A seemingly routine medical practise, nuclear medicine as a diagnostic and therapeutic tool has rarely attracted the attention of historical and social science scholarship, however, it sits at a unique entanglement within the socio-political world of nuclear energy. The radioisotopes used in nuclear medicine are produced in the same reactors that also produce fissile materials that can be used for building atomic bombs. Tracing its genesis to the onset of the atomic age, nuclear medicine has been highlighted as the public face of the so-called peaceful uses of atomic energy, countering the perception of nuclear technologies as harmful and destructive. These issues were recently addressed (March 20-21, 2023) at the “Nuclear Research in Medicine after the Second World War” symposium in Vienna. A highly interdisciplinary group from Europe, Asia, the United States and Canada presented on the history of nuclear medicine in local, national, and international contexts and explored the establishment of the field, its institutionalisation, and other interconnected social practises.
Bringing together case studies dealing with Europe, North America, South Africa, India, Taiwan and Japan, the conference participants utilized various approaches within the history of science and medicine, gender studies and science and technology studies. Perspectives from the global south enriched our views on how the field of nuclear medicine was founded, developed, expanded, contested, and negotiated chronologically in new arenas. The event turned out to be a true melting pot of interdisciplinary expertise, practical experience within the medical field, and historical knowledge.
The conference was organized and sponsored by the Austrian Academy of Sciences, the Chair of Science, Technology and Gender Studies at the Friedrich-Alexander-University-Erlangen-Nuremberg and its European Research Council funded program “Living with Radiation”, the Medical University of Vienna and the Austrian Society of Nuclear Medicine and Molecular Imaging. It took place over two days, the first of which was dedicated to the ‘founder of nuclear medicine in Austria’ RUDOLF HÖFER (Vienna) in honour of his 100th birthday. After a brief introduction by the conference organizers, JOHANNES MATTES (Vienna), CÉCILE PHILIPPE (Vienna) and MARIA RENTETZI (Erlangen), HELMUTH DENK (Vienna), JOHANNES FEICHTINGER (Vienna), and MARCUS HACKER (Vienna) each took the floor to talk about the achievements and endeavours of Höfer, and to reminisce on his long history of working on nuclear medicine in both Austria, Europe and in international contexts such as the International Atomic Energy Agency (IAEA).
It was a touching moment for all of us when Professor Höfer, a hundred-year-old perfectly alert man, stood up to address us all and speak about his experiences, which represent Austria’s half century history of nuclear medicine. The venue added to the emotionality of his speech as we were seating in the historic and architecturally characteristic Jugendstil-Hörsaal at the Medical University of Vienna.
MICHAEL WEISSEL (Vienna) took on the role of laudator, giving his recollections of Höfer’s professional and personal history. Much credit should be given to Philippe and Mattes, who over the years of their research have established a close, trustful relationship to Höfer, documented his achievements, and made possible to save his personal archive.
A highlight of the first evening was a detailed tour of the Department of Nuclear Medicine at the Medical University of Vienna. The tour gave the participants the opportunity to learn about a very exotic and highly technical medical field, accompanied by its practitioners. Touching the machinery and being immersed in the atmosphere of a real nuclear medicine laboratory was an extraordinary and unforgettable experience, offering a unique perspective and a deeper understanding of the field.
The second day in the Johannessaal at the Austrian Academy for Sciences began with HSIU-YUN WANG (Tainan) whose main question was what had been the impact and consequences of the introduction of nuclear medicine in Taiwan. Focusing especially on the endemic thyroid issues plaguing the island state, Wang showcased how two different medical approaches and groups started to congregate during the 1950s. The first, a more traditional surgical approach became dominant in Taiwan, while the newer nuclear medicine approach, supported by US funding and expertise, was confined to major hospitals due to its high cost and specialisation. Following up, LOUKAS FRERIS (Erlangen) focused on the foundation of nuclear medicine in Greece supported by the IAEA. Greek medical doctors and diplomatic functionaries introduce nuclear medicine in the country in the 1950s, purchasing equipment and signing technical assistance deals with the IAEA. Freris highlighted local and international connections, showing how the IAEA encouraged the establishment of nuclear medicine in Greece to gather information and experience for the introduction of nuclear technologies in other countries.
In a similar vein, Mattes and Philippe highlighted the emergence of nuclear medicine as a specialised medical discipline as it was founded in a very heterogenous European context. Focusing on Austria as a mediator in European and East-West relations in the Cold War, Mattes and Philippe highlighted that the diverse medical and scientific European environment necessitated a strong transnational and transdisciplinary approach for nuclear medicine to finally emerge as an independent field. Rounding of the first section, KAPIL PATIL (Erlangen) moved the geographic focus to India. In his case, the emergence of nuclear medicine took place in an arena of improvisation, where the Indian scientists succeeded in making new innovations and treating patients despite the lack of trained personnel and state-of-the-art tools. Compounding the issues was the question of radiation protection standards showing primacy of the International Commission on Radiation Protection’s (ICRP) standards over IAEA’s all-encompassing Basic Safety Standards (BSS) and the changes in prescribed dose limits potentially causing exposure to certain patients.
The second session illuminated the broader socio-political aspects and practices of modern-day nuclear medicine. Rentetzi focused on an exploitative use of the X-ray technology in the resource-rich African Botswana. Since the early 20th century X-rays became involved in the colonial extraction of resources to prevent the smuggling of diamonds by workers in the Kimberley mines in South Africa. The colonial history of the mines goes back to Cecil Rhodes (1853-1902), an English-born entrepreneur and statesman who made his fortunes though the rampant physical exploitation of black African workers, including their forced overexposure to ionizing radiation through daily X-rays before leaving the diamond mines. Growing awareness of radiation hazards led to the development of a low-dose X-ray machine called Scannex, which now is also extensively used in hospital emergency rooms. Rentetzi argued that the use of x-rays reveals a blind faith in technology, leading to resource extraction and economic accumulation.
The second talk by SANDRA KLOS (Vienna) focused on the role of women in early nuclear medicine. In her presentation, Klos explored whether nuclear medicine as a scientific field presented a higher permeability for women than other medical fields and highlighted crucial statistics supporting her thesis. The medical students in Vienna had grown significantly over a century from 1900 till 2022, with a historically high ratio of women medical practitioners compared to their male counterparts. By the turn of the 21st century, the women medical students in Vienna had surpassed men and reached an all-time high in 2001. Klos argued that nuclear medicine as a newly emerging, interdisciplinary discipline offered brighter prospects for women. Through an extensive biographical probe of 10 leading female practitioners, Klos revealed exciting details about these women’s backgrounds and career trajectories. Her assessment involved several pertinent questions, such as why early atomic medicine as a scientific field was more open to women than other medical fields and what career paths led women to nuclear medicine research.
The next presentation by MOHAMED ELSAYED (Erlangen) underlined the humanitarian aspects of medical aid in times of war using the case of the trafficking of medical radiological equipment to Ukraine’s war zone. Elsayed pointed to the damage of Ukraine’s hospitals and clinics and the death of over 62 healthcare workers at the time of his presentation. Similarly, Russian-occupied areas had experienced instances of severe injuries, imprisonment, hostage, and forced labour. Although international humanitarian law sets out clear obligations on warring parties to facilitate the delivery of medical aid and services, the Russian occupation has led to severe disruption of Ukraine’s healthcare services. Elsayed highlighted the necessity of observing international laws and preventing any direct or collateral damage to medical facilities in the ongoing conflict.
The third and final session of the symposium began with KAORI LIDA (Hayama), who focused on the development of nuclear medicine in post-World War II Japan. The first clinical cases for diagnosis and therapy were conducted in Hiroshima, some of which involved hibakushas exposed to radiation from the bomb. The US Atomic Energy Commission and the Atomic Bomb Casualty Commission were quick to seize on the Japanese interest in "peaceful uses" of atomic energy, finding it advantageous to their own interests. Lida analysed various factors that contributed to this development, including foreign influences and the "frontier spirit" of masculinity. She further uncovered the troubling practice of subjecting individuals to radioactive procedures without due consideration of risks and benefits.
HEIN BROOKHUIS (Leuven) shed light on the institutional role of nuclear medicine in Belgium, focusing especially on the evolution of the Belgian Nuclear Research Centre (SCK CEN). He showcased how SCK CEN positioned itself as a leader in nuclear medicine, going beyond isotope production by partnering with academic experts, the global medical industry, and the public. By analysing the use and perception of the BR2-reactor, Brookhuis argued that transnational competition and the drive for financial gain shaped the meaning and application of research reactors in the field. In the second-to-last presentation, MAHDI KHElLFAOUI (Québec) demonstrated the usefulness of digital humanities methods to help historians, by tracking the spread of natural and radioactive isotopes in scientific and medical literature between 1913 and 1965. Using a database of 63,000 peer-reviewed articles, bibliometric techniques, and a community detection algorithm, Khelfaoui mapped consecutive networks that displayed the evolution of research communities and their relationships to the use of isotopes. The resulting maps showed how new instruments, techniques, and isotopes gradually diffused through different scientific disciplines and medical research specialties.
Last, ASKE HENNELUND NIELSEN (Erlangen) focused on the role of the Swedish medical physicist Rolf Maximilian Sievert (1896–1966) in reorienting the International Commission on Radiological Protection (ICRP) in the post-war period. Hennelund Nielsen introduced the term “Diplo-Scientific Actors” to illustrate the importance of certain actors in creating and developing international, scientific organizations through co-produced diplomatic and scientific processes and practices. Hennelund Nielsen highlighted Sievert’s repeated endeavours to turn the ICRP into an independent scientific organization in the post-war period. Despite the fact that Sievert was mostly unsuccessful in this attempts, Hennelund Nielsen noted that Sievert’s proposal played a significantly role in re-orientating the ICRP’s work. From an exclusive focus on medical practitioners and patients before the second world war, the ICRP gradually turned to radiation protection recommendations for general populations.
Despite its relatively recent history, the field of nuclear medicine demands a closer look. From the time artificial radioactivity was discovered in 1934 to the moment that the first radionuclides were produced for medical use by the Oak Ridge National Laboratory, nuclear medicine gradually entered the clinic and drew together a highly interdisciplinary team of practitioners, physicists, radiologists, and technical experts. The symposium on “Nuclear Research in Medicine after the Second World War” reminded us that nuclear medicine is not only a highly interdisciplinary and international field but also largely unexplored. Participants to the symposium discussed collective issues of radiation safety and its intentional (or unintentional lack); the use of newly designed medical devices and the need for the synthesis of novel radiopharmaceuticals; the role of international organizations in promoting nuclear medicine and the development of national styles in clinical practise; the emergence of new actors; the development of new medical technologies through the exploitation of entire populations; the professional controversies over the establishment of nuclear medicine as a discipline etc. Future research should be attentive to the myriad of ways that nuclear medicine has been exported to and integrated into different national and local contexts, as well as the international nature of the field.
Conference overview
Welcome by the Conference Organizers
Opening Ceremony
Helmuth Denk (Vienna) / Johannes Feichtinger (Vienna) / Marcus Hacker (Vienna) / Rudolf Höfer (Vienna) / Michael Weissel (Vienna)
Session One: Discipline-Building Technologies and Institutions
Chair: Gabriella Ivan (Vienna)
Hsiu-yun Wang (Tainan): Going Nuclear with Colonial Legacy: Dr. Kao Tien-Cheng and Radioactive Iodine in Taiwan, 1950s-1960s.
Loukas Freris (Erlangen): “A Peaceful Bomb”: Radiotherapy and the IAEA Experiment
Johannes Mattes (Vienna) and Cécile Philippe (Vienna): Distinction matters: Therapeutic Isotopes, Imaging Technologies, and Discipline Building of Nuclear Medicine in Cold War Europe
Kapil Patil (Erlangen): Building a “Mini Mayo Clinic”: Peaceful Atoms, Technical Assistance, and the Evolution of Radiation Medicine Center in India
Session Two: Political, Social, and Gendered Aspects of Knowledge and Technology Exchange
Chair: Wolfgang Wadsak (Vienna)
Maria Rentetzi (Erlangen): Diamonds, X-rays, and Colonialism: How x-rays moved from the Medical Practice to the Diamond Mining Industry and Back
Sandra Klos: (Vienna): The Role of Women in Early Nuclear Medicine. Some Preliminary Findings and Discussion Points
Mohamed Elsayed (Erlangen): Ionizing Radiation in Medicine Under War: Trafficking Medical Radiological Equipment to Ukraine's War Zone
Session Three: Safety Issues, Radiation Protection, and the Pharma Industry
Chair: Maria Rentetzi (Erlangen)
Kaori Iida (Hayama): Nuclear Medicine and the Bombs: How the New Field was developed in Japan and in whose Bodies
Hein Brookhuis (Leuven): From Big Science to Big Pharma – the Development of Nuclear Medicine at the Belgian Nuclear Research Centre (1990 – 2020)
Mahdi Khelfaoui (Québec): Tracing the uses of Isotopes in Scientific and Medical Communities (1913–1965): A Bibliometric Approach
Aske Hennelund Nielsen (Erlangen): From Radiology to a World-In-Crisis: Rolf Sievert and the Re-orientation of the International Radiation Protection Commission in the Post-War Period
Concluding Discussion