What to Read
“An Anatomy of Addiction”: Sigmund Freud, cokehead
How a "wonder drug" shaped the birth of psychoanalysis and modern surgery
Nicholas Meyer’s bestselling 1974 novel, “The Seven Percent Solution,” isn’t mentioned once in “An Anatomy of Addiction: Sigmund Freud, William Halsted and the Miracle Drug Cocaine” by Howard Markel, but any of Markel’s readers who have also read Meyer’s highly entertaining Sherlock Holmes pastiche will think of it often all the same. The novel “reveals” that Holmes’ “Great Hiatus” (the three years between his false death at Reichenbach Falls and his reappearance in “The Adventure of the Empty House”) was actually a period of recovery from cocaine addiction after his treatment by the great Viennese therapist Sigmund Freud. The founder of psychoanalysis brought exceptional insight to bear in providing this cure; he once abused cocaine himself.
Markel’s provocative book is a dual addiction biography of Freud and his contemporary, William Halsted, arguably the greatest surgeon of his time, a founding professor at Johns Hopkins Hospital and deviser of at least a half-dozen revolutionary surgical techniques and procedures still employed today, such as the use of rubber gloves. Both were unquestionably great men, but they also wrestled with dangerous drug habits that imperiled their work. Both sought to conceal or downplay their drug use and, as a result, information on that use and how, if at all, they managed to stop it is pretty sparse on the ground. If Meyer’s novel is the story of a doctor investigating the psyche of a great detective, then “An Anatomy of Addiction” is the work of a doctor — Markel is an M.D. and director for the Center of the History of Medicine at the University of Michigan — who plays detective to understand the secret lives of two medical giants.
Halsted and Freud never met, and came from very different backgrounds, but they were both ambitious and energetic young doctors in the 1880s, when cocaine was being celebrated as a new wonder drug whose full potential had yet to be explored. In Austria, Freud wrote a prominent paper touting the newly isolated alkaloid as a treatment for morphine and opium addiction. He tested it on a close friend who had become hooked on the morphine he used to manage a chronic injury.
What Freud missed, and what became the drug’s chief medical use for the next decade or so, was cocaine’s value as a local anesthetic. Halsted, an indefatigable and daring young surgeon (he successfully removed his own mother’s gall bladder on the family’s kitchen table at 2 a.m., with his untrained father and siblings attending), was as eager to explore its possibilities as he was to adopt the new antiseptic protocols advocated by Joseph Lister. Like many doctors of the time, including Freud, he tested the drug’s properties on himself, his colleagues and his students. “In a matter of weeks,” Markel writes, “Halsted and his immediate circle transformed from an elite cadre of doctors into active cocaine abusers.”
Halsted shot up; Freud snorted. Halsted was rich and well connected; Freud was close to broke and struggling to make a name for himself in a profession afflicted by expanding pockets of anti-Semitism. Freud by all accounts figured out how to give up the drug, while Halsted, Markel believes, would go on occasional binges throughout the rest of his distinguished life. At least twice, Halsted resorted to staying at a Rhode Island sanitarium to get clean. He also used morphine, probably daily. Behavior that many of his students and colleagues shrugged off as eccentricity — lateness, incommunicado periods, a refusal to look people in the eyes (and thereby reveal his dilated pupils) — were read by a handful of astute observers as signs that the drug use he’d supposedly abandoned before arriving at Hopkins was still going on.
Freud, on the other hand, seems to have entirely stopped using cocaine by the turn of the century. For the rest of his days he strove to downplay the effect it had on his life and work. Markel will have none of this, arguing that cocaine played a major role in Freud’s friendship with Wilhelm Fliess, a general practitioner who espoused the crackpot theory that many physical and emotional problems could be cured by intensive surgery to the nose (with liberal applications of cocaine). Freud recommended one of his own patients to Fliess, who proceeded to disfigure and nearly kill the young woman in a case of flagrant malpractice. Freud made excuses for him.
The Fliess affair seems less a case of cocaine-induced incompetence than an example of Freud’s propensity for stubbornly idealizing a particular friend to the point of delusion. Similarly, it took him far too long to admit he had understated the dangers of cocaine, even after he’d witnessed its eventual, disastrous effect on his morphine-addicted friend. All discussions of Freud are further complicated by the fact that the brilliance of his ideas and his writings was not mirrored in his therapeutic success rate. He was a major thinker, but an indifferent doctor. Far better to be his student than his patient.
For the most part, however, “An Anatomy of Addiction” is persuasive and engrossing. Markel is especially good at capturing the hierarchical, ultra-competitive, pressurized world of 19th-century medicine, with its revered masters and mentors presiding over students and young doctors desperately striving to make an impression and a reputation. Perceptively, he traces the birth of psychoanalysis to Freud’s use of himself as an experimental subject in documenting the effects of cocaine. For the first time, Freud “incorporates his own feelings, sensations and experiences into his scientific observations.”
Freud was always at his best when contemplating the subject of his own psyche. (His weaknesses, furthermore, often spring from a tendency to overgeneralize from it.) If his cocaine experiments nudged him in that direction, then perhaps we do owe some of the most influential ideas of the last century to the influence of Bolivian Marching Powder. More’s the pity, then, that pride or fear or something else kept Freud from recounting how he kicked the habit.
Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
“Tubes”: What the Internet is made of
If you think your data lives in the cloud and flies through the air, you're wrong
Andrew Blum The title of Andrew Blum’s “Tubes: A Journey to the Center of the Internet” is a ricocheting joke. When Alaskan Sen. Ted Stevens described the Internet as a “series of tubes” back in 2006, he was roundly mocked for not understanding the online world despite being chairman of the Commerce, Science and Transportation Committee and therefore instrumental in overseeing it. Stevens may not have known what he was talking about, Blum (a correspondent for Wired magazine) acknowledges, but he wasn’t wrong, either. In writing this account of “the Internet’s physical infrastructure,” Blum found that “one thing [the Internet] most certainly is, nearly everywhere, is, in fact, a series of tubes.”
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Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
“People Who Eat Darkness”: The disappearing blonde
A true crime story set in Tokyo illuminates the complicated truths behind media cliches
Joji Obara and Lucie Blackman (Credit: Estate of Lucie Jane Blackman) Lucie Blackman, 21, went out for the afternoon in 2000, phoning her roommate and best friend Louise to arrange a meeting later that night. Lucie never showed up, and within a few days she’d become one of those vanished blondes whose fates fuel headlines and hours of speculative media coverage. She was British, a former flight attendant, and she and Louise were living in Tokyo. They were also bar hostesses, a profession with a very specific meaning in Japan, difficult to explain to foreigners and not entirely clear to the Japanese themselves. Lucie both did and didn’t match the classic Missing Blonde profile, and for a while the mystery of what happened to her threatened to lapse into permanent obscurity.
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Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
“The Aleppo Codex”: The bizarre history of a precious book
A reporter traces the shadowy fate of the definitive version of the Hebrew Bible
Matti Friedman An ancient and priceless book, a murky history of evasions and coverups, an underground of sinister and possibly violent dealers, a former spy who drops tantalizing hints and a wily 84-year-old millionaire who says stuff like, “The problem with this story is that it could damage your health”: Are these the ingredients for a cheesy, improbable historical thriller? Yet “The Aleppo Codex,” Matti Friedman’s account of his attempts to learn the history of one of the world’s most precious books, sports all of these assets, and it’s nonfiction. If reporting this story damaged Friedman’s health, it probably happened when he realized what he’d stumbled into and his reporter’s heart started beating in doubletime.
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Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
“Bring Up the Bodies”: Hilary Mantel’s power play
The sequel to her Booker-winning "Wolf Hall" is a thrilling exploration of what it took to run Tudor England
“Bring Up the Bodies,” Hilary Mantel’s follow-up to her Man Booker Prize-winning 2009 novel, “Wolf Hall,” is a high-wire act, a feat of novelistic derring-do. Mantel makes bold not with form — by now meaningful experimentation in that area seems exhausted — but with the very material that brings most readers to novels in the first place: our imaginative identification with fictional characters and the experiences we feel we’re sharing with them.
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Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
“Words Like Loaded Pistols”: The not-so-lost art of rhetoric
A new book celebrates the power of persuasion, from ancient Greece to Barack Obama
Sam Leith (Credit: Alice Bowden) When people use the term “rhetoric” these days, they usually mean empty language — be it high-flown or spoken in high dudgeon. A few may think of rhetoric as a deadly classical discipline devoted to the exhaustive parsing and labeling of figures of speech: zeugma, anyone? Yet as Sam Leith points out in his delightful and illuminating “Words Like Loaded Pistols: Rhetoric from Aristotle to Obama,” we live in the most rhetorical era in human history, surrounded by and embroiled in argument, enticement, invective and panegyric wherever we turn.
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Laura Miller is a senior writer for Salon. She is the author of "The Magician's Book: A Skeptic's Adventures in Narnia" and has a Web site, magiciansbook.com. More Laura Miller.
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