I wrote a few reviews for this journal of history of science – I think I lost confidence after having to confess a mistake in a review I wrote in the errata. I consulted Dormandy’s book more recently about something and founds it eccentricities a little off putting rather than charming.
Makers of modern medicine
In recent years, historians in general and historians of science in particular have tended to shy away from approaching their subjects as ‘Great Men’ of history and providing a narrative account of their achievements. The story of science is no longer told as a series of eureka moments, with lone geniuses toiling away in the isolated pursuit of truth. Sociology, feminism and critiques of capitalism and imperialism – all have informed the new approach to scientific history.
Yet there seems to be an inexhaustible public demand for those Great Man (and, occasionally, Great Woman) stories. Books with titles like ‘The Man Who Changed Everything: The Life of James Clerk Maxwell’ and ‘The Man Who Invented the Twentieth Century: Nikola Tesla’ populate the shelves. The hunger that generates the demand for such books might reflect some deep-seated psychological need to believe in brilliant magi transforming the world. Perhaps it reflects a deeper truth: individual human beings do make breakthroughs and change practices, and although the more febrile romanticism of the Great Man school is evidently ridiculous, portraying science as the product of the interplay of impersonal social forces is equally misleading.
The subtitle of William Dormandy’s Moments of Truth: Four Creators of Modern Medicinesuggests that it is firmly of the Great-Man school. However, this is not the case. Dormandy firmly puts the lives of his subjects in their social and historical context, and explicitly states that it is necessary to do so in order to truly understand their achievements. His pithy, jaundiced tone is not one of blind obeisance to the ideas of progress and scientific omniscience, or to Great Men – self-proclaimed or elevated by others – in any sphere. However, Dormandy remains free from any ideological hang-ups and respects the individuality and humanity of his subjects.
The 19th century marked the birth of recognisably modern medicine. Dormandy has written about four medics whose lives spanned that century and, as they comprise a physician, an obstetrician, a surgeon and a pathologist, represent four major branches of medicine. He accepts a certain arbitrariness to his selection, but by covering the century and the fields that are the specialties of his subjects he hopes to achieve some kind of representative sample.
René Laennac was born in Brittany eight years before the fall of the Bastille in 1789 and would die of tuberculosis in 1825, four years after Napoleon. As well as engaging in epic battles with the blood-letters of the day, Laennac belonged to a new school of medical thinking that emphasized physical examination and the careful tabulation of results. He invented what would become the modern Caduceus: the stethoscope, thus earning his place in Dormandy’s quartet.
Ignác Semmelweis’ story is perhaps the best known of the four ‘creators’ among contemporary medical students. The Vienna hospital this Hungarian obstetrician worked in was divided into a section for wealthier women staffed by doctors, and a section for poor women staffed by midwives. There was a much higher rate of fatal puerperal fever among the wealthier women, and Semmelweis eventually proved that this was due to infection from necrotic material brought in to the ward by doctors from dissections they had conducted in the mortuary. This idea met with much resistance, owing to the medical politics of the era as well as Semmelweis’ abrasive nature.
Joseph Lister developed the principles of antisepsis; the careful avoidance of any possible source of infection during surgery that explains the ritual ‘scrubbing in’ of surgeons today. Walter Reed completes the quartet, and was a pathologist with the US Army Medical Corps. He established that yellow fever was spread by mosquitoes while he was working in Cuba, and this discovery helped to establish principles of modern infection control and prevention.
All four of these men were serious minded, and felt that they were in the vanguard of a new kind of medicine blowing away the superstition and stuffiness of the past. Dying young seems to be as beneficial for a posthumous reputation in medicine as in rock’n’roll or the movies. Of the four, only Lister had a long life, and Dormandy describes his evolution into ‘a slightly petulant enemy of many “new fangled” notions’.
As that little sample indicates, Moments of Truth is a pleasure to read. The writing is fresh and stimulating, judicious but unafraid of bracing judgement. The footnotes are as entertaining, if not more so, than the text itself. Indeed, I found myself with one hand wedged firmly in the back of the book to make sure I didn’t miss a trick. Another attractive feature of the book is a certain warmth and sympathy that is infused into the writing. Some medical histories read like the abstract manipulation of official memoranda and minutes, with the intention of proving some ideological or theoretical point or other – Dormandy’s stories are of living, breathing patients and doctors.