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Medicine and Culture by Lynn Payer
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Medicine and Culture (1989)

by Lynn Payer

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I read this book just after it was published 25 years ago, but had the East Detroit Library copy. I have remembered a number of quotes from this book, and decided to search for it on Long Island and found it at the Rockville Centre Library.

It compares medical practice in The United States, England, Germany and France, with occasional references to other counties. In France people frequently complain of their liver, the so-called crise de foie, which virtually no one else has, and may really be a migraine headache.

Tightly sewn numerous stitches for any injury frequently point to a Belgian surgeon, who is paid by the number of stitches. Germans are known to treat for Herzinsuffizienz (heart insufficiency) where other countries would see only a slight diagnosis. Britains value economy with smaller dosages and shorter doctor office visits. Americans see viruses everywhere.

A fun, but perceptive read. ( )
  vpfluke | Dec 27, 2013 |
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This book is dedicated to the memory of my mother, whose English ancestry may explain her tendency to greet new scientific developments with a skeptical "How do they know that?"  It is also dedicated to my father, whose French ancestry may explain his proclivity to halve the doses of medcine proscribed for hm.
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While living in Europe and working there as a medical journalist, I was struck by the differences between U.S. and European medicine. Why, for example did the French talk about their livers all the time? Why did the Germans blame their hearts for their fatigue when there didn't seem to be anything seriously wrong with them? Why did the British operate so much less often than the Americans? And why did my French friends become upset when I said I had a virus?
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The Spanish doctor will have two sutures.  An Austrian doctor would have put in six sutures, and the Belgian doctor would have put in as many sutures as he could, as they are paid by the number of sutures. (P. 35)
The French were ready to accpet the the English trial as well as other, uncontrolled, trials as definitive.  The English thought there should be more trials.... And the Americans mostly didn't come.

Americans value doers, the French value thinkers.

The late Spanish diplomat Salvador de Madariaga defined the Englishman as the man of action, the Spaniard as the man of passion, and the Frenchman as the man of thought.  (P. 37)
The West German health care system accommodates both he effcient and the romantic aspects of the German character by including high-tech medicine ... and "soft" medicine ... such as homeopathy and spas.  (P. 77)
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Table of Contents:

Is Medicine International
Culture Bias in Medical Science
France: Cartesian Thinking and the Terrain
West Germany: The Lingering Influences of Romanticism
Great Britain: Economy, Empiricism, and Keeping the Upper Lip Stiff
UnitedStates: The Virus in the Machine
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Amazon.com Product Description (ISBN 0805048030, Paperback)

A classic comparative study of medicine and national culture, Medicine and Culture shows us that while doctors regard themselves as servants of science, they are often prisoners of custom.

(retrieved from Amazon Mon, 30 Sep 2013 13:43:46 -0400)

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