Medicine for Beginners, 2nd edition

Where to buy:

In the UK is: https://www.amazon.co.uk/dp/B0CVHLLTYL

In the US: https://www.amazon.com/dp/B0CVHLLTYL

In Canada: https://www.amazon.ca/dp/B0CVHLLTYL

Also available in these countries:

Review

By J.T.H. Connor, Memorial University, St John’s, Newfoundland, Canada

First published in 1984 but out of print for decades, Medicine for Beginners is now again available in the form of a 40^th anniversary edition. Although it contains a new foreword and preface, the text and images are identical as before (but noting a correction on p. 20 regarding the number of theses Luther nailed to a church door that went from 10 to 95), so this book is more correctly identified bibliographically as a reprint and not a second edition. Similar to the original but now modified with vibrant colors is the cover design by Louise Fili that was inspired by the René Magritte painting “Son of Man” (1964) with the iconic bowler-hatted man now suitably “medicalized” with a stethoscope draped around his neck, along with a drug capsule replacing the apple. (On p.78 there is a more direct visual refence to the Magritte work.)

To avoid any confusion, readers need to know that Medicine for Beginners is not a do-it-yourself or self-help book on medical care; rather, it is an illustrated romp through the last couple millennia of medical history from a distinct critical, leftist if not Marxist, slant. Accordingly, organized (read Big Pharma/American Medical Association/corporatism) bioscientific medicine take a lot of hits. Occasionally, some criticisms are especially blunt and oversimplified, but then again over the years organized medicine has itself mounted some pretty spirited and wrongheaded disinformation programs and smear campaigns against its enemies. So, touché. Balancing criticism, however, is the book’s recognition of genuine medical triumphs and life-saving measures over the ages. Also constructive in tone is perhaps the main message of Medicine for Beginners that holistic/integrative/alternative therapies (e.g. homeopathy) ought to have much more to do with healthcare today than is currently the situation.

Full appreciation for Medicine for Beginners must start with its publication history and context. The first edition of this book was No. 23 in a series with titles such as Marx for Beginners (1976), Lenin for Beginners (1977), Darwin for Beginners (1982), and even Elvis for Beginners (1986) that were produced in the UK by the Writers and Readers Publishing Cooperative in London, UK. Founded in 1974 by Glenn Thompson (1940-2001) who was born in Harlem, NY but moved to London, UK in the late 1960s, and who was described in his Guardian obituary as a “pioneering black publisher [who] saw books as a window for opening the minds of the oppressed” (https://www.theguardian.com/news/2001/sep/12/guardianobituaries1). His publishing cooperative would disintegrate due to internal wrangling, but later was reinvented in the early 2000s as For Beginners LLC located in Danbury, CT, which re-released many original titles, along with new books in its “series of documentary comic books on complex topics” (https://www.forbeginnersbooks.com/). The professional backgrounds of joint creators of Medicine for Beginners are also noteworthy. Richard Clark, the author and now publisher of this new edition, is British and trained as an acupuncturist and holds English medical qualifications; he has been an advocate and activist supporting integrative medical practice.

Tony Pinchuck is a South African artist and illustrator who has penchant for “quirky images” (https://www.tonyp.art/). In the 1980s he was living in London; so, teamed up with Clark to produce a book whose textual bark was equally matched by the bite of its graphics. Medicine for Beginners owes a lot to its graphic presentation resulting in a clever, smart, and sophisticated book. Relying heavily on the methods of montage and collage involving historical images, real medical/pharmaceutical ads, and original drawings, the book’s satirical and humorous tone is unmistakable. On the one hand, this style and approach reminded me of the creative work of the American-born British artist Terry Gilliam and his contributions to the Monty Python enterprise—and I mean that as a compliment. On the other hand, I also think the style and goals of agitprop equally apply here. This neologism dates to the early days of Communist Russia when printed posters and like communications were employed with a combination of agitation and propaganda to educate and mobilize the populace into action. I don’t think this link is a stretch given the radical message of the book. One drawback however in comparison to the 1984 work, is the somewhat washed-out appearance of some of the images, because the first edition’s photostats were no longer available. Originally, the black and white illustrations were high-contrast with the dark being really dense but now many of them are more greyish and faded looking. Not a problem but unfortunate as they don’t pop off the page in the same way.

Three approximately equal sections comprise the book. The first, “Roots,” covers the evolution of Western medicine from Classical Greece to the later nineteenth century, with the occasional nod to contributions from ancient middle eastern cultures: Hippocrates, Vesalius, Descartes, Harvey, and the master minds of germ theory (Pasteur and Lister) all take a bow. This section also is skewed a bit to the larger theme of the book (namely, holistic medicine) by giving a lot of air time to both the sixteenth-century physician known as Paracelsus and to the German physician Samuel Hahnemann (1755-1843), who together espoused the tenets of homeopathic medicine. The section following, “The Doctators,” is where the book really starts to bare its teeth with its recounting of the rise of professionalized medicine in both the US and the UK. Both the American Medical Association and the British Medical Association don’t come off too well as they battled various forms of “socialized” medicine in the earlier parts of the twentieth century. The alliance of science, industry, and capitalism with organized medicine also gets walloped. In particular, in the US the drive by medical schools to limit if not outright bar minority groups (women and people of color) from entry to their institutions in return to be eligible for large philanthropic grants from foundations grounded in massive corporate profits.

Pages 28 – 29, Medicine for Beginners, Second Edition

The final section, “Medicine: The Unsocial Face,” displays the most polemically political aspects of the book. Opening with a graph derived from the famous 1970s research of the Canadian-British physician and epidemiologist Thomas McKeown which posits that over the last couple of centuries the medical profession and its efforts had less to do with increasing health and the decline of infectious diseases than did the rise of better nutrition, improved working conditions, and a general increase in the standard of living and sanitation. Also discussed are the indiscriminate prescribing of antibiotics over the decades that lead to massive bacterial resistance rendering these agents almost useless, along with the medical peddling of antidepressants (and today one could add painkilling opioids to that, such as oxycontin) leading to dependence on them which gave rise to the notion of iatrogenic disease—illnesses actual caused by doctors. In addition to these topics, section three deals with malnutrition in developing countries, death and disease due to bad occupational working condition of, for example, coal and other miners, and the fact that wealthy segments of the population have overwhelming better access to health facilities than the less well off. The paternal if not implicit misogyny of the medical profession is highlighted, along with its feminist backlash.

But is there anything that is constructive and positive in this critique of medicine? And after 40 years does the book have any meaningful relevance today? In my opinion the answer to both question is a qualified “yes.”  The book’s main message about the healthful role of holistic medicine is salutatory because the

increase of [medical] specialization has led us to lose sight of the context of illness in people and in society. A sick person is mainly concerned with his suffering and what it means to his life…. The holistic approach takes feelings and relationships into account. By respecting each patient as a whole person in a unique set of relationships to the social and physical world, it tries to them work creatively towards positive health. (p. 161)

I have no antipathy regarding such sentiments, but as an historian of medicine I would inform readers that this message is not new for in 1939 the American physician G. Canby Robinson published The Patient as Person: A Study of the Social Aspects of Illness, a book with a similar take-home message. This in no way vitiates Clark and Pinchuck’s goal, but it does underscore that pursuing their aim can be an uphill but still relevant and worthwhile battle.

In many respects, Medicine for Beginners was and remains a unique work owing to its creative design, along with the critical tone of its overarching narrative. In a pinch it could sit on a bookshelf beside Richard Gordon, The Alarming History of Medicine (London: Mandarin Paperbacks, 1993), but that book while humorously critical of medicine is antagonistic toward holistic healthcare practices. Maybe beside Gael Jennings and Roland Harvey, Bloody Moments: Highlights from the Astonishing History of Medicine (Toronto: Annick Press, 2000), which contains many irreverent comical illustrations but is ultimately directed toward a juvenile readership.  Possibly, Jean-Noel Fabiani and Philippe Bercovicci, Medicine: A Graphic History (London: SelfMadeHero, 2020), although the book’s triumphalist tone is at odds with the work reviewed here. On my personal library bookshelf the 40^th anniversary edition of Medicine for Beginners is currently nestled nicely beside my copy of the original 1984 edition which I have owned for decades, and which author/publisher Richard Clark informs us was a  “sellout success.” Maybe history will repeat itself.

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J.T.H. Connor is John Clinch Professor of Medical Humanities and History of Medicine, Faculty of Medicine, and is also cross-appointed as a Professor of History, Faculty of Humanities and Social Sciences, Memorial University. He has published widely on science, medicine, and technology in the Victorian era and in twentieth-century North America.