Taiwan’s response to the COVID-19 pandemic is often applauded internationally as a success story, yet it has only been possible because of Taiwan’s strong medical profession and vibrant civil society. Few scholars have investigated both the colonial origin of Taiwan’s medical profession and the development of Taiwan’s public health system and civil society engagement after democratization. Since the 2000s, Professor Ming-Cheng M. Lo has produced many pioneering writings on doctors, disasters, grassroots activism, and cultural identities in Taiwan. How did the medical profession in Taiwan emerge in the Japanese colonial era? Why are there many doctors actively participating in today’s Taiwanese politics? How did civil society engagement contribute to Taiwan’s pandemic response?

The Taiwan Gazette is pleased to interview Professor Lo to discuss these important questions related to public health and civil society in Taiwan.

Ming-Cheng M. Lo is Professor of Sociology at the University of California, Davis. Professor Lo’s research focuses on the cultural codes, narratives, and networks in East Asian civil societies. She has also written about the sense-making processes regarding disasters and cultural traumas. Applying similar cultural approaches to medical sociology, her research also addresses how individuals make sense of healing, illness, and suffering, and how medicine intersects with politics, ethnicity, colonialism, and neoliberalism. Lo is the author of Doctors within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan (University of California Press, 2002; Japanese edition published in 2014). She has published actively on culture, civil society, and health and illness in sociology and interdisciplinary journals.

The interview was conducted online in English and has been edited for clarity.

Interviewed by Sida Liu and Man Xu
Transcribed and edited by Man Xu
Cover Image: National Repository of Cultural Heritage

Taiwan Gazette: Professor Lo, we noticed that before you became a sociologist you did your BA in foreign languages and literatures at National Taiwan University, and your MA in comparative literature at the University of Michigan. How did your training in language and comparative literature and your interdisciplinary background shape your research interests and approach as a sociologist?

Ming-Cheng M. Lo: Thank you for that question. I was a very passionate student of literature during my time as an undergraduate student at National Taiwan University. In fact, I remember that many years ago, I asked Professor David Wang (David Der-wei Wang; 王德威), who was my teacher at NTU and is teaching at Harvard now, for a recommendation letter for my graduate school application. I described to him my vision and passion for literature, and he wrote me an apparently very good letter. Then, of course, many years later I met him at a conference after I had changed my field from literature to sociology. I was thinking at the time: how should I explain this career change?

Joking aside, this is what happened. When I studied literature, what fascinated me the most was actually the social and identity issues that are richly explored in different novels and poetry. These social and cultural issues, more than the beautiful writing, were what drew me to literature, but I didn't know that when I was an undergrad. I think getting my MA training in comparative literature made that clear to me. That's why I transitioned from comparative literature to sociology.

But your question is: how did that early training shape my way of approaching sociology? I think it did, in that it helped promote a strong interest in cultural sociology for me. I tend to look at the sociological issues I study through cultural sociological lenses and focus on meaning-making processes. The early formation of my academic identity is still quite relevant today.

Taiwan Gazette: After becoming a sociologist, you wrote this excellent book titled Doctors Within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan — a study about the medical professionals in Taiwan during the Japanese colonial era. How did you become interested in Taiwan’s medical profession in the Japanese colonial period in the first place?

Ming-Cheng M. Lo: When I was growing up in Taiwan during the martial law period, I felt there was a missing page in our history education – the social history of the formation of Taiwanese elites and intellectuals during the colonial period. We were taught that there was Zheng Chenggong (also referred to as Koxinga; 鄭成功), then came the bad guys from Japan, and then Chiang Kai-shek (蔣介石) liberated Taiwan. And that doesn't quite match up with a lot of the folklore or street-talks by ordinary people, which involve many stories about Taiwanese elites and commoners during the colonial period. So, I was curious about this unspoken social history.

Besides, my paternal grandfather was from that generation. He was not a doctor, but he did get his college education in Japan in electronic engineering. The family stories about him painted a very different picture about what the Taiwanese intellectuals were like during that time, compared to what I was taught at school. So my personal experience was another reason why I was interested in understanding more about this topic. There is a little bit of an autobiographical origin to probably all of our first books, right?

“From national physicians to medical modernists—from resistance to assimilation—[Taiwanese doctors’] identity narratives both internalized and subverted the colonial ideology and manifested different modes of transcending the colonizer/colonized dichotomy. . . . Their story illustrates how colonial subjects’ interpretations of the ambiguous colonial relations in the Japanese Empire altered the meanings of the official colonial discourse and shaped their own identity.”

— Ming-Cheng M. Lo, Doctors Within Borders: Profession, Ethnicity, and Modernity in Colonial Taiwan

Taiwan Gazette: In the book, you discuss the “in-betweenness” of Taiwanese physicians during the Japanese colonial rule. What do you mean by in-betweenness, and how did the in-between positions of Taiwanese doctors change over time during the colonial period?

Ming-Cheng M. Lo: Indeed, if I were to identify a core theme of that book, I would probably pick in-betweenness. In-betweenness means a number of different things to me. At an empirical level, I tried to describe and conceptualize the ways in which Taiwanese physicians tried to inhabit this contradictory position. On the one hand, they were the native elites; on the other hand, they were colonial subjects. Politically they were mostly against Japanese colonialism, but many of them had very close relationships with their Japanese colleagues, mentors, and friends and had developed a very Japanized cultural identity. Analytically, in-betweenness is a concept that captures their social, political, and cultural hybridity, as they were put in a structural position where they needed to constantly negotiate tensions and contradictions.

At a more theoretical level, I came to realize the following point more clearly and deeply after I finished the book and as I continue to write about other topics of sociological interest in an Asian context. In-betweenness or hybridity becomes a key theme in the ways in which I’m trying to apply Western sociological concepts to the Chinese, Taiwanese or other Asian contexts. It represents to me a perspective of “provincializing Europe”.

“To provincialize Europe was then to know how universalistic thought was always and already modified by particular histories, whether or not we could excavate such pasts fully.”

- Dipesh Chakrabarty, Provincializing Europe: Postcolonial Thought and Historical Difference

We have many wonderful theoretical tools developed by excellent European or American sociological scholars who are nevertheless limited and biased by the empirical experiences they study, through which they formulate these theories. We often have to apply these concepts, which are derived from Western experiences, to the cases outside of Europe and North America, and we try to negotiate the mismatch in a way that is productive. Again, I find myself ironically embodying similar positions as the doctors I studied – I’m constantly trying to hybridize. There are theories that I admire, but there are also the empirical cases that are marginalized in these theoretical traditions. Negotiating and hybridizing these two positions is what in-betweenness also means to me.

To answer your second question, the book points to the contrast between “national physicians” and “medical modernists”. The doctors that came of age in the 1920s [the national physicians] broadened the concept of caring beyond just providing medical care. They embraced the social and political mission that they viewed as important to the nation of Taiwan, which was to challenge Japanese colonialism.

The younger generation that came of age during the late 1930s and the 1940s [the medical modernists] tended to describe their physician identities by trying to de-emphasize the relevance of ethnicity. They believed that science has no national boundaries, and that it doesn’t matter whether it was the Japanese, the Americans or the Germans that brought biomedicine to Taiwan; “medicine is medicine.” But when I tried to ask them about their ethnicity, I realized that they had difficulty articulating what it means to be a Taiwanese physician during the colonial period. I think their silence spoke volumes about the relevance of ethnicity. The contrast between these two generations of physicians captures the fluidity of in-betweenness.

Taiwan Gazette: The time span of your book ended in the 1940s. Can you talk about the legacies of the colonial medical profession for social development and the medical profession in Taiwan in the post-1949 period?

Ming-Cheng M. Lo: There are different ways to answer this question. I’ll just mention two things. The first thing comes from my interview experiences with the doctors. Most of the doctors who came of age in the 1920s were no longer alive in the 1990s when I was pursuing my PhD at Michigan. But I was able to interview around 10 of the “medical modernists” -- the doctors who were young medical students during the 1940s. It was interesting that when I asked them about their experiences during that period, the first thing they said was about how horrible things were after Chiang Kai-shek came to Taiwan. And I had to redirect them repeatedly, asking “wait, can you talk about the wartime period? How was it like to be a Taiwanese who was trained by Japanese doctors and living in a colony which was at war with America?” But it felt like they didn’t want to answer that question; rather, they wanted to tell me how horrible things were after the war. It took me a couple of interviews to realize: their silence was very meaningful! For them, what happened after the war was a stronger reference point in their youth. So, what's the relevance of that legacy? I think some of the doctors may have romanticized their memory under the Japanese because of their bad experiences after the regime change. So, they would say, yes, the Japanese were relentless in their political control, but at least they built railroads and hospitals, among other things; at least they were really serious about public health, and their policemen were not corrupt! To the extent that we all resort to later experiences to re-interpret earlier memories, these doctors may have romanticized their experiences during the colonial period, which to me implies a social criticism of what transpired in Taiwan after the war ended.

The other legacy is this larger-than-life image of what a doctor should be. They are respected social elites, not just someone doing their job. I think this image is still readily available even in today’s Taiwanese cultural repertoire. That is not to say that most Taiwanese doctors go into politics. Quite the contrary, most of them don't. But whenever some of them do, they invoke the legacy that Taiwanese doctors were actively engaged in social activism during the Japanese period, and they claim that they should carry on the torch.

Taiwan Gazette: This naturally leads to our next question. In today’s Taiwanese politics, there are many doctors who turned into politicians, and some of them have attained high-level positions. However, in East Asia and other parts of the world, you rarely see so many doctors who achieve high political positions. How would you explain that?

Ming-Cheng M. Lo: That really dovetails with your previous question about the legacy - the cultural imagination that doctors are more the caretakers of the people than strictly biomedical healers. I think Taiwanese doctors got this idea from traditional Chinese culture. Chiang Wei-shui (Tsiúnn Ūi-súi, 蔣渭水), for example, mentioned that good doctors should heal the nation, which comes from a Chinese saying.

This cultural motif is definitely relevant in the broader Chinese context, but why is it amplified particularly in the Taiwanese context? I think the colonial social history played a role, in that the Japanese were very afraid to let Taiwanese youths obtain higher education, because they felt that if they became too educated, they’d start thinking independently and rebelling against colonialism. So, for a long time Taiwanese people were only allowed to go into two fields for college-level education. One is education, because the Japanese were really keen on bringing up the literacy rates among the Taiwanese and they needed teachers. And the other profession is medicine, because the Japanese wanted Taiwan to be a productive colony for the empire. So, it’s for purely instrumental reasons that they were training teachers and doctors. These colonial policies channeled many talented youths into medicine. People who would have chosen to study philosophy or music or politics were often channeled into medicine, because the Japanese wouldn’t let you study these other things. These youths did become doctors, but perhaps they brought their humanistic concerns into medicine, making them more inclined to embrace this cultural motif that doctors should be caretakers of the people.

Read Part 2 of the interview here.