Susan Wise Bauer’s “The Great Shadow” offers a sweeping look at how illnesses have shaped human history, intellect, and commerce. This book arrives at a moment when our collective awareness of bodily vulnerability is heightened, following a severe winter and the recent COVID-19 pandemic. The fragility of our physical selves is, quite understandably, at the forefront of many minds.
Bauer’s work is a millennia-spanning account exploring the profound effects of sickness on both individual lives and broader societal beliefs and actions. From the very concept of guilt to the items we choose to purchase, the organisms that cause us to feel unwell have left an indelible mark.
Context in a Crowded Field
The theme of sickness as a historical force is not entirely novel. Since the pandemic, other significant works have emerged, including Jonathan Kennedy’s “Pathogenesis” and updated editions of “A Short History of Disease” by Sean Martin, alongside “Disease and History” by Frederick F. Cartwright and Michael Biddiss. The pertinent question then becomes: what distinguishes Bauer’s contribution?
Shifting Perspectives: From Humors to Germs
Bauer’s primary emphasis lies in tracing the transition from what she terms the “Hippocratic universe” to our current era of “germ theory.” The former framework was characterized by a near-superstitious adherence to ancient Greek notions concerning humors, bodily fluids, and internal equilibrium. In contrast, the latter is much more grounded in empirical scientific understanding.
The book vividly illustrates the lengthy duration of this paradigm shift. The scientific consensus that microbes are the cause of disease, a realization that paved the way for advancements in vaccinations and treatments, took centuries to solidify. This understanding only gained widespread acceptance in the late Victorian era. The human cost of this prolonged transition is immeasurable, marked by millions of premature deaths.
Enduring Echoes of the Past
Yet, the question remains whether the principles of Hippocratic medicine have been entirely supplanted. “The Great Shadow” functions as both a historical chronicle and a form of argument. Each chapter progresses through historical epochs—urbanization, the Black Death, the battlefields of World War I—before drawing connections to contemporary issues. Bauer contends that vestiges of past attitudes towards sickness persist in our modern discourse and interpretations.
At best, this comparative approach can feel somewhat unilluminating. It might not be surprising to learn that 19th-century anti-vaccine sentiments bear some resemblance to modern anti-vaxxer movements. At worst, some connections can appear perplexing. For instance, Bauer includes an admission that she avoided medical check-ups for several years after the COVID-19 pandemic, attributing this to a reluctance to be “lectured” about gaining 8 kilograms. She suggests that such a lecture would stem from a doctor’s “Hippocratic understanding of what illness is,” rather than a scientifically informed assessment of the health implications of weight gain.
Narrative Strength and Enduring Insights
Despite occasional tendencies towards overwriting, such as the sentence “That sky is the residence of mystery, a mirror of the unknowable,” Bauer demonstrates a skill for crafting compelling narratives from archival sources. Her chapter detailing the pioneering efforts of germ theory proponents like Alexander Gordon and Ignaz Semmelweis—men ostracized, even driven to illness, by the medical establishment—would undoubtedly make for a compelling television miniseries.
The book’s concluding point is perhaps its most impactful. While humanity has largely progressed from superstition to science, a new set of challenges has emerged. Bauer describes our current era, termed the Third Epidemiologic Transition by scholars, as defined not only by the diminishing efficacy of antibiotics and the rise of novel diseases lacking vaccines or cures but also by a global transportation network that facilitates the rapid worldwide dissemination of such illnesses.