In the 1880s, Sigmund Freud, the founder of psychoanalysis, and William Halsted, the founder of modern surgery, independently and personally discovered the powerful anesthetic, and terribly addictive, effects of cocaine. Markel (Quarantine!), a medical historian at the University of Michigan, eloquently tells the parallel stories of these two pathbreaking physicians and how their stories intersect in remarkable and sometimes tragic ways. The ready availability of cocaine starting in the 1860s drove Freud to experiment with the drug as an antidote to morphine addiction. Using cocaine to treat his own migraines and anxiety, he became addicted. At about the same time, when surgery remained dangerous because of easy infection and the lack of effective anesthetics, William Halsted in New York discovered the anesthetic effects of cocaine, and it appeared that the latter problem was solved; however, experimenting with cocaine himself, Halsted steadily sunk into such a terrible addiction that his brilliant career as a surgeon ended. Reviewing debates over the impact of addiction on the two physicians and why they fell prey to cocaine, Markel concludes simply and fairly that even these "intellectual giants were all too human." Markel's extraordinary achievement combines first-rate history of medicine and outstanding cultural history. Illus. (July)
It is well known that Freud, before becoming the founder of psychoanalysis, wrote about the medical uses of cocaine and did a good deal of experimentation with the drug himself. At about the same time, as Markel (George E. Wantz Distinguished Professor of the History of Medicine, Univ. of Michigan) relates, Halsted, a pioneering young American surgeon, also began experimenting with cocaine, self-injecting it to learn how to standardize the dosage. He became seriously addicted and eventually was placed in a mental hospital after all other attempts to control his drug use failed. Despite a prestigious medical career, he continued to use cocaine and morphine throughout his life. Freud, on the other hand, seems to have stopped his cocaine use on his own. There is an interesting story here about the history and sociology of medicine and drug use, but Markel doesn't pursue it; instead, he shoehorns the facts (and gossip) about the two men into a modern, 12-step view of addiction. VERDICT If you already know something about the history of medicine or drug use or have read biographies of either scientist, you may enjoy disagreeing with this book. But there are plenty of better places to start on all of these topics.—Mary Ann Hughes, Shelton, WA
Medical historian Markel (Medicine/Univ. of Michigan; When Germs Travel, 2004, etc.) writes of a time when many Americans and Europeans enjoyed their daily rendezvous with cocaine.
Two of them were giants: Sigmund Freud and William Halsted, and no history of their fields—psychology and surgery—is complete without considering their contributions, for "each man changed the world." They were also both cocaine addicts for part of their lives, and Markel investigates how that condition may have impinged on their work. The author is a convivial writer, but careful with his data; he musters his facts, then deals them out with a pleasurable flourish. He situates both the rise and fall of cocaine in the medical world, and that world writ large during the late 19th century, as well as broadly exploring each man's significance to medicine. Markel ably covers cocaine's effects as it made its way into the surgery—it was the anesthesiologist's godsend—as well as Freud and Halsted's bloodstreams. Reports of its revivifying powers had been floating out of South America since the early 19th century, and the substance gradually came into everyday use. Markel is particularly good with the social history of the drug: how it was laced into wine and Coca-Cola (as a response to the outlawing of liquor in Georgia), and the same-as-it-ever-was shenanigans of Big Pharma. Freud and Halsted, however, are cautionary tales as self-experimenters: Cocaine's progress played upon their insecurities and vanities, exacted physical and emotional tolls and disrupted their personal lives, not to mention that "their most fallow professional years coincided with their most prodigious substance abuse."
From wonder drug to the monkey on their back, Markel testifies that cocaine did neither Freud nor Halsted any favors.
Freud and Halsted never met. But Markel's alternating chapters bring them together in a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function. He has written a tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discoveryand the not insignificant cohort of experimenters who have fallen victim to their own research.
The New York Times
“A tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discovery. . . . Absorbing and thoroughly documented . . . a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function.”
—The New York Times Book Review
“Incisive. . . . An irresistible cautionary tale.”
—The Wall Street Journal
“Terrific. . . . This rich, engrossing book reminds us of the strangeness of even heroic destinies.”
—Los Angeles Times
“Markel creates rich portraits of men who shared, as he writes of Freud, a 'particular constellation of bold risk taking, emotional scar tissue, and psychic turmoil.'“
—The New Yorker
“A rich, revelatory new book. . . . [Markel is] a careful writer and a tireless researcher, and as a trained physician himself, Markel is able to pronounce on medical matters with firmness and authority.”
“A splendid history . . . [Markel is a] fluent, incisive and often subtly funny writer.”
—The Baltimore Sun
“Provocative . . . persuasive and engrossing.”
"Compelling and compassionate . . . a book that profoundly demonstrates the complexity and breadth of their genius . . . a richly woven analysis complete with anecdotes, historical research, photos and present-day knowledge about the character of the addictive personality."
“From the dramatic opening scene on the first page to the epilogue, An Anatomy of Addiction is a hugely satisfying read. Howard Markel is physician, historian and wonderful storyteller, and since his tale involves two of the most compelling characters in medicine, I could not put it down—addictive is the word for this terrific book.”
—Abraham Verghese, author of Cutting for Stone
“It’s a fascinating book about fascinating men, but even more interesting for those of us who want a glimpse of modern medicine when it was just starting to develop.”
—The New Republic
“Dr. Markel braids these men’s stories intricately, intelligently and often elegantly.”
—The New York Times
“Markel brilliantly describes the paradox of [Halsted’s and Freud’s] lives.”
“Inspired, entertaining and informative . . . [Markel] tells this fascinating tale in an insightful contemporary book that is both intellectually engaging and exceptionally well written.”
—Journal of the American Medical Association
“[A] witty, wide-ranging book.”
“A richly engaging book . . . highly recommended.”
“Well-researched. . . . A thoughtful picture of late 19th century medicine.”
—The San Francisco Chronicle Book Review
“Colorful study . . . brisk . . . an engaging well-researched historical homily about fame and foible.”
“A fascinating revelation of conditions prevailing in hospitals and medical circles in the late 19th and 20th centuries.”
—New York Journal of Books
“The best medical histories are the ones that cause the imagination to run riot. A fast-rising master of satisfying this human quest for mind-altering willies is the Michigan medical historian Howard Markel.”
—The Winnipeg Free Press
“With both wit and style, Markel has produced a scrupulously researched, meticulously detailed account of the history of cocaine, as well as the drug dependences of Halsted and Freud.”
—Hopkins Medicine Magazine