- Notes of a Medical Maverick
memoirs, medical practice
For at least three millennia, the practice of medicine and the history of medicine were inseparable. Central to the understanding of medical practice were its history, philosophy, ethics, and models of relationship between the physician and patient. The Hippocratic tradition contributed to subsequent paradigms, all aspiring to preserve the best of what had preceded them—both in knowledge and in humanistic skill and insight. Subsequent models followed the same pattern of addition and synthesis.
Even with the rise of “scientific medicine” in the early twentieth century, William Osler articulated the need for explicit allegiance to the Hippocratic code as medicine made use of the emerging tools of scientific diagnosis and treatment. Arguably, Aequanimitas and Other Essays was essential to the proper application of The Principles and Practice of Medicine. The physician as priestly guide, as neighbor and friend, as heroic figure of self-sacrifice, or as bearer of noble obligation could not be made complete by scientific and technical means only.
As science gave rise to greater and greater mechanistic knowledge and to more and more effective treatments, hubris and preoccupation began to erode the space preserved and indeed sanctified for the heritage, character, and behavior of the physician. To be sure, great figures such as Philip A. Tumulty and Tinsley Harrison invested their considerable stature in attempting to maintain the synthesis, but it was a rearguard action. More recently, Eric Cassell and others have tried to reclaim the grand vision, but competition for the attention and allegiance of both practitioners and academicians is great, to say the least.
Until this Great Divorce around the time of World War II, an academic physician could expect to apply meaningful effort to understanding, protecting, and professing this synthesis of science and humanism. Thus, it would not be at all unusual for a renowned Professor of Medicine to maintain interest and scholarly productivity in the history of medicine and its pertinence to current advances—particularly as history illuminated the need for perseverance, imagination, and honest reflection in the effort to enlarge the capacity to heal, restore, and comfort. [End Page 143]
We live in a different world. Academic physicians hoping for advancement and the opportunity to make significant contributions to medical knowledge and practice are likely to involve themselves in the scholarly pursuit of medical history only if history itself is their chosen area of specialty. Historical research, essays, teaching, and related work are unlikely to strengthen the portfolio of an Assistant Professor of Medicine and Cardiology in his quest for promotion and tenure.
It appears that for such reasons, Allen B. Weisse, M.D., presents himself as a “medical maverick.” As an academic cardiologist, Weisse has persevered as a proponent of the usefulness and relevance of the history of medicine in our ahistorical age. The result is a perspective that can benefit not only the lecturer in medical history, but also the busy interventional cardiologist, robotic surgeon, or clinical trials researcher.
To be sure, in Notes of a Medical Maverick as in his earlier works, Weisse engages in more than straightforward historical research and analysis. Previous books and articles have involved health promotion, anecdotes of medical practice, and the tensions of the doctor–patient relationship. His Lessons in Mortality: Doctors and Patients Struggling Together (Columbia, Missouri, University of Missouri Press, 2006) draws on patient vignettes and his own experience as a survivor of testicular cancer. On the other hand, his Conversations in Medicine (New York, New York University Press, 1985) and Heart to Heart: The Twentieth Century Battle against Cardiac Disease: An Oral History (New Brunswick, New Jersey, Rutgers University Press, 2003) provided useful additions to the chronicles of that scientifically explosive century.
Notes of a Medical Maverick shares the back and forth of these themes, and if there is an objection to be made to the collection of essays, it is their competing subject matter and diverse purposes. Even so, they are delightfully written and contain fascinating information. Surprising research findings (“The Phoenix Phenomenon”), controversies about the role of...