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Bulletin of the History of Medicine 74.3 (2000) 583-586
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NetNotes: Medical History on the Internet
Russell C. Maulitz
These columns on medical history and the Internet can now boast a certain middle-aged spread. They date back to something penned in 1996. 1 That was, of course, the Pleistocene--if not of the Internet, then certainly of its most robust and successful offspring, the World Wide Web. 2
Most of what has been said in these pieces has dealt with the end products of the medical historical enterprise: research, education, and a smattering of specific projects. But I find I have not yet touched on what is likely the most important impact of the Internet on this and many similar enterprises: not the product, but the process. At times, as Richard and Patricia Kahn showed in these pages, this process may be as straightforward, and as epochal, as the impact on research of remote access to archival collections. 3 For teaching, for research, and for the "culture" of scholarship there is, however, an even more basic part of the process that is often overlooked: it is simple communication. [End Page 583]
One of the reasons I chose "NetNotes" as the title for these columns is the relative antiquity, compared to the Web itself, of the antecedent Internet. 4 The Internet started out as a method of communication. In his excellent retrospect-cum-prospect, "Health Care Computing and the Next Generation Internet," medical informatics pioneer Edward Shortliffe quotes Joshua Lederberg on "digital communications [as] the new literacy," where the year of nascence was 1978. 5 Electronic mail followed shortly thereafter, and was used by virtually all universities in the industrialized world by the early 1990s. (Despite the much-touted "digital divide," a decade later it is difficult to find anyone without it, as many clinicians who are used to responding to patients' e-mails will attest.)
And the Internet, the "Net" in "NetNotes," remains extraordinarily important for both the medical clinic and medical humanities scholarship, precisely because of the necessity of communication. In current techno-parlance, "pinging" our colleagues implies our attempt to get their attention, to verify their whereabouts, and to ensure that they are in "receiving mode." 6 As barriers to "real time" communication continue to fall to the onslaught of Internet technology, it is interesting to speculate about the further effects on how we do history. Medical history, heretofore (and perhaps inevitably) always a rather isolating pursuit, may continue so to a greater extent than, say, patient care, which is intensely social. But here are a few changes that have already occurred, and a few more that may follow.
Electronic mail has become absolutely pervasive: in a few short years it has gone from an "opt in" position in our work lives, to an "opt out" position, and finally, now, to a "no opt out" centerpiece vital to the flow of collaborative scholarship. The simple expedient of providing for documents attached to e-mail has been epochal. It may jangle nerves among those struggling to become used to the demands of near-instant turnaround in the production of the written word, but it is a strong impulsion to the development of collaborative relationships.
Other, less pervasive communications modes rely completely on the Internet. So-called instant messaging, available now through many providers without cost, shifts the scholarly collaboration from "store and forward" mode to real time. It is analogous to a contemporaneous [End Page 584] telephone call instead of the answering machine. Some may claim this is too much of a good thing, but in small doses it can be most useful. 7
A logical next step, beyond passing real-time text messages between, say, my research assistant in Paris and myself, might be a voice-and-video conference through which we share not just facial expressions and "talking heads," but views of archival documents and the like. This technology exists now, through applications like Microsoft NetMeeting, 8 but as of early 2000 it is used rather infrequently. Why? One may speculate that scholars prefer collaboration at...