The Points Interview returns today after a six-week holiday, with the fourteenth installment of the series featuring Howard Markel’s An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine. Just released by Pantheon, An Anatomy of Addiction has already received considerable notice, including this review in the Sunday New York Times and this review in Salon. Markel is the wearer of many hats at the University of Michigan, including serving as the George E. Wantz Distinguished Professor of the History of Medicine, and we’re grateful to him for taking a moment to discuss his book.
1. Describe your book in terms your mother (or the average mother-in-the-street) could understand.
An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine is the story of two medical giants who happened to abuse cocaine. Freud, of course, is the father of psychoanalysis, while Halsted, who is less well known to the general reader, was the father of modern surgery. Both experimented with cocaine to help others. Freud hoped it would cure a dear friend of morphine addiction, and Halsted believed cocaine was destined to be the world’s first truly effective local anesthetic. Both used themselves as guinea pigs, and were soon ‘hooked’. Through their shared addiction, Freud and Halsted are tragic figures, but the sum of their life achievements makes them heroes. Freud never used the drug intravenously, and very likely overcame his addiction just as he started developing the therapeutic process we know as psychoanalysis. Halsted wasn’t as lucky. He used cocaine and morphine intravenously for the rest of his life, and underwent the personality changes and alienations we now associate with the addiction process. His iron will to develop new and better surgical techniques, and to teach these to students at the Johns Hopkins University School of Medicine was strong enough to insure that he confined his addictive excesses to times away from the hospital.
2. What do you think a bunch of drug and alcohol historians might find particularly interesting about your book?
The book uncovers a wealth of archival data and documentation not only on the secret addictions of Freud and Halsted that has long been ignored or glossed over by historians but also traces the drug’s trajectory from wonder drug to scourge. Using a trove of sources from archives, personal letters and the medical literature of the day, I was able to tell a much richer story of the history of cocaine and its effects on the lives of these two great physicians. I was also able to offer a medically and historically informed account of what addiction does to the mind and body as well as debunk the trope that because Freud and Halsted were so successful in their professional careers there was no collateral damage caused by their cocaine use. Of course, there was—as every addict, loved one of an addict, physician and historian of drugs and alcohol knows all too well. The opportunity to describe and document their course of addiction within the context of their eras was one of the great historical research adventures of my career.
3. Now that the hard part is over, what is the thing YOU find most interesting about your book?
I was most fascinated at how both Freud’s and Halsted’s colleagues tolerated and enabled their addictive and often destructive behavior for years, even when patients were involved. It was also incredible to document how Freud never fully acknowledged cocaine’s subversive influence on his work and life. He simply compartmentalized—or should I say repressed—the consequences of his addictions away. Astonishingly, the man who invented psychoanalysis, the once revolutionary pursuit for self-truth, was prey to the same “big lie” most every practicing addict tells himself every day. And, of course, Halsted’s story was absolutely heartbreaking and, for me, addictive, in that I wanted to know more and more about his haunted, tragic life. I still do.
4. Every research project leaves some stones unturned. What stone from An Anatomy of Addiction are you most curious to see turned over soon?
I would love to have found evidence that the two men actually met. They both worked in the Vienna General Hospital at the same time from 1879-1880, while Halsted was a visiting student there and Freud was a research assistant in the Institute of Physiology. Finding a description of these two men actually meeting—after weaving a story of how their lives were so intricately braided by a handful of scientific papers and an unhealthy lust for cocaine—would have been utterly breathtaking. If such documentation exists, I would love to see it.
5. BONUS QUESTION: In a Ken Burns film version of this book, who should provide the narration?
I would like to see such a documentary narrated by Kenneth Branagh with the stipulation that Freud’s voice be played by Armin Mueller-Stahl and Halsted by Tom Hanks. But in reality, I would be so thrilled to see this story made into a film that I would likely shut up and leave those decisions to the professionals in Hollywood.