Clio in the Clinic: History in Medical Practice

Alan Belk is a sessional instructor in the Philosophy Department at the
University of Guelph.

The title of this insightful book is too academic to attract the wide
readership it deserves. The work contains 23 short pieces written
anecdotally by medical doctors about their clinical experiences. The
contributors include several internists, psychiatrists,
infectious-disease specialists, and pediatricians, as well as a surgeon,
a neurologist, and an emergentologist. For example, Jacalyn Duffin’s
“One Blue Nun” shows how accurate clinical diagnosis can require
knowledge of the history of a specialty as well as geopolitical
awareness. Joel D. Howell finds that one outcome of the Tuskegee
syphilis experiment is that 70 years later he, as a white doctor, is
mistrusted by black patients. This view is reinforced by Margaret
Humphreys, who observes that “[e]very practitioner who talks to an
African-American patient about a new treatment or, especially, inclusion
in a clinical trial, needs to remember this ugly story and be sensitive
to overcoming its legacy of suspicion.” T. Jock Murray, in the
tradition of Dr. Arthur Conan Doyle’s hero Sherlock Holmes, solves the
mystery of an unexplained death in 1909 from knowledge of the sudden
cocaine-related deaths of popular entertainers.

There are two main points that emerge from this work. The first is
about history: the authors’ awareness of medical history has made them
better doctors than they might otherwise have been; they each relate how
historical informedness has altered the way they practise medicine.
Second, the pieces show the humanity and fallibility of medical
practitioners—for example, how medical procedures (such as radical
mastectomy as performed in the early 1950s, which left the patient’s
heart unprotected by rib bones) can be driven by faddishness.

All the stories are written with great clarity, and the book should be
required reading for medical students.