy Porter, then thriving in Cambridge. Roy and I had become good friends in the early 1970s, when we were both doing postgraduate work there. We ran some reading groups together, and discovered subsequently a mutual love of chess, which by then we were playing by post – or, more usually, by a phone call that consisted precisely of the next move.
We duly advertised the post, and I knew I was in gravy when I had an inquiry from a distinguished scholar who said he would apply only if Roy did not. Roy and five other people applied (it was a small world, then), and the other applicant, now in an endowed chair in a major US university, quietly withdrew. One could never get away with it now, but Roy seemed so far above the field that I convinced the Trust and UCL that formal interviews were unnecessary. The only stipulation was that a distinguished historian at UCL vet the applications and give it his blessing. I left the files with him without comment and returned a couple of days later. He merely said, “I assume you mean Porter?”
Porter at the Institute
Roy had been a star at Cambridge. Coming from a working-class background in south London, he had had his interest in history fired by an outstanding teacher. He took a double first in history at Christ’s College, Cambridge, and was soon elected to a Junior Research Fellowship there. His exposure to the history of science had occurred when taking a special subject on the Darwinian revolution, and his PhD research was the basis of his first book, ‘The Making of Geology: Earth science in Britain, 1660-1815’ (1977). It remained one of his best books, still fresh after 40 years. At the time he applied to the Wellcome Institute, he was working on the 18th-century volume in a new ‘Social History of England’ for Penguin, a book still in print in its second edition.
His 18th-century history talked about health and disease, but when he applied to us he was more of a social historian with a special interest in the earth and life sciences. But his application proposed to offer courses on the history of patient-doctor interactions, and on the history of psychiatry. These he duly did (he was a superb teacher and lecturer), and these areas became the basis of much of his innovative work in the field.
By the time he arrived at the Institute in 1979, we had already been encouraged by Peter Williams to expand our range of public activities. I had arranged a weekly research seminar at UCL since 1974, and now as part of the Institute, we started a series of all-day symposia as well as occasional public lectures and themed research seminars. Among the latter was a series that Roy and I ran on the history of psychiatry. These were often electric occasions, with large attendances and lively discussions, at a time when the whole concept of the profession was being seriously evaluated. They vitalised a field of enquiry and produced three volumes of essays (‘The Anatomy of Madness’, 1985-88), which are still widely cited. The wonderful title was Roy’s, inspired by Robert Burton’s ‘Anatomy of Melancholy’ (1621), a volume to which he often returned for quotations and insights.
The history of psychiatry was thus one topic that Roy continued to work on during his years at the Institute, producing books and articles and stimulating psychiatrists to take a serious and critical look at their discipline’s past. The Royal College of Psychiatrists made him an Honorary Fellow, as did the Royal College of Physicians of London. He was a Fellow of the British Academy and was the first historian to be elected to the Academy of Medical Sciences.
The second major subject area that Roy pioneered was the history of the patient. As he liked to point out, medical encounters always involve at least two individuals, the healer and the sufferer, but the history of medicine had too often been top-down. The patient’s voice needed to be rescued from oblivion. As would often happen, when Roy wanted to explore a topic, he would organise a research seminar. His seminar series on the history of the patient yielded an important volume, and with his third wife (of five), Dorothy Porter, he produced two monographs on patienthood and the experience of illness in his beloved 18th century. These and other works firmly placed patients on the historical map.
Roy’s third important area of historical innovation was on the fringes of medical practice. He was himself a flamboyant figure and was naturally drawn towards his historical counterparts. The 18th century was a golden age of quacks, and he found there much to occupy his historical gaze. He loved James Graham and his celestial bed and early forms of sex therapy, but many other racy fringe practitioners were also lovingly brought back to life by his fertile pen. The stories he told were always entertaining, but it was the framework within which he paced his actors that was the real stroke of genius. This was the concept of the medical marketplace, within which all medical practitioners – from august Fellows of the Royal Colleges to the most marginal quack – plied their trade. He never did any serious work on medical economics, but his insight into the importance of earning a medical living provided an important motor to his view of how clinical medicine has developed over time. His major book on quacks (the second edition was simply called ‘Quacks’) was dedicated to me: I always thought it was a simultaneous act of affection and a sly joke.
For more than 15 years, Roy could be described as the soul of the Wellcome Institute. He and I each got into the office early (he earlier than I), and we would begin each day with a cup of coffee, two chess moves – we always played one white and one black game simultaneously – and a discussion of what the day held. The chess moves would continue during the day, on post-it notes, but I might not see him again until the next morning. He always cleared his desk of the day’s post, which was often massive, with manuscripts to read, books to review and, increasingly, invitations to speak. Whenever I gently chastised him for running himself ragged, he would reply that he accepted only a tiny fraction of the invitations he had received. Those who got him always got good value for money.
During the 1990s, his pace intensified. His output increased with the coming of computers, and his obsession with meeting deadlines meant that he was working day and night to meet his commitments. His later work was more derivative than his earlier books and articles, but as he perfected his racy style, the writing was always distinctive and compulsively readable. We used to say jokingly that Roy wrote faster than most people read. I read most of his output in manuscripts (so did a lot of other people: he was forever sending out his writing to multiple friends). Nevertheless, after he died, I discovered a couple of books on which he was actively involved that I did not even know about.
For Roy, books were merely containers of information. He had a very large personal library, neatly organised in a continuous alphabetical sequence (save for the few that he needed for a particular project). He was happy to dog-ear them, and, on modern books, to deface them with a vile yellow magic marker as he read them. I borrowed or acquired some of these volumes, and I could never make any sense of which passages he underlined. It seemed almost random, but he had a greater capacity quickly to absorb a book’s argument than anybody I have ever known. Maybe I just missed the deeper patterns in his yellow marks.
He loved sport as well, although I am not aware that he ever attended a live match during the time I knew him. I was at Lord’s as often as possible; his luxury was to keep ‘Test Match Special’ on on a radio he kept hidden in a desk drawer. Theatre, too, was a deep love, but his frequent attendance at London theatres mostly coincided when he was presenting a Radio 3 arts programme, and he went as a critic. Fronting that programme once a week also took him to opera, ballet and art galleries, and he could interview people learnedly about them all, but when that commitment ceased, if he continued to go, he didn’t talk about it.
Roy always knew that he could live by his wits, and as his media and writing commitments increased, he began to talk of early retirement. By the time he was as good as his word, in 2001, aged 54, academic history of medicine was well established in Britain. It depended, then as now, on Wellcome support, but it was in place. Alas, he did not live long to enjoy his freelance retirement.
Special places attract the best, allowing those who work there to achieve their best. Roy Porter was in that class, and the Wellcome Institute for the History of Medicine was fortunate to have had him.
Bill Bynum is Emeritus Professor of the History of Medicine, University College London.
Find out more about activities marking the Wellcome Trust’s 75th anniversary, including links to other features as they are published.