AN ANATOMY OF ADDICTION

Medical historian Markel (Medicine/Univ. of Michigan; When Germs Travel, 2004, etc.) writes of a time when many Americans and Europeans enjoyed their daily rendezvous with cocaine.

Two of them were giants: Sigmund Freud and William Halsted, and no history of their fields—psychology and surgery—is complete without considering their contributions, for “each man changed the world.” They were also both cocaine addicts for part of their lives, and Markel investigates how that condition may have impinged on their work. The author is a convivial writer, but careful with his data; he musters his facts, then deals them out with a pleasurable flourish. He situates both the rise and fall of cocaine in the medical world, and that world writ large during the late 19th century, as well as broadly exploring each man’s significance to medicine. Markel ably covers cocaine’s effects as it made its way into the surgery—it was the anesthesiologist’s godsend—as well as Freud and Halsted’s bloodstreams. Reports of its revivifying powers had been floating out of South America since the early 19th century, and the substance gradually came into everyday use. Markel is particularly good with the social history of the drug: how it was laced into wine and Coca-Cola (as a response to the outlawing of liquor in Georgia), and the same-as-it-ever-was shenanigans of Big Pharma. Freud and Halsted, however, are cautionary tales as self-experimenters: Cocaine’s progress played upon their insecurities and vanities, exacted physical and emotional tolls and disrupted their personal lives, not to mention that “their most fallow professional years coincided with their most prodigious substance abuse.” From wonder drug to the monkey on their back, Markel testifies that cocaine did neither Freud nor Halsted any favors.