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willwork4airfare's review against another edition
4.0
I hate Freud so much and usually refuse to read anything about him, but this book piqued my interest and even had me feeling vaguely sympathetic for him. It helped that only one chapter really covered his psychoanalytic techniques or Interpretation of Dreams.
Written in a compelling, easy-to-read style with alternating chapters on Freud and Halstead. It was a quick and interesting read with lots of cool pictures (and several unnecessary and gratuitous ones). The author shares many primary source documents as evidence and excerpts from letters from Freud and Halstead themselves. The author didn’t come off as overly moral or condemning of cocaine, merely described its effects and the experiences of many addicts. Some tangents went too long and could use better editing, but overall, I really enjoyed this read.
Written in a compelling, easy-to-read style with alternating chapters on Freud and Halstead. It was a quick and interesting read with lots of cool pictures (and several unnecessary and gratuitous ones). The author shares many primary source documents as evidence and excerpts from letters from Freud and Halstead themselves. The author didn’t come off as overly moral or condemning of cocaine, merely described its effects and the experiences of many addicts. Some tangents went too long and could use better editing, but overall, I really enjoyed this read.
mark_lm's review
3.0
A good account of these stories. There are several things mentioned that I haven't seen elsewhere. For example, I always assumed that Halstead washed his hands in carbolic (phenol) like Lister did, but he used a series of baths of permanganate, oxalic acid and bichloride of mercury [!!!]. Markel says that they had their hands in mercuric chloride for five minutes. This seems unlikely to me. It's probably just me, but I don't see why the author sometimes refers to Dr. Halstead as Halstead and sometimes as William.
kurt_von_nugget's review against another edition
challenging
informative
reflective
medium-paced
5.0
socraticgadfly's review
5.0
Two medical pioneers -- including pioneers in the potential medical use of, and actual personal misuse of, cocaine. Howard Markel paints a cautionary tale of addiction that powerfully resonates a century and more later.
Many people know a bit about Sigmund Freud's history with cocaine, despite the best efforts of generations of Freudian acolytes and disciples to cover up just how much he used (or abused), how long he used it, and how much it affected his general work habits and his psychological theorizing.
Markel gets behind the story, not just with Freud, but a somewhat older near-contemporary, William Halsted. Halsted, less familiar to many, was essentially the father of modern American surgery, a pioneer in introducing the use of antiseptic techniques in surgery, introducing new operating techniques and more, mainly from his perch of director of surgery and one of the founding doctors at Johns Hopkins School of Medicine.
When I was a kid, I read a mini-biography of Halsted in a compendium of lives of great doctors, so I had heard about his "sea cruise" attempt to overcome his cocaine addiction. But, the story closed with what Markel notes was long the "official line" about Halsted: that he had no major problems, or problems at all, after that.
How wrong I was, Markel shows.
I had no idea he was "committed" to Butler Hospital, a "sanitarium." Nor that he was given morphine to "help" with cocaine withdrawal. Nor that he, as a result, apparently became a lifelong morphine addict. Nor that he apparently struggled to some degree with cocaine addiction for the rest of his life.
Markel, an M.D. and Ph.D. with addiction support help background, shows a clinician's skill in diagnosing how addiction affected Halsted's life, his work at Johns Hopkins, his relation to surgical interns and patients and more.
In parallel chapters, he also looks at how cocaine use affected Freud's personality, his own medical theorizing (including, in reverse of Halsted's time at Butler, the idea that cocaine could be used to treat morphine addiction), his psychological theorizing (including how "The Interpretation of Dreams" was likely largely affected by guilt trip over his participation in how a doctor friend and fellow cocaine touter, Wilhelm Fliess, medically mistreated one Emma Eckstein) and more.
Was Freud, like Halsted, an addict? Markel carefully uses the distinction between "abuse" of a drug and "addiction" to a drug to say that Freud was clearly a cocaine abuser, and may have crossed the addiction line, without us being able to know for sure.
A few lines from the epilogue show Markel's insight:
"When Freud and Halsted first became acquainted with their chemical bete noire, they fully expected cocaine to become the wonder drug of modern medicine. Neither had any idea of its potential to dominate and endanger their lives. Addiction as a bona fide medical diagnosis was not yet in the doctor's lexicon, let alone his textbooks. ...
"Each man actively participated in the birth of the modern addict, and their clinical histories prefigure the ever-challenging spectrum of substance abuse, addiction and recovery. Freud somehow escaped from his cocaine dependency even as he was plagued by periods of sexual turmoil, increased alcohol consumption, and depression. Decades after Halsted restricted his cocaine use to occasional binges, he still availed himself of daily morphine injections to quell his addictive urges, often with negative results."
Going beyond the parallel biographies, Markel then discusses issues of drug addiction in general, from how it was understood at the time of Halsted and Freud to how our understanding has evolved today. Without being harsh, he also notes his medical peers today are often like those of a century ago in still often offering biochemical help to addicts that turns out to promote a substitute addiction.
He then, behind that, notes the development of cocaine from a raw substance in coca leaves to its refinement into cocaine hydrochloride of snorting use both then and today, as well as other methods to use it. Besides Coca-Cola, which did, yes, originally have a bit of cocaine in it, though not much,there were cocaine-laced alcohol products, quite popular then. I had heard of them, but didn't know the details, including that alcohol actually combines with cocaine to produce an even more intoxicating compound, cocaethylene, in the liver. So, in addition to the "speed-ball" like effect Halsted had when he was using both morphine and cocaine, we already were having cross-addiction being promoted back then.
I definitely now want to read Markel's "Quarantine" about East European Jewish emigration to the U.S. and the diseases that came with this.
emmkayt's review
4.0
Compassionate and thought-provoking look at the development of cocaine and the rise of addiction through the prism of two early cocaine advocates, pioneering surgeon William Halsted and Sigmund Freud, both of whose lives were forever affected by their initially enthusiastic use. Interesting context for thinking about the ongoing development of addictive pharmaceuticals, the relationship between medicine and the pharma industry, etc. A bit of clunky writing here and there, tinges of the 'great man' theory of history, but overall was a great read.
rose_reads_books's review against another edition
4.0
This book was a wonderful starting point for my journey of reading non fiction. It got recommended to me a few years ago as a must read for future med students and I have to say I get it. The book is engaging and offers a nice insight into the lives behind the names one always hears thrown around.
I decided to read it as a follow up of The Trafikant, which is a great fiction book, in which the life of Freud is discussed. I loved reading about the peculiar stories and battles Halstead and Freud had to battle and see their way of dealing with them. Even though the topic isn’t one I’m interested in, the problem with medical Durgs can be applied to today’s modern practice, especially in light of the opium crisis.
For me this was a humanization and demystification of very distant and well know individuals, that also helped me understand the book I previously read.
I decided to read it as a follow up of The Trafikant, which is a great fiction book, in which the life of Freud is discussed. I loved reading about the peculiar stories and battles Halstead and Freud had to battle and see their way of dealing with them. Even though the topic isn’t one I’m interested in, the problem with medical Durgs can be applied to today’s modern practice, especially in light of the opium crisis.
For me this was a humanization and demystification of very distant and well know individuals, that also helped me understand the book I previously read.
abraresque's review
4.0
An easy and an engaging read. Although, now it makes sense why Freud was the way that he was; he was a coke addict. Who would’ve known.
jbogerhawkins's review against another edition
dark
informative
mysterious
reflective
sad
medium-paced
3.0
sarahjsnider's review
4.0
A little repetitive in the opening chapters, but the look at two influential minds struggling with addiction is worth it.