For Her Own Good: Two Centuries of the Experts’ Advice to Women – Barbara Ehrenreich and Deidre English (1978/2005)

Continuing with my ongoing goal of reading from my own TBR (ha!), I pulled down this title. I’ve read Ehrenreich NF before (such as Nickel and Dimed: On (Not) Getting by in America [pre-blog]) so I knew to expect a well-written and pretty thoroughly researched non-fiction read from her (and the co-author), but what I was really impressed about was the breadth (and depth) of this look of women’s health (and the accompanying [mostly male] advisers. 

So – what is this book about? It’s an almost academic survey of how the health of women (and thus women themselves) have been on the receiving end of very questionable “scientific” advice over the years, and since it was a large overview of a long period of time, it was interesting to see the general patterns of the authoritarian (mostly male) through the years. 

For example, it’s pretty well known that the Victorian woman was treated as though she was an infantile imbecile by the males (and some females) in her life, but it was amusing to see how the advice from the “scientific experts” evolved from this to the Edwardian woman (who was told that her whole life was to produce children but then hand them over to a nanny or similar) to the next generation of women who were advised to treat their children via the whole “children should be seen but not heard” paradigm, to another stage when the foci of the family was to please the child first and foremost… and so it continues.

I am hoping that the most recent trend of viewing children as “equal” in power to (or sometimes with more power than) the parents will end soon, as I am seeing the result of that in some of the college students in my classroom at times. 

(The Helicopter parent has now been replaced by the Lawnmower parent, it seems. Lawnmower parents do more than the hovering of the Helicopter parent: the Lawnmower group actually leap into their adult child’s life and mow down any obstacles for their kid. Thus, the analogy of the Lawnmower… Of course, I’m not asserting that every parent does this, but it is common enough to be a “thing” in higher ed.) 

The “expert advice” for women has also evolved in tandem with the evolution and maturation of science as a discipline, since according to Ehrenreich, almost every piece of advice has been painted with the color (and authority) of science, whether it was crud or not. People followed what these “experts” recommended, regardless of how wacky the advice was. (This also follows with the notion that women were also infantile and did not have the wherewithal to make their own health decisions.) 

(Thinking about it, it’s a horrifyingly interesting exercise to see how this is playing out right now in some of the states and their recent (anti-)abortion laws. Women are still being told how to control their bodies by large legislative bodies of ill-informed men. Plus ca change…)

So, anyway, I really enjoyed this provocative (in terms of “thought-creating”) read, and if you’re interested in medicine, in women’s issues, in medical history… you’d enjoy this title. 

(Note though that this book was originally written in 1978, but the text has been updated in pieces. The updating is a little patchy in places, but overall, it’s a really interesting read as both a piece of history and an overview of social issues.) 

Words new to me…

Parlous: full of danger, precarious. (Also, in the olden days, it would mean excessive…) 

Anatomization: the process of cutting something natural apart to learn about its internal structure et al. Example: medical students will dissect a body in the morgue to learn more about how how everything is connected in the human.

Velocipedes: An early form of bicycle that is propelled by working pedals on cranks fitted to the front axle. (See pic below.)

Camera lucida: optical device that allowed surgeons to trace images projected onto a piece of paper and then “practice” their cutting skills using that. 

Pultaceous: having a soft consistency; pulpy.

Ragged Schools: 19th century charity schools in England around 1840s. Provided free education, along with a home, food etc., for those students who were too poor to pay. 

Hectic fever: this is a type of fever that sustains itself during a 24-hour period. 

Pyemia: another name for blood-poisoning (septicemia) caused by spread in blood stream of pus-forming bacteria released from an abscess. 

Erysipelas: a skin infection caused by Strep (typically). 

Hospitalism: the adverse effects of a prolonged stay in hospital. (Also called anaclitic depression). Common pediatric diagnosis in1950s for infants required to stay in hospital for long periods of time and due to their mental health (from loneliness, lack of human touch etc.) would waste away. 

Carious: decayed. 

Animalcule: old name for a microscopic animal. (Latin for “little animal”.) 

De novo: starting from the beginning of something.

Cicatrix: the remaining scar of a now-healed wound.

Antiseptic:from “anti” and “septic ” so material to prevent further infection leading to sepsis. Obvious to me now, but honestly, I hadn’t put that together before reading this. Duh, I know. 

Aleatory: depending on the throw of a dice; chance; random. 

Flaneur: a person who handles the art of strolling or sauntering. 

(Mostly taken from the title, The Butchering Art by Lindsey Fitzharris (2017).)

A velocipede in action. (Note pedals are on front wheel.)

The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine – Lindsey Fitzharris (2017)

“The ascendancy of knowledge over ignorance, and diligence over negligence, defined the profession’s future…”

If you are interested in Victorian times, in medical history, in social history, in well-told narratives… have I got the book for you. The Butchering Art by Lindsey Fitzharris ticks all the boxes for me with regard to having a great read: dry sense of humor, loads of facts, about a time period that I’m very interested in, and medicine? Yes please. 

I think that it’s quite amazing how fast (and how far) medicine (especially surgery) has come from its roots in Victorian science. In close to 150 years, we’ve completely reshaped the goals and methods of surgery, along with significantly reducing the death rates associated with that. When you keep in mind just how grubby surgery was, it’s an astonishing leap forward. 

So, always curious about the history of medicine, I was trawling my TBR shelves (go me!) and stumbled upon this title. Shortlisted for the 2018 Wellcome Book Prize along with other notable accolades, it was a brilliant read and one of those “read at the right time” situations for me. I loved it. 

So, what’s the book about? It’s revolves around Joseph Lister (1827-1912), a surgeon who introduced new principles of cleanliness (along with the germ theory) which went on to transform surgical practice and reduce post-operative mortality (or “ward fever”) deaths by huge numbers. Or, as the book says, the shift in medical procedure from antisepsis (germ killing) to asepsis (germ-free practices). It’s quite the story. 

Fitzharris reports that during this period of time, surgery was traumatic and risky. No anesthesia was available, surgeons’ cleanliness habits were anything but, and this was a time when most physicians believed that pus from a surgical incision was a “good thing” instead of an ominous onset of sepsis. In fact, surgeons were known as having a particular odor when they were working: “good old hospital stink” which was really the smell of rotting flesh and blood from their time in the operating theater. Crikey.

It was actually safer to have an operation at your own home (instead of in hospital) – hospitals had mortality rates that were three to five times higher. Curiously, Death was known at the time as Old Jacky, and some patients were said to be able to predict who would recover and who would die during surgery. Odds were that the patient would die… 

In fact, hospitals were such filthy places that many of them had a person who was charged with going around to rid the patient mattresses of lice. In fact, this person was more highly paid than surgeons, so that demonstrates how important hospitals viewed this lice person. 

Despite being such places of high mortality rates, there were a lot of hospital expansions and excitement about new techniques for surgeons at this time. The latest official medical text, The Art of Surgery, was in its ninth edition and was such a respected resource that a copy of it was given to every single doctor in the federal army during the U.S. Civil War. 

The medical field was still ignoring germ theory though, and so public health was still pretty terrible, particularly for those who were in poverty. The world’s first flushing toilet came about during Albert’s Great Exhibition, and more 800,000 people paid a penny to test these facilities out for themselves during their visit. 

(Interestingly (for me – maybe not for you!), this is where the English saying, “going to spend a penny” (for needing to go to the lavatory) arose. I remember my grandma frequently using this euphemism when I was growing up, and it was because in my childhood (1960s/1970s), the lavatories at the local park would have a locking mechanism so anyone in need would have to put a coin (usually a big penny) into the slot before it opened. I can only imagine how many wet pants this tradition caused British schoolchildren as they didn’t have a penny to use.) 

London, packed with all these thousands of visitors for the Great Exhibition, was not really equipped to deal with the teeming masses, and there was a time when the river Thames was called “The Great Stink” due to it smelling particularly badly due to the huge amount of human excrement that had piled up on the riverbanks. Yuck, but where else were people supposed to go? 

One of the old locks that used to guard the access to the public lavatories back in the 1960’s/1970s in England. No penny? No luck. 🙂

Back to Victorian medicine: Fitzharris uses a wide variety of sources for this history, including one called the Yearbook of Medicine, Surgery, and Their Allied Sciences, which gave the helpful statement: 

“The bandages and instruments which have been employed for gangrenous wounds ought not, if possible, to be employed a second time…” 

This was the world of medicine that Lister entered, after having given his first speech at his new job in LATIN because the establishment believed that that showed these men (of course) were of higher learning. (Imagine the reaction of today’s surgeons being told to do that…) 

(Non sequitur: Glasgow (in Scotland where Lister’s first job was) was actually growing in such numbers that people called it “the second City of the Empire” after London. Well, didn’t know that.)

I think it’s best to do bullet points from now on…:

  • Lister was extremely interested in the parallel work of Louis Pasteur and his research on fermentation and the decomposition of organic matter. Lister was convinced that it was linked with the health of surgical wounds, but no one else was ready to listen yet.. (Curiously, another doc, Thomas Spencer Wells, was also interested in Pasteur’s work. Wells happened to be the surgeon for Queen Victoria… I love these overlaps!)
  • There’s also a good link between Lister and Lord Brougham (who founded University College of London where my brother teaches). Lord Brougham was president of the both the university and the hospital, and Lister was trying to get a gig teaching there as a professor. Brougham is also the name for a type of carriage and was so named for this guy. (See here for more on Lord Brougham and his travelling mummified body.) After other doctors started to believe that Lister was onto something with his cleanliness theories, they began to be known as the “Listerians” and as they became more established in the medical world, they gradually started to spread the theory throughout the profession. 
  • Random trivia: it was around this time that more personal hygiene items started to come on to the market, including a mouth-wash called, wait for it, Listerine. Developed by an American in Philadelphia after he had listened to a speech by Lister as part of his professional medical society meeting…  It was marketed as a variety of things, including a treatment for dandruff, a floor cleaner, and notably, even a cure for gonorrhea. (I know. I’d never put this together with Lister either…)
  • All this was happening around the time of a big flu epidemic that occurred earlier than the most famous flu epidemic of 1918. This particular epidemic was in 1889-1890, and brought a doctor to the fore named Robert Wood Johnson, who, influenced by one of Lister’s talks, joined together with his two brothers to develop a company focused on developing sterile surgical dressings and sutures. The name of the company: Johnson & Johnson. Huh.
  • (And also, around this time, was the start of public health and John Snow mapping the outbreak of cholera… Well, I never. It’s fascinating how things overlap sometimes…)

And, really, the information goes on and on in one of the most interesting reads I’ve had this year. 

Honestly, if you’re looking for some great non-fiction about a field that still holds its importance today, Fitzharris is a great guide to show you the way of Victorian medicine. I loved it (in case you can’t tell). 

For some Victorian social history reads, you could try these: