Is There a Southern Doctor in the House?

Steven M. Stowe. Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century. Chapel Hill: University of North Carolina Press, 2004. 373 pp. Notes, bibliography, and index. $45.00.

Doctoring the South does not go down easily, but a patient reader will benefit immeasurably from this brilliantly conceived and thoroughly researched book. Stephen Stowe has penetrated the scientific and cultural world of southern physicians during the mid-nineteenth century, showing how white doctors made meaning of their lives as they struggled to gain mastery of the sickly bodies of others. The confrontation between patient and physician, between sickness and health, reveals what Stowe calls the country orthodoxy style of southern practitioners. Country orthodoxy inextricably tied a doctor's understanding of what it meant to be a professional to his local community. It was within a specific locale that the day-to-day reality of practicing medicine gave shape and meaning to the art of healing.

Stowe's emphasis on country orthodoxy does not result in a detached, scientific examination of doctors at work. Rather, country orthodoxy enables Stowe to bring the reader into the college medical classroom, to hear the words of the instructors, to read the notebooks of the students, and to walk the hospital rounds with medical interns. Country orthodoxy also takes the reader to the backcountry road circuit, where newly minted physicians fought hard to secure clients while seeking membership into their communities as men of learning. And country orthodoxy brings the reader into the sickroom where a doctor earned his reputation by conquering the hidden enemies of disease, communicating to patients who were suspicious of "science talk," and compromising with family members who demanded to have a voice in the healing process.

Stowe does not limit country orthodoxy to the descriptive; he shows how country orthodoxy created a dilemma in the self-identities of physicians. On the one hand they needed to detach themselves from their own communities if they were to live up to the idea of a scientific professional, but this desire for exclusive status risked social alienation from the very people who determined a doctor's public reputation and private sense of self-worth. The author argues that physicians turned to their daybooks and journals, where they constructed an exalted version of everyday medicine in which they described themselves as compassionate observers as well as heroic actors who saved lives through a combination of scientific knowledge, personal morality, and a deep sensitivity to local customs and traditional folkways.

Country orthodoxy, as an explanatory device, is the greatest strength as well as the greatest weakness of this book. It serves Stowe well when he describes the everyday experience of a physician or when he explains how these same men tried to make meaning of their professional and personal lives. While country orthodoxy captures the reality of being a southern physician, the term's definition fails to give the experience of a physician a sense of unity and coherence. Stowe acknowledges that country orthodoxy drew from the particular and each expression must be traced to the unique material and moral conditions found in countless individual communities across the South. One must therefore conclude that the experience of being a southern doctor was wildly diverse and essentially defies generalization. Stowe does not suggest the latter, however, and he admirably tries to recreate the broad educational, social, emotional, and intellectual contours of the lives of physicians. Unfortunately, the idea of country orthodoxy never brings these various components into a coherent whole, a problem made worse by a writing style that at times is stilted and mechanical. While the prose reads smoothly in most places, there are critical analytical passages that are so overdone, so filled with academic jargon, and so burdened with psychoanalysis that crucial ideas and themes are difficult to discern.

Even when Stowe's discussions of country orthodoxy are accessible, one has to wonder how this term fits...