The Limits of Medicine: Better Than an Ice Cream Parlor

By: Mandy Stephan

Golub, Edward S. The Limits of Medicine. Chicago: The University of Chicago Press, 1997. 226 pp. Paper, $11.95. IBSN 0-226-30207-5

You walk into the ice cream store, preferably Baskin Robbins because after all they have thirty-one flavors. You're interested in getting a scoop of chocolate ice cream. When you see that in addition to plain old chocolate ice cream, there is chocolate with peanut butter, rocky road, chocolate brownie, German chocolate, and chocolate mouse. Plus there are probably a handful of other chocolate flavors that you missed. It is simply marvelous, all the choices, all of the chocolates, and all of the other flavors you didn't think you'd be interested in. Butter pecan, cookies-n-cream, and bubble gum all catch your attention. You have gone into Baskin Robbins for a scoop of chocolate, but you are leaving with a huge three scoop Sunday with hot fudge, nuts, and a cherry on top.

Why do I bring up my once-a-week habit at the local ice cream shop? This experience for me, an ice cream lover, is also the type of experience a reader has when they pick up Edward Golub's The Limits of Medicine, and they are passionate about science. I am lucky enough to be passionate about ice cream and science.

The reason I used the ice cream analogy earlier is to describe exactly what the reading experience is like when you pick up this book. I first read the title and thought, 'hmm, a book about medicine.' But as I devoured each page, I realized I was in the middle of the science equivalent to Baskin Robbins. There are so many flavors in this book, biology, chemistry, genealogy, immunology, and of course…medicine.

Golub attempts to write this book with more in mind than giving the reader two-hundred pages full of science related facts and history. He addresses the reader before jumping into the text, discussing exactly why he has written this book. I have pinpointed three reasons that he describes. First, he wants to inform readers of where we are coming from. In other words, what our past was like in terms of science and health issues. Another reason he claims is to caution the readers. He states early on, "I think that part of out problem is that we have allowed "experts" to make decisions for us because we think that problems are too complex and difficult to solve by ourselves" (xiii). Golub cautions the reader to get them into the mindset of being an active, intregal part of the healthcare system. A repeated theme in this book is that society is just going along with what the experts say because of credentials that are added to the end of the expert's name or written on a plaque hung in the office. Golub claims:

My main goal is to give the reader the context in which to understand the changes that are going on in the world of science and medicine today, which are usually received in a passive way because we think we are being swept along in the flow of history. We aren't (xiii).

He wants his readers to comprehend that the extreme changes that have been made in medicine and the awesome discoveries we have made in science are relatively recent occurrences. For many years, actually centuries, healthcare and medicine seemed to be in a state of unchangedness. In fact, the book points out that it was less than two hundred years ago that society believed that there were divine causes for disease and God was sending forth punishments to his people through sickness and plagues. Golub wants to impress upon his reader that there is room for more changes and advances. The cures and techniques that we have today for treating the sick, may drastically change in our lifetime, we therefore, should not "get swept along in the flow of history."

So, I have outlined three main intentions for the Limits of Medicine. One: to give the reader a history of the evolution of medicine. Two: to encourage critical thinking of our own and not to full heartedly except everything that the so called experts tell us. Three: to have an appreciation for how new our technology really is. Within these goals, Golub certainly bombards us with plenty of information: timelines, facts, and history of our past to show the extreme changes that have come about in such a relatively short amount of time. It is as though he has made our jobs easy. By 'our,' I mean the scientifically minded, and by 'easy,' I mean that he has compiled so much history into two hundred pages that he has done all the research for us. As readers, we can curl up on the sofa with a dish of ice cream and The Limits of Medicine, and not have to get up to retrieve an encyclopedia off the shelf or go to the computer to browse the Internet for background information. Golub has done the dirty work, it is all here for us to devour and digest.

In regards to his first intention, to give the reader a history of the evolution of medicine, Golub has succeeded with flying colors! At no point did I think to myself, well he should have told us more about the polio vaccine, or he was insufficient with his explanation of religion's role in health care. As far as this book's informative features, the book gets an A+ with "splendid" written on top.

Next we go to Golub's encouragement to the reader for more critical thinking. I do not feel that this was as successful as he would have liked. But then in his defense, the successfulness of this goal does not rest solely in his hands. Each individual who tackles this book has the power to analyze what Golub says and then apply it to his or her own lives. An example that I have has to do with my visit to the dentist. For my annual check ups at the dentist I usually go with the attitude that I will sit there, relax as best I can, and focus on something else, usually a magazine. I let the hygienist and dentist alone to tinker around in my mouth. This Spring, while I was somewhere in the middle chapters of this book, I awoke one morning and realized that a chunk of one of my back molars had broken off. So off to the dentist I went. This time, however, I did not just sit idly by as the dentist poked and prodded. She told me that I would need a crown. My first response was, why? The next thought I had was, do I really need this crown or is my dentist out to make a few extra bucks? I can honestly attribute this new inquisitive role as a patient to Golub's criticism of society's passivity in healthcare. I used to be in the habit of trusting my healthcare providers without question. After all, they are the ones with a higher education and a piece of paper on the wall backing up their professionalism.

I think Golub would be happy to know that the criticisms in his book had an influence on at least one of his readers. Though the bulk of his writing is telling writing about history, there is an agenda that he expresses whenever he talks about society's expectations from medicine.

Lastly, Golub's attempt to instill an appreciation for the newness of healthcare and medicine is another success. Though one of his methods for doing this is giving his reader a thorough historical background, he succeeds with his commentary on how new all of these advances really are in the whole scheme of things. By describing the evolution of the germ theory, sanitation, and all of the advances in society involving immunizations, he gives us a good indication of the timeline of important medical breakthroughs and events. All of these advancements take place within the past couple hundred years. He also goes into modern research that deals with genes and the field of medicine, like the research being done with the Human Genome Project. This research helps convey the idea that there is still a lot of discoveries to be made and more ground to be covered in terms of the conditions we have in society at this very moment.

Overall I would describe this book as excellent reading material for anyone who is interested in science, most specifically biology. Another type of reader that would be attracted to this book is the history-lover that likes to learn about the changes of social conditions over time. This is a exceedingly informative book. It tells about our past in a way that keeps interest. Though it is informative and historical, it does not read at all like a text book, something that I was afraid of.

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