On the Shelf

The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery Wendy Moore Broadway ~ 2005 ~ 352 pp. $26 (cloth) $14.95 (paper)

Grave robbers, corpses, exotic animals, grisly diseases and grislier operations, blood, gore, and some of the most famous men in English history all populate Wendy Moore’s biography of a pioneering surgeon — but none is so colorful as the surgeon himself. The Knife Man recounts John Hunter’s role in the revolution of mid-eighteenth century medical practice, in a society philosophically engaged in the Enlightenment but still reliant on bloodletting, purging, and toxic elixirs to treat disease. With almost no formal education, Hunter was an avid naturalist who paid little heed to any doctrine but the powers of observation. To obtain the cadavers for his research, Hunter employed the services of grave robbers, turning an assorted collection of bounty hunters into an organized criminal industry which emptied entire graveyards of their wards. The house in Dr. Jekyll and Mr. Hyde was inspired by Hunter’s abode, which received high society at the front and dead bodies at the back. Dismembering live animals, dissecting thousands of stolen corpses, experimenting on patients, and even infecting himself with venereal disease, he defied more than convention in his efforts to understand human anatomy. Moore’s telling does not sanitize this side of the story but embraces it in lovingly graphic detail. Her account, which reads like an adventure story, allows Hunter’s humanistic mission to eclipse any unanswered ethical questions.

Although radical in his experimentation, Hunter was moderate in his approach to treatment. One of the most capable surgeons of his time, he favored invasive surgery only with great restraint, often preferring to do nothing and let nature take its course. He infuriated many of his contemporaries with his outspoken opposition to unnecessary pills and potions, and his naturalist studies anticipated some of The Origin of Species by almost seventy years. Amid the controversy, he rose to become London’s leading surgeon, treating such patients as William Pitt and Adam Smith, but more often the nameless poor. Moore gives us a captivating account of a man whose techniques were uncompromising, unconventional, often shocking, and perhaps even morally questionable — the man “to whom anyone who has ever had surgery probably owes his or her life.”

— Caitrin Nicol

Illegal Beings: Human Clones and the Law Kerry Lynn Macintosh Cambridge ~ 2005 ~ 286 pp. $28 (cloth)

This poorly written, painfully tedious, and simpleminded book reflects the worst of modern legal academia. Law professor Kerry Lynn Macintosh makes her best public-policy case for human reproductive cloning and argues, further, that laws against it violate the Constitution’s Equal Protection Clause. Macintosh repeats umpteen times various forms of the assertion that humans who are illegally cloned will have to “endure a society that has attempted through its democratic institutions to prevent their very existence.” But she does not confront the fact that the same could be said of those human beings conceived as a result of rape, nor does she explore the obvious respects in which her analogy to anti-miscegenation laws is inapt. Her philosophical insights are cartoonish: For example, to those who believe that cloning “offends God,” Macintosh replies simply that “there is no scientific proof that God exists,” and, “even if God does exist, there is no objective way to show what God thinks about cloning.”

American courts, unfortunately, are filled with judges who learned from the likes of Macintosh and who will seek to make their name by inventing new rights that undermine democratic self-governance. But even they are unlikely to find any helpful guidance in this sloppy book.

— Edward Whelan

The Box: How the Shipping Container Made the World Smaller and the World Economy Bigger Marc Levinson Princeton ~ 2006 ~ 392 pp. $24.95 (cloth)

Box Boats: How Container Ships Changed the World Brian J. Cudahy Fordham ~ 2006 ~ 352 pp. $29.95 (cloth)

The recent controversy over the decision to allow a Dubai-based company to manage the operations of some U.S. ports had the effect, for a while at least, of putting port security on the nation’s political radar. Perhaps the most frequently noted fact was that no more than 5 percent of the cargo containers coming into U.S. ports are inspected. That fact is a testament to the astonishing number of cargo containers that come into American ports each day.

In part, we can thank Malcom P. McLean for the problem. McLean, who died in 2001, is considered the father of “containerization.” A half-century ago, McLean sold his successful trucking business to purchase Pan-Atlantic Steamship Co., a cargo carrier, to experiment with transporting containers. It was his aim to make cargo transportation intermodal, seamlessly integrating the different modes of transportation (truck, rail, and ship) by means of a standardized container. Today, the process of detaching containers from trailer trucks (or trains) at the port of departure, hoisting them onto ships, and reattaching them to different trucks at the destination seems mundane, but the significance of this innovation for both global commerce and international security is difficult to overstate.

Economist Marc Levinson’s The Box tells how McLean inaugurated the era of containerization on April 26, 1956 by transporting 58 containers from Newark to Houston aboard a ship called the Ideal X. McLean’s fundamental insight, Levinson writes, “was that the shipping industry’s business was moving cargo, not sailing ships.” To reduce the cost of shipping, new modes and orders would have to replace every part of the existing system: “ports, ships, cranes, storage facilities, trucks, trains, and the operations of the shippers themselves.”

McLean’s aim was to save money, and save money he did: what would normally cost $5.83 per ton, McLean accomplished for 15.8 cents per ton. McLean’s obsession with cutting costs lives on not just in the global shipping industry but also in contemporary logistics management. When McLean introduced the container to the military — a move that made it possible to improve the delivery of supplies to American troops in Vietnam — logistics was primarily a military discipline. “By 1985,” Levinson writes, it “had become a routine business function” for manufacturers and retailers whose logistical precision reduces inventory levels and cuts warehouse costs. With the help of modern communication and computer technology, containerization has made possible the extremely efficient supply chains of corporations such as Wal-Mart and Dell.

In Box Boats, Brian Cudahy, a transportation historian, concentrates on the history of the ships that carry the world’s intermodal containers — so many containers that they “would more than encircle the earth at the equator.” Cudahy points out that the great aim of containerization, “the ability to dispatch a sealed container from origin to destination with no intermediate handling of the cargo it contains,” can become “a terrible liability if a sealed container is used to deliver a lethal cargo.” He reports that “new systems of surveillance are being developed and deployed at world seaports”; for instance, American-built technology is used to scan every container that enters the port of Hong Kong. But the fact remains, Cudahy writes, that the very efficiencies “that were responsible for the growth of containerization over the past fifty years can quickly become liabilities” that terrorists will try to exploit.

Levinson points out that when inspections were stepped up after the 9/11 attacks, “auto plants in Michigan began shutting down within three days for lack of imported parts.” This, then, is the great challenge for American policymakers concerned with port security: creating an inspection and certification system capable of finding containers with dangerous or illicit cargo, without disrupting the fragile supply network of ultra-efficient modern industry.

— Steven Fairchild

Artificial Happiness: The Dark Side of the New Happy Class Ronald W. Dworkin Carroll & Graf ~ 2006 ~ 336 pp. $24.95 (cloth)

The past forty years have seen a remarkable change in mental health care, as the bulk of the work has shifted from psychiatrists to primary care physicians, and the annual number of anti-depressant prescriptions in the U.S. has skyrocketed to 250 million. In Artificial Happiness, Dr. Ronald W. Dworkin argues that the widespread use of medication to treat unhappiness creates a gap between experience and emotion, which is detrimental to achieving real fulfillment. Charting the shifting roles of medical and religious institutions over the past few decades, he explains how “everyday unhappiness” has come to be treated as a disorder, and discusses the implications for society.

Concerns that Artificial Happiness is an indictment of all psychopharmacological therapy are misplaced, as Dworkin supports the use of drugs to treat serious mental illness. However, confusion on this point is the inevitable result of his failure to explain more clearly the difference between “minor depression” and “everyday unhappiness,” and to offer precise criteria for when medication might really be appropriate. In addition, he offers little discussion of the differences between medications in their purposes and effects; they are instead lumped together with alcohol as “stupefying” influences on the natural mind. The questions underlying his argument are sound: What does it mean to have one’s “natural” identity mediated by another substance? What are the implications for one’s ability and incentive to achieve “real” happiness? What is the significance of the escalating numbers of Americans — both adults and children — taking psychotropic medication? Dworkin’s modern history of the medical profession is extensive, and the data thought-provoking. But the interpretation lacks precision and depth, and the important subjects he addresses are more richly explored in the 2003 President’s Council on Bioethics report, Beyond Therapy: Biotechnology and the Pursuit of Happiness.

— Caitrin Nicol