Drawing Blood

In "Drawing Blood", medical historian Keith Wailoo uses the story of blood diseases to explain how physicians in this century wielded medical technology to define disease, carve out medical specialties, and shape political agendas. As Wailoo's account makes clear, the seemingly straightforward process of identifying disease is invariably influenced by personal, professional and social factors - and the result is not only clarity and precision but also bias and outright error. The long-diagnozed condition of chlorosis in adolescent girls, for example, disappeared as women began assuming new roles in American society and challenging the notion of the "delicate female". The clinical status of some conditions reflected the fate of the experts who had defined and treated them - "splenic anaemia" vanished quickly when "abdominal surgeons" lost autonomy in matters of diagnosis as the hospital itself changed. Even current understandings of diseases such as sickle cell anaemia, pernicious anaemia, leukaemia and prostate cancer, Wailoo argues, have been shaped by medical technology's interaction with issues of race, identity, politics and economics.