By Sara Farhan ~
The Fourth Annual Middle East Medical Assembly (MEMA), hosted by the American University of Beirut, took place in Lebanon in April 1954. With a program that listed prominent figures in the field of medicine and surgery, the assembly attracted regional and international attention. MEMA’s organizing committee invited Dr. Michael E. DeBakey. The invitation accompanied the persuasion of the U.S. State Department. And so, DeBakey left the United States on April 7th, 1954 to present at the Fourth Annual MEMA. DeBakey’s visit set a course for a series of interactions with the region wherein his expertise as a skilled surgeon as well as a phenomenal instructor forged new connections and reinforced existing ones. These interactions were facilitated by the internationalization of surgical education. Surgeons and doctors in the Middle East were not working in a vacuum isolated environment. On the contrary, they were part of an intricate network of professionals who celebrated the exchange of knowledge and embraced new developments in the field.
The international dimension of medical education can be observed in the nineteenth century when international public hygiene and sanitation committees were formed in order to come to a universalist approach in managing disease outbreak. These dimensions were broadened after World War I where political rationales about peace, cooperation, and mutual understandings reinforced existing collaboration networks and forged new networks. However, it was after World War II, with the establishment of World Health Organization that the internationalization of medical education became more structuralized. Pointedly, the links that European colonial enterprises forged with the educated classes in the Middle East were weakened after World War II. This was a critical moment in the history of American pedagogical hegemony. The United States, which had already established educational networks in the Middle East, was able to capitalize off of the weakening ties between former colonies and Europe. The United States’ interject was considered a more viable option for students seeking post-graduate education while departing from the colonial networks that had previously shaped educational trajectories in medicine.
American medical missions in the Middle East can be traced back to the nineteenth century. However, in the aftermath of World War II, we see an increase in graduate students seeking out post-graduate certification at American institutions. There are numerous explanations to this trend: One being that France and England faced the consequences of post-colonial movements that worked to sever ties with the colonial centre. These weakening ties were further pronounced during World War II when France and England incurred substantial damages. Secondly, the United States’ quick resolve to replace European educational missions were welcomed by some segments of the Middle East’s educated classes. With the backdrop of these geo-political dimensions we see emboldened education relationships between the United States and the Middle East. In particular, American medical education was established in the Middle East in the nineteenth century with the founding of the Syrian Protestant College in Beirut, later known as the American University of Beirut (AUB). The medical college faculty of AUB trained a plethora of Arab students who went on to pursue further specializations in the United States.
DeBakey in the Middle East
In the aftermath of World War II, Arab nationalism helped frame pedagogical trends in the Middle East. Being of Lebanese dissent, Dr. DeBakey was seen as yet another example of Arabs’ commitments to advancing medical thought. Precisely, Arab doctors and medical instructors considered and dissertated Dr. DeBakey’s accomplishments as part of the region’s centrality in and contributions to the evolution of medical thought. DeBakey’s identity was almost always at the forefront of conversations regarding advances in medicine in the Middle East. DeBakey’s 1950s visit was therefore a welcomed affair as it celebrated the homecoming of a prominent figure in medicine, and helped reinforce, but also establish new, connections in the realm of medical education missions.
DeBakey remained in the Middle East for almost all of April. He took it upon himself to tour, lecture, and demonstrate applicable instructions at various regional facilities. He not only strengthened Beirut’s medical education ties to the United States, but established personal ties to medical colleges in Aleppo and Damascus in Syria, as well as in Baghdad, Iraq. In addition to presenting at the Fourth Annual MEMA, DeBakey also gave lectures at the Medical College of AUB, visited the medical college of St. Joseph’s—a French faculty established by the Jesuits in the nineteenth century, then travelled to the medical colleges in Syria, in Aleppo and Damascus. He also lectured at these faculties. Unlike DeBakey’s positive assessment of the Lebanese medical colleges, DeBakey was critical of the Syrian curricula. He was concerned that the Arab nationalists sentiments in Syria was thwarting advancements in medical education in the country. He feared that instruction in Arabic and the difficulties in translating foreign language text limited the abilities of the students of these facilities and distanced them from broader international networks. After leaving Syria, DeBakey headed to Iraq and visited the Royal Medical College in Baghdad. The college’s dean, Hashim al-Witri welcomed DeBakey and requested he participate in a number of conferences with the Iraqi Medical Association as well as provide lectures to students of surgery and practicing surgeons. In his 1954 annual report, Dr. al-Witri specified that the visit was informative to the students and faculty alike.
Surgeons and doctors in the Middle East followed the operations performed in by DeBakey and his mentor Alton Oschner, among many others well before the historic 1954 visit. As early as 1940, medical journals in the Middle East, particularly in Iraq, cite DeBakey’s work on the sleeve-valve transfusion instrument. The conversations Iraqi doctors were having amongst themselves were in relation to international developments within the field. Their publications cite international research, including DeBakey’s contributions. However, the exchange of knowledge was not unidirectional. DeBakey also studied the works and contributions of doctors and instructors from the Middle East. For example, DeBakey acquired the works of Lebanese physician and faculty member of AUB, Amin Khairallah, Dr. Khairallah composed a collection on medical ethics for medical students. The work includes the philosophies and applications of medical ethics in and outside of clinical settings. This indicates that DeBakey celebrated knowledge exchange and considered medical advances and philosophical thought emerging from the Middle East as laudable publications worthy of study.
DeBakey’s Lebanese heritage was contextualized along dichotomous yet interconnected narratives in the Middle East. On the one hand, DeBakey was central to advancing the notion that modern medicine is not exclusively western medicine. Instead, DeBakey was positioned alongside prominent historical figures in medicine, i.e. Averroes (Ibn Rushd), and Avicenna (Ibn Sina), to demonstrate the continuous centrality of the region in the trajectory of medicine. On the other hand, DeBakey’s biography was narrated along the ‘Brain-drain’ critique and lamented as yet another talent courted and anglicised by the west: a process that involved the dilution, if not complete erasure of identities and the westernization of prominent figures from the region. This dichotomy is evident in a 1969 article entitled, “Medicine in the Middle East,” published by the oil giant, Aramco:
From Avicenna to DeBakey…It is difficult to evaluate completely the quality and the quantity of Arab work in medicine. … Many are siphoned off by the brain drain, lured not only by higher salaries but by more prestige or greater facilities for research—notably post-graduate students abroad who simply don’t return. In 1966, statistics show, the Middle Eastern graduates licensed to practice in the United States alone came to 10 per cent of the area’s yearly crop. Once established abroad they melt into the landscape; Arab names crop up, unnoticeable unless one knows how to look, metamorphosed into unrecognizability: a Khoury into a Corey, a Dabaghi into a DeBakey, an al-Hawa into a Howard.
Sara Farhan, PhD, is an Assistant Professor of History in the Department of International Studies at the American University of Sharjah and a 2019 NLM Michael E. DeBakey Fellow in the History of Medicine.
Watch Dr. Farhan’s NLM History Talk from September 9, 2020 on the topic of “DeBakey in Baghdad and Beirut: The Internationalization of Surgical Education, 1945–1970.” Watch previous NLM History Talks in the NIH Videocast Archive, and stay informed about about future ones on Twitter at #NLMHistTalk.