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The Laboratory and the Clinic: The Bergen Experience
| My departure point will be the much proclaimed antithetical relationship between the laboratory sciences and the clinic. In this paper, I will explore the introduction and development of laboratory medicine in Bergen (Norway) c. 1890-1920, with emphasis on its interaction with the clinical wards in the city’s hospital. First, I will explain the reasons for why a prosector, with knowledge of laboratory medicine, was appointed at the hospital, despite lack of interest from the chief physician at the hospital. I will then, by using patient journals, demonstrate when laboratory technologies and techniques became part of diagnosing living patients in the clinical wards.
The case of Bergen will suggest that the relationship between the laboratory and the clinic was not so much marked by conflict as portrayed in much of the historiography of the last thirty years. I will argue that the shift in the attitudes of the clinicians towards laboratory medicine in the city hospital in Bergen, was mainly a generational one. As a generation of young doctors trained in bacteriology took hold of the clinical wards as well as the laboratory in the hospital in the mid-1890s, bacteriology was accepted in diagnosing work. The chief physicians and the prosector all belonged to the same cohort of medical students and shared the same medical culture. Also, the first prosectors did not aim to do more than to provide services to the hospital, and was not affiliated with the image of the abstract and esoteric expirements of physiology. In consequense, the laboratory and its techniques was rather easily accepted by the clinicians. As the laboratory was upgraded and full time scientists with ambitions to research and publish were employed on the eve of the First World War, a more antagonistic relationship between the laboratory and the clinic evolved as the clinic was still in the hands of the cohort of the 1890s. I will argue that this conflict was more a result of the meeting of two different generations and cultures of medicine, than a conflict between the laboratory and the clinic as such. The relationship between the laboratory and the clinic is, I will claim, not so much antithetical, but can be better described as a local and temporal improvisation.
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