Drawing blood: technology and disease identity in twentieth-century America

Is the play the thing? The answer, it seems, would depend upon the nature of the conscience one sought to catch-and, relatedly, on the nature of the play itself. Wailoo's provocatively entitled Drawing blood presents the history of anaemias in twentieth-century America; one can argue, much in the style of a traditional five-act play. Though the author himself never uses the term, an overview of the book quickly convinces that the dramatic metaphor is apt. The text is concise rather than epic; its main story is told over five brief chapters, each of which focuses on a particular anaemia. The "hero", however, is not anaemia, but technology. Wailoo's central question is, what was technology's role in "negotiating" the shifting "identities" of the anaemias. Key supporting roles are played by medics ("moralizing" physicians; "conquering" abdominal surgeons; "managerial" laboratory workers), institutions (hospitals; factories; pharmaceutical companies) and cultural biases (racism; classism; paternalism). The stage itself is set with obligatory post-modern furnishings: women's blood, Negro blood and workers' blood. Within this framework, Wailoo casts technology as almost wholly the product of surrounding actors and scenes. Within the play, our hero, technology, manages to define disease only because the alignment of institutions, ideas and ideologies permitted it to do so. And so, the question remains: does Wailoo's presentation of his story within this format effectively, and persuasively, illuminate the complex interactions of technology and disease definition? To answer this question, a summary of the argument itself is necessary. Wailoo opens by asserting that "the anemias. .. earned a collective identity with the advent of new tools of blood analysis in the nineteenth century" (p. 5). Following this relatively strong statement about technology's role in creating the very frame in which anaemia was defined, he changes course. His study itself focuses on particular anaemias, and the very limited role technology played in determining their identities. The American history of one of five main anaemias serves as subject for each of his main chapters. (A sixth chapter acts as a kind of epilogue, treating several types of anaemia in the postwar US.) Others have told these histories. What Wailoo has done is gather them together within a particular interpretive structure. For, within each chapter, Wailoo looks to the medical practitioners who used blood technology to trace the ways in which their socio-cultural biases were reified in their conceptions of their patients' very blood (sickle cell and Negro …