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nunia
[个人文集]
加入时间: 2005/11/04
文章: 2184
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作者：nunia 在 寒山小径 发贴, 来自 http://www.hjclub.org
Read a negative review on this book that i would like to translate its entirety into Chinese.
EUGENE PERRY LINK, The social ideas of American physicians (1776-1976): studies of the humanitarian tradition in medicine, Selinsgrove, Susquehanna University Press, and London and Toronto, Associated University Presses, 1993, pp. 317, illus., £40.00 (0-945636-34-2).
Professor Link has written a traditional hagiographic account of American pfiysicians-with a twist. Instead of describing forebears in order to illustrate scientific prowess or therapeutic distinction, he selects past exemplars defined by their social activism. This is a book about heroes and villains, with the repeated warning that physicians who are not "interactionist" in their social relations risk sliding down the slimy slope of Nazi physician atrocities.
At the outset, Link describes five roles that physicians can assume in regard to broader community issues: (1) iatrocentrics who focus only on medicine and are little involved with social change; (2) sanitationists who find order in maintaining cleanliness supported by government aid but fear regulation of the profession; (3) public health advocates who feel social criticism is necesary because sanitation is not sufficient; (4) social activists who keep professional and social concerns in separate compartments in their lives; and (5) those physicians who treat citizenship duties as an integral part of medical practice. Category one is heaped with opprobrium whenever mentioned; category five is presented as the ideal behaviour for a physician. Link feels that the doctor who is not socially active will fall into traps of mislabelling his/her patients as "other" and become a practitioner of biased approach. This is the foundation of his appeal, yet he offers little contemporary or historic evidence that "iatrocentric" doctors treat their patients poorly. He does vilify Nathaniel Chapman of late eighteenth-century Philadelphia for his anti-democracy views, and then mentions his inappropriate use of a patent medicine. Yet when Link comes to Chapman's contemporary Benjamin Rush, extolled as a shining light of the Jeffersonian democracy movement, he fails to mention the excessive bloodletting that was Rush's trademark. While assessing these physicians' practices for quality is an anachronistic exercise at best, this is the only place where Link offers evidence that reactionary physicians practise poor medicine.
Link is not just arguing that social activism is necessary for the model physician, but that such a physician cannot hold conservative political views. His list of politically correct opinions includes being anti-slavery, concerned about the poor, and pacifism. He is unsure about temperance, and lapses from his praise for pacifism when describing the physicians who served against the fascists in the Spanish Civil War. Largely avoiding the complexities that would have arisen from considering these figures within the context of their own time, he keeps a scorecard on how well the physicians ascribed to his own political views.
Professor Link's training is in American history, and his lack of familiarity with standard works and themes of medical history is obvious. He analyses physicians' reactions to the temperance movement without knowledge of the active debate on alcoholic therapeutics that was happening simultaneously in the mid-nineteenth century. Whilst making much of Daniel Drake's nationalistic fervour he could clearly have benefited from the historical literature on antebellum regional styles of medical practice. Although he gives extensive attention to Nathan Davis, who founded the American Medical Association, he lacks sophistication in understanding the impetus towards the medical school reform in the nineteenth century. Overall, he offers biographical vignettes lifted out of the context of the medical world in which these physicians practised. Granted he is not interested in the clinical side of their lives, but he frequently misunderstands the thrust of their social ideas because of this lack of context.
Nowhere is this more evident than in the sections that discuss the public health movement. After setting up the unusual dichotomy of public health approaches in his list of types of interaction, he then never uses it in his analysis. Link chooses to focus on two rather obscure figures while ignoring the leaders of the movement. Although he discusses Henry I. Bowditch's anti-slavery stand, Link ignores the large role Bowditch had in state and national public health work. Discussion of choices in public health direction might have offered Link a rich field for analysis, yet his lack of awareness of the complexity of arguments about, for example, focused attack on the tubercle bacillus versus tenement house reform, limits his account to the superficial.
Typographical errors include paragoric (p. 15 1), untrammeted (p.21 1), and experince (p.242). He has Rudolph Matas living 151 years on page 46, and refers to the "Dorothy Reed cell" on page 150 when its usual name is the "Reed-Steinberg cell".
Link has read widely in the manuscript materials of the physicians he describes, and uses them well. His plan is laudable, and this writer agrees with him that physicians with a broad humanitarian gaze are admirable people and worthy role models. Yet ultimately this book fails to convince the reader that such activities are essential to the identity of the superior physician.
Margaret Humphreys, Duke University
From: pubmedcentral.nih.gov
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1036898
作者：nunia 在 寒山小径 发贴, 来自 http://www.hjclub.org |
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