When I first began calling myself an ‘integrative anatomist’ (nearly ten years ago), Google showed that I was possibly the only person doing this back then. Fortunately, there are now more of us, and, as it turns out, I was just a somewhat geeky, early adopter of a useful idea.

By the time I was halfway through my master’s degree studies in clinical anatomy, I’d realized that I wasn’t particularly interested in (or talented at) scientifically studying things like the transverse humeral ligament – which may not in fact be a ‘ligament’. Me being who I am, I found myself wanting to look at anatomy subjects in a different, ‘bigger-picture’ sort of way. Fortunately, I received the necessary (and hugely appreciated) support to do this, and eventually completed a PhD project that explored ‘the meaning of fascia in a changing society’.

Nowadays, most – though not all – research anatomists are scientists. They have a variety of ways of finding-out-about human body structure (remember the story about the six blind men examining an elephant). Their different ways of doing this are represented by the several branches of the anatomy profession, each of which is associated with a particular way of exploring the body’s structure. Gross (or macroscopic) anatomy, for example, relates to the ‘parts’ of human cadavers that can be ‘grossly’ examined with naked eyesight. Microscopic anatomy studies much tinier ‘parts’ of the body (e.g., cells, organelles, protein fibres) that can only be seen through microscopes; and radiological anatomy entails the use of X-Rays and other imaging technology.

The anatomists’ varying ways of examining ‘the body’ (including, anatomical dissection, microscopy, radiological imaging) help them develop several very useful types of information about the body’s structure.

Yet, something that is often overlooked, is that anatomists are not the only group of university researchers who are developing  and using information about the body’s structure.

Imagine a large house set on the ground in a beautiful valley. The house has lots of windows, each of which allows the people looking out through them to describe what the valley looks like. The windows on the north side of the building make it possible to see the snow-capped mountains at the head of the valley. Those on the east overlook a tranquil river, and those on the west are just meters away from the edge of a forest. The windows on the south gaze across farmland towards a town in the distance.

The windows that are on each of the four sides of the building have a similar general outlook (i.e., of the mountain, river, forest, or farmland). Each window frames a different view of that side of the building’s outlook, hence provides its own unique way of viewing the valley around it. Yet none of these views will reveal everything that may potentially be seen of the valley.

A university may also be thought of as four-sided building, whose great many windows also face out in one of four directions. Anatomists normally look at ‘the body’ through some of the windows on the ‘science side of the building … while the windows used by physiotherapists, epidemiologists, and anthropologists are found on the other three sides of the building. [I’ve written more about this in an optional-to-read, academically denser section at the end of this article]

To cut a long, and potentially yawn-inducing, story short… integrative anatomists are anatomists who deliberately integrate (or meld) the information that is developed in offices on at least two, and up to all four sides of the building. There are potentially many ways of combining them – each of which will give a different flavor to our integrative anatomy work. For example, my work blends the knowledge I obtained with my anthropology, bodywork therapy, clinical anatomy, medical history, physiotherapy, and public health training … which gives my work a distinctive transdisciplinary flavor.

The value of integrative anatomy lies in its merging of views, which makes it possible for us to holistically explore some of society’s hard-to-solve problems in some new and potentially useful new ways. This can be crucial when it comes to addressing some of our society’s really complex health challenges … including, for example, dealing to some nasty new diseases (e.g., ‘long covid’), and finding some cost-effective new ways of treating their ageing populations’ chronic health problems.

“Many views yield the truth. The truth can only be arrived at when it has been expressed in all of its various forms and perceptions… after they have been harmonized, after opposition has been expressed and softened, and all of the varying views have been brought into alignment with one another … so that all aspects of the truth are sung.”
(Tepper, 1989, p, 204)

The following is an optional-to-read section for those who may want a more academic explanation about some of the ideas I’ve mentioned above.

This is by far the geekiest article I intend to ever write for this forum, so please don’t be put off by the theoretical ideas I’ve woven into it. I anticipate that this next (final) section of it is likely to be incomprehensible to many, if not most, of this article’s readers … i.e., scientifically trained anatomists and healthcare practitioners (who normally haven’t been taught about the value of working with theory). I’ve included it just in case (fingers crossed) some of you can ‘get it’, and hopefully find the ideas it contains are valuable for you. Please don’t worry if you aren’t one of them. 😊

Erich Jantsch, an Austrian systems theorist, seminally described what I’ve analogously called the four ‘window-containing directions’ as empirical, pragmatic, normative, and purposive (1947) – though he explained them in a much more abstruse manner than I’m using here.

• The empirical research windows are mostly used by basic and applied sciences disciplines – e.g., gross anatomy, histology, and biochemistry. This (numerically largest) group of researchers use empirical observation and deductive reasoning to help them describe the body in clear-cut, positivist terms
• The pragmatic research windows are the domain of the disciplines that are concerned with treatment and technology – g., medicine, health technology, and health communication. These people are interested in the purposeful application and communication of empirical anatomy knowledge.
• The normative research windows are predominantly used by the (numerically smaller) group of researchers concerned with administering the operation of a society’s health system – e.g., epidemiology, macroeconomics, and medical sociology. Their work helps inform a society’s health planning and policy decisions, which helps them prioritize the ways they allocate their resources.
• The purposive research windows are used by the (relatively few) researchers who work in the humanities side of the university building. Their disciplines – e.g., anthropology, history, and philosophy – examine ways (anatomical) knowledge is interpreted and used in society, through their special bank of ‘big-picture’ windows.

A researcher’s (or research discipline’s) choice of ‘wall-and-window’ governs the scope of their of vision – ranging from the highly precise and narrowly focused empirical views valued by scientists through to the expansive, society-scale purposive outlooks that are important to humanities researchers.

Every window makes it possible for the people looking through it to see some things, and, at the same time, it prevents them from seeing some others. None of them is inherently more important or valuable to society than any other, as they are all interconnected and inherently reliant on each other. Merging what can be seen through several of them (theoretically) enables us to develop some richer and more nuanced sets of knowledge that may hopefully help us understand some of society’s complex problems in some fresh and useful new ways.

Integrative research is now (deservedly) situated “at the leading edge [of] scientific enterprise” (Leshner, 2004), where it is valued for its potential to influence public policy and attitudes, hence is encouraged by research institutions and funding agencies, and diversely employed by health researchers. (References can be supplied on request).

A report commissioned by the American Association of Anatomists’ (1981) recognizes the worth of integrative anatomy research … although its recommendations do not (as yet) seem to have had much effect on the anatomy profession at large. The report’s anonymous authors suggest the future vigour of the anatomy profession is contingent on its members’ commitment to innovation and change and broadening their collective “realization of what constitutes modern anatomical science” (p. 15). They specifically recommend that “undergraduate studies for future anatomists should include intellectually demanding humanities courses, in English, history, sociology, philosophy and economics” (p. 91); and that doctoral research should “optimally… be a meld of more than one discipline” (p. 93).

Carlson (1998) similarly advises that the future strength of the anatomy profession depends on its members collectively embracing academic diversity and, as individuals, broadening their “breadth of focus.”

While certain areas of the anatomy profession have already heeded this challenge – through their involvement, for instance, in large scale transdisciplinary projects (e.g., Hiatt, Haslam, & Osuch, 2009), transdisciplinary university departments, and integrative anatomy groups – integrative research has yet to seriously arrive in the world of anatomy.

Maybe it’s time to think seriously about this.

References:

American Association of Anatomists’ (1981) American Association of Anatomists. (1981). The report of the American Association of Anatomists to revitalize anatomy.

Carlson, B. M. (1998). Interconnectedness of Anatomy [Editorial]. The Anatomical Record 253(2): 33.

Hiatt, R. A., Haslam, S. Z., & Osuch, J. (2009). The Breast Cancer and the Environment Research Centers: Transdisciplinary research on the role of the environment in breast cancer etiology. Environmental Health Perspectives 117(12): 1814-1822.

Jantsch, E. (1947). Inter- and transdisciplinary university: A systems approach to education and innovation. Higher Education Quarterly 1(1): 7-37.

Leshner, A. I. (2004). Science at the leading edge. Science 303(5659):729.

Tepper, S. S. (1989). The Enigma score. London, UK: Corgi Books.