The mysteries within Book

Sherwin Nuland (1930-2014) was a surgeon and a professor of medicine, bioethics, and the history of medicine at the Yale School of Medicine. A rare scientist who could both write well and communicate complicated ideas to laymen, his How We Die (1994) was a finalist for the Pulitzer Prize.

In this work, Nuland discusses premodern notions about the major visceral organs of stomach, heart, spleen, liver, and uterus; and in the process, he also provides anecdotes'including a couple very striking ones' about his surgical relationship to four of them. The thesis of this discursive work is that the modern world needs to remain on guard against "magical thinking," which Nuland (a religious skeptic) identifies with superstition and religion. Some parts of this work are nicely written, some worth pondering for their insight, others simply to be enjoyed as examples of well-paced medical drama.

Unfortunately, average readers will probably find much of the book a slog as they make their way through Nuland's accounts of earlier notions about bodily organs. For instance, while it is curious to discover that previous eras thought the uterus might move around the body, Nuland mentions that fantasy over twelve pages. Extended descriptions about how erroneous ideas developed into other erroneous ideas are a hard sell even when written in lively prose.

Finally, some truly ancient texts are less "magical" than other more recent ones. Despite its great length, the Bible contains remarkably few passages that might be described as magical descriptions of bodily processes (though later commentators often tried to fritter away that strength), nothing more than figurative language about the heart or the kidneys or the bowels being the seat of the emotions, nothing more literal than our reference to being "heartbroken" or finding some decision "gut wrenching." Nuland does not repeat the Bible's declaration that "the life of the flesh is in the blood" (Lev. 17: 11).