Fascinating but flawed book explores how sickness shapes our lives

The big shadow
Susan Wise Bauer, St. Martin’s Press

It may be perverse to say it, but this is the perfect time to publish a book on the history of the disease. We are currently going through a particularly harsh winter in the northern hemisphere. And, of course, we all remember the even worse winter of 2020-21, when we closed our doors against the covid-19 pandemic. The fragility of our body is, as they say, a major concern.

So here is The Big Shadow: A story about how illness shapes what we do, think, believe and buy by Susan Wise Bauer, a millennia-old account of the effect of illness on individual lives and on collective beliefs and actions. Everything from the idea of ​​guilt to the contents of your shopping cart has been affected by the organisms that make us feel bad.

The problem is that other people had the same good idea. Since the pandemic, we have had, among other things, the brilliant Pathogenesisand updated versions of A by Sean Martin Brief history of the disease and Frederick F. Cartwright and Michael Biddiss Disease and history. So what’s new here?

The answer is accent. Bauer focuses on the transition from what she calls the “Hippocratic universe” to our era of “germ theory.” The first is defined by an almost superstitious adherence to ideas that first appeared in ancient Greece – about humors, bodily fluids and internal harmony. The latter is more grounded in real science.

One thing the book shows in a surprising and saddening way is how long the change lasts. The medical consensus that microbes cause our diseases – which, in turn, helped advance vaccinations and cures – took centuries to emerge, only taking hold in the late Victorian era. The cost can be counted in millions and millions of premature deaths.

But have we completely left Hippocratic medicine aside? In addition to a historical account, The big shadow is also a kind of argument. Each chapter enriches the chronology – through urbanization, the Black Death, the trenches of the First World War – before linking everything to the present. Too often, Bauer says, our modern attitudes toward illness retain vestiges of the past.

At best, this is an unenlightening form of inquiry: does it surprise you that the anti-vaccine activists of the 19th century were much like the Trumpian anti-vaccines? At worst, it’s just plain confusing. Take the risky passage early in the book in which Bauer admits that she didn’t get checked for a few years after the COVID-19 pandemic because she “didn’t want to be lectured” about her 8-kilogram gain. Apparently, this conference was that of his doctor “operating outside [a] A Hippocratic understanding of what disease is” – rather than, say, an informed judgment about the health consequences of weight.

Yet if you persevere, there is light The big shadow. Despite a tendency toward overwhelm (“This sky is the residence of mystery, a mirror of the unknowable”), Bauer knows how to weave stories from archival sources. His chapter on germ theory pioneers like Alexander Gordon and Ignaz Semmelweis, rejected by the medical establishment and, in fact, driven to disease by their efforts, deserves to become a Netflix miniseries.

Then there is the last point of the book, the most memorable. We moved from superstition to science, but something else followed. Our era, nicknamed by academics the Third Epidemiological Transition, is, says Bauer, “marked not only by the failure of [antibiotics] and the emergence of entirely new diseases without vaccines or cures, but thanks to a global transportation system that makes… probable… that these diseases will spread rapidly throughout the world.”

Peter Hoskin is books and culture editor at Prospect magazine