The Undisciplined, the Multidisciplined, and the Interdisciplined
Reflections on a half-century's academic sojourn
By Andre Nahmias, Richard W. Blumberg Professor of Pediatrics and Professor of Pathology and Public Health

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Interdisciplinarity as an End in Itself
Cautionary reflections on the Luce Seminars
By James Gustafson, Former Luce Professor of Humanities and Comparative Studies, October/November 2000

The Undisciplined, the Multidisciplined, and the Interdisciplined
The unabridged version

Interdisciplinary and Multidisciplinary
A table of some generally differential attributes

This essay was written in response to James Gustafson's "Interdisciplinarity as an End in Itself: Cautionary reflections on the Luce Seminars" (October/ November 2000 Exchange). An expanded version, including footnotes and "Relevant and Irrelevant Reflections," is available by clicking here.

"There is a time to divide and a time to unite" (André Lwoff)"

". . . and one must judge wisely the time to do either--or neither" (André Nahmias)

Over the several months since I first reacted to Jim Gustafson's recommendation that we avoid the "interdisciplinary," I have tried to reflect upon our apparent disparate views. As personal experience was used by Jim to explain his position, so have I chosen to elaborate my response from a personal perspective, sharing an academic sojourn of several decades that has helped the ever-undisciplined student to become a multidisciplined pediatrician/scientist/public health practitioner and an interdisciplined humanist. My views, contrasting the interdisciplinary and the multidisciplinary (too often used interchangeably), are summarized in the accompanying table, with the hope of eliciting further un-, multi-, or interdisciplinary exchanges.

The undisciplined student

I began life in multicultural Alexandria, Egypt--where my early education was spiced by attendance at a French elementary school and, later, at an English Eton-like high school. Accepted at the University of Texas in Austin as a pre-med student, my desire for knowledge took many undisciplined (some might say uncontrolled) paths. Often bored by the prerequisite chemistry, physics, and zoology courses, I audited classes in philosophy, sociology, literature, and the like. I also joined the "Curtain Club," directing and writing several plays (mostly on scientific themes). This was good preparation for several of my later academic activities-directing a laboratory and an infectious diseases team, and presentations (play-acting?) in classrooms, meetings and conferences. The playwriting proved particularly helpful in preparing grant applications--after all, both are figments of our experiential imagination.

My readings in college included science history books recounting the lives of the discoverers of the bacterial causes and prevention of many diseases. This led me, as a foreign student unable to be accepted in a U.S. medical school, to ask the chair of bacteriology at Texas (this was 1950), if I could pursue a master's degree with a major in bacteriology and a minor in playwriting (alas--my minor had to be biochemistry). My tenure in the University of Texas Student Assembly (gained, I must confess, by obtaining the vote of the minority group of foreign graduate students) also helped me learn how to withstand, with some equanimity in later years, the "slings and arrows of outrageous" majorities.

The dualism I confronted then between the particular and the
general--between the individual patient and focused laboratory research, and the larger issues related to health in society--intensified in my later education. After Texas, I followed the "general" path, as I went on to obtain a master's degree in public health at the University of Michigan. The following year involved the "particular," as I attended medical school at George Washington University. My freshman year was the worst in my life, partly due to my holding three jobs, but primarily because I had
to leave behind all pretense of using my brain, except for rote memory.

After an internship year in New York, with my greatest achievement being learning how to play the violin, I first came to Atlanta to join the CDC's Epidemic Intelligence Service. These wonderful two learning years combined epidemiology, veterinary medicine, and laboratory bench work-supplemented by rounds at Grady Hospital with Emory's new chair of pediatrics, Richard W. Blumberg. After the CDC years, I was torn again. Should I further my pediatric training? Should I continue in the larger
epidemiology/public health world? In laboratory bench research? Irresolute, I visited Dr. René Dubos at the Rockefeller Institute; he wisely told me that if I worked in the laboratory, I may never see a patient again. That settled my choice, and I opted for pediatrics in Boston. Subsequently, I also obtained training there in virology during the very exciting era of a great number of virological discoveries.

The multidisciplinary physician/scientist/public health practitioner

Soon after joining Emory in January 1964, I encountered a baby with a severe case of herpes simplex virus (HSV) infection, born to a mother with genital herpes, whose new viral etiology I helped to ascertain. This led to my first multidisciplinary experience by combining medical-scientific-public health approaches to the study of herpes viruses.

Such approaches were also the mainstay of the international conference I organized at Emory in 1980 entitled The Human Herpesviruses --An Interdisciplinary Approach. In retrospect, I now believe that it should have been subtitled instead A Multidisciplinary Approach. There was indeed a central focus--the five human herpesviruses known at that time--but we discussed these viruses primarily from medical, scientific, and public health perspectives. I did include discussions on the evolution of herpes and other viruses, as I had appreciated that the most holistic approach to biology and many other fields is the evolutionary perspective. There was no attempt at the conference, however, to bring out the more human aspects--the cultural, economic, sociological, ethical, psychological-related to these viruses.


The interdisciplined humanist

Evolutionary thinking stimulated me later to pursue studies identifying the first human immuno-deficiency virus type 1 (HIV-1) in blood collected in Zaire in 1959.
By the early 1980s, however, it had already become apparent to some
of us that HIV/AIDS was not only a scientific-medical-public health problem but one presenting many fundamental human issues, such as the rights of the (infected) individual and the rights of society (uninfected members). In 1985, as
president of the International Interdisciplinary AIDS Foundation (IIAF) in Geneva, I helped to bring together scientists, physicians, nurses, social workers, and public health officials worldwide, along with representatives of the law, media, politics, religion, ethics, philosophy, economics, sociology, anthropology, education, history, and other disciplines. The 1987 IIAF Conference in Atlanta on "AIDS in Children, Adolescents, and Heterosexual Adults" was truly interdisciplinary, in contrast to the earlier herpesviruses conference. aids also taught me, best of all, that we could not respond to its many challenges with the old, "vertical," hierarchical approach, but that a more "horizontal," circular one was needed, whereby all participants are equal contributors with their own expertise and experience.

I really only discovered the university and its academic community after being at Emory about twenty-five years by attending the Luce Seminar, led by Jim Gustafson. The focus of our discussions, "Responsibility," although abstract, stimulated me to engage in later practical initiatives on child advocacy. The first was to try to help children in our city by embracing the unifying community spirit engendered upon learning that Atlanta was hosting the 1996 Olympics. The submitted plan would have had the Olympics Committee interact with the many governmental and non-governmental child-related agencies and the various metropolitan universities, showing the world that "Atlanta is a city that cares for children." The proposal was turned down; unswayed, I later directed my children's initiatives within the more local setting of our pediatric department and the larger university. I have helped to make "Child Advocacy and Public Service (CAPS)" part of the academic mission for our department--as it had already been for our law school--with the hope that other departments and schools might follow suit.

I empathize greatly with Jim Gustafson choking on the word "interdisciplinarity"--it is indeed an abused and overused buzzword. Coming from my field of science, however, which has progressed well with its reductionist approach, I do not believe this approach alone will help us bridge, for instance, the Nobel-rewarded neuroscience on the brain of lower species and the pathos of children with autism, or
of adolescents and adults with schizophrenia. We are academicians, with a richness of expertise-whether particular or general, basic or practical, as philosophers, pediatricians, or poets. Jim has shown us repeatedly that no matter our expertise, our unique perspectives add to the richness of the academic moment. He demands particularly the "intellectual rigor that is required to understand differences between disciplines-something essential before one thought about synthesizing them." I agree in large part-but I also believe that there is still room for contributions to the interdisciplinary dialogue by others, such as a poet without a formal education. Certainly, no one wishes for the university to be a Tower of Babel; but neither should it be an Ivory Tower--rather, it ought to be an active participant within the communal Circle of Life.



Differences in definitions are likely to explain my apparent disagreement with Jim Gustafson. Thus, in Webster's dictionary, "discipline" is a word used to define largely three concepts: 1) teaching and learning; 2) a system of rules governing conduct or activity; and 3) punishment. The integration of these three concepts leads me to suggest that, within the wide expertise of the various academic disciplines, if discipline is not placed on past, current, and future vital areas related to the human condition, academia will indeed risk being disciplined by society, now and in the future.

Jim--we need your help.