Perri Klass

The life-or-death fate of children has changed dramatically over the past 200 years due to research, medicine, and public health. Abraham and Mary Todd Lincoln famously grieved the loss of their child in the White House years ago, but they were hardly alone. Rather in that era, losing a child, often due to illness or mishaps, was pretty much normal though still tragic. Today, such an experience is the exception, and we are all better for it. In this book, pediatrician Perri Klass examines show more the slow but steady triumph of science over common childhood ailments.

Science, especially in the twentieth century, witnessed advances over most diseases of childhood. A list of the most common causes of death in 1900 looks very different than a similar list in 2000. Tuberculosis, rheumatic fever, scarlet fever, measles, and diphtheria are presently known – or forgotten – as historical anomalies, yet they were all dreaded entities decades ago. Research advances in treatment and vaccines prevention spare us today.

Disease by disease, Klass describes the story behind each of these victories. Reading this work can open a reader’s eyes to the power of science and the power of empowering researchers. She concludes by dwelling on how societal attitudes have changed due to these breakthroughs. We are now hyperaware – and thus often overprotective – of dangers to the young. Childhood death sometimes casts shame over a family today. We can expect too much perfection instead of too little, as we did in prior eras. We also deal with massive misinformation and mistrust of medicine… despite all its triumphs.

This book is well suited to those interested in medical history. It’s also good preparation for those entering health professions to learn about these diseases through the engaging lens of history. Klass tells a good story that shouldn’t pass into the dustheaps of a forgotten past. Life is a treasure, and remembering prior successes can refine our focus towards engaging present challenges – and hopefully winning future successes. This book offers a nice narrative to dwell upon these themes. show less

This is not the book I was promised. It was obsessively focused on the USA, despite the original summary that caused me to pick it up implying it was going to be a global survey of the history of paediatric medicine (if I had been sufficiently familiar with the names mentioned, that might have been obvious). The historical sections gloss over what was happening elsewhere, except for very short sections, usually a sentence long, none more than a paragraph. There were also a lot of times where show more I was bemused that what I've read about American medical research (in medical journals) paints a much less rosy picture that this -- there were times when I wondered if the author had looked outside their own demographic (there is mention of some of it, but argh). One section that talks exclusively about US and UK writings on child death seems to think that these are representative of the whole world (also: author is not a literary scholar and certainly, from the works quoted, doesn’t seem to have gone very far from a very limited literary ‘classics’ collection, talking about them in a way that assumed familiarity with all of the works -- I, as a middle aged middle class white Anglo Australian missed most of the references)

I would recommend against reading the introduction/first two chapters, as not being relevant to the thesis of the book. My reading notes on the intro say:

"*wow is there some willing ignorance here - that there are no child deaths due to the various ills like poor water, poor nutrition etc. There is acknowledgement that the death rates are higher in poor and marginalised communities, but there isn't the recognition about how inaccessible some of the medical treatments are for populations both within and without the USA.*"

Chapter two, for inexplicable reasons, is entirely about the American civil war. Includes abhorent details of the treatment of African American women, including what reads as medical research without consent. From my reading notes:

"*I am bemused at how this chapter's recounting in detail the mistreatment of people under the American slavery system counts as either science or public health*"

Sections I did like: The sections on scarlet fever and diptheria were fascinating; slightly more European history there, not least because that is where some of the dramatic discoveries were made, and it is harder to gloss over them. I noted that p252 had an interesting discussion of ethics (which: I don't remember whether this was because it was the only mention, or because I had been so horrified at the lack of mention of ethics in other sections, but that I'm referencing a single page is concerning).

I would not normally keep a book that I rated this low, but there are sections that are potentially worth revisiting. show less

The epitome of Klass' work -- a pedantic and often obnoxious narrative voice overlying the fantasies and fears that are, in fact ubiquitous among medical trainees. After reading this I knew that I wasn't the first to secretly desire running off to practice medicine in some rural third-world country -- not out of benevolence, but to be able to utilize history and physical skills, without any pesky high technology to ruin my intellectual fun and I now know that I share the mixed dread and show more exhilaration boarding an aircraft knowing that they may call "Is someone on board a doctor?"
Klass is maybe the most renowned medical writer and although she is far from the best, she never fails to entertain. show less

Dr. Lucy Weiss is a mom, a pediatrician to at-risk, low SES families, and an advocate for foster children. As she herself was "rescued" from foster care and adopted by her teacher, she feels it is her mission to try to save as many children as she can from the disruptive, often abusive conditions that children experience in the system. The marked contrast between Lucy's current life with her children in private school and her husband a university professor and the harsh reality that she show more deals with in her work becomes the stage where Lucy's struggles play out. While this novel is not highly action oriented, it is interesting to watch Lucy ponder larger philosophical and political questions about the role of the government in protecting kids from abusive and neglectful homes. Lucy's anger at the system, a supposedly well-meaning system, is palpable, as she confronts the problems of continually changing and unseasoned child caseworkers who keep returning kids to bad circumstances due to their lack of experience and naivity about chronic adults.

For me, this book was very personal, as I am a child clinical psychologist working with the same families and same systems that Lucy addresses. I share her passion and outrage at this system and it was affirming to see that Dr. Klass feels the same way. This is a topic that it seems few people really understand as children are put in harm's way every day, in an effort to "preserve families" but at the cost of abuse, neglect, and sometimes death of these kids, who have no voice or resources to protect themselves from people who often have no business having kids at all.

The only concern I had about this book (taking it from 5 stars to 4.5) is that it drove me crazy that the book went back and forth from first person to third person narration without any particular pattern! Arrggh!!! Otherwise, I LOVED IT! show less