Editor’s Note: In the second part of our inaugural post to the “Teaching Points” series, Contributing Editor Joe Gabriel ruminates on teaching to both medical students and PhD candidates in the humanities.
Interventions in the Teaching of American Mediine
Yesterday I posted the syllabus to a class I taught for the history department here at Florida State. As I mentioned, I’m actually on faculty at the medical school and so I spend most of my time teaching medical students. If you haven’t done it, teaching medical students is incredibly rewarding – they are extremely hard working, very smart, and it’s gratifying to know that you might actually be helping them become better doctors. However, it’s also very nice for me to get the opportunity to interact with doctoral students in the humanities, as it allows for different types of conversations that just aren’t possible in the medical school.
As you’ll see from the syllabus, the course is an effort to provide a broad overview of the history of medicine in the United States. I tried to organize the class both chronologically and methodologically, with both earlier periods of history and more traditional approaches to the history of medicine being covered earlier in the course. There are, I think, some problems with the syllabus.
Editor’s Note: Building on successful contributions by Eoin Cannon and Caroline Acker, Points this week inaugurates a five-part series that looks at teaching alcohol and drugs as history, culture, and policy issue. Each week we’ll feature two posts on the topic: a complete syllabus, followed by the instructor’s comments, questions, and musings on the teaching experience. Our aim in this as in all things Point-y is to share work in progress (and yeah, teaching counts!), generate new ideas, and converse across the stupid disciplinary and institutional barriers that the contemporary academic and policy worlds like to throw up around us. Contributing Editor Joe Gabriel kicks of the series, bringing a History of Medicine perspective to the topic of “Culture, Medicine, and Society.” In the next few weeks, look for Michelle McClellan talking about “Hooked: Addiction and American Culture”; Sarah Carnahan on”Women and Addiction”; Rob Echeverria and Sid Issar on “Drug Hedonism”; and Bruce Bagley on “Drug Trafficking in the Americas.”
Totoro, Joe Gabriel's Favorite Avatar
I’ve been on faculty at the Florida State University College of Medicine for four years now, and while I primarily teach medical students I also occasionally have the opportunity to teach in the history department here at FSU. This is the syllabus to a graduate course I put together which I called “Culture, Medicine, and Society.” As you’ll see, the class is a broad overview of the history of medicine in the United States. A mix of graduate students from the history department and from the department of religion took the course, which provided for some very interesting conversations.
Much of the material we covered did not directly overlap with the topics we talk about on this blog. Some of it did – such as our discussions about the history of the pharmaceutical industry – but in general we didn’t spend a significant amount of time talking about drugs, and virtually none talking about alcohol. (The one class I had scheduled to talk about addiction we spent talking about Bruno Latour instead). However, I think the general approach of the course overlaps with some of the conversations we have been having here; one of the themes in the class, for example, is how to think about the relationship between brains, genes, microbes, and other parts of the “material world” and social and cultural “discourses,” such as those of race, gender, and nation. I’ll discuss some of the dynamics in the class around these issues, and how I think the class might be improved, in my next post. For the moment, here is the syllabus. I hope you enjoy it.
This weekend, the New York Times treated readers once again to the spectacle of opium addiction in Afghanistan, a country, according to the article’s title, “Trapped in a Narcotic Haze.”
Photo: Mauricio Lima for the New York Times
The article did note in passing that economic forces might have something to do with increased addiction, as men traveling in search of work encounter intravenous drug cultures not (yet) indigenous to Afghanistan. Aside from this nod to the country’s economic distress, the article was remarkably silent about the way that political economy– say, colonialism, decades of war and occupation, massive displacement of peoples, a ravaged infrastructure, etc.– might factor in to the question, focusing instead on the lurid details of “this particular circle of hell” and the inability of public health officials to get a handle on the growing problem.
A Big Book, but not THE Big Book
Okay, fine: it’s an article in the Sunday paper. I myself have said that while the political economy of addiction is a crucial part of understanding it, it’s the rare junkie indeed who gets clean by reading Hardt and Negri. (Points readers whose experiences differ, please do write me!) If you want a very concise discussion of why opium production is Afghanistan’s leading industry– including acknowledgement of the US government’s pivotal role in creating the situation– Pierre-Arnoud Chouvy provides it here, in China and Eurasian Forum Quarterly (2006). If you want a more careful and well-sourced discussion of the public health issue, you can get it from Catherine Todd, Naqibullah Safi, and Steffanie Strathdee in their matter of fact article on “Drug Use and Harm Reduction in Afghanistan” (2005).
But where should those of us interested in the history of recovery turn?
Good blogs are hard to find. Literally. One of the weird quirks of our marvelously interconnected age is how challenging it remains to locate good blogs in one’s field of interest. They’re out there, but existing methods of web searching aren’t particularly helpful in locating them. Sure, we can use basic search engines to find bits and pieces of language–“opium” “moral panic” “Quaalude”–but more often than not, there’s no efficient mechanism for finding tone, point of view, organization, or quality. Those are the things that matter, and it is in that spirit that this ongoing series takes a closer look at some blogs of interest.
The first of these is a sole-authored blog called Drugs, Law and Conflict. The blog’s author is Nina Catalano, currently of Harvard Law School. If you head over to the blog, you’ll notice that Drugs, Law and Conflict has been on hiatus for about a year. Nina reports that the blog may start back up again this fall. Even if it doesn’t, the archive of posts from September 2008 through August 2010 (and there are a lot of them) constitute a useful collection that retains a great deal of value.
1. Describe your book in terms your mother (or the average mother-in-the-street) could understand Smack is about two things: markets and the social environments in which people consumed heroin. New York City dominated a centralized national market from the 1920s until the 1970s because a handful of mostly Italian and Jewish illegal entrepreneurs controlled access to the European sources of heroin. Over time, new groups and new points of entry challenged New York’s supremacy, with African Americans, Cubans and Mexicans importing heroin from Southeast Asia, Latin America and Mexico through a variety of places. Ties to Latin America were particularly important, as increasingly large amounts of cocaine traveled along the same routes and set the stage for the emergence of crack cocaine as a new mass market product in the 1980s.
What did not change much was the location of retail marketplaces. Primary marketplaces located in poor African American and Latino communities, where unemployment was high and the underground economy, including drug selling, provided jobs in what was essentially the free market’s answer to deindustrialization. In addition, police sheltered some sellers while arresting others, thus waging an ostensible ‘war on drugs’ while taking advantage of opportunities for graft. The persistence of retail marketplaces in a neighborhood also encouraged the recruitment of the next generation of users and sellers as adolescents acquired the ‘drug knowledge’ needed to negotiate the market. As heroin use expanded, secondary heroin markets opened up in the suburbs closest to traditional heroin-using center cities. (Basically, venturesome users would make larger purchases in the primary marketplace and then return home and support their habits through sales to less-venturesome peers.)
Heroin consumption began among the socially and economically marginal, those most alienated from mainstream American life.
Henry David Thoreau’s (1817-1862) essay, “Wild Apples,” was published posthumously in the November, 1862 edition of The Atlantic Monthly. In it, Thoreau celebrated the history, beauty, fragrance, taste, and meanings of apples and apple trees – i.e., both regarding apples in general and wild apples in particular. His essay ended with a rueful lament suggesting that, owing to the rise of temperance and the grafted apple, the days of the wild apple were numbered.
William J. Rorabaugh’s The Alcoholic Republic (1979) told of two great transitions in the long history of U.S. alcohol consumption: namely, from hard cider to beer and from rum to whiskey. Of cider’s great popularity in the colonial and Early Republic periods, Rorabaugh wrote:
Ed. Note–This post originally appeared on August 1. We removed it briefly while pursuing an opportunity to speak with Rep. Bachmann about the questions posed below. Unfortunately, the Bachmann camp did not respond to our query. We welcome readers’ insights into the candidate’s stances on these issues and urge fellow bloggers and mainstream journalists to ask Bachmann about her approach to drug policy – and pain management praxis in particular – if given the chance.
Tucker Carlson: Trouble-Maker
Points has been investigating the regulation and increasing criminalization of opioid pain medications in the U.S. with posts like Siobhan Reynolds‘ on DEA meddling in pain management practices, Joe Spillane‘s on historical accounts of law enforcement interference in medicine, and Kenneth Tunnell‘s look at the first OxyContin scare. Conservative political news site the Daily Caller (run by formerly bow-tied pundit Tucker Carlson) alleged in late July that Republican presidential candidate Michele Bachmann takes “all sorts of pills” to deal with “incapacitating” migraines. Since narcotic pain relievers are one of several tools in many a migraineur’s survival kit (as well as that of at least one president), that story got us thinking about how the congresswoman’s experience with chronic pain might affect her approach to drug policy. The response to the allegations also illuminates the way in which media discourses work to reproduce normative representations of gender and power, even when media commentators attempt to upend those discourses.
The Points Interview returns today after a six-week holiday, with the fourteenth installment of the series featuring Howard Markel’s An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine. Just released by Pantheon, An Anatomy of Addiction has already received considerable notice, including this review in the Sunday New York Times andthis review in Salon.Markel is the wearer of many hats at the University of Michigan, including serving as the George E. Wantz Distinguished Professor of the History of Medicine, and we’re grateful to him for taking a moment to discuss his book.
1. Describe your book in terms your mother (or the average mother-in-the-street) could understand. An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine is the story of two medical giants who happened to abuse cocaine. Freud, of course, is the father of psychoanalysis, while Halsted, who is less well known to the general reader, was the father of modern surgery. Both experimented with cocaine to help others. Freud hoped it would cure a dear friend of morphine addiction, and Halsted believed cocaine was destined to be the world’s first truly effective local anesthetic. Both used themselves as guinea pigs, and were soon ‘hooked’. Through their shared addiction, Freud and Halsted are tragic figures, but the sum of their life achievements makes them heroes. Freud never used the drug intravenously, and very likely overcame his addiction just as he started developing the therapeutic process we know as psychoanalysis. Halsted wasn’t as lucky. He used cocaine and morphine intravenously for the rest of his life, and underwent the personality changes and alienations we now associate with the addiction process. His iron will to develop new and better surgical techniques, and to teach these to students at the Johns Hopkins University School of Medicine was strong enough to insure that he confined his addictive excesses to times away from the hospital.
