Tuesday, April 22, 2008

Hey, you guys just gonna throw that away?: F. González-Crussi and the strange, chaotic story of medical science

In J.G. Ballard’s superb new memoir Miracles of Life: Shanghai to Shepperton, the author describes his abbreviated study of medicine as having an unexpectedly formative effect on his distinctive powers as a writer of fiction. Ballard particularly covets his memories of pathological research, the subjects of which were routinely cadavers of other doctors. “Dissecting the face,” Ballard writes, “revealing the layers of muscles and nerves that generated expressions and emotions, was a way of entering the private lives of these dead physicians and almost bringing them back to life.”

This passage has stuck with me, partly because it serves as a vivid reminder for those of us with no special interest in medicine to recognize its role as a source wonderment, and its inherently human foundations—what is medicine but a science wholly driven by the dictates of human life in all its strange and unwieldy patterns? I was reminded of this further still when I recently discovered a terrific book by an author I’d never heard of. There’s a moment in On Seeing, introduced with a certain, provocative brio, where F. González-Crussi, professor emeritus of pathology at Northwestern University Feinberg School of Medicine—not to mention a witty, unfathomably knowledgeable essayist—directs our attention to how deeply our tendency to see only what we choose effects even our most critical historical endeavours. He refers here to the always awkward, not-at-all orderly story of medical science in general, and anatomy in particular:

“Historians of science have wondered why the systematic study of anatomy did not originate sooner than it did. And as puzzling as the when is the where of its origination. Several ancient cultures left proof of keen intelligence and extraordinary powers of observation. Many learned men in ancient times performed dissections on cadavers or somehow became acquainted with the interior of the body. Yet, knowledge of anatomy, as we now understand it, remained unexplainably rudimentary.”

No matter how many hearts were ripped from decidedly unlucky Aztecs as a method to placate gods and stave off catastrophe, how baffling, writes González-Crussi, that this society, the authors of exquisite poetry and astonishingly accurate astronomical observations, revealed no interest in the actual functions of said organ. Likewise, the ancient Mesopotamians produced impressive codes of law, an admirable literature, and practiced a sophisticated form of divination involving the study of entrails, yet they appear to have developed no anatomical knowledge. Such willful ignorance is found repeatedly in cultures the world round.

The way González-Crussi conveys this feature of human history, our selective perception, is fascinating, fun, clear, and kept me happily distracted for days after reading it. It was with great anticipation then that I awaited the arrival of his newest book, its appeal made plain in its title: A Short History of Medicine (Modern Library, $29.95). Though not quite as conducive to weird anecdotes, literary analogues or philosophical playfulness as On Seeing, this compact yet breezy doctoring-for-dummies is a chamber of insight, careful research, scientific basics and wide-ranging anthropological interest. Finally, while pulling no punches with regards to the abundant failings of medical science, the book nonetheless inspires tremendous respect for the way medicine in all its forms has changed almost every aspect of human life.

Chief among A Short History’s most colorful passages are, naturally, its quick dips into biography. González-Crussi tells of Andreas Vesalius (1514-1564) the hugely influential iconoclast who was so obsessed with knowledge of the body that he kept rotting corpses in his bedroom and encouraged students to hover over terminally ill patients; of Ignaz Semmelweis (1818-1865), who was tragically fired from his post and driven from Vienna for having the gall to suggest that the practice of hygiene on the part of doctors would drastically diminish cases of puerperal fever in pregnant women; of Alexis St. Martin (1794-1880), the French Canadian trapper and all-around tough motherfucker who after surviving a musket shot to his abdomen spent the rest of his life having his conveniently exposed digestive system studied by William Beaumont (1785-1853); of William Halsted (1852-1922), who pioneered the radical mastectomy through the injection of cocaine into nerve trunks, only to fall victim to cocaine’s addictive powers; of the two-man Franco-Prussian War fought between the flamboyant Louis Pasteur (1822-1895) and the more reserved and historically underappreciated Robert Koch (1843-1910). These and many other profiles emphasize that the story of medicine is also a story of politics and personality.

Dividing his broad subject into sections—anatomy, surgery, procreation, disease, diagnosis and therapy—González-Crussi breaks medicine down into its essential components, rendering its evolution into a jargon-free, easily digestible network of interrelated fields of study. He ends each section with some reflections on where this evolution has brought us; what we may have lost on our path toward longer, less painful lives; how a surprising number of folkloric or instinctive remedies have proven to be effective (did you know: swallowing semen does help to induce childbirth!); how and whether or not the eradication of pain is a plausible or even desirable goal. In short, A Short History of Medicine asks numerous questions while answering others. And it does what any such volume should do: it presents history as something relevant, alive and ongoing.

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