Learning from the past to understand the present and create the future

Carl Sagan (1934–1996), the famous American astronomer and planetary scientist, once said, “You have to know the past to understand the present.” The ability of humans or their societies to reflect on the temporal dimensions and relationships of the past, present, and future is instinctive. Several national and global issues we see and experience today have been experienced in the past. Learning from the past helps us understand and make sense of today and improve the future. However, studies have shown that young people see history lacking relevance to their lives.[1] History is not perceived as a subject connected with their lives or interests. The students of Medicine are not untouched by such perceptions.[2] As Sir Rudolph Virchow (1821–1905) said, “It is one of the worst aspects of our present development that historical knowledge diminishes with each generation of students.”[3]

Learning from history is important for future. The individual and collective historical consciousness of any science is critical not only for it to progress but also to determine the speed and dimensions of that progress. I can exemplify it briefly with my experience of searching for lacrimal drainage history.[4] So far, nearly 2 years of effort have gone by what began as a simple and earnest urge to credit as many individuals as possible who have significantly contributed to the lacrimal drainage sciences since antiquity till the present. Like the future, the past was found to be ever-expanding. Several dimensions of this search had lessons that can help us shape the future of lacrimal sciences. How Dominique Anel (1679–1730) was ahead of his time when he put forth the concepts of lacrimal irrigation and probing?[5] Had Anel not been threatened with widespread vitriolic criticisms, would the concepts of lacrimal irrigation be more advanced than what they are at present?[6] The story of the evolution of dacryocystorhinostomy surgery is fascinating, and is it right to credit Addeo Toti for the first description of external DCR?[7,8] If not, what is the truth, and how can it influence our surgical understanding?[8,9,10] Can we not be inspired by the power of observation of Johann Gottfried Zinn (1727–1759) that catapulted him to be one of the best Anatomists of all time (he died at 32 years!)?[11] Several prominent figures of the 18^th century, like Johann Platner (1694–1747) and Percivall Pott (1714–1788), lamented the lack of focus and the lack of understanding of the anatomy and physiology of the lacrimal system as the principal causes for the inabilities to treat its disorders satisfactorily.[10,12] Would the lacrimal sciences be much more evolved had someone dedicated their lives to it in the past? Could our management of lacrimal disorders today be different had someone focused single-mindedly on understanding its anatomy and physiology? With some people dedicating their lives to lacrimal sciences today, can we significantly alter the present course to change the future for the better? Such are the valuable lessons from history, and there are many more out there to be discovered.

The vantage point of the present helps us to better analyze the past, learn from it, understand who and where we are, and how best we can leap into future. The French Historian and Philosopher Etienne Gilson (1884–1978) said, “History is the only laboratory we have in which to test the consequences of thought.” I am glad several efforts are being made to expose medical students to the history of Medicine in an engaging and relevant manner, including its incorporation into the medical curriculum, specific tasks (for example, the anatomy students are given a task to examine historical anatomy texts like Vesalius’s “Di Humani Corporis Fabrica” and to write an essay on what they learned), and focused seminars that teach several critical aspects (methodology of searching the past, handling rare manuscripts, picking any disease or topic of their interest, and researching it back in time).[13] These give me hope that the present generations will increasingly look toward the past to improve their future. Paul Litcher, former president of the American Academy of Ophthalmology, in its centennial year said, “Ophthalmic history must be taught in our residency programs and a must read for all ophthalmologists as too few of our students revere history and the lessons it can provide.”