David Healy (1)Critiques

La medicina oggi è solo marketing. E ci peggiora la vita. Sarà poi vero? Leggiamo questo libro.

Clearly written and never too dry. This does a great service to the subject as a history, and also to Healy's other subject, which is the brave new world we're entering via expansions of the DSM that pathologize human variation, as well as diagnosis by proxy, and drug trials that leave a lot to the imagination.
Fun fact for painters: Carbamazepine was one of a series of tricyclic molecules stemming from the iminodibenzyl dye, summer blue.
Chilling words: "Adolescence has been easy to deal with because until fairly recently it was all but standard to view adolescence as a time of semipsychosis, when suicidal ideation or erratic behaviour was common. But this period of turmoil was also seen as a necessary development phase that often laid the basis of later creative genius or other accomplishments. It is not clear what we might lose if marketing departments capture our views of adolescence."
If there's a Joyce among us, we're going to drug him.

Masterful!

An indictment of the pharmaceutical industry citing both historical and contemporary examples that also takes a broad look at the medical/industrial/academic complex. Includes suggestions for possible reform.

An indictment of the pharmaceutical industry citing both historical and contemporary examples that also takes a broad look at the medical/industrial/academic complex. Includes suggestions for possible reform.

The idea of outlining the history of "drugs, insanity, and society" and demonstrating "how changes in the relationship between them cause changes in the way we experience our selves" is daunting to say the least. (1) These are the questions and issues David Healy valiantly attempts to address in his 2002 book, The Creation of Psychopharmacology. Despite having shed substantial light on the topic, he falls short of his goals.
The tale Healy tries to tell spans more than a dozen decades and several continents. It draws from science, medicine, and industry and deals with issues of society, culture, gender, and class. Undertaking such a far-reaching project demands impressive research skills in a broad variety of disciplines, which Healy undoubtedly possesses. Presenting the results of such a project demands even more impressive organization and communication skills, which Healy may well possess, but which are sadly not demonstrated here.
This poor presentation and lack of organization often make it difficult to absorb the undeniably impressive amount of information the book has to offer. In particular, the time line is often unclear. There are certainly valid reasons for not employing a strictly chronological approach when recounting a complex series of events, but a non-chronological approach does impose particular demands for clarity on the author. It is far too easy for even a careful reader of Healy's book to be uncertain of when a particular event occurred and, more importantly, how it fit into the bigger picture. It is also easy to loose track of the extensive cast of characters. The names of countless chemists, researchers, doctors, therapists, and theorists dot the pages, and it is often difficult to distinguish the bit player from the major one.
Healy also has difficulty striking a balance between providing his readers with a complete account of a complex subject and overwhelming them with scientific detail. Talk of how someone "hung the side chain of chlorpromazine onto a nucleus similar to the phenothiazine nucleus, the imminobidenzyl nucleus (derived from the dye summer blue), and produced the drug imipramine" or of attempts to "improve on pethidine's analgesic effect and speed of action by removing a methyl group from it to make it more fat soluble (lipophilic)" are a bit much for a general audience. (227, 118) The science matters, and it undoubtedly has a place in the account, but Healy's treatment of it is more off-putting than informative.
It is clear that Healy is trying very hard to tell an interesting story, one that is quite relevant to society today. However, his organizational problems and his tendency to provide detail without context make it difficult to notice the most important things he has to offer. They are lost in the background noise instead of commanding the attention they deserve.
In "Mind-Body Problems," the 1999 presidential address to the Spring Meeting of the American Ethnological Society, Emily Martin also considers the interaction between science and society. Although much smaller in scope, Martin's work shares several themes with Healy's, especially the idea that changes in scientific knowledge and changes in how people conceive of themselves are closely related.
Martin chooses to explore this relationship by examining a conflict between "neuroreductive cognitive sciences" (the idea that all kinds of learning are dependent on things happening in the brain, rather than in the culture) and anthropology. (574) She begins by clearly and succinctly laying out the relevant aspects of neuroscience, then outlines the criticisms of neuroreductionism that fit a more anthropological approach. With this background firmly in place, she turns to a search for events in the recent past that could "[incite] a turn to a neuronal account of human consciousness, an account that...erases social context." (577) She sees the reversal of the "gendered associations with the realm of entrepreneurial capitalism" as a prime candidate. (578)
This notion may seem shocking at first, but Martin supports it in a logical fashion. She first shows that he 20th century capitalist ideal was linked with many masculine traits, then establishes that manic states were associated with women, then shows a recent tendency to associate mania with the economy (a 'feminine' trait with a 'masculine' field). She proposes that this is a shocking enough transition that it demands new ideas of the self in which individuals take precedence over societies, a view that neuroreductionism supports by seeing society and culture as results of inherent brain function. The article certainly does not establish this idea beyond any possibility of doubt. It does, however, propose a theory, provide appropriate background, and provide relevant support - all in an orderly fashion without bogging down in extraneous detail.
Both works deal with the complicated relationship between science and society. Both have intriguing insights and information to offer. Healy covers an immense amount of material, but because of poor organization and an over emphasis on minutiae, it is difficult to absorb the most important aspects of his story. Martin's theory, although probably not as strong or as important as Healy's, is clearly presented and very accessible and so more readily understood than Healy's. These pieces serve as perfect examples of just how important presentation is.

My review in the Bulletin of the History of Medicine (subscription required).
http://muse.jhu.edu/journals/bulletin_of_the_history_of_medicine/v079/79.2ballen...½