Warning: For persons concerned about “triggers,” this book has some specific descriptions of drug use.

Two medical pioneers — including pioneers in the potential medical use of, and actual personal misuse of, cocaine. Howard Markel paints a cautionary tale of addiction that powerfully resonates a century and more later.

Many people know a bit about Sigmund Freud’s history with cocaine, despite later attempts to cover up just how much he used (or abused), how long he used it, and how much it affected his general work habits and his psychological theorizing.

Markel gets behind the story, not just with Freud, but a somewhat older near-contemporary, William Halsted. Halsted, less familiar to many, was essentially the father of modern American surgery, a pioneer in antiseptic and operating techniques in surgery, mainly from his perch of director of surgery at Johns Hopkins School of Medicine.

When I was a kid, I read a mini-biography of Halsted in a compendium of lives of great doctors, so I had heard about his “sea cruise” attempt to overcome his cocaine addiction. But, the story closed with what Markel notes was long the “official line” about Halsted: that he had no major problems, or problems at all, after that.

How wrong I was, Markel shows.

I had no idea he was “committed” to Butler Hospital, a “sanitarium.” Nor that he was given morphine to “help” with cocaine withdrawal. Nor that he, as a result, apparently became a lifelong morphine addict. Nor that he apparently struggled to some degree with cocaine addiction for the rest of his life.

Markel, an M.D. and Ph.D. with addiction support help background, shows a clinician’s skill in diagnosing how addiction affected Halsted’s life, his work at Johns Hopkins, his relation to surgical interns and patients and more. Continue reading →