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• W1649273610 abstract "IN THE DELIGHTFUL 1976 FILM “THE SEVEN PERCENT SOLUtion,” Sherlock Holmes, found by the trusty Dr Watson to be hopelessly addicted to morphine, is taken to Vienna to consult with an up-and-coming medical authority, the young Sigmund Freud. Of course, these famous figures never met, not least because one of them never existed. But no matter— the juxtaposition worked. In An Anatomy of Addiction, Freud is once again paired with a famous personage, but this time it is with the real-life figure of William Halsted, one of the foremost surgeons of his day. What this book has in common with the above-mentioned fictional work is that once again, the persons also never met. Nevertheless, Howard Markel, a medical historian and expert in addiction medicine, has written an inspired, entertaining, and informative book, moving back and forth between the lives of these great men, both of whom inhabited the same historical period and worked within a similar medical milieu. He tells the unsettling tale of how they were first scientifically attracted to the newly discovered wonder drug cocaine, then became abusers. He recounts how eventually one (Freud) gave it up and the other (Halsted) probably never did. A previous book by Gerald Imber described how Halsted fell into the clutches of addiction, how it affected his personality and judgment, and how it affected the opinion his colleagues had of him. One of the most interesting stories relating to Halsted’s drug abuse described in Imber’s book was first described in detail by Michael Bliss in his magisterial biography of Sir William Osler. Osler, the great physician and for many years Halsted’s close colleague in Baltimore, penned a secret account, the “Inner History of Johns Hopkins Hospital.” In that manuscript, probably written around the beginning of the 20th century but, according to instructions in Osler’s will, not meant to have its seal broken until many years later, Osler tells all. As Markel puts it so well, the account (which in fact came to light a bit early, in 1969) contains material that “makes the hearts of medical historians instantly beat faster” by confirming in Osler’s long-hidden words and beyond the shadow of a doubt the fact of Halsted’s addictive behaviors. Despite Halsted’s lifelong addictions, likely off and on, to both cocaine and morphine (the former often used by contemporary physicians as a cure for addiction to the latter), he continued to function as a surgeon, researcher, and teacher and might have accomplished much more if he had not had these drug dependencies. Given his odd behavior, Halsted was known as “an indifferent instructor,” and one student wit referred to Halsted’s ward rounds as “Shifting Dullness.” As I offered in my review of Imber’s book, “[O]ne can only imagine what else this great surgical pioneer might have accomplished had he been free of drug addiction.” For his part, Freud also fought his inner demons via medication abuse—but in his case, abuse of “only” cocaine, not morphine. However, in contrast to Halsted, this neurologist/ psychiatrist eventually managed to prevail over his drug dependency. With respect to cocaine, Freud wrote the book (Uber Coca) on this new wonder drug but did not underline its effect as an ocular and nasal anesthetic. Markel postulates, however, that Freud’s use of cocaine may have had an influence on his thinking processes while composing the masterwork The Interpretation of Dreams. As in the successful fictional juxtaposition of physician and detective alluded to above, Markel’s coupling in An Anatomy of Addiction of 2 real figures—psychiatrist and surgeon—works. Both Halsted and Freud were greats in their respective medical fields, and each struggled with drug abuse. But while one was able to overcome his inner demons, the other could not. Markel’s book tells this fascinating tale in an insightful contemporary book that is both intellectually engaging and exceptionally well written." @default.
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• W1649273610 title "BOOK AND MEDIA REVIEWS" @default.
• W1649273610 doi "https://doi.org/10.1300/j088v05n04_08" @default.
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