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An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine [Deckle Edge] [Hardcover]

Howard Markel
4.5 out of 5 stars  See all reviews (22 customer reviews)

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Book Description

July 19, 2011

From acclaimed medical historian Howard Markel, author of When Germs Travel, the astonishing account of the years-long cocaine use of Sigmund Freud, young, ambitious neurologist, and William Halsted, the equally young, pathfinding surgeon. Markel writes of the physical and emotional damage caused by the then-heralded wonder drug, and how each man ultimately changed the world in spite of it—or because of it. One became the father of psychoanalysis; the other, of modern surgery.
 
Both men were practicing medicine at the same time in the 1880s: Freud at the Vienna General Hospital, Halsted at New York’s Bellevue Hospital. Markel writes that Freud began to experiment with cocaine as a way of studying its therapeutic uses—as an antidote for the overprescribed morphine, which had made addicts of so many, and as a treatment for depression.
 
Halsted, an acclaimed surgeon even then, was curious about cocaine’s effectiveness as an anesthetic and injected the drug into his arm to prove his theory. Neither Freud nor Halsted, nor their colleagues, had any idea of the drug’s potential to dominate and endanger their lives. Addiction as a bona fide medical diagnosis didn’t even exist in the elite medical circles they inhabited.
 
In An Anatomy of Addiction, Markel writes about the life and work of each man, showing how each came to know about cocaine; how Freud found that the drug cured his indigestion, dulled his aches, and relieved his depression. The author writes that Freud, after a few months of taking the magical drug, published a treatise on it, Über Coca, in which he described his “most gorgeous excitement.” The paper marked a major shift in Freud’s work: he turned from studying the anatomy of the brain to exploring the human psyche.
 
Halsted, one of the most revered of American surgeons, became the head of surgery at the newly built Johns Hopkins Hospital and then professor of surgery, the hospital’s most exalted position, committing himself repeatedly to Butler Hospital, an insane asylum, to withdraw from his out-of control cocaine use.
 
Halsted invented modern surgery as we know it today: devising new ways to safely invade the body in search of cures and pioneering modern surgical techniques that controlled bleeding and promoted healing. He insisted on thorough hand washing, on scrub-downs and whites for doctors and nurses, on sterility in the operating room—even inventing the surgical glove, which he designed and had the Goodyear Rubber Company make for him—accomplishing all of this as he struggled to conquer his unyielding desire for cocaine.
 
An Anatomy of Addiction tells the tragic and heroic story of each man, accidentally struck down in his prime by an insidious malady: tragic because of the time, relationships, and health cocaine forced each to squander; heroic in the intense battle each man waged to overcome his affliction as he conquered his own world with his visionary healing gifts. Here is the full story, long overlooked, told in its rich historical context.


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Editorial Reviews

Review

"An incredible book...an absolutely fascinating read".
--Ira Flatow, National Public Radio's Science Friday


"Markel brilliantly describes the paradox of [Halsted's and Freud's] lives".
--George Rousseau, NATURE


"A witty, wide-ranging book".
--Boston Globe


"Inspired, entertaining, and informative...[Howard Markel] tells this fascinating tale in an insightful contemporary book that is both intellectually engaging and exceptionally well written."
--Journal of the American Medical Association


“Markel creates rich portraits of men who shared, as he writes of Freud, a ‘particular constellation of bold risk taking, emotional scar tissue, and psychic turmoil.’” 
 —The New Yorker
 
“Terrific . . . This rich, engrossing book reminds us of the strangeness of even heroic destinies.”
 —Richard Rayner, Los Angeles Times


“[A] rich, revelatory new book . . . . [Markel is] a careful writer and a tireless researcher, and as a trained physician himself, Markel is able to pronounce on medical matters with firmness and authority.”
—Lev Grossman, TIME
 
“[An] incisive—and often damning—story of the “miracle drug cocaine.”. . . Elegantly subversive . . . . The author’s insights and analytical skills make An Anatomy of Addiction an irresistible cautionary tale”
—Deborah Blum, The Wall Street Journal
 
“A splendid history. . . [Markel is a] fluent, incisive and often subtly funny writer.”
—Michael Sragow, The Baltimore Sun

“Absorbing and thoroughly documented. . . a vivid narrative of two of the most remarkable of the many contributors to our understanding of human biology and function . . . A tour de force of scientific and social history, one that helps illuminate a unique period in the long story of medical discovery.”
 —Sherwin Nuland, on the cover of The New York Times Book Review 
 
“Provocative . . .  persuasive and engrossing.”
 —Laura Miller, Salon.com 

"Compelling and compassionate. . . a book that profoundly demonstrates the complexity and breadth of their genius. . . a richly woven analysis complete with anecdotes, historical research, photos and present-day knowledge about the character of the addictive personality."
Booklist

“Howard Markel eloquently tells the parallel stories of these two pathbreaking physicians and how their stories intersect in remarkable and sometimes tragic ways . . . Markel's extraordinary achievement combines first-rate history of medicine and outstanding cultural history.”
Publishers Weekly (starred)

“From the dramatic opening scene on the first page to the epilogue, An Anatomy of Addiction is a hugely satisfying read. Howard Markel is physician, historian and wonderful storyteller, and since his tale involves two of the most  compelling characters in medicine, I could not put it down—addictive is the word for this terrific book.”
—Abraham Verghese, author of Cutting for Stone

About the Author

Howard Markel, M.D., Ph.D., is the George E. Wantz Distinguished Professor of the History of Medicine and director of the Center for the History of Medicine at the University of Michigan. His books include Quarantine! and When Germs Travel. His articles have appeared in The New York Times, The Journal of the American Medical Association, and The New England Journal of Medicine, and he is a frequent contributor to National Public Radio. Markel is a member of the Institute of Medicine of the National Academy of Sciences and lives in Ann Arbor, Michigan.


Product Details

  • Hardcover: 352 pages
  • Publisher: Pantheon; 1 edition (July 19, 2011)
  • Language: English
  • ISBN-10: 0375423303
  • ISBN-13: 978-0375423307
  • Product Dimensions: 6.6 x 1.2 x 9.6 inches
  • Shipping Weight: 1.4 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (22 customer reviews)
  • Amazon Best Sellers Rank: #372,051 in Books (See Top 100 in Books)

More About the Author

Howard Markel, M.D., Ph.D., an award-winning and New York Times bestselling author, is the George E. Wantz Distinguished Professor of the History of Medicine and Director of the Center for the History of Medicine at the University of Michigan. He also holds professorial appointments in Psychiatry, Public Health, History, English Literature and Language, and Pediatrics and Communicable Diseases. He was born in Detroit, Michigan on April 23, 1960 and grew up in Oak Park and Southfield, Michigan. Educated at the University of Michigan (A.B., 1982, summa cum laude; M.D., 1986, cum laude) and the Johns Hopkins University School of Medicine and Hospital (Intern, Resident and Fellow in General Pediatrics, 1986-1993 and Ph.D, in the History of Medicine, Science and Technology, 1994), he joined the University of Michigan faculty in 1993.

A critically acclaimed social and cultural historian of medicine, Dr. Markel is the author, co-author, or co-editor of ten books including the award winning Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892 (Johns Hopkins University Press, 1997; paperback, Johns Hopkins University Press, 1999) and When Germs Travel: Six Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed (Pantheon Books/Alfred A. Knopf, 2004; paperback Vintage/Random House, 2005). His most recent book, An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine (Pantheon Books/Alfred A. Knopf) was published in July, 2011 and was a New York Times Best Seller, a San Francisco Chronicle Best Seller, an ABA IndieBound Best Seller, and a New York Times Book Review "Editor's Choice".

From 2005 to 2006, Professor Markel served as a historical consultant on pandemic influenza preparedness planning for the United States Department of Defense. From 2006 to the present, he serves as the principal historical consultant on pandemic preparedness for the U.S. Centers for Disease Control and Prevention. From late April 2009 to February 2011, served as a member of the CDC Director's "Novel A/H1N1 Influenza Team B", a real-time think tank of experts charged with evaluating the federal government's influenza policies on a daily basis during the outbreak.

In collaboration with the U.S. Centers for Disease Control and Prevention, he is Editor-in Chief of The 1918-1919 American Influenza Pandemic: A Digital Encyclopedia and Archive, now in composition and production at the Center for the History of Medicine and the University of Michigan Scholarly Publications Office. Funded by grants and contracts from the National Endowment for the Humanities, the Robert Wood Johnson Foundation, and the CDC, the digital encyclopedia is due to go live in Fall of 2012. Working with the CDC and a team of historians at the Center for the History of Medicine, Professor Markel currently directs a research team of medical historians at work on documenting the social history of the 2009 H1N1 Influenza pandemic.

Dr. Markel is a contributing writer and columnist for The Journal of the American Medical Association. From 2010 to 2012, he appeared monthly on National Public Radio's Talk of the Nation/Science Friday; his segment, "Science Diction," discussed the history, evolution and meaning of scientific words.

In addition, Dr. Markel has contributed over 350 articles to scholarly publications and popular periodicals, from The New England Journal of Medicine, Journal of the American Medical Association, American Journal of Public Health, and The Lancet to The New York Times, Harper's Magazine, The Atlantic, The Baltimore Evening Sun, The New Republic, International Herald Tribune, and The Wall Street Journal. He has appeared on numerous national radio and television news broadcasts and film documentaries about the history of medicine and public health for NPR (All Things Considered, Morning Edition, Talk of the Nation, Science Friday, Here and Now, Tell Me More, and Market Place), ABC's Good Morning America and World News Tonight, PBS (Nova, Frontline, NewsHour), BBC The World, CNN, MSNBC, and the History Channel.

Professor Markel's work has been recognized with numerous grants, honors and awards. In 1996, he received the James A. Shannon Director's Award of the National Institutes of Health and the Burroughs-Wellcome Trust 40th Anniversary History of Medicine Award. In 1998, he was named a Centennial Historian of the City of New York and was an inaugural fellow at the Center for Scholars and Writers of the New York Public Library from 1999-2000; in 2003 he received the Arthur Viseltear Award from the American Public Health Association. In 2007, he received the Theodore Woodward Award from the American Clinical and Climatological Association and the Robert Wood Johnson Health Investigator's Health Policy Award. In 2008, in recognition of his scholarly accomplishments, Dr. Markel was elected as a Member of the Institute of Medicine of the National Academy of Sciences.





Customer Reviews

4.5 out of 5 stars
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This is an informative book I thoroughly enjoyed and highly recommend. Spudman  |  5 reviewers made a similar statement
Staff called upon Halsted, their best surgeon, but he had just taken a dose of cocaine. Loyd E. Eskildson  |  6 reviewers made a similar statement
In finishing this book, which was hard to put down, sent me searching for other books by this author. Joseph Klinger  |  5 reviewers made a similar statement
Most Helpful Customer Reviews
24 of 24 people found the following review helpful
5.0 out of 5 stars "Genius is not found in a bottle, pill, or potion." August 8, 2011
Format:Hardcover
In Howard Markel's "An Anatomy of Addiction," two renowned figures are attracted to "a miracle drug" that reduced appetite and the need for sleep, sharpened one's focus, relieved depression, and induced a feeling of euphoria. It also had anesthetic properties that could be useful for surgeons performing dental or ophthalmological procedures. Both Sigmund Freud, the pioneering psychoanalyst, and William Halsted, one of the greatest surgeons of his time, were fascinated by this drug and decided to try it out on themselves. As a result, both became addicted to cocaine.

Dr. Markel's command of his subject is impressive; his excellent source materials include letters, journal articles, and monographs. The author provides enlightening background information about medical practice in the nineteenth century, especially in the United States and Vienna. He vividly describes Bellevue Hospital in New York City, Johns Hopkins in Baltimore, and the Allgemeines Krankenhaus in Vienna, large complexes that were bursting at the seams with both affluent and indigent patients. Young physicians-in-training flocked to these institutions to learn from more experienced and skilled medical practitioners.

It is fascinating to learn how naďve people were concerning cocaine's short and long-term effects. The same could be said of opium, morphine, and laudanum, all of which were dispensed liberally to treat a host of complaints. No one understood the underlying nature of addiction. There were no "rehabs." If someone were unfortunate enough to become dependent on a drug, he or she would have a very difficult time breaking the habit. Freud and Halsted were particularly susceptible to this disease because of who they were.
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22 of 22 people found the following review helpful
5.0 out of 5 stars An Anatomy of Addiction by Howard Markel August 9, 2011
Format:Hardcover|Amazon Verified Purchase
In finishing this book, which was hard to put down, sent me searching for other books by this author. It is one of the best presentations that I have read, complete with excellent notes, and close to 100 pertinent illustraions, The scholarship of this Medical Historian is extraordinary.

While the focus is on two contemporay physcians, both trapped by the addictive powers of cocaine, Markel details enlightens us as to the ways of the era of modern medicine. Freud and Halsted (the premier surgeon-in-chief of the John Hopkins Hospital) belief that the super drug potentially capable of curing anything. It would bring them fame and fortune as a pharmaceutical. Sadly there personal trials brought them a debilitating curse. The study details the pathological dispersion of addiction in a manner that is very easily understood by a layman. Through-out the book is written to be understood, and the story line will captivate you. To readers,as myself, the author Markel may be addictive!
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19 of 22 people found the following review helpful
Format:Hardcover|Amazon Verified Purchase
Sigmund Freud's first major published paper, in July 1884, reported his praise of the "magical substance" of "Über Coca", which he had been studying and experimenting with personally. It also marked the beginning of a transition for Freud, in moving from controlled scientific observations within the laboratory environment, to including his own personal thoughts and experiences into his work. Was experimentation with cocaine an important factor in Freud's revolutionary work in psychology? The reader can reach his or her own conclusions, with this book providing a fascinating accounting of the journey that Freud made (he is said to have discontinued his use of cocaine by 1896, prior to the publishing of his most influential works).

William Halsted, a contemporary of Freud, was a Yale trained chief of surgery at John Hopkins Hospital who developed important surgical techniques while also dealing with his own addiction to cocaine. His efforts to control the addition also resulted in a profound self-control which contributed to his development of surgical techniques with significant theraputical benefits, including the introduction of germ-free operating rooms at Johns Hopkins Hospital. He is also created with first using the now mandatory rubber glove in surgery.

The story of these two scientific pioneers, and the role that cocaine played in their personal and professional lives, is fascinating. Also included are stories of famous advocates of the cocaine-enhanced wine "Vin Mariani", developed in the 1860's, who included Ulysses S. Grant, Jules Verne, and Thomas Edison, among many others.
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8 of 8 people found the following review helpful
5.0 out of 5 stars Insightful and Credible - September 11, 2011
Format:Hardcover
Both Sigmund Freud, father of psychoanalysis, and William Halsted, originator of modern surgery, practiced medicine in the 1880s and experimented on themselves and others with cocaine's possible therapeutic uses. Freud was interested in it as an antidote for morphine addiction and as treatment for addiction, Halsted saw it as a possible anesthetic. Freud found the drug cured his indigestion, dulled his aches, and relieved his depression. After taking the drug for a few months Freud shifted from his initial focus on neurology to psychology/psychiatry. Halsted became professor of surgery at Johns Hopkins Hospital and devised new and safer surgical techniques - while struggling with his addiction acquired experimenting.

'An Anatomy of Addiction' opens with a laborer being admitted to Bellevue Hospital with a serious compound fracture of the leg. Staff called upon Halsted, their best surgeon, but he had just taken a dose of cocaine. He took one look at the patient and went home to a seven-month cocaine oblivion. Meanwhile, in Europe Freud was using the drug to self-medicate his own anxieties. At the time almost 15% of prescriptions contained cocaine, there were no controlled substances, and addiction was not yet a medical diagnosis. Other users of the day included Ulysses Grant, Queen Victoria, the Shah of Peria, Thomas Edison, and Arthur Conan Doyle (also a physician).

Freud's career goals was to be appointed to a faculty position at the Vienna Medical School, and saw lab experimentation as his preferred means of getting it. His focus on cocaine was initially motivated by a desire to help a friend, Dr. Fleischl-Marxow, addicted to morphine because of the intense, chronic pain created by a non-healing amputation.
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Most Recent Customer Reviews
4.0 out of 5 stars Good read, but not a show stopper
I enjoyed reading the book and how some doctors practiced medicine during Freud's time. Some places kept me reading, but usually I had no difficulty setting it down. Read more
Published 12 days ago by ask_me
5.0 out of 5 stars Intriguing journey of addiction for two outstanding medical...
This book was well written and well researched. It's especially accurate in its use of terminology and explanation of
cocaine addiction such that a layperson can understand... Read more
Published 4 months ago by Kat
5.0 out of 5 stars Interesting
If you are a reader who enjoys non fiction this is the book to read. Filled with interesting facts it held my attention to the very end.
Published 4 months ago by Alyssa Gecsedi
4.0 out of 5 stars Book Review
An excellant read about a very interesting topic not covered elsewhere. A fascinating study of two giants in the world of medicine & how each dealt with his cocaine addictions.
Published 9 months ago by Bruce
4.0 out of 5 stars Veteran Users
While the author references literature on the subject, he omits discussion of the event that helped to power opiate use and addiction to levels likely unimagined previously. Read more
Published 10 months ago by Harvey C. Greisman
4.0 out of 5 stars So Glad I Did!
I bought this book after hearing a radio interview with Dr. Markel on a local community-based radio station here in Atlanta, and I am so glad that I did! Read more
Published 11 months ago by annalise fonza
4.0 out of 5 stars Engaging Style. Photos Add to the Story.
This is a study of the first medicinal uses of cocaine and the resulting addiction of two medical practitioners who went on to fame. Read more
Published 12 months ago by Loves the View
4.0 out of 5 stars Surprising
I appreciate knowing more intimate details of Freud's personality, history, and addiction. His addiction and denial certainly affected his theory of human personality dynamics. Read more
Published 15 months ago by ChristinaO
4.0 out of 5 stars Even the stars of the 1800s did cocaine
Great minds think alike and that was true for Freud and Halsted, two men who sought to use cocaine as a remedy but ended up addicted to the drug. Read more
Published 16 months ago by Kevin Scott Brown
5.0 out of 5 stars Interesting insights
This book rotates between the story of how cocaine use personally and professionally affected two historically significant medical doctors, each of whom trained in Vienna during... Read more
Published 17 months ago by Nanci
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