Radiation Evangelists: Technology, Therapy, and Uncertainty at the Turn of the Century by Jeffrey Womack (review)

A few years ago, I was on a seven-hour train from London to Marseille. The man in the seat next to me, a stranger, talked at me for six hours and forty-seven minutes. Of the many, many things he shared, only one thing has stayed with me. In the 1950s, his brother had received radiation therapy for his childhood brain cancer. Over sixty years later, his brother still lived—cancer free, but suffering from the after-effects of radiation damage to his young, developing brain. The man on the train claimed that his brother was the longest surviving recipient of radiation treatment in cases of cancer.

I thought about this anecdote a lot while reading Jeffrey Womack's Radiation Evangelists. This is a book about medical uncertainty, technological faith, the damage done by interventions designed to heal, and about the allure of survival. It explores X-ray and radium therapy in both Britain and the United States at the end of the nineteenth century and into the early decades of the twentieth. Using a religious framing, Womack recounts the efforts of early "radiation evangelists" who placed huge, and sometimes mystifying, trust in new energy sources. Womack ably dissects the motivations of these pioneering men and women and charts their affective commitment to innovation and technology. In doing so, this book attests to the messy, complex, and profoundly contingent nature of scientific development in the fin de siécle and offers a rich, illuminating, and lively account of the heterogeneity of medicine in this period.

This is a very readable book. There are plenty of quirky characters, absorbing plotlines, and riddles to solve. Womack takes clear delight in his subject matter, and he is an engaging writer. His real skill, however, and the thing that will make this book invaluable for undergraduate and graduate-level courses alike, is his ability to take a narrow slice of medical history and use it to unpack big, thorny problems such as medical professionalization and specialization, the boundary line between orthodoxy and quackery in nineteenth-century healthcare, and why certain technologies prove popular when others do not. You do not need to have a special interest in radiation therapies to find this book illuminating. As Womack insists, his story is "exemplary rather than extraordinary" (p. 5) and he takes radiation therapy as a case study to explore an "unavoidable problem in medicine"—uncertainty in treatment.

The central question that motivates Womack seems to be why, in the face of ample evidence of substantial harm caused by radiation therapy and with only limited understanding of radiation's mechanisms for bodily change, did the technology's proponents evangelize with such ferocity? This book is not, by any means, a straightforward or simplistic account of technological advance or medical progress. It is instead an exploration of professional motivations, self-interest, and hypocrisy. However, it is also not patronizing or dismissive of late-nineteenth-century errors of judgment of misappropriations of evidence. Even if the ultimate answer to Womack's central question is elusive, he engages seriously and sympathetically with people and the past.

There is plenty of material in this book to suit a variety of historical interests from consumerism to physics. As a historian of medicine in general, and cancer in particular, I (perhaps unsurprisingly) found the material on treatments for malignancy most compelling. Some of the most interesting passages deal with patients. Womack describes how X-ray and radium evangelists used patient choice and autonomy to justify the efficacy and value of their new technologies. Patients suffering from malignant tumors or cancerous sores not only lacked other therapeutic options, but also X-rays allowed them to avoid the "mutilation" of the "operating table" (p. 132). Of course, and as Womack argues, X-rays carried with them their own risks of painful and disfiguring damage. But these risks...