In which I clear out the book review file. Got to do it and move on. Which is too bad because there are books here to which I wanted to give extended attention, but that’s just not going to happen. So, onward:
First, I suppose I’ll gather up the three-medical-related books.
(Why these books? Well, Embryo should be obvious. But the other two? History is my thing – my key to understanding the present, and I’m particularly history in social history in the broadest sense. I want to know how people lived, how they thought, how they made sense of life, how they changed. Medical history is of interest to me, not because I’m sick, but simply because I’m interested from a technical standpoint (as a child I did want to be a doctor for the longest time) and I’m interested in the point at which human beings confront mortality and have to decide what to do about it. Finally, I’ve got this broad interest in religion, particularly Catholicism, naturally, and I want to understand how Christianity and Catholicism impacted the way people lived in every aspect of their lives. You’ve got to go beyond the religion section to figure that out. Even religious history. Maybe especially religious history.)
So:
Embryo by Robert P. George and Christopher Tollefsen is a good introduction to the scientific and philosophical issues. It would be helpful for anyone who’s not familiar with the arguments or wants a deeper look at the science presented in a way helpful to a layperson. I was struck by two things during my quick reading:
First, the amount of intellectual energy that goes into excluding embryos (and not only embryos, of course) from the larger human family, recognized and protected by law. The more you read, the more perverse it becomes, quite frankly. Put in that sort of perspective, it is darkly striking.
Secondly, a nagging question. The authors explore lines between various types of research, maintaining that embryo-destructive research is immoral, as well as any research that objectifies the embryo. However, in the repeated, detailed explanations of early embryonic development, I kept thinking, “How could this have been discovered without embryos in a petri dish being watched, teased apart, chemically analyzed and eventually destroyed?” It was an ethical issue I didn’t see addressed (perhaps it was, and I missed it), and wondered about. How is it possible to gain knowledge about embryonic development in a way that respects an embryo’s personhood?
(Will Saletan has had exchanes w/the authors on this book. I’ll find and link tomorrow.)
Moving on. The Worst of Evils was just the kind of book I dig into. So to speak. It is, as the subtitle indicates, a history of humanity’s battle to minimize pain, particularly in relation to surgery, so anesthesia is a big part of the story. It was a library book, and I read it about two months ago, so it’s not here with me so I can pull out details, unfortunately, but there’s a lot of material there, well-told. Reading about the pain that most people endured for much of their lives (and in parts of the world, still do) is a humbling and bucking-up experience. You can see how the advances of the 19th century truly were miraculous. The book is filled with good stories, but of greatest interest to me was the development of ether, which is closely tied to American dentistry – they called it the “Yankee Dodge” on the other side of the oceaan – and resonates with echoes of the carnival sideshow and shows how murkey the line between medicine and recreation was – because of course, throughout the century, all of these advances in anesthesia, beginning with nitrous oxide, were greatly enjoyed as party drugs before they gave it to you when they cut off your leg.
I was also interested in (of course) the religious aspect. Were Christian churches opposed to painkillers in any way? Not really. Before I get to that, let me say that the author gives explicit props to Christians for essentially inventing the hospital, making clear that nothing of the sort existed in the classical world, particularly for the poor. Because God is Not Good. Right?
Anyway, the only real resistance among Christians to any kind of pain killer that the author spends time with involved the giving of anesthesia during childbirth. Genesis 3:16 and all that. Queen Victoria pretty much took care of that with “blessed chloroform”…
Next up, and related and highly recommended is Bad Medicine. It’s a really intriguing book – perhaps overdone in its argument and undoubtedly flawed in the narrative it suggests (not being an historian of medicine, I can’t judge, but I wouldn’t be surprised if there were vigorous disagreements with his take out there.)
The book isn’t about malpractice, as the title suggests, in the specific sense. It’s an attack on the dominant narrative line of medical history which suggests that since Hippocrates and Galen, medicine has progressed in a steady way, providing the human race with advance after advance, all to our benefit.
Bosh, says the author, who maintains that medicine, both because of the pride of doctors, an attachment of the false paradigm of the humors as a causal factor in illness, as well as other factors, medicine didn’t advance at all from the ancient world until the 19th century – the advent of germ theory. Doctors, he says, hardly helped anyone and probably killed a lot more people than they cured. Unnecessarily.
Which is not anything new – what this author brings to the table is the argument that they should have known better. That the advances that were occurring in anatomical knowledge and such were essentially being ignored by doctors, or not followed through in any useful way. I was pretty intrigued by the book, because I’m always intrigued by contrarians, particularly when it comes to historiography. I could see his point many times, but I also believe that there are (gag) paradigms that are almost impossible to surmount when we’re in the midst of them.
For example, the author looks at the lag time between the discover of germs and the understanding of the necessity of aseptic techniques, aka wash your hands. He’s got a tremendous point for the most part – when you learn how Semmelweis’ seemingly blindingly clear findings in the maternal hospital in Vienna were discounted, you do think…how could this be? The same, just as dramatically with scurvy – James Lind pretty much proved the connection between scurvy and vitamin C deficiency, but it took the Royal Navy decades to implement the findings, at the cost of a tremendous loss of life, of course.
Yes, it’s crazy. And professional arrogance undoubtedly played a part in a lot of it. But I couldn’t shake the sense that it’s pretty difficult for human beings to see beyond what they want to see, and while germs=puerperal sepsis=fixed by aseptic techniques seems like kindergarten logic to me, the reason for not seeing, while not “excusable” also seems to be very much an expression of the human condition.
Which is why I enjoyed this book so much. It’s useful to be reminded that various groups (in this case many medical historians) have a vested interested in promoting a particular narrative. (Yes, it is true of religious entities as well.) It’s not wise to take any particular narrative as gospel truth. It’s startling how many “things we know for sure” from the trajectory of medical history to the “facts” told to us by various intellectuals over the past two centuries are simply not true. (In my fantasy mega-post related to this, the book on the sidebar, Burning to Read, was going to be involved – but it’s late and we’re have to do that another time) The whole story, in the end, belies that simplistic narrative of “progress” that we’re fed by all sides and should induce a healthy jolt of skepticism to the claims of scientists of all sorts who claim to be so much better than the rest of us by virtue of their objectivity and clarity of thinking.
As if.