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Sherwin B. Nuland
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message 1: by Barron (new)

Barron Lerner (lernerbarron) | 4 comments Hi all--

I am a physician and historian of medicine and new to this group. I thought I would share a post (see below) that I wrote for the Huffington Post about Sherwin Nuland, one of America's best-known medical historians, who recently died. Comments welcome. Thanks for your interest. Barron Lerner

SHERWIN NULAND AND THE MEDICAL HISTORY WARS

Most of the obituaries for the physician-historian, Sherwin A. Nuland, who died on Monday, March 3, have rightfully emphasized his 1994 book, How We Die, which won the National Book Award.

But Nuland held an interesting place in the world of the history of medicine, a torch holder for an older type of scholarship that praised great doctors of the past. Maligned at times for what he himself called a "gee whiz" approach to his craft, Nuland's brand of history -- and its celebration of a march of progress in medicine -- still holds an important place both within academia and among the general public.

The earliest historians of medicine were, in fact, physicians. Many of them wrote biographies of their mentors or other past doctors, who they believed had made important contributions to medicine. But physicians also prized medical history because they believed that it conveyed important aspects of humanism to medical students who were entering the profession. The stories of earlier physicians, it was believed, taught professionalism and counteracted deleterious trends in medicine, such as an overreliance on technology and specialization.

Nuland fit easily in this mold. He began his career as a surgeon, but in the 1980s began to write history. His 1988 book, Doctors: The Biography of Medicine, was perhaps his most explicit love letter to doctor-driven history. The book is a series of chapters detailing the stories of great doctors, beginning with the father of modern medicine, the ancient Greek physician, Hippocrates.

Subsequent chapters of the book told the stories of individuals, such as the 17th century English physician William Harvey, who discovered that blood circulated within the body, Rene Laennac, the 19th century French physician who invented the stethoscope, Ignaz Semmelweis, the 19th century Hungarian obstetrician who realized that doctors were causing deadly childbed fever by spreading it from autopsy specimens to healthy patients and William S. Halsted, the pioneering Johns Hopkins surgeon at the turn of the 20th century who popularized the radical mastectomy to treat breast cancer. Nuland included one famous woman: Helen Taussig, one of the team that developed a heart operation that saved the lives of "blue babies" whose blood did not contain enough oxygen.

By the time Doctors came out, Nuland was cutting against the grain of historical scholarship. The new "social history," which emphasized the lives of ordinary individuals, such as patients, was in ascendance. Patients whose experiences were negatively affected by their race, gender or class attracted special attention. Nuland's type of work, with its hagiographic approach to doctors, had become "bad" history.

Nuland was well aware of this dynamic. At the meetings of the American Association for the History of Medicine, which he and I attended regularly, there was an annual breakfast at which the group's "clinician-historians" endlessly debated whether or not their work had become obsolete. The introduction to Doctors is full of self-deprecating asides about how some of his colleagues found there to be a "defect" in his scholarship. "But I do not apologize," Nuland wrote. "I am most assuredly not only impressed but quite frankly flabbergasted at the talents, industriousness and accomplishments of most of these people," (1).

Even if Nuland's peers sometimes took him to task, his books did better than most. How We Die, for example, sold over 500,000 copies. He also wrote a well-received memoir, Lost in America, that told the story of his immigrant family and his decision to enter medicine.

And although Nuland was criticized for overlooking the flaws of his physician-ancestors, he was well aware of how mistakes were made on the road to progress. When I interviewed him for my 2001 book, The Breast Cancer Wars, he admitted that he and his fellow surgeons were so enamored of Halsted's radical mastectomy that they bullied their patients into having the operation even after its value had been questioned. His 2003 book on Semmelweis criticized the famous physician for being so stubborn that his insights into the contagiousness of disease were rejected.

Ultimately, it was Nuland's own humanity that made his writing so compelling. Quoting the legendary Johns Hopkins physician William Osler, Nuland wrote that physicians should study history not only to learn about past events, but to study "the silent influence of character on character." [2]

I was reminded of the influence of character when Nuland recently sent me an e-mail apologizing that due, to his illness, he would not be able to do an advance reading of my new book, "The Good Doctor."

"I believe a book like yours should have a wide readership not only because of its contents, but also the literary skill of its author," he kindly wrote. "May it have the success it deserves."

Two days later, he died.

# # # # #

References:
1. Sherwin B. Nuland, Doctors: The Biography of Medicine, Knopf, 1988, p. xx.
2. Ibid., p. xx.

Barron H. Lerner, professor of medicine and population health at New York University is the author of five books, including "The Good Doctor: A Father, A Son and the Evolution of Medical Ethics," to be published in May 2014.


message 2: by Bunnie (new)

Bunnie O'hara | 210 comments Dr Barron, I too am impressed with the doctors you mentioned--i have read Dr Nulands books-i have read the book about Halstead.I have a text book by osler
given to me by a dentist i worked for years ago. i have read a book on Ignaz Semmelweis by Morton Thompson called "Cry and the Covenant" also many yers ago i read "An american Doctors Odyssey" by Victor Heiser-he was a public health doctor working in the Orient--The history of medicine is fasinating --Modern medicine surely is responsible for saving the lives of many --i just wish the computer was not the first thing the doctors look at when they come into the examining room--what ever happened to the hands on,the smell, the look,as a diagnostic approach along with,of course, lab results. my doctor has never seen my body.
i am sorry we lost Dr Nuland and with it many good books.


message 3: by Bunnie (new)

Bunnie O'hara | 210 comments Correction--Dr Lerner


message 4: by Sara Van Dyck (new)

Sara Van Dyck (saravanc9) | 9 comments Generous, informative apreciation.Thank you.


message 5: by Bunnie (new)

Bunnie O'hara | 210 comments Sara,
You're welcome


message 6: by Barron (new)

Barron Lerner (lernerbarron) | 4 comments Hi Bunnie--My dad (the subject of my new book) gave me "The Cry and the Covenant" when I was about 10 years old! He was obsessed with Semmelweis. My dad was an old-time doctor of the type you mention. I try to treat my patents like he did, but the computer makes it hard! Thanks for your comments, BL


message 7: by Bunnie (new)

Bunnie O'hara | 210 comments Barron, i have read about medicine since i was very young--i find it the most interesting subject --right now i am reading Hawkings book and trying to figure out this stuff about time and space--but i still love medicine first--i admire the old time doctors who had to diagnose with their sense of smell,feel.observations
and so on, a patient feels so much better with the hands on approach.
One of the earliest books i read was Paul De Kruif's "Microbe Hunters" -he also wrote many other books on medicine---please let me know what the name of your new book is--i would like to read it.--yes i know you do have to use the computer today-so i don't blame you for that.


message 8: by Barron (new)

Barron Lerner (lernerbarron) | 4 comments Bunnie: My new book is called "The Good Doctor: A Father, A Son and the Evolution of Medical Ethics." So it is part history, part biography and part (eeks) autobiography. I'd love to hear what you think of it. It will surely evoke "The Microbe Hunters" for you as I talk about the excitement associated with new scientific discoveries in the early and middle twentieth century. Anyway, the book comes out 5/13/14. Thanks for your interest!


message 9: by Bunnie (new)

Bunnie O'hara | 210 comments Barron,
i will be sure to look for it and let you know what i think. i supose it will be in Barnes and Noble.
It's ok about your Autobiography--i will like that too i,m sure.


message 10: by Bunnie (new)

Bunnie O'hara | 210 comments Barron, i reread all the comments made before and noticed the remark about Helen Taussig--there was a man named Vivian Thomas that was also responsible for the blue baby operation--he was a black man who was unable to enter medical school because of the great depression-so he became a lab assistant to Dr Blalock-he did the experiments Blalock wanted and devised the operation which was a palative cure for the blue babies condition--Taussig was i believe a pediatrition
who asked if there was anything they could do to relieve the condition-she was tired of seeing her babies die.Thomas was finally given his due and supposedly his portrate hangs in Johns Hopkins along side Blalock and Taussig--not enough black peope get recognition for their accomplishments.


message 11: by Bunnie (new)

Bunnie O'hara | 210 comments Dr Lerner,
i will be looking for your book-- it will be coming out this month.Can hardly wait to read it.


message 12: by Barron (new)

Barron Lerner (lernerbarron) | 4 comments Hi Bunnie--It came out last week. Pretty cheap on Amazon! Barron


message 13: by Bunnie (new)

Bunnie O'hara | 210 comments Barron,
ok i am looking


message 14: by Pedro (new)

Pedro Puech | 4 comments Bunnie wrote: "Barron, i reread all the comments made before and noticed the remark about Helen Taussig--there was a man named Vivian Thomas that was also responsible for the blue baby operation--he was a black ..."

Yes! Vivian Thomas´story is beautifully told in the film "Something the Lord Made". To those who haven´t seen it, I strongly recommend.


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