Desmond O’Neill: Anthropology, ageing, and medicine

Desmond O'NeillThe Meeting Room of the Royal Irish Academy is one of the hidden gems of academic architecture in Dublin, a city belatedly recognising the richness of its Victorian heritage (1). Behind a discreet red-brick façade on a busy street in central Dublin, the prelude to the experience is by way of a hushed procession through an active working library.

We then enter a chamber over two stories in height, the book-lined walls graced by an elegant iron balcony, and Victorian light-fittings perfectly complementing the vaulted ceiling. Modelled on the Great Hall of Euston Station in London which was demolished in 1962 but more modest in scale—a maximum of 120 participants—we feel we have entered a haven of reflectivity in contrast to the hectic pace of city life outside. This in turn is usually tempered by eye-catching posters relating to the current exhibition, reflecting the mission of the Academy to make advances in research in the sciences and the humanities accessible to the Irish public.

No matter how many times I have participated in colloquia in this chamber, at each visit I continue to be delighted by its restrained theatricality and sense of a vibrant and active academic tradition.

My most recent visit was as a panelist to respond to a presentation last week by a pre-eminent European thinker, Christoph Wulf, of the Freie Universität Berlin, on Emotionality and the Human—An Anthropological Perspective. Wulf, a professor of anthropology and education, has developed an extraordinarily wide-ranging platform of research and reflection on how anthropology helps us to understand many aspects of the human condition, with a significant focus on rethinking what are the components of anthropology, as well as how a global perspective adds both complexity and clarity.

I was daunted at the prospect of responding, not only because I felt very much at the extremes of my competencies, but also because no advance copy of his talk was circulated, so we were truly responding in real-time. In addition, formal anthropology has a very low profile in Ireland, perhaps because a strong literary tradition has traditionally subsumed some elements of the discipline.

However, comforted by the range of expertise of my fellow panelists (a professor of English literature whose specialism was James Joyce, a lecturer in computer science and informatics, and a physicist/poet) as well as expert chairs (a professor of philosophy and a lecturer in German and English), and also by Nietzsche and Adorno’s positivity towards the concept of dilettantism, I sallied forth.

It was not only a highly stimulating intellectual experience but also one which reinforced the sense of the strong linkages between medicine, science, and the humanities, consistent with the philosophy of the Alexander von Humboldt Association of Ireland, under whose auspices the meeting was organised.

The content of Wulf’s discourse, delivered with charm and humanity, not only covered the major forms of anthropology—evolutionary, philosophical, historical, cultural, social, and integrative—but also the evolving process of reflectivity and criticism of culture and techniques of anthropology itself, and in particular the balance between evolving from Eurocentric tradition while preserving the cumulative gains from centuries of research.

In a lively panel and audience discussion, one of the most participative I have witnessed, the key items for discussion revolved around approaches to complexity, and the importance of avoiding premature closure on complex concepts through simplistic terminology and paradigms.

From an ageing and age-related disease perspective, the colloquium provided rich material for reflection on ethnographic approaches to a better understanding of each. For example, the process of emotional regulation throughout the life course can be seen as the development towards a greater, and more subtle, mastery of our interaction with our emotions (2), one of the gains of ageing into later life. Indeed, the past is a foreign country!

The ethnography of dementia provided two avenues of exploration, in the first instance Kitwood’s ground-breaking work on recognizing the dementia experience as a separate but related ethnographic phenomenon (3), which has led to a revolution in our understanding and recognition of the subjective experience of dementia.

The greatest resonance for me with Professor Wulf’s overview of the gains of intercultural anthropology was surely with the extraordinary work of the 10/66 consortium on rethinking what Alzheimer’s disease means in various cultures, from the Peruvian altiplano through the tropics of Africa to north-western Europe. The evolving research of this group has allowed us to prise Alzheimer’s disease from the tight grasp of simplistic mechanical models to a broader vision from which we can all benefit.

With hindsight, I regret that I did not circulate an invitation to the seminar among the medical staff and students in our university, because many would have enjoyed and learnt much relevant to the human condition from the afternoon. As ever, we can all benefit from getting out more!

1.    Barry M. Victorian Dublin Revealed, the remarkable legacy of 19th century Dublin . Dublin, Andalus Press, 2011.
2.    Charles ST, Carstensen LL. Emotion regulation and aging. In Gross JJ (ed), Handbook of emotion regulation. New York, Guilford Press, 2009, 307-330.
3.    Kitwood T. Dementia reconsidered: the person comes first. Milton Keynes, Open University Press, 1997.

Desmond O’Neill is a consultant physician in geriatric and stroke medicine in Dublin, and an immediate past president of the European Union Geriatric Medicine Society.