The Great Shadow: A History of How Sickness Shapes What We Do, Think, Believe, and Buy

by Susan Wise Bauer

From alchemy to wellness culture, from antisemitism to disposable plastic, a gripping account of how getting sick has shaped humanity.

Anti-science, anti-vaccine, anti-reason beliefs seem to be triumphing over common sense today. How did we get here? The Great Shadow brings a huge missing piece to this puzzle—the experience of actually being ill. What did it feel like to be a woman or man struggling with illness in ancient times, in the Middle Ages, in the seventeenth century, or in 1920? And how did that shape our thoughts and convictions?

The Great Shadow uses extensive historical research and first-person accounts to tell a vivid story about sickness and our responses to it, from very ancient times until the last decade. In the process of writing, historian Susan Wise Bauer reveals just how many of our current fads and causes are rooted in the moment-by-moment experience of sickness—from the search for a balanced lifestyle to plug-in air fresheners and bare hardwood floors. We can’t simply shout facts at people who refuse vaccinations, believe that immigrants carry diseases, or insist that God will look out for them during a pandemic. We have to enter with imagination, historical perspective, and empathy into their world. The Great Shadow does just that with page-turning flair.

Genres: Nonfiction, History, Science, Health, Medical, Medicine, Historical

352 pages, Hardcover

Published January 27, 2026

About the author

Susan Wise Bauer is an American author, English instructor of writing and American literature at The College of William and Mary, and founder of Well-Trained Mind Press (formerly Peace Hill Press).

Reviews

[Barbara · Rating 4 out of 5]

Humanity has always feared illness, and sought remedies for the body's discomfort and dysfunction. In this book, author Susan Wise Bauer traces the progression of our understanding of disease, and the evolution of treatments, cures, and prevention.

For illustrative purposes, Bauer includes comparisons of paleolithic sufferers with modern patients, which adds a whimsical element to a serious subject.

For example:

➽ Late fall, 4,000 years ago: Last night you had bad dreams, and were sweating, restless, hot and wretched. This morning, your mouth is dry, your teeth are chattering, and swallowing is painful.

You get an asu (healer) to treat you with herbs and barks and salts stirred into beer to drink; and powdered snakeskins and river clay kneaded into fats to massage your aching limbs.

Because of the nightmares you also need the ashipu (priest), to determine which demons have invaded you and what you did to invite punishment (such as insufficient offerings to the gods). The ashipu will then instruct you to make amends, and perform an incantation to purify you.



➽ Late fall, 2020: You wake up sick, think about who might have infected you during the past week, and hope you don't have Covid.



*****

I'll provide a brief look at the book's contents, but keep in mind Bauer's coverage is MUCH MORE extensive, with NUMEROUS examples.

Over thousands of years, beliefs about the causes of disease have changed: from angry deities, to unbalanced humors (elements that make up the body), to miasmas (bad air), to germs. Naturally, prevention and treatment of illness changed accordingly.

Prehistoric humans had few problems with infectious disease because hunter-gatherer populations were sparse, and transmission from person to person, or by way of the environment, was limited.

When humanity formed settlements, however, and communities became more tightly packed, bacteria prospered in the growing heaps of feces and food scraps; hookworms, roundworms, and other intestinal parasites infected children who played in the dirt; water reservoirs for crops bred mosquitoes, and nurtured parasites that caused amoebic dysentery, dengue fever, schistosomiasis, and so on.

Animals also became a problem. Rodents and birds that nested around homes shed viruses, fungi, and bacteria; and domesticated animals - dogs, sheep, goats, cattle, pigs, horses, chickens, camels, etc. - 'shared' their diseases.



➽ Deities

We now understand why people get sick, but thousands of years ago, sickness was a mystery. Diagnostic methods, therefore, relied on various kinds of 'magic.' For instance, one method of diagnosis was 'extaspicy' - the ritual sacrifice of an animal, and the examination of its insides for messages from the gods.


Extaspicy

Other diagnostic tools included reading marks on oracle bones, and interpreting cracks on turtle shells. The answer was always that the sufferer had sinned, offended the gods, and had to make amends to be cured.

➽ Humors

Greek philosophers believed four elements made up the body: flesh, blood, bones, and breath. In the same way, four elements made up the universe: fire, water, earth, and air. In the body, the elements were represented by fluids, or humors, that moved through the tissues and determined health and illness. The humors were yellow bile, blood, phlegm, and black bile.



When the fluids were in equilibrium, people were healthy; when the fluids were unbalanced, people became ill. So, for example, too much phlegm in the head was thought to block the proper flow of air and cause seizures (epilepsy).



The physician's role was to determine the reason for the imbalance (such as cold weather and winds), and to provide suggestions for a remedy (such as resting near a warm fire).

The idea that unbalanced humors cause disease evolved into the Hippocratic model, which lasted for 30 generations. Bauer writes, "For Hippocrates and his followers, the body is naturally healthy. The humors WANT to be in proper proportion. But they are constantly pushed and pulled at by their surroundings, and since each body responds slightly differently to airs, and waters, and places, each body can easily get out of whack in a slightly different way."



The Hippocratic physician diagnosed the surroundings and experiences of the patient (food and drink; humidity and dryness; cold and heat; noise and quiet; and so on), diagnosed the imbalance, and sought to right it. As an illustration, if you got stomach pains, you might be advised to change your diet.



Bauer goes on to an extensive discussion of Hippocratic medicine, and the manner in which it was amended by Galen - who included human anatomy in the diagnoses of illness.

The author also discusses HORRIBLY DEADLY epidemics and pandemics, such as bubonic plague, which broke out repeatedly over the centuries.






The bubonic plague was horrific and deadly

When plague diseases didn't respond to Hippocratic and Galenic methods, people scapegoated those considered 'different' than themselves, especially Jews, who were hunted down and murdered.

Bauer notes that scapegoating never faded away, and continues into modern times. For example, in 1900, Chinese immigrants were blamed for epidemics of tuberculosis, syphilis, and other diseases; in 1916, Mexicans were blamed for outbreaks of typhus; and in 2018, Donald Trump spread the word that "poor, uneducated, foreign immigrants are a particular threat to White Americans", and he later called the Covid pandemic "the Chinese virus" or the "Kung flu."


Chinatown was destroyed during the epidemics of 1900


Mexicans were forced to take kerosene baths when crossing the border in 1916

➽ Relief (Drugs)

From early times, humans understood that beer, wine, and opium juice made them feel better, so the idea of using substances - like plants, herbs, and vegetables - to relieve symptoms is very old. Our ancestors had no idea how the remedies worked, and paired characteristics of plants with (supposed) cures. For instance, plants that split rock crevices were administered to break up kidney stones.



Over time, curative substances, and foods and drinks made from them, VERY SLOWLY evolved into drugs. Unfortunately, the proliferation of drugs also gave rise to quack remedies from hucksters, which persists in modern times (i.e. suggestions to use hydroxychloroquine and chloroquine for Covid).


Quack Medicines

➽ Human Anatomy

In ancient times, the human body was sacred, and healers would never open a body to diagnose illness, even after death. Over time, enterprising physicians overcame this superstition, did extensive autopsies, and wrote books about human anatomy. This was a big step forward in understanding illness and disease.

➽ Germ Theory

Historically, physicians had no knowledge of germs, but returning epidemics - like smallpox, plague and flu - demonstrated that humors couldn't be blamed, and that 'seeds of disease' spread the scourges. Though MANY people (including doctors) resisted this idea, what came to be known as germ theory slowly gave rise to inoculation and vaccination.



Sadly, failure to acknowledge that germs cause disease led to countless unnecessary deaths, since physicians who refused to wash their hands killed patients, especially when women got puerperal fever (an infection) after childbirth. [The arrogance here is mind-boggling; did the doctors also sit down to dinner with dirty hands that stunk from autopsies‽‽]


Childbirth was deadly in unsanitary conditions

➽ Cleanliness

Once humanity accepted the fact that germs cause disease, cleanliness became an issue. Bauer writes, "The first best response to sickness in the home was to examine the sinks, replace the drainage pipes, install traps to block the miasma [germs] from rising up from the cesspools beneath." Moreover, people eschewed furnishings that were difficult to clean, and assiduously scrubbed their homes.



Household cleaners and personal products changed as well, and in the late 1800s - early 1900s, items like Listerine and Vicks VapoRub, which had very strong odors, became popular. Bauer writes, "The American Medical Association found itself obliged to warn the public that too many health products were created 'to smell and to sell', rather than to actually kill germs." The author points out that the addiction to 'germ killers' continues in modern times, as demonstrated by our purchase of all kinds of soaps, disinfectants, and cleaning products.



Fear of germs also led to a 'throwaway culture', and we now use myriad disposable items, such as plastic cups, paper plates, paper towels, styrofoam containers, tissues, plastic wrap, plastic bottles, and on and on.

➽ Antibiotics and Vaccines

Sulfa drugs were the first antibiotics, followed by penicillin, which - since it killed almost all bacteria - was considered a wonder drug. Lamentably, bacteria mutate quickly, and many germs eventually became immune to penicillin.



Other, stronger antibiotics were developed, but bacteria inevitably become immune sooner or later. Thus, we can't count on antibiotics to rescue us from bacterial epidemics, and antibiotics DON'T WORK AT ALL on viruses and other pathogens.

Vaccines can help fill the void, since they stimulate a person's immune system to mount a defense against invasive germs. Bauer discusses the discovery and development of vaccines, and notes that, during the Covid pandemic, some people shunned the Covid vaccine because "they didn't understand the science." A portion of the population also defied government attempts at quarantine and lockdown, perhaps egged on by Donald Trump.



Bauer observes, "In early March, 2024, former president and then-candidate Donald Trump announced, at a campaign rally in Richmond, Virginia, 'I will not give one penny of federal money to any school that has a vaccine mandate." Nevertheless, vaccines are currently our best hope for protection against disease.

Bauer wraps up her narrative by noting that, sooner or later, another pandemic will arrive, and hopefully we'll be ready.

The book is interesting, informative, and understandable. Highly recommended.

Thanks to Netgalley, Susan Wise Bauer, and St. Martin's Press for an ARC of the book.

You can follow my reviews at https://reviewsbybarbsaffer.blogspot.com

[Dona's Books · Rating 5 out of 5]

Magnificent book.

Pre-Read Notes:

This is a book written by a doctor who grew up in a medical family, which I know from experience means human vulnerability is like a second language for her. She's writing here about how sickness impacts our whole species, like on a universal scale. So far, it's fascinating, and I'm just getting going.

"We could not set the earth free to wander in space, one planet among many, until we were able to abandon our bodies as unique and essentially connected to us, so worthy of honor that they would be reassembled by God Himself at the end of time. First the body became an object; and then, the earth followed suit. Once the physical body was a machine, no longer the absolute image of the divine, then the earth where those bodies lived could become, not the peak of God’s creation, but an object among others." p109

"The passions, in illness, paved the way to psychology, and from there to psychiatry. These fields would offer whole new vistas of help and relief to the sick, provide new strategies and medications that would change lives. And at the same time, the need to control the passions would load an additional burden onto the backs of the sick." p141

Final Review

(thoughts & recs) THE GREAT SHADOW is a pleasure to read. Yes, a book about disease and death was a joy to enjoy. But also, it's a book about disease and death  So be sure to adjust your expectations accordingly.

I loved this book and I'm looking forward to Dr. Wise Bauer's next foray into history of medical science.

If this book is your jam, make sure to check out The Viral Underclass by Stephen W. Thrasher and

My Many Favorite Things:

✔️ "Malaria was probably with us from our earliest days on earth.... Not long after came tetanus, possibly sleeping sickness, the swelling and paralysis of trichinosis. But these sicknesses struck individuals, not groups, and came in discrete and isolated instances. They were not epidemic; they did not cluster; they did not move through the small roving bands. ...In this newly sedentary world, though, different illnesses slithered quietly into villages and moved sideways through them . Bacteria prospered, strengthened, and mutated in the growing heaps of feces and food scraps...." p17 I've read more than one history or popular science book that blames modern human problems on our building societies to begin with. We started stressing our environments in order to grow our population and germs started doing the same exact thing.

✔️ "Nicolaus Copernicus did not live to see the reverberations of his newly proposed sun-centered model— which was, in all likelihood, his intention. He knew the many dangers (scientific, philosophical, theological) in challenging the geocentric model.... It would fall to the scientists after him— most notably Johannes Kepler (1596’ s Mysterium Cosmographicum) and Galileo Galilei (Dialogue Concerning the Two Chief World Systems, 1632) to insist that the earth was, actually and in reality, not special. Full acceptance of this truth would take decades of arguments, excommunications, heresy convictions, imprisonments. Our movements through space were duplicated by nine, a score, a hundred, a thousand other planets." p109 I had no idea this is what it took for the sun-centered model to become accepted science! I love this story. It amazes me and makes me very glad to live in contemporary times.

✔️ "Pope Clement’s physician, Gui de Chauliac, records that [black death] was so infectious, “especially in those who were spitting up blood, that not only did one get it from another by living together but also by looking at each other.” Spitting up blood meant pneumonic plague, highly transmissible, so Chauliac is faithfully reporting a real phenomenon." p122 Holy crap I mean, that is scary as heck. And something else I didn't know.

✔️ "...But the greater responsibility lay with the patient. Already struggling with pain, fever, sleeplessness, and lack of appetite, the sufferer had a new task: Remain serene. If you become agitated, you’ll only make yourself worse. Make yourself worse: the responsibility here has been shifted onto the sick person.... This remains with us." p141 Hell yeah it did, it's baked into contemporary culture as one of ableism's many faces.

✔️ "Within a decade, the DPT shot—combined, newly effective (and safe) vaccinations against diphtheria, pertussis, and tetanus in the same dose—had changed our world yet again. The strangling cough, the membrane choking off air, the galvanic convulsions that broke bones: all of them could be prevented. Cases of all three diseases plummeted, and deaths slowed to a trickle." p271 Need a reason to get your vaccines? Read this book!

✔️ "Children lived. And because the survival of all children, not just the wealthy and lucky, was now a real possibility, the conversation about child welfare shifted to become a major item on more aggressive government agendas. ...Once they were saved, they had to be cared for. The rights of the child were a direct outgrowth of our triumph over infectious diseases. The survival of children changed the lives of women too. Women no longer had to give birth to eight children to guarantee that at least one would live to adulthood. Birth rates plummeted." The UN granted rights to children but the US did not. It might explain in part why infant and child.mortality is so high in the US.

Content Notes: illness, animal cruelty, sewage, germs, dental pain, dental surgery, garbage, animal death, just like sooooooo so much violence against animals, animal sacrifice, skin disease, grievous illness, contagious disease, grievous injury, childhood disease, death of children,

Thank you to Susan Wise Bauer, St. Martin's Press, and NetGalley for an accessible digital arc of THE GREAT SHADOW. All views are mine.

[Logan Kedzie · Rating 5 out of 5]

Writing my review for this book was delayed because I got sick. Tested out clear on all the nastier bugs, just a pernicious cold.

Of course, you say, all that reading about disease made you prone to it.

Ah, I say, you have fallen into the trap the book seeks to teach you to avoid.

This is a book about the history of illness. I am already prone to like a book like this about the invisible intellectual architecture of our world, the ideas that we do not think about yet are the Water that creates what ideas we have. It has its limitations: it is not global, and primarily about the West and Near East; not about injury rather than disease, and less about chronic conditions than about infectious diseases. These are reasonable limitations, and the last is the most interesting, in the sense that part of the thesis here is that the paradigm of infectious disease is vital to the cultural (mis)treatment of chronic conditions.

The style is perfect. A touch melodramatic, it consists of introductory vignettes of people, contemporary and ancient, both trying to reckon with disease before discussing the particularities of that point in history. I complain about history writers trying to make something too sexy, but this is the exception that proves the rule. Illness is so personal, and now so prosaic, that it takes narrative flair to stick the point like it needs to. This is not limited to the fear that is illness in the past, but also that same invisible architecture of the present that radically changes how we live and think about living.

Most of the book is history and it is consistently captivating history, because much of the history is about how the language and ideas around illness from discredited science persists into the contemporary world - the fact we call it a cold, for instance. This matters a lot for how we treat one another and our lives.

Likewise, the book sticks the landing on one of my other persisting complaints in non-fiction writing about the flirting with anti-science thinking. There is a temptation in a book like this to oversell the value of science, and the triumph of it over superstition. But as often as not, it is a triumph of empiricism. It is not the vaunted scientific method at work but a real jumble of following lines of results. Everything is obvious, once you know the answer. This has big effects for how to look at bad ideas about health, medicine, and science, and policy choices in general.

The kinda sorta problem here is that there is a bit of a formal mismatch between the facts and the conclusions. The range of discussion gets briefer the closer the book gets to the contemporary day, to the point that the end feels a bit abrupt. The place where the overall thesis is going is a retake on the Pax Antibiotica and how much that dismal side of that has come to control contemporary life. There is a sort of negative space sense to this in terms of the rest of the reading, that the conclusion is established by how much this was not the case earlier in human history. But the body of the text being primarily about the ways in which the past affects the present thinking, maybe not always negatively but to great extent, feels disconnected.

Still, this is an unreserved recommendation, as that just makes it more like two excellent books, both that could have been expanded on further, and probably with a third in there for the issues skipped in the process. You will not think about the world the same way.

My thanks to the author, Susan Wise Bauer, for writing the book, and to the publisher, St. Martin's Press, for making the ARC available to me.

[Kristine]

I always Love Books about Medical 🏥 Beliefs. This one like since it talks about how we shape our Beliefs based on actually having illness. It covers several hundred years. Find that Fascinating.

Hope I get an early copy, so can catch up on my Books and Start Reading It.

💊 😷 🤒 🤕

[Mikala · Rating 5 out of 5]

Susan Wise Bauer's The Great Shadow is a deep dive into how illness has cast a long shadow over what we think, do, believe and even buy. From the alchemical quests of medieval Europe to today's influencer-driven supplement fads, Bauer masterfully traces the threads of human response to disease, blending rigorous scholarship with vivid storytelling that makes centuries-old events feel immediate and personal.

What sets this book apart is Bauer's skill in weaving together distant eras: she juxtaposes the miasma theories and divine punishments of plague-ridden times with the pandemics of our own century, exposing how shame around sickness persists as a cultural undercurrent. Her research shines through in the wealth of primary sources including eyewitness accounts from patient and doctor perspectives, forgotten treatises, and propaganda pamphlets that bring the terror and folly of past outbreaks to life. It's not just history; it's a mirror reflecting our own vulnerabilities.

Particularly powerful is her unflinching examination of racism and scapegoating woven throughout. Time and again, societies pinned plagues on "outsiders" including Jews during the Black Death, immigrants in colonial eras or ethnic minorities in recent crises using disease as a flimsy excuse for violence, expulsion, and murder, utterly divorced from scientific reality. Bauer doesn't shy away from these dark patterns, yet she frames them with nuance, showing how fear exploits division while urging us toward evidence-based empathy.

This book left me both enlightened and unsettled, challenging me to rethink health narratives in politics, media, and daily life. If you're fascinated by the intersections of history, psychology, and public health or just want a scientific and historical lens on today's debates, The Great Shadow is essential reading. Bauer's prose is accessible yet erudite, making complex ideas flow effortlessly.

[Becky · Rating 5 out of 5]

A heartfelt, meaningful look at the way we have failed medicine and medicine has failed us, how it has shaped our society, and how we have wielded fear of it like a scalpel to other the most marginalized among us. Also a beautiful look at how we can rise to the occasion, if we choose, how many times over we have been able to save ourselves and rebuild something better, but never by accident.


I received an advanced copy of the audiobook through Libro.FM and Pop Fiction Bookstore, an independent and woman-owned bookstore in Omaha. Order books (e/audio/print) online from Pop Fiction or your local bookstore at Libro.Fm and Bookshop.org

[Nancy · Rating 5 out of 5]

This book is a great reminder of how horribly mankind has suffered from disease and infections in the past, and how we are far from conquering all that plagues us despite amazing recent advances in antibiotics and vaccines. I particularly like the stories, either reimagined or reconstructed from or taken directly from contemporary accounts, of the sufferings real people went through due to disease. This really humanizes the past and makes me appreciate anew how good we have it now - even just the ability to alleviate pain so we don't die in agony.

I really enjoyed this book: it was well written, well organized, and a page turner (even if a rather depressing one).

[Val · Rating 5 out of 5]

Reading this book gave me amazing insights into the sicknesses of the past and the empathy of understanding 'how' the people felt at different times throughout history...

Historical author Susan Wise Bauer does an excellent job chronicling the history of illness...and how one actually feels during these times...

An interesting book...

Highly Recommended!

[Megan Leathers · Rating 4 out of 5]

Susan Wise Bauer offers a fascinating look at illness throughout human history, charting the path from initial causes and societal chaos to eventual cures. The book expertly examines the myriad ways humans fall ill, the panic that fuels irrational beliefs, and the scientific breakthroughs that lead to treatment. Despite the heavy subject matter, it remains an accessible and enjoyable read that isn’t too dense for the layperson.

However, the narrative structure can feel disjointed. While it initially hints at a linear timeline, the prose frequently jumps back and forth within chapters, which can be disorienting. While some chapters successfully use parallel storytelling to compare historical illnesses with modern counterparts, this consistency isn't maintained throughout. Furthermore, despite the overall scientific tone, the author’s personal political and religious views occasionally bleed into the text through unnecessary commentary and cherry-picked examples, which may detract from the objective experience for some readers.

3.5 stars rounded up to 4

Thanks to NetGalley and St. Martin's Press for an eARC

[Cindy · Rating 5 out of 5]

Highly recommended and entertaining for such a serious subject! This is a fascinating and very well-narrated journey through human civilization focused on our relationship with (and quest to understand) disease.
In broad terms: when, how, and why epidemics happened (and keep happening); the rise of disease-fighting medications, followed by the rise of medication-resistant disease; and the various theories over the centuries that work to explain how we can keep ourselves healthy.
This book focuses on Western medicine and diseases/plagues/epidemics in Europe and the Americas. The author notes the different paths toward health taken in other parts of the world (like Ayurveda), but to do them justice would require multiple volumes.
I was particularly taken with how medical theories translated into health campaigns, which were then reflected in our country's core values, for better and worse. Some of these unfounded/unproven prejudices (and xenophobia) persist to this day.
My thanks to the author, publisher, @MacmillanAudio, and #NetGalley for early access to the audiobook #TheGreatShadow for review purposes. Publication date: 27 Jan 2026.

[anneka vander wel · Rating 5 out of 5]

Understanding the history of sickness is essential to considering what it means to be human. Susan Wise Bauer shows how humanity has experienced and thought of sickness and health throughout our history, and how it influences more than we realize – politics, public infrastructure, prejudices, consumerism, scientific advancements, how we live our lives and perceive reality itself. She makes it clear that sickness is an expression of our relationship with reality.

With chronic illness, I often struggle with the immense grief of feeling that my life, future, and options have been ‘taken away’ from me. The reason why I feel this way is because of a relatively new phenomenon – after the “great mortality transition” and especially for us in the 21st century, we are taught to expect a long lifespan where most pain and illnesses are either temporary or treatable. People who would have died from a minor virus if they were born centuries ago, can now pop a pill and expect to recover in days. Most people around me don’t have chronic health problems or any experience of severe illness, so my ongoing illness feels that much more isolating and causes a greater lack in comparison.

The reality is that most people throughout history lived in fear of dying or being permanently altered from sickness. Throughout history, humanity has tried to prevent or cure illness, avoid pain, escape death, but it is a recent phenomenon that we feel our knowledge and technology make us invincible when it comes to our health – we feel we can defeat death, pain, and suffering.

Bauer’s book focuses on Western medicine and history (acknowledging that covering the entire globe would require several more volumes). Her research is thorough, and includes quotes and ideas from important thinkers and literature throughout history, as well as religious thought. She covers a LOT, both in terms of history, location, and intellectual ideas.

I particularly appreciated learning about
- Where the “warfare” rhetoric used to talk about sickness (something I absolutely hate) came from, and how it places responsibility and blame on the sufferer – being cured is a matter of personal strength & will; those who don’t “fight” and “defeat” it are lacking
- How sickness and our understanding of the body has impacted religious beliefs and vice versa
- How the desire to avoid illness, pain, and death has shaped individual lives, cultures, and history
- How blame for the spread of sickness is always placed on the poor, uneducated, darker-skinned, immigrants – the threat of invisible things that we can’t control causes us to act with fear and mistrust (this pattern is shockingly repetitive throughout history – and is extremely relevant right now, despite our increased medical knowledge)
- How sickness is often deemed “spiritual” in cause or nature when we do not understand the science, and across time has been (inappropriately) connected to moral culpability and divine punishment

Because of my own life, I deeply appreciated Bauer’s clear understanding of how blame is so often placed on the sufferer or on others because of fear. We all seek to escape pain and uncertainty and suffering, or at least make sense of it. When we can’t, we try to ignore it and blame others – if they caused their illness by not praying enough or living a healthy enough lifestyle, then we must be safe, because we’re doing all the “right” things. We can pride ourselves for remaining well, and feel we have a good/healthy life because we earned it. The more our technology advances, the more difficult it becomes to acknowledge that there are still sicknesses and suffering that we can’t understand or control.

This really fits with what I have seen as a sick person – the abandonment (or blame) I have experienced from healthy people, and the ignorant and hurtful comments people make to me about how I’m not trying hard enough or I should be better by now, only made sense when I realized that it’s easier for people to blame me than to accept that even if you do everything right, you can still become sick and disabled.

My only complaint is that there are some natural issues from having such a broad project that covers so much of history. The writing felt a little dry sometimes, and then disjointed at times in the attempt to make it less dry. She introduces a lot of ideas but doesn’t have the time to follow through on all of them. Threads of ideas that I wish she had explored more include where she says we have always had a sense that we’re not supposed to suffer from sickness or death, or how sickness can make us realize how much our physical bodies affect our perception of reality and our thoughts/emotions/beliefs. I also thought it would have been great to talk about systemic barriers in receiving healthcare throughout history. (These are minor complaints, though – the book covers as much as it reasonably can.) I’m so grateful to the author for writing this book!

Thank you to St. Martin’s Press and NetGalley for providing an ARC in exchange for my honest review.

[Richard Derus · Rating 4 out of 5]

Real Rating: 4.5* of five

The Publisher Says: From alchemy to wellness culture, from antisemitism to disposable plastic, a gripping account of how getting sick has shaped humanity.

Anti-science, anti-vaccine, anti-reason beliefs seem to be triumphing over common sense today. How did we get here? The Great Shadow brings a huge missing piece to this puzzle—the experience of actually being ill. What did it feel like to be a woman or man struggling with illness in ancient times, in the Middle Ages, in the seventeenth century, or in 1920? And how did that shape our thoughts and convictions?

The Great Shadow uses extensive historical research and first-person accounts to tell a vivid story about sickness and our responses to it, from very ancient times until the last decade. In the process of writing, historian Susan Wise Bauer reveals just how many of our current fads and causes are rooted in the moment-by-moment experience of sickness—from the search for a balanced lifestyle to plug-in air fresheners and bare hardwood floors. We can’t simply shout facts at people who refuse vaccinations, believe that immigrants carry diseases, or insist that God will look out for them during a pandemic. We have to enter with imagination, historical perspective, and empathy into their world. The Great Shadow does just that with page-turning flair.

I RECEIVED A DRC FROM THE PUBLISHER VIA NETGALLEY. THANK YOU.

My Review: It is unbelievably apt that this book was contracted for in 2019. I don't think I need to discuss what happened in 2020. What COVID did was to point up the absolutely amazing progress in medical treatment of disease that we've made...vaccines that have saved tens of millions of lives in the past six years developed in months not years...and how ingrained fallacies are in our species...the social distancing farrago is just miasma theory written in Times New Roman. COVID also caused the author to forego doing in-person research in favor of extensive online research. (If, like me, your eyebrows went up at the mere notion of suchlike in a serious work of nonfiction, cool your jets until you've looked through the over 400 notes and citations that make up a literal quarter of the text.)

As a narrative technique, reconstructions of past actions and attitudes work only as well as the author's ability to convey evidence from the records in appropriate prose. It's a technique I think adds some immediacy to history that otherwise is often dry and tedious. I'm happy to say Author Bauer convinced me to follow her as different events were interpreted as diving wrath, moral turpitude, and individual punishment when most twenty-first century people would see the disease process for the impersonal force it is.

It does lend itself, however, to a discontinuity of time. I followed Author Bauer's conceptual links between topics and strands of evidence without much conscious effort, often thinking "...but what about...?" mere words before she addressed the very question I was still formulating. Others might not find that to be their experience. I mention it as information only. You'll resonate with a less linear presentation in your own way. I can't offer a perfect five because even I was occasionally thrown off the scent of the idea being pursued.

I'm here to tell you I want you to read this book, no matter your beliefs about medicine or science. It is not chiding or minatory to people not in the tent with the believers on either side. It is tendentious; it is not disrespectful. Of course I can say that without hesitation because I agree with Author Bauer. I will offer my main evidence in favor of reading it by saying I was highly resistant to her take on social distancing being modern miasma theory until I read her points about the science for and against it. My mind, in the face of cogently presented and logically mustered evidence, changed.

An author who can get in under my well-entrenched, heavily undergirded arrogant illusion of knowledge deserves your treasure and your eyeblinks.

[Dan · Rating 4 out of 5]

My thanks to NetGalley and St. Martin's Press for an advance copy of this book that looks at how the human experience has been changed and effected by both our health and the treatments that humans used to treat ourselves, and how this has changed over the years, for good and in these current times for the worst.

Except for a need for glasses at an early age, a badly sprained ankle and a couple of bouts of pneumonia, I have been blessed to not have to interact with the medical profession much in my life. As a citizen of this country this is a great thing, as insurance is something that don't have to deal with, nor want to start dealing with. My mother was, well is a nurse, so I have always had the best of medical advice, advice that has helped me stay well, helped her deal with her issues, and kept my nephews, her grandchildren in the best of health also. Many have not been as lucky as I, either in health, or in advice. Quackery seems to be at an all time high. Politics and doing one's own research has effected and affected the health of many, as one can see from the return of many illnesses once thought controlled. Measles for one. I am waiting for typhus and diphtheria to come around again. I won't be surprised. Reading this book has opened my mind in many ways to why people feel the way the way they do about health, medicine and those who help us get over our medical problems. And that we as humans still have a long way to go. The Great Shadow: A History of How Sickness Shapes What We Do, Think, Believe, and Buy by Susan Wise Bauer is a look at how we deal with illness from colds to pestilence, how we adapted and learned from our bodies, and how much of what we know is ignored by those who think they know better, either through hubris, or to make a quick buck.

The book is set up in an interesting way. Looking at ailments through ancient eyes and the technology of today. The initial setup is a person waking up not feeling way, having some aspirin and tea, and maybe taking a sick day, if their company allows it. In the past, an ache is something that might no go away. That one might call a healer, a shaman, or a priest to see what is ailing the person. Bauer uses examples, text from the time, archeological findings to show what could happen, and might have been done. From simple colds, to plagues, to injuries and that most misunderstood of maladies and something that still effects women today, pregnancies. Bauer also looks at her own life, sharing problems and how they were dealt with. And why we seem to be falling backwards in many ways in both knowledge and treatment.

I have read quite a few books on medicine recently. While many discuss medicine, and treatments, along with innovators and quacks, Bauer does a good job of looking at the human factor involved. The patients suffering for reasons they no not why, the people who are sure of their ways so much patients die around them, and the survivors who are left wondering why God or science failed them. Bauer is a very good writer, and an excellent researcher, digging up stories and treatments, and making them understandable, and relatable in many ways to the post-COVID world we find ourselves in.

The book sounds like it should be miserable. It is not. This is a very hopeful story, full of stories of people saying no, this is wrong, we have to try something new. And saving lives. A fascinating book with lots of interesting stories, some that will make one mad, some that will make one happy to be alive because of what they are reading. There is quite a lot to learn, and even more to think about. A book I quite enjoyed.

[Deviant Quill Reviews · Rating 4 out of 5]

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There are nonfiction books that inform you, and then there are nonfiction books that quietly dismantle the way you understand the world. The Great Shadow is the second kind.

Susan Wise Bauer constructs a catchy, deeply human history of illness by building parallels between the old world and the modern one, showing that while our treatments have evolved, our mentalities often have not. The book moves fluidly between millennia, cultures, and belief systems, revealing how sickness has always shaped not just survival, but religion, morality, economics, identity, and social behavior.

One of the book’s greatest strengths is its structure. Bauer doesn’t present history as a dry timeline. Instead, she places the reader inside imagined but rigorously researched scenes from thousands/ hundreds of years ago. A fever becomes a divine judgment. A rash becomes a moral verdict. A seizure becomes proof of guilt before the gods. These reconstructions feel intimate, lyrical, and disturbingly familiar. Despite being nonfiction, parts of the book read with the texture of historical fiction, grounded in scholarship but written with narrative empathy and clarity. Perhaps the most unsettling thread in the book is the link between illness, morality, and belief. Bauer shows how disease has always been associated with behavior and guilt. In ancient cultures, sickness was punishment for sin. In modern culture, it is increasingly framed as the result of unresolved trauma, negative emotions, impurity, or personal failure. The language has changed. The superstition has not.

Another of the book’s most unsettling strengths is its clear-eyed exploration of how disease has repeatedly been weaponized against marginalized groups. From medieval persecutions to colonial-era paranoia and modern crises, illness becomes a convenient justification for exclusion, expulsion, and brutality, entirely disconnected from medical reality.

This is a book that anti-vaccine movements and anti-medical religious extremists should read. Ironically, it is written in accessible, welcoming language, but it requires intellectual honesty, historical awareness, and respect for science.

Susan Wise Bauer deserves immense praise for this work. Her scholarship is precise, her research is vast, and her writing is remarkably humane. She manages to combine history, epidemiology, religion, sociology, and psychology into a coherent, readable book that never feels heavy-handed or inaccessible. The Great Shadow is not just a history of disease. It is a history of fear, belief, meaning-making, and the stories humans tell themselves to survive the unknown.

Review copy provided by St. Martin's Press @ Net Galley

[Jeff · Rating 5 out of 5]

Interesting Take On The Subject With Writing Reminiscent of Rachel Held Evans. I suspect Bauer would have admired much about the late great Evans, even if they didn't agree on every particular. Here, Bauer approaches the history of sickness the same way Evans, particularly in the last few books before her death, did various Biblical topics - with a fair amount of creativity to give examples of a particular point followed by reasonably well reasoned analysis based on the available authoritative texts - whether those be the Bible (and Torah) in Evans' case or what we consider to be more "objective" science and histories for Bauer.

Bauer does a truly great job here with the scenarios she creates usually at the beginning of each chapter, showing both how a "modern" (21st century ish) approach to the next topic looks - usually in a way most current readers will readily identify with or at least have heard of - and a more historical perspective would look on that same topic, with "historical perspective" here ranging from pre-history through roughly the WWII period. With these, Bauer shows herself to have almost a novelist eye for storytelling, and a fairly good novelist eye for *compelling* storytelling.

The actual histories she presents here are fairly solid and mostly reasonably known or at minimum in line with things that are reasonably known, so I don't necessarily feel the Sagan Standard applies for this text as it exists. Which allows the 15% documentation to suffice without a star deduction, even though it *is* around the lower bound of what I expect to see from a nonfiction text.

In Bauer's message of trying to reach those skeptical of modern medicine - which should be most anyone who actually understands its history and where it actually currently is - she actually had one particular line that stuck out to me as particularly well said:

"If you're going to try to convince people of something that is going to deprive them of something vital (freedom, agency, control, their livelihood), anything less than an ironclad case isn't going to do the trick."

While this line, if I remember correctly, was specifically about trying to get docs to adopt more stringent standards in line with more current thinking, it really does apply equally well to anyone seeking any change from any other person for any reason at all. Thus, it is both quite wise and quite well spoken - and gives you a pretty solid idea of what to expect from the overall tone of the book here to boot.

Very much recommended.

[Veronica · Rating 2 out of 5]

2.5 out of 5 stars

I was excited going into this book. A history of sickness and how that shaped the views and actions of society over time is right up my alley. The contents of the book lived up to the title, unfortunately this book fell apart for me immediately.

In “The Great Shadow: A History of How sickness Shapes What We Do, Think, Believe, and Buy,” Susan Wise Bauer does exactly what is promised and discusses how sickness shapes how societies acted and what they believed in. She covers a wide-range of history and discusses how views changed over time with new information and the impact of sickness on societies.

This book contains fascinating histories of sickness and their impact of the places hit the hardest by them. However, the way the information is presented is some of the worst writing I have seen in a while. The book starts in second person, which is an immediate no from me. Even though the second person does not stick around for long, the writing does not stay consistent. Some of the historical accounts are presented in first person with an excessive use of “we” instead of “them,” while other accounts are shared in third person. This writing choice prevented my ability to get into the book at all. I found myself feeling too annoyed to enjoy the contents. I count this as a major flaw. The book can hold the most exciting information, but if it is presented in a poor way, the book becomes unreadable.

I am truly bummed about the writing in this book. I really wanted to get into the history of sickness and its impacts on societies. Unfortunately, the inconsistent writing style is unforgivable to me. I could not get past it and because of that, I was unable to enjoy any part of this book. If you are interested in the history of sickness and are not bothered by the constantly changing point of view, then I recommend picking up this book. But, if you are like me and enjoy uniform writing styles, then skip this one.

[Paula W · Rating 4 out of 5]

If we sprain an ankle, the treatment is rest and ice. If we break an arm, it must be reset and immobilized so the bones can mend. If we cut ourselves deeply, the skin should be brought back together through stitches or bandages. I think we all agree on the accepted ways to treat these and other injuries no matter our ethnicity, race, religion, or where in the world we sit in our favorite chairs to watch the big sports game. But science (biological sciences, genetics, social sciences, astrophysics, psychiatry, and every other type of science) has effectively made us forget what it’s like to be sick. Sick as in diseased rather than injured, and widespread rather than individually. The forgetfulness of a species is one of the drivers of the anti-science, anti-vaccine, and frankly anti-common sense rhetoric flying around today. This book asks and answers a lot of questions like: What did it feel like to be a woman or man struggling with illness in ancient times, in the Middle Ages, in the seventeenth century, or in 1920? When did concern for self become concern for others, and then revert back to individual apathy about public safety? And can I have a rational discussion with someone who believes that vaccines are full of microchips and autism, or believes that their god will protect them from diabetes or from a pandemic?

Overall, it’s a good book. The epilogue that looks forward has a sense of hope that I have sort of lost in the past 6 years. Here’s to hoping that next time we all do better.

Thanks to St. Martin’s Press, Macmillan Audio, Susan Wise Bauer (author), Edelweiss, and Libro.fm for providing an advance digital review copy and an advance listening copy (narrated by the wonderful Jennifer Pickens) of The Great Shadow. Their generosity does not influence my reviews in any way. 


[Anna · Rating 5 out of 5]

A book about the history of medicine could easily have been a dry read with a recitation of dates and overly complicated medical terms. Instead, this is one of the best narrative nonfiction books I have ever read.

The book is arranged chronologically for the most part. We begin about 12,000 years ago, when humans began to settle in cities and towns, birthing the spread of communicable illnesses. From ancient history, we then move into the Middle Ages, the multiple outbreaks of plague, Reformation and Enlightenment ideas about illnesses, the spread of germ theory in the 19th century, the quest for vaccines and cures in the 20th century, and finish with the COVID-19 pandemic. Throughout we see how ideas about the causes of illness have changed (angering the gods, an imbalance of humors, miasmas in the air, germ theory) as well as the treatments that we used to cure or prevent these illnesses (divination, alchemy, blood-letting, antibiotics).

With the luxury and advancements of modern medicine in the 21st century, it is so easy to believe that we are enlightened and above the horrors of the illnesses and suffering that plagued our ancestors in the past. However, it was both eye-opening (and horrifying at times) to read how much of our attitudes and behaviors over the centuries haven’t changed. Vaccine skepticism began at the same time as vaccines. We still blame “the other” as a cause for illness. We use the same chemical cleaners that were invented in the 1920s to kill germs. And we are still vulnerable to the illnesses and diseases that have plagued us in the past (tuberculosis, measles, STDs) as well as new ones (HIV, MRSA, COVID-19).

I cannot recommend this book enough. Bauer effortlessly weaves history and medicine with the human story, leading to an approachable, compelling, and thought-provoking narrative.

[MaryEllen · Rating 4 out of 5]

When I was offered the opportunity to read an advanced copy of The Great Shadow: A History of How Sickness Shapes What We Do, Think, Believe, and Buy written by Susan Wise Bauer, I was immediately intrigued. The title caught my interest and I was surprised by the author, who I am aware of because of her Well-Trained Mind Press and books written with classical education in view.
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I found the book overall very interesting although at times, my interest flagged. Parts of the book were very engaging and then it seemed to drag on for parts. The writing overall was good, but at the same time, something was off, which I never quite put my finger on.
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Bauer traced the History of disease from the beginning of time up to and including Covid-19. There were three broad time periods. It was interesting to see the development of thought and understanding, as well as how the realities of each past time period impacted the changing present. I learned a great deal and had some interesting introspection as a result of reading the text.
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You can also see how our beliefs about disease have shaped our country’s wariness about people who are found to be “different” from the mainstream. It shows incredible ignorance.
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Read this book if you are interested in the way our medical advances have taken place or history in general. I gave this 3.75 stars
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Thank you NetGalley and St. Martins Press for the Advanced Readers Copy given in exchange for my unbiased opinion.

[East of Reality · Rating 4 out of 5]

The topic is equally grim and fascinating as the author traces how humans react to disease — from blaming evil spirits to blaming groups of people, blaming how we live and how we pray; surely only bad people deserve to get sick, so if you’re ill, what did you do to bring it upon yourself? — as well as the slow understanding humans gained over viruses, vermin, parasites and poisons.

Written with a very approachable style it focuses on small tidbits, personalizing the stories of the people who developed drugs, who opened up the human body to try to understand why it failed, how it was affected by sickness, and showing how plagues spread. There is even a chapter on colonization and how people bring disease with them, as well as fall prey to the diseases of a new place and climate. There’s a lot here, none of it overwhelming, and written to be positive and hopeful despite the subject matter.

It also doesn’t shy away from racism, misogyny, a reliance on outdated thinking, conspiracy theories, anti-vaxxers and how we really haven’t moved on from early days of fearing bad air, angry gods, and roaming spirits cursing us with disease. If you’re interested in history, medicine, and science with an optimistic bent, you should give this book a try.

Thank you so much to Net Galley and the publisher for the ARC.

[Sarah · Rating 5 out of 5]

TL;DR: A great overall summary of sickness and how it’s impacted humanity.
Source: NetGalley, thank you so much to the publisher!

Sources: This had quite a few interesting sources, a good length back section that would make for great additional reading.
Readability: I found myself flying through this, and everything was so interestingly presented.

Thoughts:

If you’ve read any medical history texts then you are going to be somewhat familiar with the path that medicine has taken over the years. This will still be a fantastic addition to your reading, as Susan Wise Bauer does a wonderful job of really showing us the impact of things like the various plagues and viruses we’ve faced in the past. If by chance this is your first medical history book - boy you’re in for a good time.

Possibly my favorite trick that our author pulls out is the setting up of narratives to parallel one another. For example she talks about her son getting Scarlet Fever and how a simple antibiotic took care of it. Yet before that existed another woman lost two sons, years apart to the same illness. It brings a note of relatability and realism to the scope to see how these would have actually effected individuals.

This is also well researched with footnotes and sources to keep you busy for days. I ate this up, was genuinely terrified at times and relieved at others (thank you modern science for a lot of great vaccines and antibodies). This is a fascinating and well drawn journey, I really recommend it for the curious.

[Kelsey Ellis · Rating 4 out of 5]

The Great Shadow was a fascinating read about how we as a human society have viewed sickness, disease, medicine, recovery, etc.,. It goes through early archaeological case studies, historical documented case studies, and looks at the present day (COVID-19), etc. "Pop" non-fiction books are typically really generalized to a point that an archaeologist like me gets a bit annoyed. This book was often times too generalized and then too cherry picked with certain examples and case studies. I think the biggest example of this was with the chapters on how disease and sickness has historically been blamed on those of Jewish ancestry- I found it interesting that the author used COVID-19 as an example where Jews were blamed- but! More importantly COVID-19 was also named the Chinese virus by many many people and those of Asian heritage were also blamed and shunned. I feel like this would have been a better chapter is the author had generalized the ways that cultures (not just Jews) get the scapegoat of blame (for example).

The audiobook was very well done! It is an easy one to listen to with each chapter being a different topic.

Overall, it was a lovely read and I would recommend. The chapter on dissection was a bit much for me hahah but I have a soft stomach.

Thank you to MacMillan Audio, NetGalley, and St. Martin's Press.

Publishes January 27th!

[Erika · Rating 5 out of 5]

I don’t often review nonfiction, so bear with me. That said, The Great Shadow was a fascinating and unexpectedly immersive read. This book offers a deep dive into the history of illness and, more importantly, how humans behave in its presence.

Susan Wise Bauer does an excellent job researching the subject from both historical and scientific perspectives, weaving the two together into a clear, detailed timeline that never feels overwhelming. What stood out most to me was her focus on human behavior and psychology. Rather than treating illness as an abstract concept, she centers the lived experience—how people reacted, feared, denied, adapted, and survived.

I especially loved how she set the scene around patients struck by illness, creating a palpable atmosphere that made each period feel real and immediate. You can sense the confusion, desperation, and resilience of people facing something they could not fully understand or control. It made the history feel alive, not distant.

This is the kind of nonfiction that reads with the weight and pull of a narrative, while still being deeply informative. If you’re interested in history, medicine, or the psychology of collective human behavior, The Great Shadow is a rewarding and thought-provoking read.

[Amy · Rating 4 out of 5]

So much to love here! I love the whole sweep of history, why isn’t this in more books?

We travel from the earliest recorded history to Covid 19 and the sicknesses we face today. Traveling this far through time, shows us the practices and beliefs that have clung to illness, for both the health and at times the death for the sufferer. (A doctor who would do an autopsy and then deliver a baby with unwashed hands and then wonder why there was such a high mortality rate for the moms: so disturbing!!). I find this all fascinating, though it can be fodder for nightmares!

We also see how our fear of germs inspired the creation of toilet paper, tissues, and SO many disposable items. Even scented soaps, cleaners, and “air fresheners” are tied to germ disposal and the belief that a clean scent means no germs…

Be prepared to encounter snubs at a belief in God’s sovereignty, Trump policies, and someone willing to question the current medical stance on vaccines. (This was surprising given the authors popular history curriculum is widely used by families that often fall into the categories above).

Huge thank you to NetGalley and Macmillan Audio for the opportunity to enjoy this audiobook!!

[Emi]

This audiobook follows a tense, character‑driven narrative where secrets from the past collide with present dangers, building to a suspenseful climax. Themes of memory, power, and moral compromise thread through a plot that balances intimate scenes with broader stakes.

The narrator delivers a nuanced, emotionally resonant performance. Voices for key characters are distinct without feeling caricatured, and the pacing of delivery matches shifts in tension. Pronunciation and accents are consistent and believable.
Production quality: clean audio, well‑timed chapter breaks, and subtle ambient touches enhance immersion without distracting from the story.

Who will enjoy this audiobook
Fans of literary suspense who appreciate character depth as much as plot twists.

Listeners who value strong narration and production that enhances mood.

Commuters and long‑drive listeners who want an immersive, emotionally driven story.

Final recommendation for NetGalley listeners
Recommended. The Great Shadow is a compelling audiobook experience anchored by a skilled narrator and high production values. If you enjoy atmospheric suspense with rich character work, this is worth a listen. If you prefer nonstop action, be prepared for a few slower stretches.

[Stephanie · Rating 5 out of 5]

Long before modern medicine, people believed disease came from offended gods or spirits—and healing meant performing the right rituals to make peace with them. Then came Hippocrates, who broke from superstition and argued that illness had natural causes. Greek doctors believed health depended on balancing four bodily “humors,” so treatment focused on restoring that mix rather than curing a single disease. Though old remedies like bloodletting have vanished, the idea of purging what ails us survives in today’s detox trends and spa culture.

As Bauer points out, science has transformed medicine, but some old fears remain. We still worry about outsiders spreading disease, mistrust experts, and turn to alternative cures when science feels distant. Our anxieties have evolved—but they never really disappeared.

As this phenomenal book shows us, we are far from the complete understanding of illness. And as humans throughout history we just try our best to heal ourselves and one another.
This book was truly enlightening for me and I cannot thank Netgalley enough!

[Janine · Rating 5 out of 5]

This is a powerful and stimulating examination of mankind’s attempt to understand its mortality. Focusing on the history of medicine, the myths and taboos surrounding disease and illnesses, and extrapolating how these affect our world today, the book is a marvelous and compelling read.

I especially liked how the author told the story - using real examples against the historical time as well as examining the common “thinking” of the period, we are treated to a better understanding as to why myths remain so common - religious misconceptions primarily in my view - and why people are willing to disdain science.

The sections dealing with beliefs that diseases are the results of immigrants and the excitement over the polio vaccine were of great interest to me. The former aligns with another book - Infected by Mohammad H. Zaman - showing how this untruth is spurious and untrue. I experienced the joy of the polio vaccine and the joy and freedom it gave to me and others. We need to focus on truth and not myths.

I truly enjoyed this book. It would be a great addition to anyone’s library, especially those interested in the truth about medical science.

I would like to thank NetGalley and the publisher, St. Martin’s Press, for allowing me to read this ARC.

[Phoebe · Rating 5 out of 5]

When I saw this book available to read in advance on NetGalley, I snapped it up. I've read Susan Wise Bauer's "The Well-Trained Mind" as well as "The Story of the World" series with my children, so I knew this book on the history of sickness would be insightful and engaging. I wasn't disappointed. It is FASCINATING. I enjoyed the way Bauer juxtaposed the dramatically different ways humanity experienced the same sort of infections during different time periods. I learned a lot about how our understanding of sickness has evolved as science and medicine have advanced, sometimes unwittingly but sometimes with barriers created by the medical establishment itself, which puts a lot of the public distrust in medicine today into perspective. I also found it intriguing the way the treatment of illness moved away from its relationship to religion and yet, in a way, became its own religion. The book gives lots of context for the literature written during different time periods and makes a great addition to any historical fiction writer's bookshelf.

[Jacquelynn Lyon · Rating 5 out of 5]

The Great Shadow is a broad history of how disease has interacted with human culture throughout time--shaping viewpoints and practices on every level. While some of the information was a little broad for my tastes, I really enjoyed the dives into different moments either way. One of the most surprising pieces of information was how in the first cities around 50% of woman died in great numbers due to childbirth interacting so poorly with cities grime in particular. Other sections explored inoculation as an "old wives practice" originally and how the humors informed a very individual approach to disease (people becoming off-balance in deeply personal and individual ways) as compared to biochemical medicine which dictates that we can and do break in similar ways. While I did find some of the narrative portions, portions that detail how people in the past versus the present FELT while being sick, a little unnecessary, I overall learned quite a bit.

The book is interesting, accessible, and highly relevant, really enjoyed my time with it.

[Joan · Rating 4 out of 5]

We may forget the hundreds of years it took to have the understanding of disease and medicine we now enjoy. Bauer takes us on an informative journey of experience and attempted cures, such as religious attempts to explain death and attempts to appease the gods. Assuming the cause was external, attempts were made to drive the cause away. Eventually a cause was sought inside the person, such as with epilepsy. She draws from a variety of sources, sometimes including personal accounts. There are many interesting and informational stories, like the development of the word disease, from dis-ease. Another section relates the troubled development of inoculation. What a breakthrough to finally understand the reality of germs.

This is a very readable exploration of how disease was understood and has been treated over the centuries. Thank goodness we have scientific investigation now rather than mere speculation or superstition.

I received a complimentary egalley of this book from the publisher. My comments are an independent review.