Passion for Medical History Leads Diller to Chair Winkler Center Board

Philip Diller, MD, PhD, Fred Lazarus Jr. Professor and Chair of the Department of Family & Community Medicine, was recently appointed chair of the Winkler Center Advisory Board. The Winkler Center for the History of the Health Professions, part of the UC Libraries' Harrison Health Sciences Library, is a medical archive, library and exhibit facility that encourages visitors and researchers to explore the Cincinnati area's rich medical history and to discover the people who have contributed to important advances in medicine, nursing, allied health and pharmaceutical sciences. 

Tell us about your interest in chairing the Advisory Board of the Winkler Center.

I first became acquainted with the Winkler Collection in the 1990s when I offered an enrichment program for medical students, the Family Medicine Scholar's Program. Once a year we would meet in the Library, serve pizza and Billie Broaddus would introduce them to the collections—the original (Daniel) Drake diploma; some of the original Drake letters; the hand drawings of Civil War wounds drawn by Dr. Daniel Young, a local surgeon who served in the war; the portraits; and the Martin Fischer Italianate ceramics collection, a replica of jars from a 15th century apothecary shop. I learned then that this library at that time was thought to have one of the top three collections of original medical books from 1800-1900. 

When I became chair of Family Medicine and my office was now on campus I expressed an interest in serving on the Board. I have been a member of the Winkler Advisory Board since 2011. Serving on the Board has been a natural outcome of my interest in the history of medicine that began back in graduate school and medical school. My predecessor, Dr. Marianne Ivey, asked me if I would follow her in that role and it was easy to say yes. This is one of the fun parts of my role here at UC-College of Medicine.

Do you have any specific goals in mind for the Winkler Center?

I am working with the other board members, Dean of Libraries Xuemao Wang, and Leslie Schick, associate dean and director of the Health Sciences Library, and the UC Foundation to sharpen our goals for the coming year. Here are few though that are desirable:

• Meet specific Center fund-raising goals in the coming years. We will be working to provide a plan for execution in order to achieve those goals
• Increase use of the Winkler Collections/Archives for education and scholarship.
• Institutionalize the Oral History program.
• Create a History of Medicine Club for interested individuals to read original papers before the group.
• Develop educational experiences/opportunities for medical students and other learners

What are some things about the Winkler Center that people might not know?

The primary collection of medical books from 1800 to 1900 is one of the best in the country. Many of these books came from different physicians and from early libraries. We are still cataloging it. Before journals (typically 1850) there were single topic pamphlets printed. We likely have the best collection in the country of original pamphlets.

The lore is that some of the early books (1800-1850) were originally owned by some of our early teachers of the Medical College of Ohio and particularly Daniel Drake himself. Drake donated 50 of his books to the Cincinnati Medical Library Association in 1851 to get it started, and I suspect they are in our collection, but not yet cataloged or identified. 

What role does the Winkler Center play at the UC Academic Health Center?

The Winkler Center is the repository for the history of the Academic Health Center and its colleges. It is a medical archive, a library, an exhibit center and a meeting /special event site. The resources of the center provide a lens to understand our current state by teaching the historical context—how we got to where we are and who were the key individuals who played significant roles. This is important because knowing our history can potentially help us avoid the same mistakes, or discover solutions to similar problems, or be inspired by those who persisted against challenges. 

Do you have a favorite object or item in the Winkler Center?

The original diploma of Daniel Drake, hand written by his preceptor William Goforth in 1805, is priceless. Drake was the first medical student in Cincinnati and, for that matter, west of the Alleghenies. He was proud of that. In his remarks upon the founding of the Cincinnati Medical Library Association in 1851, Drake described to his listeners details of his early program of learning medicine under Dr. Goforth and then summed it up saying, "Such was the beginning of medical education in Cincinnati. I say beginning, for I was its first pupil." 

How did you develop your passion for medical history?

I was first influenced during graduate school when I was writing my PhD. I took a study break one afternoon and browsing the stacks I looked up and saw a copy of Osler's "The Principles and Practice of Medicine." Amazingly it was a first edition copy inscribed by Osler to John Shaw Billings, (one of our medical school's most notable alumni, and seeking to understand who Billings was further shaped my interest in Billings—that is another story). Next to that book was Harvey Cushing's Pulitzer Prize-winning biography, "The Life of Sir William Osler." Reading the Osler biography lit the fire for me for medical history. He was a collector of rare medical books, he read to learn the lessons of the masters from previous generations. Their works inspired him. I came to see that physicians from previous generations shared their lessons about doctoring and living the life of a doctor–lessons still relevant today. I have confirmed this over and over again in my career. 

For example, I began early in my career asking the question how was medicine an art? To answer that question I began reading the historical literature to discover how physicians from earlier generations conceptualized it or thought about it. Osler, Peabody, Balint, Cassel, Trotter, Flexner, Stoeckle, Cabot, Leach, Blumenthall and Brody are just a few who come to mind. I discovered that a definition for the art of medicine or a conceptual model did not exist. Many themes, but no one had put it together. That became a personal problem to solve with the goal of creating a working definition that included the fundamental themes (my definition: the art of medicine occurs during encounters where a physician and a patient who have a relationship based on a medical ethic create works of care to achieve good outcomes). This led to a deeper dive in each of the themes in order to understand each element in the definition and charted my territory for learning medicine. This in turn has helped me grow as a clinician and teacher. In addition, it has led to a growing textbook and a course I teach each spring in the new Medical Sciences Pathway major—Becoming a Master Physician. 

Can you share some details on the book about Daniel Drake which you are writing?

The life of Daniel Drake is not only relevant to our institutional history but also for individuals who want to make a difference in their community and particularly young physicians. He is a role model for how one person can intentionally create an enduring community culture through helping create institutions and/or shape the work of those institutions. Osler, writing to UC College of Medicine Dean Paul Wooley in 1912, said that Drake, "started nearly everything in Cincinnati that is good and has lasted." There is a great deal of truth to that statement. 

Drake's bibliography is over 800 individual writings; books, pamphlets, addresses, editorials, medical articles and essays that share his thoughts, plans, motives and insights. These writings fall into five major categories: formative experiences leading to who he became, physician, educator, writer/author and citizen. In those writings are valuable lessons of how to impact your profession and community in a positive way as an engaged citizen. I am collecting excerpts from his writings in these five categories to illustrate how he impacted his community through a multitude of roles and approaches. My desire is to challenge the reader to consider what he/she can do in his/her lifetime to impact the community for good.

Have you done any other research or writing on health history?

The book in progress I referred to above—"Becoming a Master Physician"—is in this same genre.

Is an understanding or appreciation of medical history important for health care providers?

From my other remarks, you know my answer is a resounding yes! The long story of the practice of medicine is a story of impactful discoveries applied for the benefit of mankind. Each medical specialty has a beginning and an evolution over time that came about due to founders and subsequent generations who sought to create new information by asking questions and advancing what was previously known. These individuals were often inspiring for their persistence in discovery, or in creating something and working through obstacles on their journey to mastery. It is valuable in knowing the life journey of others as we are walking our own journey.

What impresses you about the mark the University of Cincinnati has made on local and national health history?

There are many firsts in our UC history and we can be proud of that. Drake's essays on medical education calling for higher standards presaged the Flexner report by 80 years. John Shaw Billings in 1879 created "Index Medicus," a monthly comprehensive bibliographic index of scientific journal articles focusing on medical science fields. Scientists from all over the world relied on this resource for 125 years before the internet and PubMed came into being.

But there is a one mark that is often overlooked or taken for granted: the impact an academic health center has on preparing the workforce that serves the community. The University of Cincinnati's prime products impacting the health of the community are the graduates of our colleges of Medicine, Nursing, Pharmacy and Allied Health Sciences and the graduates of the residency programs at our teaching hospitals. Imagine a Cincinnati where these individuals had to be imported from other parts of the country or abroad or never become part of the fabric of our community. Health leaders of our institutions who donate time and expertise sitting on community boards frequently have ties to our local universities. Many of these same leaders have a national presence and shape the national discourse on health, research and education. They also attract very good people to come to Cincinnati and become part of our institutions. We often and rightfully so recognize the individual, but as we look deeper we come to also recognize strong formative experiences an institution, like the University of Cincinnati, had on shaping that individual.