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CAITJAN GAINTY: My name is Caitjan Gainty. I am a historian of medicine here at King's College London. And I'm a historian mainly of medicine in the 20th century, with a little bit of overlap into the 19th century.

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And I work a lot on how health care systems are built. And my current project is about the history of health scepticism and health activism, so thinking about the ways in which people have reacted

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to medicine, critiqued medicine, and thinking about that as a way to narrate medicine more broadly. But across all of the work that I've done has been this kind of abiding interest in filmmaking.

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And a lot of the work that I have-- the earlier work that I've done is really about different medical filmmakers and the way in which they produce their work

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and the goals they had for it. One of the best ways, I think, to think about public health films is to go back a little bit into the history of filmmaking, medical filmmaking, more broadly.

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So one of the things that I think we sometimes forget about early film is that its original purpose was, and its original use was really scientific. It was about studying motion.

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And so there are these great stories from the late 19th century about the way in which this kind of high-speed photography made possible the study of motion. So there's this story about Edward Muybridge in the United

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States, who used this high-speed photography to make a flip book, really, essentially that kind of process, to resolve a bet as to whether a horse at mid-gallop would have all of its hooves off the ground or just some

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of its hooves off the ground. And so he was able to do this. He was able to capture something that you wouldn't ordinarily be able to see with the human eye.

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And it turns out, yes, all four of the hooves are off the ground in mid-gallop. And that kind of thing, then, really added to the study of physiology more generally, the idea

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that you could study animal motion and human motion and that, like the microscope, eventually the motion picture camera was a scientific tool primarily more than it was anything else.

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And I think this has real significance for thinking about public health filmmaking, because it gives us this way into thinking about why the particular aspects of, especially early 20th century public health

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filmmaking, why they exist. So you see all of these films, you get these kind of microscopic images, or you get these sort of animations, and all of this

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is about revealing, via the motion picture camera, what the human eye can't see ordinarily. So you've got that trajectory, where these films are being made as a kind of augmentation

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of the human eye. And then you've got the trajectory that's about entertainment film, which becomes more and more narrative over the early 20th century.

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And people are starting to go to the cinema to see these films. And they meet in the middle in these public health films, which in some ways are about this tradition of being able to see something that the human eye ordinarily can't see

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and telling a story that then makes use of that invisible world to tell you something about your health behaviours. And I think that's a really useful way of thinking about how public health filmmaking emerges on the scene in the early 20th

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century. And people would be seeing these films, of course, mostly in the cinema. The idea that motion picture films,

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filmmaking more generally, was really a classless sort of act, not classless in the sense that it's terrible, but in the sense that it appeals across a broad range of social classes. And this is helped by the fact that going to the cinema

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is very inexpensive. And so lots of people, therefore, are going once or twice a week. And it peaks in the 1920s.

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People are going all the time. And so this becomes a great way to show these public health films, which, again, are partly really, really entertaining in the sense that-- sort of grotesque.

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You get these films that show you things that are invisible to the human eye because they're too fast or too slow, or even because they're too small.

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So now you can see things that scientists are seeing through the microscope. And one of the examples in this collection is the film Swat that Fly, which is one of these early films.

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And in that film, you get to see the kind of real disgustingness of flies, which is brought-- it takes place over a much longer period, but it's contracted because of, again,

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the abilities of the motion picture camera into a narrative that takes place over just a few minutes. And so it makes this invisible world visible. And it makes it truly grotesque.

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It's disgusting watching this fly. And it's laying its eggs on rotten meat and dead lizards and things like that. And then you see the life cycle and all that kind of stuff.

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And so there's a real exhibitionism around this science that's matched by, in these very early films, a loose narrative flow. And so I think it's really important when

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thinking about the advent of public health filmmaking, to think, yes, about the educational content and the way that it adds into the way we think about social history, the rise of the modern state and the authority

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that the state has to tell people how to live their lives. But it's also very much about the way science is being represented for the public, about the idea that you can observe these things

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and take them home with you and understand them. And I think those trajectories coming together is really an important way to understand early public health filmmaking in particular.

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Famously, what happens in World War One around public health, the story is really about absence. So as World War One is ending, we get the Spanish flu, this massive early 20th century pandemic.

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But it's a pandemic that is, in some senses, underrepresented, both in public health filmmaking, in the media more broadly, in part because the war is the story. The war is the main story that's being told in this period.

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And in part also because you don't want to be the country that's acknowledging in your newspapers that everybody's dying of flu and that you're weak as a country.

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Instead, you want to give this impression of strength. And so famously, what's really interesting about World War One is that we don't see a lot about this really huge pandemic. Whereas in World War Two, we get a lot of public health films,

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even though there isn't a pandemic raging. But the public health films that take place during World War Two are these films that are about doing your part, doing your part in terms of rationing,

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in terms of watching the metre, energy consumption, those kinds of things, but also doing your part in terms of staying healthy. And in this collection, there's really

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great contrast between two films, which is the first one is Dr. Wise on Influenza from 1919, which is actually about Spanish flu, even though it doesn't specifically describe Spanish flu.

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And this is really a rare exception of the films, the public health films that we have from this period that are about public health and specifically about flu.

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But of course, it comes around after World War One is over and still during the Spanish flu pandemic, but as it's slowly coming to an end. But that film has all sorts of advice

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about how to avoid spreading germs, et cetera, making masks so you can wear those around. And it does this familiar thing of presenting side-by-side images of germs and things

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under a microscope and then a narrative story about this guy who gets up in the morning, doesn't feel well, is sneezing all over the place, decides to go to work anyway, infects everybody, comes home, dies a few days later.

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And then there's the fallout from that. And it really is actually an interesting depiction of Spanish flu. We don't normally now think, like, oh, you get the flu

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and eventually you die. But of course, that's what was happening during Spanish flu. And there we get a lot of information about hygiene. But in many ways, this is after the fact.

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It's after Spanish flu has been around a little bit. It's after media reports. Now that World War One has ended, media reports are starting to talk more and more about flu.

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So that's when we get this particular film. Whereas in World War Two, we get these films right away. And there's a really lovely film called A Tissue that I've worked a lot on and written a lot about with one

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of my colleagues. And that film is also about sneezing and coughing and trying to keep these things in check and keep yourself healthy. Part of that is about taking the necessary precautions.

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So if you're in an air raid shelter, for example, wear a mask so that you're not infecting other people. And part of that is about protecting the nation

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more broadly. So if you're sick, you can't go to work. And that means productivity and efficiency fall off. And that means that the war effort is hindered by the fact

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that you weren't there, you weren't healthy, and you, therefore, can't do your part. And so it's folded into this narrative about collectivism and what we all must do as our civic duty

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to support the war effort. So there's an interesting way in which the wars contrast in this view about flu, quite particularly, and coughs and sneezes, which is always

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a big theme in public health filmmaking. But I think the other thing to say about the world wars more broadly is that they lent to public health this-- the terms of war, to think about germs.

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So germs now become the invaders. They're the enemies, and they need to be attacked by particular sort of-- or they need to be prevented, or they

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need to be addressed in some kind of way. But you get this set of really militaristic metaphors to think about public health. And I think that becomes quite useful.

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It's really effective in a lot of ways, because this is a language that people are familiar with, that they understand, that they've had experience with as a result of these experiences of war.

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And now that's applied to the body and to these germs. And there's this way in which there's a lot of commonality then between other films that are related to the war effort

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and think about these kind of militaristic sorts of metaphors and public health more broadly. So I think the world wars, war more generally, but the world wars in particular,

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really offer a lovely way of thinking about public health and what it's doing in each of these contexts, and I think offer, also, these really nice points of contrast that really help us to understand what the public is

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thinking and doing in each of these particular moments and how their civic responsibility is being described to them in broadly similar moments of total war, but in very different moments in time.

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The films in the collection really appeal to a range of publics. And they are suited to a range of publics. And that in and of itself is really

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representative of the kinds of publics, the kinds of people, the kinds of audiences who would have seen these films. And so the early films, really, as I said,

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are for these kind of-- it's now opened up. It's not just like a luxury item, like going to the theatre. The cinema is for everybody.

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And the films reflect that. They become these kind of like-- you get the Richard Massingham films, which are just really wonderful and incredibly comic. But they are about this kind of fundamental every man

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in a really important way. And they invite the viewer then to think of themselves also as that every man, or at least probably a more rational version of that person

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because absurdist in so many different kinds of ways. So I think that there's this kind of positioning of these films early on as something that everybody can relate to.

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And the Massingham films in particular from the '40s and so, again, has this kind of-- gives us this really good sense of what British society looks like over this period.

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And it is this kind of more communal, thinking about the NHS, which comes around in 1948. The Massingham films run over this period. And it is this more communal sort

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of moment, this kind of rise of the welfare state. And people are pulling together in all sorts of different kinds of ways. Or at least that part of the national character.

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And so these films in particular position people as part of this public and position the buffoon that we see Massingham play in these films as this outlier

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that we can all laugh at together and then do the proper thing that this buffoon won't do, so using your handkerchief in an appropriate way, which Massingham can't do in these films.

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He's incapable-- or sneezing and coughing into your handkerchief, not in people's faces and things like that. So there's a very interesting way in which that set of films really positions and really is for a particular kind

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of audience. But others of the films in the collection are medical training films and give us this real insight into particularly important periods in medicine.

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So there's a film about polio diagnosis and treatment that comes around in the late 1940s. And it arrives hot on the heels of one of the biggest upticks in polio--

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in the history of polio in this country. Because, of course, the vaccine arrives on the scene in the 1950s. And so in the late 1940s, there's this moment of real

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concern about polio because lots of people are getting polio. But it's also not something that medical practitioners have seen. And so this film is about telling people, telling other medical practitioners how to diagnose

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and then also properly treat polio. And it sounds, I think, really dull. But it's actually a fascinating film for all sorts of different reasons.

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It tells you a lot about how filmmakers are responding, medical filmmakers are responding to these kind of moments, to these kinds of epidemic moments. It also tells you a lot about how medical practitioners are

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being educated in this period, and the use of film for medical practitioners in this period. And as it turns out, it's a use that very quickly falls away. With the rise of television, this kind of filmmaking

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starts to disappear. And there are these easier ways to distribute messages about how to do various-- how to do, in this case, diagnosis and treatment.

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So that's a really important audience that, I think, we think less about when we're thinking about public health films. We tend to think instead about government agencies making films

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to distribute to the public. But I think, in this case, we see the way in which film becomes something that distributes messages across medical practise in a really efficient way,

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or potentially a really efficient way. And then finally, we see, towards the '90s, the end of the period that's covered in the collection, we see this, crazy animated film called Kate's Party,

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where Kate arrives at the party. I guess-- sorry-- I guess her name is Jean. She arrives at the party, and then she says she's Hy-genie and shows everybody

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all the germs around them and how they're about to eat these very germy bits of food. And that's really for this school age audience. It's animated.

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I mean, it's bizarre in a lot of ways, actually, and it's sort of funny. But it's also dramatic in this way that represents a familiar situation, going to a birthday

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party, Kate's party, and then eating the food unthinkingly. And then this Hy-genie-- this has never happened at any party I've ever been to-- but this Hy-genie appears and says,

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oh, no. There's all sorts of disgusting things in the world around you. And that's quite interesting. It shows this new medium of public health messaging,

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which is much more TV-based. You can see that it's gotten this genre shift. But also, I mean, the continuities are really interesting, too, when

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you think about how these films are being made. So throughout the period, there's a fascination with sneezes and coughing. And throughout the period, there's

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a fascination with germs and their spread and flies that are the culprits in spreading these germs. Not in this collection, but certainly throughout the public health film archive,

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you see lots of stuff about mosquitoes spreading all sorts of diseases. And so these are constants over the period in a way that I always find quite striking, that audiences

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have changed and their expectations about what a film will look like have changed. But public health messaging in very peculiar and particular ways hasn't changed.

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We're still supposed to be thinking about the invisible world of germs around us. And we're still encouraged to be sensitised to that invisible world so that we take greater care washing

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our hands or making sure that our food is covered and all of those kinds of things. And I like that because I think it offers this narrative of medical change over time.

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Normally we get this sense that medical and health care change over time is a story about progress. But here we see a story that's more fundamentally about continuities and the way in which we are all

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expected to think about the germs that are around us. And so I think that's a really helpful way. Thinking about who these audiences are really helps us to think about how both the medium and the message

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have changed. But it also helps us to really come to grips with the way in which some of these things haven't changed at all.

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And public health messages remain remarkably consistent in funny ways that, I think, are often unexpected. The films are, I think, a great reflection,

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a kind of a mirror of the social history of Britain over this same period. I think one of the things that is really worth pointing out is thinking about gender roles as they appear in these films.

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In their early films, before there's sound, the actors are basically all men. You often get a doctor who's lecturing, and then it switches over to narrative,

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which is what happens in the Dr. Wise on Influenza film. And it's all about male authority in this really fundamental way. And where women appear, they're the wives or the mothers

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or the carers who are, like-- they go, oh. They're these marginal characters who are confined to particular kinds of contexts. Over time, you start to see that change.

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And there are interesting-- a set of really interesting films that's about tracing infection that is in this collection. And there you see the interior of hospital spaces and increasingly see women, who are really

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the primary caretakers in these contexts, whether they're nurses or midwives or even laboratory technicians. And so they play a really large role in those kinds of settings.

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But one of the things that really struck me, looking through the collection, was the way in which-- there's one film that's tracing infection in neonatal care. And there you get a really nice slice of public health

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that's gendered in a very particular way, where the idea is that they're going to be able to find out who gave the baby a particular virus or bacteria by going through and looking at everybody's-- or testing everybody's hands,

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doing swabs of everybody's hands and mouths and things like that, so they can trace exactly who is responsible for this baby's illness. And so it's this very long process.

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And in the end, you get this very strong sense that the bacteria is this kind of weapon and that somehow there's intentionality. It turns out in the end, the midwife is the culprit.

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And even though it's not, I think, not totally intended in this way, it is this kind of-- well, actually, maybe it is. I take that back.

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Maybe it is intended in this way, that she hasn't washed her hands enough. And that's why she's passing on these germs to these very vulnerable little babies.

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And so I think there's really interesting ways in which you see gender emerging there. And there's also-- I mean, this, I think, is well known, obviously, in the history of medicine,

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but it's worth saying that, in that particular film, you realise that newborns are staying in the hospital for weeks on end. And their mothers are in a totally other room

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for weeks on end. And the baby and the mother are not together. And they're in the hospital for sort of endlessly, which, of course, is exactly where you're

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going to get these germs being spread anyway. And so you start to think a little bit. Like, as a mother, I thought, like, why don't they just send them home?

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Let the mother have the baby, and then they leave. But of course, that's not-- obviously, in this context, that's not how it was done. But it was quite interesting to think

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that, once they'd established that this baby had this bacterial infection, it went into isolation. And that isolation meant that it went in and stayed with its mother.

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So there's a funny way in which this concept of isolation actually brings the mother and baby together in this way that I think, for us now, feels much more natural and surely preferable anyway.

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But in any case, so we see gender throughout those films. And there's this very strange-- not strange, but very institutional film that's part of the collection that's

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about legionnaire's disease. And that was striking to me, less for the content, though that's interesting too, because it's quite specific about how legionnaire's disease is

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transmitted, and more for the fact that it's the only film in the collection that has a woman providing the voiceover. So in all of the other films, the voiceover

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is provided by the man, or the only speakers you hear are men. And for this film, in 1990, you get a woman doing the voiceover. And I think it's quite interesting to think about, OK, what could we make of that?

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I mean, obviously it's not representative. This is a small selection of films. It's not representative of every film out there. But it is striking to think about,

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even in terms of who's making these films, how they're being made, who gets to talk, all of that is quite interesting to think about. And so, therefore, it becomes interesting also to think about

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these films from the '90s, this one on legionnaire's disease, where we have a woman offering the voiceover, and then also the Kate's party film, where the hero or the main character is this girl,

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the Hy-genie. And so that, some early observations, I think, about this collection of films. But otherwise, the films are a spectacular

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for what they're able to tell us about what audiences like. I mean, I think thinking about the Massingham films and the way in which comedy is there, used in order to draw people in and to get them to pay attention and to watch these

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films at a moment when we know from other sources, people are much more likely to skip the newsreel-- that's at the cinema-- and jump straight to the main event,

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or skip the little short trailers and things like that, that this is a way of getting people's attention and making them think, like, oh, yeah, I actually want to get there in time

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to see this public health film because it might be entertaining. So that comes into it as a really important piece of keeping audience's attention and tells us

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how public health is shifting over this period. And I think, likewise, as I've mentioned already, this idea that over the 1940s, you get this really concerted sense that this is a collective effort,

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that during the war but then also after it, that health is a collective effort. And it's folded into this larger notion of social welfare, which, again, is exactly what gives rise to the NHS in ways that you

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don't necessarily see in the 1920s or 1930s, where filmmaking and the circulation of films tends to be often more local. If there are films made, they are not necessarily-- sometimes

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they are made by the government, but they're also being made by local health councils and things like that, and shown just within the community. So we do start to see this kind of change

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as well, of the way in which the social structures of the country are shifting over time from potentially much more local affiliation to something that's a more national level.

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Well, speaking from my own experience of working with these films, I think one of the really important things that we often miss when thinking about public health films, or we tend not to immediately think about,

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is the way that they're made. So it's this famous message that the medium in some ways is the message. So I've talked a little bit about,

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in the early 20th century, this notion of science as exhibitionism, that it's about observation. It's about things that you see in the world around you or in the natural environment.

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And filmmaking enters there as a way to expand that view, to make things that are normally invisible, visible. And that matters a lot. It becomes very important for the way in which these films are

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constructed. And in many cases, they are constructed to feature that as a way of maintaining viewer attention and as a way of getting a particular message across.

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And I think from our perspective, we watch some of these earlier films and can't make heads or tails of them because, especially things that are about flies or pests or things,

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you think, like, OK, I get it. Like, these are gross and germy. But what I think you're also seeing, and what the films can tell us much more about,

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is the fascination with science and with the natural world and with this invisible world that these motion pictures make clear. And I think that's an important way of thinking about it.

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Likewise, as time goes on and as filmmakers develop more techniques and become more savvy, you see the use of trick photography or trick edits, or you see animations being inserted into the film.

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And there again, you might say, OK, some of that is for effect and is to make viewers really pay attention. But some of that is also just about the kind of methods of filmmaking and what medical practitioners think filmmaking

00:32:01.050 - 00:32:14.970

can accomplish. One of the filmmakers I've worked on is this obstetrician who made a lot of obstetrical training films that he circulated to medical students and other obstetricians

00:32:14.970 - 00:32:27.700

in the '20s and '30s. And his archive is full of this kind of stuff. He talks about, oh, I toured Hollywood Studios, and now I know all the great ways of editing.

00:32:27.700 - 00:32:37.260

This is so amazing. And the lighting is so important. You don't want the lights to be too close because It'll burn the pregnant woman.

00:32:37.260 - 00:32:53.810

But you want them close enough so you can see everything. And talking about animation and what that adds to his toolkit. And for him, and I think for a lot of public health filmmaking and health filmmaking more broadly,

00:32:53.810 - 00:33:06.370

it's a way of producing on film what you can't produce in real life. So you can edit together, in his case, a bunch of different caesarean section procedures

00:33:06.370 - 00:33:14.860

and get one perfect caesarean section that you then send out into the world and say, look, it's perfect. Now, everybody do it this way, even though it took him, like,

00:33:14.860 - 00:33:28.040

10 tries to get it just right, and it's 10 different women being spliced together. And I think that is an important lesson, about what filmmaking is for, what it's capable of doing,

00:33:28.040 - 00:33:41.870

how medical practitioners understand what film is available and capable to do. And so I feel like it's really important to think about those aspects of it that

00:33:41.870 - 00:33:53.550

may seem it's not the-- the message is the message. Right? But the medium is, in some sense, also the message. And so that feels really important.

00:33:53.550 - 00:34:12.420

And then I think also, thinking about the changing genres over time, this idea that we start out in a moment when just being able to see the scientific world is this major development.

00:34:12.420 - 00:34:27.770

And that's very exciting, pushing all the way along to see these later moments, where different kinds of social or cultural or political change is marked, using the films as kind

00:34:27.770 - 00:34:40.420

of a barometer of those things and not forgetting. And I think this is a great lesson of the Richard Massingham films about coughs and sneezes and influenza, that these are part of a larger--

00:34:40.420 - 00:34:52.850

that the genre caught many different ways so that you have people who are working in the public health genre and working on public health quite particularly. But then you have people like Massingham,

00:34:52.850 - 00:35:04.960

who was trained as a doctor and looks like he's doing public health films because of that, actually, is somebody who's doing films that cut this way across the genre, where he's building

00:35:04.960 - 00:35:17.060

public health films into this much larger set of films that he's making that cover all sorts of aspects of everyday life. So he's got things about how to cross the street,

00:35:17.060 - 00:35:32.210

how to bathe in 5 inches of water, how to-- I don't know, all sorts of really crazy scenarios that he, as the filmmaker and often as the actor, has to navigate.

00:35:32.210 - 00:35:45.330

And I think it's really useful then to think of these films as also falling into these other genres, that they are about public health. But public health is also about a lot of other things.

00:35:45.330 - 00:35:53.420

It's about politics. It's about culture. It's about class structures. It's about race and gender and all

00:35:53.420 - 00:36:08.240

of these kinds of issues that the films can show us, if we consider them in the right context. So I suppose, the big piece there is to not set these aside as part

00:36:08.240 - 00:36:20.680

of this strange and bizarre world of medicine and public health that's disconnected from everything else that's happening, and instead, to allow them to speak to these larger issues and to build them back in,

00:36:20.680 - 00:36:30.250

into the set of things that are on the minds of British citizens and the British government in the everyday over this period.