Calculated or caring? : Neanderthal healthcare in social context

Explanations for patterns of healed trauma in Neanderthals have been a matter of debate for several decades. Despite widespread evidence for recovery from injuries or survival despite impairments, apparent evidence for healthcare is given limited attention. Moreover, interpretations of Neanderthal’s approach to injury and suffering sometimes assume a calculated or indifferent attitude to others. Here we review evidence for Neanderthal healthcare, drawing on a bioarchaeology of care approach and relating healthcare to other realms of Neanderthal social life. We argue that Neanderthal medical treatment and healthcare was widespread and part of a social context of strong pro-social bonds which was not distinctively different from healthcare seen in later contexts. We suggest that the time has come to accept Neanderthal healthcare as a compassionate and knowledgeable response to injury and illness, and to turn to other questions, such as cultural variation or the wider significance of healthcare in an evolutionary context

Living to fight another day : The ecological and evolutionary significance of Neanderthal healthcare

Evidence of care for the ill and injured amongst Neanderthals, inferred through skeletal evidence for survival from severe illness and injury, is widely accepted. However, healthcare practices have been viewed primarily as an example of complex cultural behaviour, often discussed alongside symbolism or mortuary practices. Here we argue that care for the ill and injured is likely to have a long evolutionary history and to have been highly effective in improving health and reducing mortality risks. Healthcare provisioning can thus be understood alongside other collaborative ‘risk pooling’ strategies such as collaborative hunting, food sharing and collaborative parenting. For Neanderthals in particular the selective advantages of healthcare provisioning would have been elevated by a variety of ecological conditions which increased the risk of injury as well their particular behavioural adaptations which affected the benefits of promoting survival from injury and illness. We argue that healthcare provisioning was not only a more significant evolutionary adaptation than has previously been acknowledged, but moreover may also have been essential to Neanderthal occupation at the limits of the North Temperate Zone

Healthcare provisioning in evolutionary context

This research provides a large scale analysis of evidence previously only available as individual reports which is of significance to an understanding of social changes in the Palaeolithic. It also highlights why healthcare provisioning should be considered as a key evolutionary adaptation and so is of interest and importance to those studying cognitive, biological and anatomical changes. We are increasingly recognising many complex ways in which the ecological, social, cognitive and anatomical elements of our human evolutionary past interact and influence each other. One relatively new area of this type of interaction is the potential significance of healthcare provisioning on other realms of human evolution and behaviour. Evidence from skeletal remains for care has traditionally been considered to be subject to some debate. However, whilst precise interpretations remain open to discussion, widespread evidence for healthcare in Palaeolithic contexts is now widely accepted [1] [2] [3]. Healthcare practices are significant in several ways, such as by changing the profile of how injuries impact both group subsistence and individual survival, as well as having a profound impact of social relationships. Here we explore this issue through the interpretation of a large scale survey of evidence for care practices in early, archaic and modern humans. We consider the ecologica l basis for care for the ill and injured, how such care changes through time and in different contexts, the role of care practices in group survival, and the potential influence of increasingly sophisticated medical knowledge on care. Although healthcare provisioning has typically been seen in purely cultural terms, we argue that it is not only a significant and often overlooked element of social relationships throughout the Palaeolithic but is also of evolutionary significance. While other animals provision the ill and injured, none go to such lengths or with such competency as seen in archaic humans, as recent research has started to highlight [4] [5]. Healthcare practices in such groups are likely to have included not only provision of food and water and protection from predators, but also a knowledgeable approach to promoting wound healing and recovery from severe injury. We argue this adaptation was an important part of hominin sociality and may have become especially importan t to humans that were trying to survive in hostile environments. Bastir, M. Pulling faces. Nat Ecol Evol (2018). Comment on Godinho, R. M., Spikins, P., & O’Higgins, P. (2018). Supraorbital morphology and social dynamics in human evolution. Nature ecology & evolution, doi:10.1038/s41559-018-0528-0 Trinkaus, E. & Villotte, S. External auditory exostoses and hearing loss in the Shanidar 1 Neandertal. (2017) PLoS One 12, e0186684. Thorpe, N. 2016. The Palaeolithic Compassion Debate--Alternative Projections of Modern-Day Disability into the Distant Past. In Care in the Past: Archaeological and Interdisciplinary Perspectives, edited by L. Powell, W. Southwell-Wright, and R. Gowland, 93–109. Oxford: Oxbow Books. Spikins, P., Needham, A., Tilley, L. & Hitchens, G. Calculated or caring? Neanderthal healthcare in social context. (2018).World Archaeology. DOI: 10.1080/00438243.2018.1433060 Tilley, L. (2015) Care Among the Neandertals: La Chapelle-aux-Saints 1 and La Ferrassie 1 (Case Study 2). in Theory and Practice in the Bioarchaeology of Care 219–257 (Springer International Publishing, 2015)