stay street

The Warden and The Inquisitor both have a kind of dignity and honor about them. They're both like "I absolutely did not want to be in this position, but here I am and we'll get this done one way or another." They both force people to work together for a greater good and unite under their banner and both are reasonably competent at their jobs.

Portrait of a Young Woman, Jean-Etienne Liotard 

My undergraduate degree was in Medieval Studies.

My professional masters degree was in Bioinformatics.

My current PhD studies are in Mammalian Genetics, emphasizing the overall physical structure of the genome.

The PhD and masters are fairly easy to relate to each other: Bioinformatics is a field that develops software and computational methods for examining and understanding biological data. Modern genetics often relies on people with these skills–while many labs can still focus intently on the workings of a single gene, if you want to understand how that gene interacts with the world, you can start generating a lot of data. A LOT. More than it would ever be feasible to process manually.

So, having a background in bioinformatics allows me to focus my work not on single genes, but on how the physical structures formed by DNA affects how genes are used. There’s 3 billion letters of DNA in the human or mouse genome, with thousands of genes, with thousands of mutations my project has cataloged, and tens of thousands of structural components to analyze along side them. If you were to randomly test each and every one of those three types of data against each other to blindly search for interactions, I calculated you’d have to run 371 trillion comparisons. My job started by trying to figure out how the fuck to pare that down to something manageable with the computing power I have, and I’m hopefully about to publish something damn cool on what I found in the process.

So, that’s genetics and bioinformatics. Sure, those fit together logically.

Medieval Studies, tho

That’s where things get interesting. The professors at my university were very careful to teach you about the idea of the “historical lens”. When you read an old text or look at a painting, you’re viewing the subject matter through the lens of your own experiences and presuppositions about the world, and about the time period you’re studying. The person who wrote that text or painted that painting had their own lens, shaped by very different circumstances. Their natural focus is not going to align with your own, and you have to be aware of that. When you start forming ideas about your object of study, you have to ask yourself, “am I seeing what the creator of this piece intended to convey, or am I making assumptions based off of what I want to see?”

In essence, the core of what was taught in that Medieval Studies program was how to think about your own thinking.

And that is so fucking important for good science. “Am I drawing logical conclusions that are supported by the data, or am I just seeing this because I want to see it? Is there some test I can do to check if I’m wrong?”

It’s not easy. Sometimes it can be really uncomfortable, in fact. But it leads to more and better results in the long run, because those moments of self-reflection help uncover possibilities that you missed before.

OKAY SO ABOUT THE MEDIEVAL HEAD TRAUMA

This post contains Thor’s migraines, Arthurian knights spinning in circles, and the medicinal use of egg whites on your brain. CW for mentions of medical gore and aggressive head bonks, obvs. Also, this is the result of undergraduate research, and should not be considered comprehensive. If you know more, throw it at me. If you have a correction, I will happily take it! And if you can remember the title of that one book I found once in my university library called something like “Head Trauma in World Myths and Legends”, TELL ME. I can’t fucking find the thing, but I swear it exists.

Also heck my life, Tumblr ate the first attempt at this post. Always write your long drafts on a more stable platform, guys

So. Depending on where and when you lived in western medieval Europe, you might have a very different relationship with the constellation of injuries falling under the category of head trauma. These injuries were either mysterious and beyond the realm of healing, a weird side effect of people not dying so often, or a comprehensible problem that sometimes could be treated by medical and surgical intervention.

A great example of head trauma as mysterious scourge comes from Norse mythology. To cruelly TL;DR a surprisingly hilarious little myth, Thor’s giant-smacking escapades result in a piece of flint getting stuck in his skull. Neither he, nor Sif, nor a witch they call up can remove it. The witch almost manages it, but Thor distracts her at a critical moment, so her magic fails. The myth ends with a moral to the audience: don’t throw your flint tools around, or you’ll give Thor a migraine. Yes, really.

(personal side note- somebody must be throwing hella flint around today, fuck)

In this story, head trauma is just something you have to live with. Magic might be able to help you, but it failed even Thor, so don’t expect better results yourself. And we do have skulls throughout European history that show evidence of lots of people living for years with untreated skull fractures, though with a higher risk of premature death. (One source here, from Denmark, which mixes in some early modern skeletons as well.)

Now, that myth fits the time and place it originated, which is true of stories in general. But one thing you can do in comparative literary analysis is look at the variations between tellings of common stories. And one great mine for this is Arthurian legend. King Arthur and His Circle Bros were popular subjects throughout the British Isles and France for centuries, which one can use to analyze the values, morals and world views of their storytellers.

And also, what happened when you got bonked on the head. See, each storyteller might have their own first-hand experiences with battle, or they’d have patrons who they wanted to flatter or entertain by incorporating Based-On-A-Shocking-True-Story details into the stories, or they were just paying attention to other storytellers at the time and seeing which action tropes were popular.

So, the early Arthurian treatment of head trauma can be summed up in three words: bonk means death.

But after the late 12th century (which admittedly is where we get a lot of our stories from), head trauma starts to become survivable. And sometimes, it’s weird.

Men’s brains swim like water, and they might fall off their horses. If they’re not mounted, they might run around in circles and then fall down. What changed?

The bonk protectors changed! the heaume or great helm style was developed, which is more likely to stay on and protect the head from any angle, though it’s vulnerable to transferring the force of downward blows into the head, neck and shoulders. With more people surviving blows to the head, that means more concussions and traumatic brain injury, and that’s reflected in the stories.

But what about medical textbooks? Well, it probably won’t surprise many to know that western European medical manuals sucked SO MUCH ASS for centuries. The reason why is a rant for another time (and I CAN AND I WILL RANT ABOUT IT), but there was light at the end of the tunnel.

While Western Europe lost almost all Greek medical scholarship and condensed the Latin texts down to near-gibberish, the Eastern Roman Empire had preserved those texts, and the Islamic world had expanded greatly upon that scholarship with their own research and experimentation. During the Islamic Golden Age, traders from Italy brought some Greek and Arabic texts back from the Muslim world, and translations were made into Latin. This gave Italian academics access to a more vibrant and systemic tradition of medical science.

Enter Rogerius, AKA Rogerius Salernitanus, AKA Roger Frugard, AKA Roger Frugardi, AKA Roggerio Frugardo, AKA Rüdiger Frutgard and AKA Roggerio dei Frugardi (jfc dude), a surgeon from Salerno (unknown-1195). While surgery would remain a low status profession for centuries, Rogerius produced a well-organized and clearly written surgical manual, the Practica Chirurgiae. This book, I want to stress, is not flawless, especially when it comes to pharmaceuticals. Digging into the German Commission E Monographs (started in the 1970s, which systematized scientifically proven effects of traditional herbal medicines), Rogerius’ poultices for wounds do fuck-all for healing, but would probably be fantastic for an upset stomach if you ate them.

HOWEVER, the surgical contents of the manual show that either he was working with fantastic written texts at the University of Salerno, and probably had some good first-hand experience with treating head trauma.

The text provides some practical information on diagnosing the kinds of head injuries a surgeon could actually treat–while concussion was still something you’d just have to deal with, a bonk on the head can have lots of other bad effects. You can develop a build-up of fluid within the skull (cerebral edema), or skull fracture that can press pieces of bone down onto the brain. Or you could have tears in the scalp, or worse, the protective layer of tissue around the brain itself (the dura mater).

Rogerius lists ways to diagnose edema and closed skull fractures (where the scalp isn’t broken but the skull is). He describes surgical techniques that are still the basis of many in use today, for incisions and suturing of the scalp, removal of bone fragments and foreign objects, and relieving pressure on the brain from edema. Yes, that last one involves trepanning, AKA drilling a hole in the skull, and yes, it can actually be life-saving in this particular case.

And there’s one bit he talks about which I find outrageously cool. See, wound healing has always been one of the biggest problems in medicine, and it was an absolute matter of life and death before the advent of sterile medical technique. Sure, you might be able to clean a wound with some alcohol-based mixture, but that would be disastrous for wounds that pierce through the skull. This probably goes without saying, but pouring alcohol on your brain is very, very bad.

So, what the fuck do you do when you have a patient with a gnarly head wound that exposes the dura mater, or the brain itself? Water isn’t clean, alcohol is potentially deadly. How do you wash the wound clean?

Get an egg.

Fresh eggs straight from the chicken are sterile capsules that protect the developing embryo. They’re full of liquid-y stuff you can use as a wash! BUT. Rogerius specifically lists egg whites for cleaning head injuries, not yolks. I don’t have any scholarship on why, beyond some interviews with a doctor in my family, but our best guess was that the cholesterol in the yolks could be harmful to the brain and dura mater. But the egg whites by themselves? They’re almost pure protein, including some anti-microbial factors that help defend the embryo in case germs sneak in.

Overall, it’s a brilliant solution to a thorny aspect of wound care, in a time before germ theory, and centuries before Europe would collectively remember you need to sterilize your medical tools. Fucking! Fresh egg whites! It’s fantastic.

So that’s the tl;dr on medieval understanding and treatment of head trauma. A mixture of mystery, medieval pop culture, and medical science. This is the kind of practical history that I found most engaging to study–not lists of kings, not court politics, not wars, but a small, strange little corner of medical history that tells you more about the life and times of people through the ages.

It’s the medieval head injury paper! Summarized beautifully for those of us that don’t have the concentration to wade through original sources!

DOCTOR SPIDER

Being abused at home, bullied at school and lost in the world, the library and all the books I could escape to the most amazing worlds, kept me alive!

I would walk to the library, and spend all day, from 10 am to 9 pm reading there!! I got special awards for how many books I read, I wrote little blurbs on why i loved the books (probably why I love to BETA and do ARCs) 

PLEASE, PLEASE, PLEASE Just hit the green arrows and the reblog!!!

As a 50 year old woman, the library offers me so much. Digital art pads to borrow, 3D printing, book clubs that are face to face (yeah, the introvert likes face to face because a moderator will stomp on anyone getting snarky)

New books in LARGE PRINT! I’m visually challenged and as much as I love my kindle, The feel of a real book in my hands will always be a beloved feeling!