Public Health

There probably aren’t many people who could say they “like” diseases, but they are interesting subjects for researchers and writers.  Especially interesting are accounts of how society copes with illness, now and in the past – and in what ways particular diseases were perceived by the society struggling with them.  Here are a few investigations of the culture-individual-illness matrix:

Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera by Sandra Hempel
This book, and Ghost Map by Steven Johnson, are about the very birth of epidemiology, and the extraordinary man responsible for the idea that disease had patterns, that understanding it had a geographic dimension, and that illness could be combated by simply removing a pump handle and ending access to tainted water.

The Plague and I by Betty MacDonald
This famous book has value on many levels — it is by and about a Seattle author and how she confronted the disease that still challenges medicine today.  Writing over half a century ago, MacDonald treats serious subjects with humor but offers very detailed descriptions of life in a tuberculosis sanatorium.  The isolation and shunning that people with TB suffered along with their disease in a time before antibiotics resonates today among victims of AIDS.

Typhoid Mary: Captive to the Public Health by Judith Leavitt  
This is an ultimately very sad story about a medical curiosity-a plague carrier who did not succumb to the disease she spread.  It is also about the unfortunate corollary of medical knowledge-medical arrogance.  The public health authorities in New York couldn’t have done other than what they did, but their methodology seems assaultive and arrogant.  

Anthony Bourdain has a different treatment of the story of Mary Mallan (Typhoid Mary) in Typhoid Mary: An urban Historical which quite predictably focuses on her cooking with less attention to her sad fate at the hands of the officials.

Nazi War on Cancer by Robert Proctor 
An intriguing account of some of the earliest developments of a ‘public health’ approach to this disease – from an unexpected source.  Such resources as disease registers, identification and listing of carcinogenic agents,  are described here, as well as the struggle of researchers to accomplish under the pressure of an all-powerful state – and how research was generally tainted by the ‘subjects’ it turned to. 

Just to mention Sherwin Nuland is to broaden the scope of this list – anything by him is worth investigating.  How We Die details the process of death by diverse conditions – what happens to our bodies, but also what happens to our spirits and the way we understand the process.  His plea for dignified passing and a greater understanding of how that dignity can be a solace for a loved one’s grief  must be juxtaposed to the very public ‘deaths’ of individuals like Terri Schiavo, who died so much in the public eye and without a shred of dignity.

 My Own Country by Anthony Verghese
This account brings us immediately into the here and now, even though it is about twenty years old now.  Verghese, an Indian/Ethiopian immigrant and doctor in a Southern town who specialized in treatment of AIDS victims, describes the process by which he came to compassion and caring, and how that journey needed to be made by all of us.  Just reading it reminds one of how far as a nation we have come via the plague of AIDS.  [Unfortunately, no longer in print – order via interlibrary loan.]

White Plague: Tuberculosis, Man, and Society by Rene Dubos 
This is a classic sociological work by a sufferer of TB.  Dubos treats of the disease through history, of the idea that people with ‘consumption’ were more artistic, creative, and amorous, of the development of an understanding of the therapy which led to sanitariums, and offers an account of the highly political struggle for cures.  Such dividends as lists of famous tuberculosis sufferers who were, in fact, more creative and passionate than the rest of society.  (Unfortunately, no longer in print, but you can request via interlibrary loan.)
~ John S.

2 thoughts on “Public Health”

  1. Another great book along these lines is “Flu: The Story of the Great Influenza Pandemic of 1918 and the Virus That Caused It” by Gina Kolata, who is a science writer for the New York Times. She marvels: “It was a plague so deadly that if a similar virus were to strike today, it would kill more people in a single year than heart disease, cancers, strokes, chronic pulmonary disease, AIDS, and Alzheimer’s disease combined.” Its cause is still a mystery, and it could happen again.

    Speaking of the culture-individual-illness matrix, “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures” is a heart-wrenching example, wonderfully written by Anne Fadiman. It relates the story of the conflict between immigrant parents and the medical establishment around the care of a girl with epilepsy.

    And in fiction, the medical mystery novel “The Anatomy of Deception” (written by popular historian Lawrence Goldstone) offers a realistic account of medical exploration and post-mortem diagnosis in late 19th century Philadelphia.

  2. Thanks for the comment, Ann. The influenza epidemic has attracted several authors and that story remains frightening to the present day. There is a large, and interesting literature on tuberculosis–Dubos’s book is a classic, but there are a number of others. It is also worth mentioning the books on psychological diseases–like Touched by Fire, by Kay Redfield Jamison. And then there’s polio–the library has a number of memoirs of growing up with polio, like In love with daylight : a memoir of recovery by Wilfrid Sheed, and also some discussions of how communities dealt with the ‘summer plague’ before the days of Salk and Sabin. Thanks!

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