Ageliki Lefkaditou in interview with Pierre-Olivier Méthot

Dr Méthot discussed his work with Dr Ageliki Lefkaditou.

Pierre-Olivier Méthot (PhD, Exeter/Paris, 2012) is Associate Professor of philosophy and history of science at Laval Université (Quebec City) and holds the Canada Research Chair in Medical Humanities and History of Biological Thought. His research draws on historical epistemology to address philosophical, historical, and historiographical questions in the biological and medical sciences (19th-21st century). His recent work has focused on the history of disease ecology and emerging infections. He has also translated and edited Mirko Grmek’s Pathological Realities: Essays on Disease, Experiments, and History (Fordham University Press 2019), and edited Médecine, science, histoire: Le legs de Mirko Grmek (Matériologiques 2019), a collective volume exploring Grmek’s legacy. He currently serves as an associate editor of the Bulletin d’histoire et d’épistémologie des sciences de la vie. He is also a member of the Centre interuniversitaire de recherche sur la science et la technologie (Montréal) and an associate researcher at the Institut des humanités en médecine (Lausanne).

Ageliki Lefkaditou works on her second PhD examining the history of physical anthropology in Greece and its interconnections with race, eugenics, and nationalism.

AL: Could you describe your research interests and how these have developed during your career?

PMO: In the early 2000s, while an undergraduate in philosophy at the Université de Montréal, I was a little bored with classical philosophical texts and I had a growing interest for the biological sciences. But instead of switching to biology, I decided to take a study-year abroad at the University of Toulouse (2003-2004). This year in France proved immensely rewarding. Some of the lectures made a lasting impression and led me to appreciate the extent to which biology and philosophy had much to learn from each another. And more importantly, that the major philosophical figures I had been reading often had to confront themselves with the biological theories of their own times! This is when I bought my first copy of François Jacob’s La Logique du vivant, Henri Bergson’s L’Évolution créatrice and Georges Canguilhem’s La Connaissance de la vie and Le Normal et le pathologique. Only later did I realize that Canguilhem came from a small town near Toulouse.

AL: Georges Canguilhem’s work has recently attracted much interest from historians and philosophers of biology and medicine. How did your study begin?

PMO: Since that time, I have always had a profound interest in the works of Canguilhem. During my PhD at the University of Exeter (2007-2011), I completed two semesters in Paris that allowed me to explore the collection of Canguilhem’s unpublished notes and manuscripts at the CAPHÉ (Centre d’Archives en Philosophie, Histoire et Édition des sciences.). I quickly used some of this exciting new material to write my first paper on the French philosopher. When in Paris I also met the historian of science Camille Limoges, who had been a student of Canguilhem (1964-1968) and was then involved in the publishing of his Complete Works at Vrin. This was back in 2008 and 2010. Not that many people (in France at least) were interested in Canguilhem then; in contrast, the library room of the CAPHÉS is now often packed with researchers from all over the world – a sign Canguilhem is getting attention from historians and philosophers of science! Very recently, I edited Vital Norms: Canguilhem’s The Normal and the Pathological in the Twenty-First Century, a collection of twelve new essays that take a fresh look at his medical thesis, both historically and philosophically.

AL: Is it correct to suggest that Canguilhem’s insights have informed your further research? If yes, in what ways and how have you moved forward?

PMO: My doctoral dissertation was not directly on Canguilhem, but was definitely inspired by his “historical epistemology” approach, which I used as a framework. Written under the supervision of John Dupré, Staffan Müller-Wille and Jean Gayon, it examined the relation between medicine and evolutionary theory in the 20th century and traced the historical trajectory of two “styles of thinking” – ecological and molecular-genetics – about the concept of (microbial) virulence. Afterwards, I did a postdoc in Geneva (2012-2013) where I had the opportunity to analyze the concept of “emerging disease” further; in particular, I sought to understand its origins in public health and epidemiology and to show how this concept was bringing together in a novel way the two styles I had described: emerging infections result not (only) from the evolution of some particularly virulent organism equipped with a set of virulent genes, but also – and perhaps especially – from the ecological interactions between organisms in a context that favors the transmission of a microbe into a new niche where it can cause disease. These insights, which have taken on a new relevance in the context of the worldwide pandemic, led me to “disease ecology.”

AL: Your studies have redirected our attention to the relevance of Canguilhem, but your research interests have also led you to another seemingly forgotten but once central figure; Mirko Grmek. Do their approaches have much in common?

PMO: While in Geneva, I became particularly interested in the works and legacy of the Croatian-born French medical historian Mirko Grmek, who was also a former student of Canguilhem! So, on my way to Geneva (after defending my thesis in Exeter in February 2012) I took a ferry to cross the English Channel and went to Caen to take a closer look at Grmek’s papers kept at the IMEC (Institut Mémoires de l’édition contemporaine), a research center located in the beautiful Abbaye d’Ardenne in Normandy. Though Grmek was a high-profile figure in the 70s, 80s and 90s – he created and directed the Ischia Summer School of History of the Biological Sciences and was the founding editor of History and Philosophy of the Life Sciences – his work was no longer on the agenda of historians of biology and medicine. But Grmek’s work, I believed, deserved more visibility and I decided to publish a book in English that would bring together some of his key contributions that had remained largely unheard of in the English-speaking world. Among those were Grmek’s early paper on the “dynamics of pathocenosis” – a concept he coined to describe the changing ecological relations between diseases – and his later study of emerging infections. The resulting book was published as Pathological Realities: Essays on Disease, Experiments, and History in 2019.

Shortly after I decided to do the Grmek book I was hired by the Faculty of Philosophy at Laval University, in Quebec City. In both my research and teaching, I used Canguilhem and Grmek’s scholarship to explore new questions with my students and my new colleagues: the history of disease and health concepts, the epistemological issues raised by retrospective diagnosis, the relation between history and philosophy of science, etc. My graduate seminars served as a kind of “epistemological laboratory” to address and formulate these questions. Over the years, I have developed a method that combines conceptual analysis and archive-based research. This approach has helped me to place an author within his or her own intellectual context and to describe what Frederick Holmes aptly termed an “investigative pathway.” I became passionate about visiting archives and I always find it exciting to delve into this unknown material, which I then use to develop new historical narrative and epistemological analyses. My work on Jacob’s The Logic of Life draws on such unpublished sources. I also enjoy working with researchers in the biomedical sciences. As the holder of the Canada Research Chair in Medical Humanities and History of Biological Thought, I now have many new opportunities to collaborate with scientists as well as with scholars in the humanities and social sciences.

AL: Your research has examined the history of modern ideas of disease ecology and the interactions between parasites and hosts. How can we understand the concept of disease ecology?

PMO: The concept of “disease ecology” was used by historian of science Warwick Anderson (2004) to characterize the works of biomedical researchers that did not fit the dominant – and largely reductionist – approach of laboratory biomedicine in the twentieth century. It refers to a way of thinking about the microorganism-host relation that is dynamic and evolutionary rather than static; disease ecologists like comparative pathologist Theobald Smith, microbiologist Charles Nicolle, immunologist Frank Macfarlane Burnet, or virologist Frank Fenner have tried to capture how epidemics (and pandemics) begin and end by looking at the interactions between the germs, their human (or animal) host, and the environment. In other words, their researches attend to the biological, ecological, and evolutionary dimensions of the microbe, not only to its capacity to cause disease. Disease ecologists seek to understand the dynamic of microorganisms; that is, how they spread into – and between – populations, which can act as “reservoirs” of potentially pathogenic germs. But instead of the old bacteriological metaphor of a “war” with microbes, most disease ecologists consider that disease results from temporary imbalances of biological relations, rather than as something that could be eradicated or conquered.

AL: Could you give us examples of historical discussions on the complex exchanges at the interface of biology and medicine and their contemporary or future reception?

PMO: Rediscovering the work of these “forgotten figures” in medical bacteriology also helps to appreciate the complex exchanges of concepts, methods, and problems at the interface of biology and medicine. For example, in 1928 British bacteriologist Fred Griffith’s “transforming experiment” had struck many as an oddity. Griffith had made the observation that colonies of pneumococcal bacterial could change their appearance from “smooth” to “rough”— and vice-versa! This meant that bacteria could reconstruct their polysaccharide capsule and become virulent again. This finding led to the discovery by Oswald Avery (1944) that genes are made of DNA and to the era of molecular biology. The transforming experiment takes on a wider significance, however, when placed within Griffith’s entire career – and might even explain why he undertook it in the first place. His earlier research had sought to determine if the bovine form of tuberculosis could infect humans. Fifteen years later, the transforming experiment had obvious epidemiological and medical implications for him: if bacteria could become virulent (thanks to an unknown mechanism), this could explain “why a ubiquitous and apparently harmless organism may suddenly become more pathogenic” and “propagate epidemics,” as Griffith’s later papers show.

Disease ecologist Frank Fenner conducted fieldwork in Australia on the virus myxomatosis that was used to cull the rabbit population. His work was informed by insights from René Dubos from the Rockefeller Institute about how changes in virulence relate to ecological conditions which govern host resistance to infection and disease. As to Nicolle, who was the director of the Pasteur Institute in Tunis for thirty years, his bacteriological research was entangled with theories and methods coming from parasitology and tropical medicine. Nicolle’s work demonstrated that lice transmit typhus, a disease that was endemic in Tunisia. Like for Fenner, the local biological conditions were key in shaping Nicolle’s interest for this particular disease, which he saw as emblematic in North Africa, and his overall vision of infectious diseases. Nicolle also articulated an early ecological framework to think about infectious diseases – some of which, he has shown, can remain “latent” and can be expressed following a change in the environment or the immune state of the individual. “Diseases, he writes, are born, develop and die.” Therefore, “there will be new diseases.” This view expressed in the 1930s was then marginal, but it has found a renewed interest during the early 1980s in the context of the AIDS pandemic and a series of other “emerging infections.”

AL: Many researchers from quite diverse fields of study would suggest that we are in the midst of three interconnected crises; a health crisis, and an environmental and climate crisis. Do you think that this affects our understandings of our roles as historians and philosophers of science in the public space beyond academia?

PMO: The historical study of disease ecology can help to understand the causes and the consequences of the current pandemic. Grmek’s notion of “pathocenosis,” for instance, calls attention to the fact that changes in the disease landscape is inevitably bound up with biological and social change. Zoonotic infections that result from the disturbance of natural habitats demonstrate in their turn the need for a better ecological understanding of epidemics and pandemics, and for increased exchanges of ideas between the social and biomedical sciences. The pandemic has somehow obscured the environmental crisis, although the two are tightly connected. Historians and philosophers can help to make these connections more visible. If we still do not know precisely where “our modern, ecological concept of infectious disease” comes from, to take up J. Andrew Mendelsohn’s phrase (1998), we do know that to avoid falling back in another era of medical complacency, the “natural history of disease” should continue to inform public health.