Medical Lives and Scientific Medicine at Michigan, 1891-1969 (review)

Although somewhat shaken in recent years, America’s academic medical centers remain one of the wonders of the modern world, and few of them, as this book reminds us, have outshone the University of Michigan, where a tradition of excellence extends to the late nineteenth century. Indeed, as this book also reminds us, four of the eight original full professors at the Johns Hopkins Medical School held Michigan degrees.

Joel Howell notes in his introduction that Medical Lives does not offer “a broad synopsis” (p. 6) of medical science at Michigan. Apart from Kenneth Ludmerer’s opening piece on the late-nineteenth-century development of the University of Michigan Medical School, and especially the formative role of Victor Vaughan, it focuses on the Department of Internal Medicine. Moreover, at its heart stand six biographical essays meant to serve as “biopsies of a period and a place” (p. 11), featuring the careers of George Dock, Albion Walter Hewlett, Cyrus Cressey Sturgis, Frank N. Wilson, Louis H. Newburgh, and Thomas Francis, Jr.

The subjects varied widely in their research interests and in their contributions to medical science. George Dock (b. 1860) “was a clinical observer, not a scientist” (p. 41), an outstanding clinician and teacher in the nineteenth-century mode of William Osler. Walter Hewlett (b. 1874) represented a new breed in academic medicine, an exponent of pathologic physiology who championed “selected laboratory tests” (p. 46) as adjuncts to clinical observation. Cyrus Sturgis (b. 1891), head of internal medicine from 1928 to 1957, earned early praise for his research but is most remembered as an able administrator, teacher, and fund-raiser. Frank Wilson (b. 1890) was an American pioneer of electrocardiography whose work presaged the post-World War II marriage of sophisticated technology and clinical practice. Louis Newburgh (b. 1883) won recognition as a student of metabolism—one of “the last of the classical calorimetrists” (p. 136)— before turning his attention in later years to renal disease and electrolyte balance. Finally, Thomas Francis (b. 1900) was an early leader in virology and epidemiology, designer of the Salk polio vaccine trials, and a key figure in pushing medical science beyond “bench” and “bedside.”

In addition to insights into the professional lives of those noted figures, the essays afford glimpses of broader issues in the history of academic medicine, including the changing emphases and approaches in medical scientific research; the unending quest for research facilities and funding; the trends toward specialization and subspecialization in research and practice; the difficulties in balancing teaching, research, and patient care; and the importance of individual leaders in the life of institutions.

In all, this brief book is both less and more than it appears. The “biopsy” approach leaves much of the anatomy and pathology of academic medicine unexplored; as examples, we learn little about the development of internal medicine as a whole, or about the struggles of women and minorities for recognition in medical science. Also, and contrary to the title, the essays do not address the explosive growth of American medical science after World War II. Finally, while the authors generally—and wisely—eschew “firsts,” they occasionally chance that slippery terrain; for example, we read that Michigan in 1870 was “the first major medical school to admit women” (p. 3), a claim that boosters elsewhere might dispute. At the same time, the authors’ lucid explanations of the evolution of technologies such as the electrocardiogram are a welcome bonus, and, overall, the essays are well executed and make an enjoyable and sometimes fascinating read, offering more than the common sketches of “great men.”