Book Review: Doctors, the Biography of Medicine William J. Yost, MD FACP | Member of AIAMC Programming Committee

    “The history of medicine is, in fact, the history of humanity itself, with its ups and downs, its brave aspirations after truth and finality, its pathetic failures.”  … Fielding Garrison, 1913

I must confess that I have long had a particular fascination with the history of science, and with medicine in particular. I believe that to truly understand the discipline we practice and teach to our learners we should appreciate the context and history of that discipline – in short, how we got here.

In his book Doctors: The Biography of Medicine, Sherwin Nuland, MD - a celebrated surgeon, medical educator and prolific author - does precisely that. The scope is broad. He begins with Hippocrates; the arguably apocryphal figure widely considered the “Father of Medicine.” He visits other historical figures through the ages through whom we can see and understand the challenges, the frustrations, and the often-revolutionary advances made in medicine and surgery. Doctors concludes with Helen Taussig and her co-invention of the revolutionary surgical procedure that enabled “blue babies” to survive.

The book is an ambitious project in scope and well worth the reader’s time. Through Nuland’s work (also available as an audio book), one gains an appreciation for the startling achievements of men and women through the centuries, advances that relieved suffering and improved the human condition. Examples?

o   A chapter is devoted to William Harvey and his discovery of the circulation of blood (a discovery, incidentally, that set Galen’s ideas and authority upside-down).  Here Nuland describes the application of what we now recognize as modern science – careful observation, the generation of a hypothesis, and experimentation with the measurement of results to support or deny the hypothesis. Observation, logic, and experimentation.

o   Rene Laennec is described in another memorable chapter. Laennec was a French physician and musician whose extensive practice included the ordinary people of Paris, and the inventor of the stethoscope. As an internist - and as one who has made his living by the stethoscope - Laennec has always been a particular favorite of mine. I often mention him to my students and residents as we explore the mysteries and subtleties of auscultation.

o   William Stewart Halsted was another particularly intriguing figure in the history of medicine. A deeply troubled genius, Halsted dedicated himself to the relief of women’s suffering from breast cancer through his novel approaches to their surgical cure, bringing some hope for cure to women stricken with a disease previously considered incurable. His contributions to medicine, surgery and medical education were many; the story of his life and personality will fascinate you.

o   And finally, there is Helen Taussig, the founder of pediatric cardiology and co-inventor of the life-saving surgery that bears her name. Nuland brings this brilliant woman to life and describes her unceasing efforts to overcome discrimination in a virtually entirely male profession, her devoted care of her patients, and, in a very real sense, the perfect role model of the subspecialist who cares for the whole patient. I found it fascinating that Taussig, left somewhat deaf by whooping cough as a child, developed such acuity in her senses of observation and touch that she could diagnose the cardiac abnormality to a high degree of accuracy by just watching and feeling a child’s chest. She devoted her life to the care of “blue babies” and she changed the world.

There are, of course, others throughout history and throughout this book. You may find descriptions of Hunter and Pare, Semmelweis and Lister, to be even more compelling than those I’ve mentioned. However, I can assure you of one thing – if you have any interest in the history of medicine or humanity, you’ll find this book well worth your time, even compelling reading.

Sherwin Nuland was a respected clinician, educator, and medical historian. On the faculty at Yale University, he died in 2014. During his career, he taught surgery, bioethics and medical history at Yale University, was the Literary (Scientific) Editor of Connecticut Medicine and Associate Editor of the Journal of the History of Medicine and Allied Sciences and a TED talk speaker including one on How Electroshock Therapy Changed Me.

Brief Bio: Dr. Yost is Chief Academic Officer, DIO, and Senior Vice President of Medical Education and Research at UnityPoint Health-Des Moines where he provides direction and oversight of UME, GME and CME. As the DIO, he engages in clinical and educational research and teaches clinical medicine and principles of quality and patient safety. He is a long-time Iowan, getting his BS and DVM (Veterinary Medicine) at Iowa State University before deciding to get his human medicine degree (MD) at the University of Iowa. He completed his GME training in Internal Medicine at Walter Reed Army Medical Center, is a Fellow of the American College of Physicians and continues to practice general internal medicine.