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An Anatomy of Addiction

Sigmund Freud, William Halsted, and the Miracle Drug Cocaine


Howard Markel, M.D., Ph.D. (View Bio)
Hardcover: Alfred A. Knopf, 2011.

An Anatomy of Addiction

From acclaimed medical historian, Howard Markel, author of When Germs Travel, the astonishing account, told for the first time, of the decades-long cocaine addiction of Sigmund Freud and William Halsted. Markel writes of the physical and emotional damage caused by the constant use of the then-heralded wonder drug, and how each man ultimately changed the world in spite of it—or because of it. One became the father of psychoanalysis; the other, of modern surgery.

Using themselves as subjects in their research—Freud took cocaine as a means of treating depression, fatigue, and morphine addiction; Halsted, as a new and safe form of anesthesia—each became caught up in the drug’s grip, nearly destroying his life, and unwittingly becoming the first participants in the birth of the modern addict. The author traces, as well, the drug’s effects on the thoughts and pathfinding work of each man.

Historians and biographers have ignored or glossed over the day-by-day archival and medical records of the chronic cocaine abuse of each doctor, as well as the psychological and physical darkness it brought them, and their struggles to rid their lives of it. Now Howard Markel’s An Anatomy of Addiction tells the full story, long-ignored, in its rich historical context.


A New York Times Bestseller

"A tour de force of scientific and social history." — Sherwin B. Nuland, The New York Times Book Review

"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.… 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…. Persuasive and engrossing." — Laura Miller, Salon

"Markel creates rich portraits of men…susceptible to drug addiction, and their professional achievements despite that condition seem all the more remarkable." — The New Yorker

"The distinguished medical historian Howard Markel’s rich, revelatory new book...is like the early pages of a family photo album, showing us cocaine as it has not been seen for over 100 years…. Markel’s account takes on the mesmerizing quality of an animal attack filmed in slow motion and high resolution, as the rapacious chemistry of the new drug falls on the refined intellectual elite of American medicine and paralyzes and consumes them…. He’s a careful writer and a tireless researcher, and as a trained physician himself, Markel is able to pronounce on medical matters with firmness and authority." — Lev Grossman, Time

"Dr. Markel braids these men’s stories intricately, intelligently and often elegantly." — Dwight Garner, The New York Times

"This book is fascinating." — Tess Taylor, Bookforum

"Splendid…. The brilliance of An Anatomy of Addiction is its strong dual focus…. This book is a tale of three doctors: Markel as well as Freud and Halsted. A fluent, incisive and often subtly funny writer, Markel is also a Hopkins-trained physician." — Michael Sragnow, Baltimore Sun

"It’s a fascinating book about fascinating men, but even more interesting for those of us who want a glimpse of modern medicine when it was just starting to develop." — Jonathan Cohn, The New Republic

"An engaging, well-researched historical homily about fame and foible. It’s a brisk read, especially with more than 100 illustrations." — Jeffrey Burke, Bloomberg News

"Lively…. His straightforward and realistic description of the medical advances made by both men reveals both their greatness and their shortcomings. An Anatomy of Addiction is a fascinating revelation of conditions prevailing in hospitals and medical circles in the late 19th and early 20th centuries. Dr. Markel is not only an erudite scholar, but is also able to convey the most complex of concepts in the simplest of terms, making this book a valuable addition not only to college and university libraries, but also to school libraries and home collections." — Lois Henderson, New York Journal of Books

"Medical historian Markel 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…. 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." — Kirkus Reviews

"Markel’s compelling and compassionate account of these two icons in the annals of medicine and their shared addictions profoundly demonstrates the complexity and breadth of their genius. Picture Halsted, the surgeon, desperate to perform painless, perfect surgeries but with too few available painkilling options. Picture Freud, a physician eager to blaze new boulevards into the physiological and psychological aspects of the mind. Each man a wizard, a driven spirit who will stop at nothing, not even self-experimentation, in order to excel in his field. Picture the then recently discovered drug cocaine, an established painkiller, an extraordinary mood and stamina enhancer. Picture its appeal to each of these overachievers who unwittingly, helplessly addict themselves to its seductive superpower. How does genius intersect with the drug, for better or for worse? Markel’s anatomy is a richly woven analysis complete with anecdotes, historical research, photos, and present-day knowledge about the character of the addictive personality." — Booklist

"In the 1880s, Sigmund Freud, the founder of psychoanalysis, and William Halsted, the founder of modern surgery, independently and personally discovered the powerful anesthetic, and terribly addictive, effects of cocaine. Markel, a medical historian at the University of Michigan, eloquently tells the parallel stories of these two pathbreaking physicians and how their stories intersect in remarkable and sometimes tragic ways…. Markel's extraordinary achievement combines first-rate history of medicine and outstanding cultural history." — Publishers Weekly (starred review)

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