Locating Medical History: The Stories and Their Meanings

14 ‘‘Framing’’ the End of the Social History of Medicine

C H A P T E R F O U R T E E N ‘‘Framing’’ the End of the Social History of Medicine Roger Cooter Apart from involving me in something close to writing my own obituary, framing the end of the social history of medicine is difficult for the simple reason that the subdiscipline’s roll into the grave was far from obvious or straightforward. The end was more in the manner, literally, of a passing—a sluggish, uneventful meltdown , nowhere much noticed or commented on. Indeed, the walking dead are still many among us: explicitly ‘‘social’’ histories of medicine continue to be written , and undergraduate courses in the social history of medicine (not to mention a journal by the name) continue to be subscribed to. This is odd because, in somewhat more than literal fashion, the end was heralded over a decade ago when Charles Rosenberg—the acknowledged doyen of the field—proposed the banishment of ‘‘the social’’ in the social history of medicine and its replacement with ‘‘the frame.’’1 The substitution was widely endorsed.2 However, the expressed motives for it (as well as the unexpressed ones I will come to) were different from the historiographical ones that might have been posed. Thus, the actual ending of the social history of medicine was obscured at the same time as the literal ending was (in that other sense of the word) ‘‘framed.’’ Such is my contention. This chapter, therefore, is mainly concerned with the wider context 310 After the Cultural Turn for the demise of ‘‘the social’’ in the history of medicine—with what might be styled (though I wish to imply no conspiracy) the framing of the framing. That our concern has to do with more than merely the substitution of words first became apparent to me in the mid-1990s when I was approached to write a social history of medicine. The prospect was enticing. Here would be a chance to pull together some of the many different themes that had come to comprise the field: the politics of professionalization, alternative healing, the study of patient narratives, welfare strategies, constructions of sexuality and gender, madness, deviance, diseases and disability, public health and private practice, ethics, epidemiology , experimentation and education, tropical medicine and imperialism, along with the various actual and rhetorical relations between medicine and war, medicine and technology, medicine and art, medicine and literature, and so on. More than that, the book would afford an opportunity under such headings, chapter by chapter, to review how, over the past two or three decades, historical and historiographical understandings had broadened, sharpened, and deepened. There was need for such a book, and there probably still is. But when pen came to paper, paralysis set in. The problem wasn’t the survey of the literatures involved, formidable though they had become. Rather, it was more the nature of, and need for, the overall packaging. A social history of medicine? In 1992, Andrew Wear proudly declared that it had ‘‘come of age,’’ to which Ludmilla Jordanova roundly responded that it was ‘‘still in its infancy.’’3 What caused my pen to falter, though, was the realization that somehow, somewhere along the way in the 1980s and 1990s, all the key words had lost their certainty of meaning, and some (pace Rosenberg) had even been threatened with excision. No longer could they be taken for granted: ‘‘history’’ and ‘‘medicine,’’ no less than ‘‘the social,’’ had become deeply problematic. The hinges of the triptych were rusting up and coming unstuck; historiographically, the whole was no longer the sum of its elemental parts. Such a realization was more than a little worrying politically, inasmuch as the implied loss of disciplinary coherence could only disable the critical, if not socialist, thrust of an enterprise that had been honed over the previous quarter-century in alliance with social medicine, medical sociology, and social history—an unusual mix of radical politics and policy, critique and theory, and empirical practice, represented by Thomas McKeown, Ivan Illich, and E. P. Thompson, respectively. I have no desire to defend the use of ‘‘the social’’ in the social history of medicine . It might be as well to admit that the subdiscipline has had its day, done its bit, much in the manner of older forms of political and economic history. Given that much social history of medicine has been intellectually flatfooted and theo- ‘‘Framing’’ the End...