Biomedical Computing: Digitizing Life in the United States by Joseph Adam November (review)

Given the centrality of computers and computing to the practice of contemporary biology and the prominence accorded to computers for the futures of biomedical research and health care, the absence of accounts exploring the history of biomedical computing is striking. In Biomedical Computing, Joseph November illuminates how biology and medicine changed from “exemplars” of noncomputable research areas into models of computable problems (p. 7). Examining the history of biomedical computing in the thirty years following World War II, November compellingly argues that the adoption of computing in biomedicine was a reciprocal process: at the same time that biomedicine was “computerized,” the development of computing was also powerfully shaped by biomedicine (p. 15).

After World War II, most biologists regarded the continuous analog data produced by their experiments as unsuited to analysis by digital computers. Computers in biology were limited to a few marginal areas, such as x-ray crystallography. However, operations research, cybernetic theory, and crystallography inspired a few biologists, such as the Americans Robert Ledly and Lee Lusted, to become evangelists for the use of computers in biology (chapter 1). Initially, Ledly and Lusted gained institutional success, creating the Advisory Committee on Computers in Research within the National Institutes of Health (NIH) to promote the use of these new machines. Their vision, however, floundered due to its attempt to restructure biological work in order to produce digital results (chapter 2).

As the committee sought to make biology fit computers, a group of engineers at MIT’s Lincoln Laboratory was attempting to fit computers to biology. In contrast to the ethos of large-scale time-share computing dominant among the engineers of MIT, former nuclear-weapons designer Wesley Clark sought to construct smaller computers capable of accepting and graphically visualizing analog data in “real time” for individual biologists as they worked. This philosophy, while intuitionally marginal at MIT, found an enthusiastic patron at the NIH who supported Clark’s development of the Laboratory Instrument Computer (LINC). In an important recasting of the history of computing, November suggests that the interests of biologists, particularly their preference for “personal” interactive computing, exerted a lasting influence on the shape of computing as a whole through the subsequent role that LINC played in the development of personal computing (chapter 3).

With the support of the NIH and Ledly’s National Biomedical Research Foundation, the LINC system was adopted in a variety of biomedical settings, ranging from Massachusetts General Hospital to CAT scans and Margaret Dayhoff’s Atlas of Protein Sequence and Structure. By following the computer and those who promoted its use, November gives us a sense of the connections among these activities, which are regrettably often separated by the divisions among the history of medicine, the history of biology, and the history of technology. In each case, the adoption of computers depended heavily on a hard sell by computing advocates rather than demonstrable utility. Nonetheless, once computers entered the laboratory or clinic, they assumed a central role in their users’ forms of life and experimental practices (chapter 4). Often, the computers found new local niches. At Stanford, computer systems like DENDRAL were first built as expert systems to perform chemical analyses associated with the search for life on Mars. Once this initial effort was frustrated, the technology became a critical part of medical diagnosis software. November’s emphasis on the role of the NIH is a critical reminder that the full impact of the federal government on the intellectual and institutional development of biology and medicine remains a fruitful historical field (chapter 5).

November’s most direct engagement with debates in the historiography of technology has been reserved for the “Essay on Sources.” He appears sympathetic to the augment of Langdon Winner’s classic essay “Do Artifacts have Politics?” favoring the idea that biomedical computers continued to express the residual intentions of their designers, even as they were transferred to new problems (p. 328). Computers may have been remarkably plastic...