This week’s MedHum Monday post, written by series editor Catherine Osborn, highlights three recent releases about historic discoveries in medicine through the lens of social context. Often such discoveries are only possible through incredible suffering, as in war or epidemics. Countless deaths provided both numerous cases for anatomists and physicians to examine and test their newest techniques and theories. They also provided incentive. Although usually met with initial skepticism or disbelief, those researchers who could successfully understand and treat traumatic head injuries from war, tuberculosis in the 19th century, and the AIDS epidemic one hundred years later, have been lauded as both pioneers and saviors. Yet, all of these books look at the humanity of these medical giants – capable of making mistakes, trusting popular (though flawed) explanations, or occasionally being undesirable characters.
The Tale of the Dueling Neurosurgeons: And Other True Stories of Trauma, Madness, Affliction, and Recovery That Reveal the Surprising History of the Human Brain
Early studies of the functions of the human brain used a simple method: wait for misfortune to strike—strokes, seizures, infectious diseases, lobotomies, horrendous accidents—and see how the victim coped. The Tale of the Dueling Neurosurgeons explores many of these miraculous survivals. Observers could only marvel at the transformations of personality that took place afterward. An injury to one section can leave a person unable to recognize loved ones; some brain trauma can even make you a pathological gambler, pedophile, or liar. But a few scientists realized that these injuries were an opportunity for studying brain function at its extremes. With lucid explanations and incisive wit, Sam Kean explains the brain’s secret passageways while recounting forgotten stories of common people whose struggles, resiliency, and deep humanity made modern neuroscience possible.
The book begins with a tale of Vesalius and Ambroise Paré meeting and treating (and autopsying) the King of France after a jousting accident. Such an account introduces the beginning of evidence-based neurology, representing a break with the traditional ideas of the ancient physician Galen. It also serves as a launch point for a discussion of deadliness of trauma and concussions. The following stories of assassinations, cannibalism, and war allow the author to provide as much science as history while explaining what and how modern neurologists know what they know.
While Kean mentions the theoretical debates and missteps taken by early physicians and researchers, the scientific discussions included in each chapter present modern interpretations of the brain in fairly unshakeable terms. Although some questions are still unanswered, The Dueling Neurosurgeons gives the reader easy-to-digest discussions of contemporary scientists’ agreed upon perspectives. Importantly, however, histories included in this work suggest that only time and future discoveries will tell which theories remain the consensus.
The Remedy: Robert Koch, Arthur Conan Doyle, and the Quest to Cure Tuberculosis
In 1875, tuberculosis was the deadliest disease in the world, accountable for a third of all deaths. A diagnosis of TB—often called consumption—was a death sentence. The Remedy explores how a German doctor named Robert Koch deployed an unprecedented scientific rigor to discover the bacteria that caused TB. Koch soon embarked on a remedy—a remedy that would be his undoing.
When Koch announced his cure for consumption, Arthur Conan Doyle, then a small-town doctor in England and sometime writer, went to Berlin to cover the event. Touring the ward of reportedly cured patients, he was horrified. Koch’s “remedy” was either sloppy science or outright fraud.
But to a world desperate for relief, Koch’s remedy wasn’t so easily dismissed. As Europe’s consumptives descended upon Berlin, Koch urgently tried to prove his case. Conan Doyle, meanwhile, returned to England determined to abandon medicine in favor of writing. In particular, he turned to a character inspired by the very scientific methods that Koch had formulated: Sherlock Holmes.
Science does not happen in a vacuum and medical discoveries are influenced by factors outside of sterile laboratories. The Remedy is a beautiful acknowledgement of how researchers are subject to their social context and that the dissemination of medical information happens in literature as well as scientific journals. Despite Koch’s failed attempt at curing tuberculosis, his meticulous microbiological study of the deadly pathogen revolutionized the way science approached disease. It was this attention to detail that Conan Doyle included in Holmes – making clear that such focus could solve the mystery of any plague or crime.
Enigmas of Health and Disease: How Epidemiology Helps Unravel Scientific Mysteries
Enigmas of Health and Disease is a principal account of epidemiology’s role in the development of effective measures to identify, prevent, and treat diseases. Throughout history, epidemiologists have challenged conventional knowledge, elucidating mysteries of causality and paving the way for remedies. From the outbreak of the bubonic plague, cholera, and cancer to the search for an effective treatment of AIDS and the origins of Alzheimer’s disease, epidemiological thought has been crucial in shaping our understanding of population health issues. By drawing from both historical and contemporary sources, Morabia provides the reader with the tools to differentiate health beliefs from health knowledge.
This book is by far the most recent of the three, being released on June 24th, 2014. It is also probably the most broad in scope as well as being the most informational. Morabia provides excellent anecdotes outlining how early population-level thinking led to many modern conceptions of disease. Many of his discussions include accounts of how many of these discoveries went on to have later social ramifications. Of particular interest, many of the discoveries enumerated used population level experimentation to create solutions for problems where microbiological/cellular explanations were not yet available. John Lind treated scurvy with citrus without knowledge of vitamin C. John Snow tracked the spread of cholera through contaminated water without measuring bacteria levels. Ignaz Semmelweis introduced hand-washing methods in obstetrics to stop puerperal fever without explaining the “cadaveric agent” spreading the disease. Using the means available, such research saved countless lives through a focus on the big picture, rather than just the individual.
That’s all for this week’s MedHum Monday. We will continue our look at medical libraries and museums next week!
Catherine Osborn, BA, BS, is a graduate student in Medical Anthropology at Case Western Reserve University, the Editorial Associate at Culture, Medicine and Psychiatry, as well as a Research Assistant at the Dittrick Museum of Medical History.