Not Just Any Medical School: The Science, Practice, and Teaching of Medicine at the University of Michigan, 1850-1941 (review)

Horace W. Davenport. Not Just Any Medical School: The Science, Practice, and Teaching of Medicine at the University of Michigan, 1850-1941. Ann Arbor: University of Michigan Press, 1999. xii + 382 pp. Ill. $52.50.

Part of the University of Michigan's celebration of its sesquicentennial, Not Just Any Medical School is a concise and perceptive overview of medical education at one of the nation's premier educational institutions. This is a revision of an earlier account by Horace Davenport, who has since his retirement from the chairmanship of Michigan's physiology department devoted himself to chronicling the school's history. A brief epilogue by editor Janet Tarolli brings the story up to the present, but it is Davenport's text, focused on the years 1850-1941, that will be of the greatest interest to historians of medicine. Building upon his many years as a student of Michigan medicine and his extensive prior publications about such luminaries of the school as Victor Vaughan and George Dock, he analyzes the research, teaching, and practice styles of the senior faculty. After three chapters recounting the struggles to found the school, Vaughan's early deanship, and student life, Davenport organizes the book by specialty. Within each specialty section he tells a chronological story that strives to place the activities of leading faculty, especially their scientific research, in both a local and a national context.

Davenport's analysis of faculty research and his careful placement of this work in the appropriate scientific context are the book's greatest strengths. His own years as a bench scientist and teacher of medical students provide him with a deep understanding of how scientific arguments and research careers are built and dismantled. The recruitment of faculty from schools with similar goals, the departure of key figures, European study, research collaborations, feuds over space, clever mechanical solutions to experimental difficulties, and responses to challenging new technologies are integral parts of this portrait of Michigan's rise to a leadership role in the American medical education system. When insight into the demands of teaching and the workings of the scientific process are blended with a firm grasp of primary material, which Davenport demonstrates in his deft use of such archival sources as lecture notes and laboratory manuals, a history of great scholarly value is produced.

Yet this emphasis on research, science, and the perspective of leading faculty leaves another part of Michigan's special personality largely unexplored. This was a state medical school in an era when private institutions played the dominant role. Moreover, it was a state university in a small midwestern town at a time when medical schools were becoming defined by access to the large pools of patients found most often in urban locations. Davenport offers some tantalizing hints of the tensions that existed between the national scientific reform agenda and the realities of life as a state medical institution in Ann Arbor, Michigan. Among the more intriguing of these hints is the recurring battle over clinical material and possible links to Detroit that Davenport refers to at several points in his narrative, but never fully explores. Equally fascinating, but only briefly discussed, is the failure of the full-time plan at Michigan and the shifting role of private practice in the fortunes of both individual faculty and the institution.

A more sustained look at this set of issues and similar community-service questions would have enhanced Davenport's argument about the institution's unique character. Although this character arose from the academic and research achievements that he illustrates so well, it was also shaped by the institution's ability to foster such activity as a state school. It will be up to future scholars to write this part of the Michigan story. Davenport's book provides...