The Word as Scalpel: A History of Medical Sociology

The Word as Scalpel: A History of Medical Sociology

The Word as Scalpel: A History of Medical Sociology

The Word as Scalpel: A History of Medical Sociology


Medical Sociology is now an established subdiscipline in both medicine and sociology. This book traces the intellectual and institutional evolution of the field in relation to antecendents of the past 2000 years and developments in American sociology and medicine since the turn of the century. Drawing on his own experience as a participant and witness, Bloom provides an engaging account of the ongoing search for knowledge about the relationship between illness, medicine, and society.


“Medicine has many faces. Whatever your interests and talents are, there is a place for you to express them in this profession. ” These words have always stayed with me, even though they were spoken almost fifty years ago on a September day in a large auditorium at the University of Pennsylvania School of Medicine. The speaker was the dean, Dr. John Mck. Mitchell, addressing the freshman class on its first official day. I was there as an observer, part of a team of research sociologists from Columbia University, just embarking on a study of medical education. Little did I realize that Dr. Mitchell's words would apply to me as well as to the neophyte medical recruits. Within a few years, I was to become a faculty member of a medical school, embarked on a career that was just being identified with a name, “medical sociology. ”

At the time, I thought Dr. Mitchell was reminding his students that the boundaries of medical subjects included much diversity, but still within the limits of biological science. Even public health and psychiatry, though different from the mainstream, were still traditional “medical” specialties. I was wrong, of course; Dr. Mitchell, a pediatrician himself, was saying what the famous medical historian Henry Sigerist had said in a different way a few years earlier: “There is one lesson that can be derived from history. It is this: that the physician's position in society is never determined by the physician himself but by the society he is serving. ”

We were, Dr. Mitchell and I, captives of the spirit of the years immediately following the Second World War. Part of the fallout of that terrible event, with its ghastly statistics of human destruction, was that it brought into question our understanding of human behavior. Never had human reasoning, in the form of science, advanced so far, but, at the same time, never had the capacity for human destruction reached such depths. In medicine, the profession assigned to be the arbiter of both health and illness, the reaction was to seek redemption through the application of the scientific method to human behavior. “Without an adequate understanding of the human habitat, and of the characteristics of human organism and environment, ” Norman Cameron wrote in 1952, “the medical student cannot be competently prepared for the role he has chosen—that of the physician in modern American society. ”

Because of farsighted medical educators like Cameron, courses in behavioral science emerged, usually in the curricula of either psychiatry or preventive med-

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