American Journal of Epidemiology Advance Access originally published online on September 21, 2005
American Journal of Epidemiology 2005 162(9):917-918; doi:10.1093/aje/kwi296
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Book Review |
Archie Cochrane: Back to the Front and A Life in Public Health: An Insider's Retrospective
The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205
Archie Cochrane: Back to the Front
Edited by F. Xavier Bosch and Richard Molas
ISBN 84-607-8958-6, Published Privately, Barcelona, Spain (E-mail: cris{at}ico.scs.es, Fax: 34-93-260-7787, Website: http://www.cochrane.org/docs/orderformarchiecochranebacktothefront.doc), 2003, 328 pp., $92.55
A Life in Public Health: An Insider's Retrospective
By Lester Breslow
ISBN 0-8261-2714-2, Springer Publishing Company, New York, New York (Telephone: 877-687-7476, Fax: 212-941-7842, Website: http://www.springerpub.com/), 2004, 234 pp., $46.95
These biographies of two renowned epidemiologists and public health leaders provide different perspectives of the same historical period. The Cochrane book is a compendium of reminiscences and articles written by colleagues and students of the great epidemiologist, while the Breslow book is an autobiography, "an insider's retrospective," as the author calls it.
A biographic book is as interesting as the life it tries to portray or present; here, we are dealing with two epidemiologist–public health professionals who had very interesting lives. A biography is also a personal story, and story telling has been at the basis of literary expression from time immemorial. Thus, compared with other books in epidemiology, our evaluation of a biographic book needs also to consider the literary merits of the product.
In a way, a biography provides an opportunity for creative expression without compromising its factual validity. A biography is successful to the extent that it is able to move or engage us in the story. H. G. Wells calls his two-volume biography published in 1934 Experiment in Autobiography. A biography should reflect a person in the truest sense of his or her reality in the times, places, and persons.
A few days ago, I was mentioning to a junior colleague that I had just finished reading the recent biography of Wade Hampton Frost by Thomas M. Daniel (Wade Hampton Frost, Pioneer Epidemiologist 1880–1938: Up to the Mountain, University of Rochester Press, Rochester, New York, 2004), and she asked me: "What did you learn from that book that you did not already know?" Of course, there were a lot of facts about the personal life of Frost that I was learning for the first time from this book, but I think she was interested to know whether the book offered us learning beyond the minutiae, such as the story and the approach behind the role Frost had in developing specific epidemiologic methodology.
My colleague made me think about the "after-you-read-the-book test." After reading a book, one needs to ask: Was there a message in the book and was it appropriately conveyed? Were we engaged or moved by its reading? Did the book get to us?
In the review that follows, both books will be presented first as to content and style, and then the final section will try to identify some differences and common threads of these publications.
THE COCHRANE BOOK
This is a luxurious book that reflects the love and high esteem that the editors and the various authors have for the life and work of Archie Cochrane. Following introductory remarks by Joan Clos, the primary editor and mover of the project, F. Xavier Bosch, has his personal introduction to the book and sets the tone for the rest of the book through his reminiscences of Archie Cochrane.
The first section deals with "Cochrane the Man." It has 12 presentations from some of his many colleagues including Sir Richard Doll, Julian Tudor Hart, Devra and Lester Breslow, and Josep M. Anto. The second section of the book presents him as a "Man of His Time" engaged in the International Brigades during the Spanish Civil War (1936–1939), followed by his participation in World War II and his life as a prisoner of war in concentration camps. The action during the wars in this second section is complemented by reminiscences of Archie as a leading health services researcher in Wales. The third section of the book presents the story and legacy of the Cochrane Collaboration both in the United Kingdom and internationally. The final Epilogue section of the book takes us back to Barcelona and the Spanish Civil War. It also presents two published obituaries.
Archie Cochrane as a person, as a role model, and as an innovator and organizer is very much alive through all the pages of this book, which are richly illustrated and presented.
Throughout the book, one comes across many interesting details and facts. For example, although the Cochrane Collaboration is devoted to meta-analyses of clinical trials, we learn that Archie Cochrane never carried out a randomized clinical trial himself.
The book becomes very interesting when it provides an opportunity for Archie Cochrane to express himself. One of the most interesting pieces is the text of one of his lectures entitled, "Epidemiology and Health Services Research." His actual reminiscences of his life as a prisoner of war in the concentration camp at Salonica, Greece, taken from his autobiography written with Max Blythe, are most revealing. In this excerpt, we get a personal encounter with not only the heroic figure that Archie was but also the field epidemiologist who continued to be productive under very miserable circumstances.
Considering that this is a multiauthored book, it is very difficult to control the quality of the writing across the book. Many of the tributes highlight the same characteristics of this great man and are repetitive. In addition, since many of the authors are not native to the English language, the book could have benefited by better editing and translation. The poor technical editing of this book contrasts with its luxurious publication.
THE BRESLOW BOOK
The autobiography of Lester Breslow starts by describing a couple of decades in the life of the Breslow family in North Dakota and Minnesota and his growing up during the Great Depression. While reading this first chapter, we get the impression that it is written to provide a background for the rest of the book, where the focus is on a life in public health. In this first chapter, we learn that the author's commitment to public health, starting from his medical student days, is consistent with his social and liberal perspective on the practice of medicine. These ideals prompt him, early on, to seriously consider volunteer service in the International Brigades during the Spanish Civil War. However, his personal circumstances do not allow him to do so. Later on, he is able to get involved in the antifascist struggle by volunteering for the US Army Medical Corps in 1943. In a way, World War II provides a congruence of his personal political ideals and his professional role in public health.
The 11 chapters of the book describe the trajectory of Breslow's life from medical school in Minneapolis to life in the military and as a public health officer in Minnesota and a leader in the California Public Health Department. These chapters show his engagement in the major public health issues of the time, including infectious and chronic diseases and tobacco control, and his leadership in the development of the Alameda Human Population Laboratory. A brief description of his international experiences, including the establishment of the International Epidemiological Association, is followed by reminiscences about his life in academia, capping a remarkable set of achievements as the Dean of the School of Public Health at the University of California in Los Angeles.
The last chapter of the book has a number of reflections and recommendations that seem to be directed to a new generation of public health professionals. Despite the many current challenges in the field of public health, Breslow is optimistic at the end of the book that better times and new advances in health will come.
The story that is presented to us is quite representative of a generation of American public health professionals and epidemiologists whose lives embraced an early beginning during the Depression and professional development and maturation during and after World War II. It was through this generation, which included so many leaders, that the stage was set for some of the most radical changes in public health in the United States and internationally. Lester Breslow, through this narrative, provides us a complete picture of the issues and concerns of his generation.
This book is written for a relatively nontechnical or nonspecialized audience. In it, the author takes time to explain specialized medical and technical terms. It presents a great deal of factual detail that makes, at times, for not very engaging reading. Some of the facts and detail are repeated across the book. Unfortunately, whatever strengths this book provides in organization and presentation of ideas is not complemented with enjoyable literary style. Some specialized editing along these lines could have provided additional luster to the book. Nevertheless, besides being a personal narrative, this book is a good historical record of an important period of public health.
SOME COMMON GROUND
When comparing these two books, one may note some obvious differences that are not very important, such as the fact that one is a personal autobiography and the other is a book of reminiscences from multiple authors. The Breslow book starts with multiple events in his life and drives to a synthesis of ideas and reflections, while the Cochrane book tries to weave a large number of ideas and philosophical perspectives around one major event in the life of the individual: his participation in the International Brigades of the Spanish Civil War.
Although these two books may have been written with different audiences in mind, they serve similar ideals about our social roles as epidemiologists and public health professionals. Both books cover the same historical period of public health. They portray the same generation of public health professionals. This is a generation where commitment to public health is a choice influenced by a sense of mission and strong social ideals, a generation where missionary zeal and strong evidence of effectiveness complement each other and affect the lives of millions in a positive way.
Having read these two books, one asks: How do they fare as to the after-you-read-the-book test? Both books deliver their messages very effectively, but they could have served us beyond our intellectual curiosity by involving us more in the spirit of the times, places, and persons. Both books should have a good place in public and personal collections of epidemiologic and other health sciences libraries.
ACKNOWLEDGMENTS
Conflict of interest: none declared.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||