Lapham’s Quarterly Fall 2009: Medicine

[CATEGORIES: Literature, Lapham’s Quarterly, Reading, Book Review, Medicine]
[Click HERE to see my previous posts referencing Lapham’s Quarterly.]
[Some of LQ’s contents are available free.]
[L.Q. cover, art, and banner fro L.Q. Fall 2009: Medicine.]

Medicine.  Published Fall 2009 but current in that it spans over 2,000 years of thought on the subject.


It’s coincidental and appropriate that this issue was next in my L.Q. archival reading as I recently conducted an impromptu but extensive internal investigation of medical procedures, hospitals, and nursing care.  I quickly concluded that modern medicine is the best we’ve ever had (duh!) and it is very, very good.  I never would have made it even 75 or 100 years ago, let alone 500 or 1500 years ago.

L.Q. describes itself much better than I:

“Lapham’s Quarterly is a journal of literature and history, edited by Lewis Lapham. Four times a year we collect fiction, non-fiction, poems, and essays from over four thousand years of recorded time, all gathered around a single theme.”

The graphic this issue by Haisam Hussein depicts a brief history of malaria, smallpox, and leprosy and their global spread.


Lewis Lapham’s Preamble is titled The God In The Machine. Ever the insightful critic (see his list of books here or here) he rails against the monetization of healthcare, and who can blame him?

“…the voluminous additions to the body of medical knowledge have come at increasingly higher costs, which, in the 1970s, prompted the development of health maintenance organizations that placed the country’s medical profession in the hands of insurance companies. …Whether in the form of simple prescription or complicated surgery, treatment requires “pre-authorization” from a corporation seeking to lower its “medical-loss ratio” (i.e., to reduce the amount of money spent on the care of the patients) in order to improve the health of its profit margin and preserve the life of its stock price.”  (p. 17)

“Any system that construes medical care as profit-bearing merchandise is by definition dysfunctional.  The attempt to mark down the gifts of the human spirit to the measure of their weight in gold is an idiocy along the lines of the nineteenth-century attempt to cure tuberculosis by removing one lobe of an infected lung and filling the vacancy with ping-pong balls.”  (p. 19)

As always this issue is  7″ x 10″, printed and richly colored on very high quality paper, and EXACTLY 221 pages.  The three sections in the main body Voices In Time are:

Symptoms and Diagnoses (22 items)
Doctors and Patients (26)
Remedies and Treatments (25)

There are a generous 6 extended essays in the Further Remarks and Departments sections that close the issue.

Positron-emission transaxial tomograph, 1977. Photograph by Burt Glinn.
Positron-emission transaxial tomograph, 1977. Photograph by Burt Glinn.

The extracts in the main body are a mixture of factual and fictional accounts that jump around the last 2000+ years of recorded history.  All are of interest, some more than others.  Following are some of my favorites.

Jerome K. Jerome’s 1889 missive on hypochondria is amusing:

“It is a most extraordinary thing, but I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form.” (p. 36)

This is immediately followed by a serious description (1974) of psychiatry professor Kay Redfield Jamison’s own manic-depressive illness.  Along with writer Joan Didion’s superb look at her near-paralysis during migraine headaches I found these particularly noteworthy.

Virginia Woolf waxes eloquent On Being Ill in 1926 London:

“Considering how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, that precipices and lawns sprinkled with bright flowers a a little rise of temperature reveals…” (p. 53)

Susan Sontag is very insightful in her extract from Illness As Metaphor:

“Punitive notions of disease have a long history, and such notions are particularly active with cancer.  There is the “fight” or “crusade” agains cancer; cancer is the “killer disease: people who have cancer are “cancer victims.”  Ostensibly, the illness is the culprit.  But it is also the cancer patient who is made culpable.  Widely believed psychological theories of disease assign to the luckless ill the ultimate responsibility both for falling ill and for getting well.”  (p. 55)


The brief White-Man Giver (p. 57) is noteworthy on the intentional gift of smallpox to the Ottawa Indians.  Man’s inhumanity at its finest.

Broyard, Moliere, Elizabeth Blackwell, Sinclair Lewis, Freud.  (I annotated nearly all of Freud’s piece.  I wouldn’t know where to begin to quote.)  Pieces on Nazi science experiments and the Rwanda genocide, lest we forget.

Rudyard Kipling, 1908: “Of course it is a little unfortunate that Death, as the senior practitioner, is always bound to win in the long run…”  “…Every sane human being is agreed that this long-drawn fight for time which we call Life is one of the most important things in the world.”  (p. 127)

Mastectomy in 1811 Paris. (p. 138)

George Orwell on the impersonal treatment of poor hospital patients in 1929 Paris. (p. 140)

C.S. Lewis is particularly poignant on the loss of his life-long love.

“Meanwhile where is God?” …”Why is He so present a commander in our time of prosperity and so very absent a help in time of trouble?”  (p. 178)

Of the complete essays in the Further Remarks section I enjoyed the first two.  The first on the evolution of medicine, the second on Early Islamic Medicine.  The third, Dissection, on looking for a brain to pick, was ok, but the fourth I found very rambling. The fifth is a conversation about The Hippocratic Oath.  The final essay is a book review of The Magic Mountain by Thomas Mann.

“If my doctor told me I had only six minutes to live, I wouldn’t brood.  I’d type a little faster.” –Isaac Asimov, c. 1980 (p. 203)


Keep reading.  (This means YOU.)

P.S.  Don’t forget that the beautiful and newly formatted L.Q. website offers many portions of each issue for free.  (Free!  FREE!!  FREE!!!)  Those of you who want to ‘own knowledge’ might consider subscribing and buying back issues while they can still be obtained.

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