Medical Moments

Mavericks, Miracles, and Medicine. Julie M. Fenster. New York: Carroll & Graf; 2003. 304 pages. $15.00. ISBN:0786714158

Mavericks, Miracles, and Medicine was commissioned to accompany and complement, but not duplicate, a four-part series on the History Channel in 2003. The author selected to produce the book was Julie Fenster, who, as readers may remember from my earlier review [

], wrote Ether Days. Whereas Fenster’s propensity to go off on tangents distracted from that earlier book, it suits the present series of vignettes, covering twenty-five scientists who were considered ahead of their time.

The book is divided into five large sections (Understanding the Body, Germ Theory, Magic Bullets, The Mind, and Toward Better Surgery), each of which comprises three or four chapters focused on one of the titular “mavericks.” Fenster details not only the social and educational backgrounds of these biomedical scientists, but also outlines the cultural and scientific environment of the times and provides the historical context of the relevant “miracle.” In many cases, Fenster also goes into some detail about the “beneficiary” of the scientific breakthrough, (e.g., Mary Mallon, more commonly known as Typhoid Mary or Richard Herrick, the first successful kidney transplant patient). If the stories sometimes move in leaps and starts, it is understandable given the amount of material that Fenster manages to cover in these relatively short chapters.

The earliest subject about whom she writes is Andreas Vesalius, the Belgian author who wrote De Humani Corporis Fabrica (Of the Structure of the Human Body) in 1543. This book provided medicine with the first detailed map of human anatomy, produced by Vesalius from insights gained from hundreds of dissections (of bodies frequently gotten by nefarious means). In order to explain the impact of the Fabrica, Fenster briefly covers the history of the printing press as well as the influence of the Reformation on academic life and the effect of the Renaissance in Italy on artistic (and anatomical) rendition. Without the printing press, the Fabrica would not have been widely known. Without the freedom of thought produced by the Reformation, Vesalius would likely not have shed the ties that bound him as son of the apothecary to Charles V. Without the student of Titian who illustrated the Fabrica, it would not have been the marvel of depiction that it was.

Some of the names covered by Fenster will be familiar to most of us (e.g., William Roentgen, Antony van Leeuwenhoek, William Harvey, Selman Waksman, Paul Erlich, and Ian Wilmot), but others are much less well known, such as Lady Mary Wortley Montagu, Jean-Baptiste Denis, and Werner Forssman. Not surprisingly, many of these individuals possessed rather quirky personalities, which often accounted for the difficulty they had in getting their ideas accepted. Some were raised in medical families, but others found their way into medicine through much less traditional routes. Thomas Willis, credited with being the father of neurology through his book Cerebri Anatome (and namesake of the Circle of Willis at the base of the brain), was the son of a butler. Antony van Leeuwenhoek, discoverer of the cell, was a draper and a burgher who collected microscopes as a hobby. Some of the individuals profiled received the recognition they deserved in their lifetime. Others so alienated their colleagues that it wasn’t until after their death that the import of their work was recognized. Some made seminal contributions but were overtaken by life events that forced them to let others bring their “miracle” to fruition. Werner Forssmann, for example, developed the idea of the cardiac catheter and tested it on himself (the description of this particular experiment is entertaining enough to be part of a medical sitcom), but because he had joined the Nazi party, he was ostracized from the postwar biomedical community. He retired to a small town in Bavaria to practice medicine and follow, from afar, the work of others in the developing field of cardiac catheterization. When he received a phone call telling him that he had been awarded the 1956 Nobel Prize for Physiology or Medicine, he “felt like a village pastor who had suddenly been made a cardinal.”

One of the most interesting aspects of this book is Fenster’s treatment the societal contexts of the important scientific discoveries, through which the reader often comes unexpectedly across people who are not normally associated with medicine. Christopher Wren, architect of St. Paul’s Cathedral in London, worked closely with Thomas Willis and became the artist for Willis’s book on the anatomy of the brain. Charles Lindbergh, first person to fly nonstop across the Atlantic Ocean, was very early involved in engineering aspects of the first artificial heart–lung machine.

I was frequently quite taken with Fenster’s turn of phrase. She often manages to capture, in a single sentence, the tenor of the characters and times that she surveys. “In Wilhelm Roentgen’s life,” she writes to describe his academic prowess, “the Nobel Prize was easy; getting into college was the long shot.” In characterizing public reaction to cloning, she observes, “While still quite young, she (Dolly) ushered in a unique moment in medical history, when a sheep looked like a poised individual and the people looked very much like sheep.” Fenster compellingly sums up the impact of the printing press on academic medicine: “With books, the medical world was united as it never had been before—not behind any one master, but behind one philosophy of shared learning.” And she critically assesses the intertwining of personality and history, noting that Ignaz Semmelweis, discoverer of the cause of puerperal fever in new mothers, “…was telling a world of physicians that they didn’t only cure illness, they might also cause it; they didn’t only save lives, they could take them. He was right. But that didn’t make him the right man to say it.”

Although I found the chapter on the discovery of ether to be every bit as hard to follow as I did her book on the subject, Julie Fenster has definitely redeemed herself as an author to me. This book makes great travel reading because, as long as you do a chapter at a time, you can put it down and pick it up. And every chapter contains at least one conversational nugget you can use if the occasion arises.

Julie Fenster is a historian, a columnist for American Heritage, and a contributor to the New York Times.

• © American Society for Pharmacology and Experimental Theraputics 2006