BOOKSHELF

A questionable tradition

BOOK NOTES

Book notes

ON CAMPUS

Roger Glass

Eric Campbell

Disssection: Photographs of a Rite of Passage in American Medicine 1880–1930 by John Harley Warner, Ph.D., Avalon Professor of the History of Medicine; and James M. Edmonson (Blast Books)

A questionable tradition

The dissection photo, now taboo, and its societal implications are explored in a history of the genre.

By Cathy Shufro

During the five decades from the Gilded Age to the Great Depression, American medical students created a distinctive genre of photograph: the group portrait with cadaver. First popularized in the 1880s, these tableaux commemorate the experience of dissection—what co-author John Harley Warner calls “a harrowing ritual of initiation.” His new book contains roughly 200 such photographs.

Warner, chair of the Section of the History of Medicine at the School of Medicine, describes dissection as central to early medical education, and yet “transgressive, practiced on the social, legal, and moral margins.” He analyzes the photographs to explore societal ambivalence about dissection, gender roles, race, class, and the iconography of the white coat. Warner collaborated with the chief curator at the Dittrick Medical History Center at Case Western Reserve University to collect the portraits. These photographs proliferated during an era when dissection was performed on paupers, executed criminals, and corpses “resurrected” from graveyards—bodies that were disproportionately black. Some photos convey morbid humor, including pipe-smoking skeletons and propped-up cadavers seemingly dissecting a medical student.

Warner argues that the photographs express a violent impulse in early 20th-century society, with such captions as, “He lived for others. He was killed for US.” By the mid-20th century, bodies used for dissection were increasingly donated to medical schools rather than stolen, and the dissection photograph became taboo. Today, as Warner notes, even the act of dissection is in question: computer simulations may render the gross anatomy lab obsolete.

Bookshelf focuses on books and authors at the School of Medicine. Send suggestions to Cathy Shufro at cathy.shufro@yale.edu.

Book notes

Genetic Diseases of the Kidney
edited by Richard P. Lifton, M.D., Ph.D., Chair and Sterling Professor of Genetics and professor of medicine, Stefan Somlo, M.D.; the C.N.H. Long Professor of Medicine and professor of genetics; Gerhard Giebisch, M.D., Sterling Professor Emeritus of Physiology; and Donald Seldin, M.D. ’43, HS ’46 (Academic Press) This book identifies and analyzes genetic abnormalities causing renal disease in humans.

Principles of Addiction Medicine, 4th ed.
by Richard K. Ries, M.D.; Shannon C. Miller, M.D.; David A. Fiellin, M.D., HS ’95, associate professor of medicine; and Richard Saitz, M.D., M.P.H. (Lippincott Williams & Wilkins) This book blends scientific principles underlying addiction with practical essentials of clinical addiction medicine to help professionals who specialize in addiction medicine and who treat patients with addiction disorders.

The Soul of Medicine: Tales From the Bedside
by Sherwin Nuland, M.D. ’55, HS ’61 (Kaplan Publishing) This book is a compilation of stories in which more than a dozen specialists describe their most memorable patients. The contributors also recount instances of fallibility and vulnerability that prove that doctors are human and caring.

Faith, Hope & Healing: Inspiring Lessons Learned From People Living With Cancer
by Bernie Siegel, M.D., HS ’61, and Jennifer Sander (Wiley) In this collection of first-person accounts, Siegel brings together almost three dozen cancer patients to share their stories and the lessons they have learned while living with cancer.

Surgery of the Human Cerebrum
edited by Michael L.J. Apuzzo, M.D., HS ’67 (Lippincott Williams & Wilkins) This book documents advances in surgery on the human cerebrum during the past 30 years, bringing together new and archival articles to provide sources of information on contemporary cerebral surgery.

Handbook of Radiation Oncology: Basic Principles and Clinical Protocols
by Bruce G. Haffty, M.D. ’84, professor (adjunct) of therapeutic radiology; and Lynn D. Wilson, M.D., M.P.H. ’86, professor of therapeutic radiology and dermatology (Jones and Bartlett Publishers) This handbook covers the issues most pertinent to patients undergoing radiation therapy, including general oncologic principles; workup, staging, and multidisciplinary aspects of treatment; basic principles of physics and radiobiology; and such specific technologies as brachytherapy and radiosurgery.

Otolaryngology: A Surgical Notebook
edited by K.J. Lee, M.D., associate clinical professor of surgery (otolaryngology); and Elizabeth H. Toh, M.D. (Thieme New York) This handbook uses a bullet-point format to present an overview of the fundamental concepts and core techniques for basic and advanced otolaryngologic procedures.

Perez and Brady’s Principles and Practice of Radiation Oncology, 5th ed.
by Edward C. Halperin, M.D. ’79; Carlos A. Perez, M.D.; Luther W. Brady, M.D.; et al. (Wolters Kluwer/Lippincott Williams & Wilkins) This book provides an understanding of radiation oncology; the physical methods of radiation application; the effects of irradiation on normal tissues; and site-specific applications of radiation therapy, either as a single modality or as part of a multi-modality treatment program.

ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults
by Clarence T. Sasaki, M.D. ’66, HS ’73, the Charles W. Ohse Professor of Surgery (Plural Publishing) This book provides an understanding of the three principal functional priorities of larynx protection, respiration, and phonation and features numerous illustrations and tables. Most chapters are preceded by focused case presentations introducing relevant clinical descriptions.

Laryngeal Physiology for the Surgeon
by Clarence T. Sasaki, M.D. ’66, HS ’73, the Charles W. Ohse Professor of Surgery (Plural Publishing) This book provides an understanding of the three principal functional priorities of larynx protection, respiration, and phonation and features numerous illustrations and tables. Most chapters are preceded by focused case presentations introducing relevant clinical descriptions.

Royal Maladies: Inherited Diseases in the Royal Houses of Europe
by Alan R. Rushton, Ph.D., M.D., HS ’80 (Trafford Publishing) The author provides an historical study of the effects of two hereditary diseases, hemophilia and porphyria, on the personal and political lives of European royal families.

Comprehensive Review of Psychiatry
edited by Rajesh R. Tampi, M.D., associate clinical professor in the Child Study Center; Sunanda Muralee, M.D., clinical fellow in the Child Study Center; Natalie D. Weder; and Heath Penland (Lippincott Williams & Wilkins) This text will prepare resident and practicing psychiatrists for all types of standardized examinations, including the Psychiatry Resident-In-Training Examination, the American Board of Psychiatry and Neurology (ABPN) written exam, and recertification exams. The book contains 2,000 multiple-choice questions divided into 10 200-question tests, each test covering all psychiatry and neurology topics in the ABPN curriculum.
The descriptions are based on information from the publishers.

Send notices of new books by alumni and faculty to Cheryl Violante, Yale Medicine, 300 George Street, Suite 773, New Haven, CT 06511, or via e-mail to cheryl.violante@yale.edu.

On campus

A new vanguard to address global health

The fight against disease in the developing world has often been waged not by public health professionals, but by economists, politicians, and even military personnel, said Roger I. Glass, M.P.H., M.D., Ph.D., director of the Fogarty International Center at the National Institutes of Health, during a talk at the medical school in April. Glass spoke at the spring symposium of the Wilbur Downs International Health Travel Fellowship Program.

“It was Colin Powell and Madeleine Albright saying the health of Africa was a security issue,” Glass said, that launched the President’s Emergency Plan for aids Relief (PEPFAR). “Global health has changed in the last 10 years,” he said, noting the emergence, in addition to PEPFAR, of the Bill and Melinda Gates Foundation and the Global Alliance for Vaccines and Immunization, organizations that also address health issues in the developing world. “Global health in the 20th century was schools of public health and departments of international health at medical schools. In the 21st century global health is more than that. It is engineering. It’s business and organization of delivery of care. It has to do with international ethics and law. It has to do with economics.”

—John Curtis

Ubiquitous industry ties have risks and benefits

By the time they’ve reached their third year of medical school, said Eric G. Campbell, Ph.D., virtually all medical students have accepted a free meal from drug companies. While this treat may appear to be a small gift, it could also be the first of many that lead young doctors and scientists into conflicts of interest and the erosion of trust between physicians and the public.

“There’s a lot of eating going on in academic medicine,” joked Campbell, an associate professor of medicine (health policy) at Massachusetts General Hospital and Harvard Medical School, who spoke at the Perspectives on Medicine series in March.

Relationships between industry and academia are not necessarily bad, Campbell said, noting that the pharmaceutical industry underwrites $1.5 billion in research each year. “They have benefits that are very important,” he said. But industry-sponsored junkets, along with ghostwriting, speaking, consulting, and advisory fees can create the impression that medical findings are “bought and paid for,” he added.

“Managing conflicts of interest is a fundamental part of medical professionalism today,” Campbell said. “We need to disclose these things and we need to manage them.”

—J.C.