In 1998, the FDA approved the use of tamoxifen in women considered at high risk of developing breast cancer. This development ushered in a new era of chemoprevention, the drug being the first that was officially recognized for its ability to prevent breast cancer in otherwise healthy women. Originally a failed morning-after contraceptive pill, tamoxifen had eventually proved effective in controlling breast cancer in women in the late stages of the disease. Repurposed in the 1980s, it soon became a treatment to decrease recurrence rates in women whose cancer was in remission—though not, critics warned, without serious side effects. This chapter focuses on the rejection of tamoxifen as a preventative technology and of the concept of chemoprevention itself by the grassroots organization Breast Cancer Action (BCA) and its coalition “Prevention First”. Founded in 1990 by women diagnosed with breast cancer in the San Francisco Bay Area, by the end the decade, BCA had become the first group to refuse donations from the medical industry, thereby claiming the role as watchdog of the breast cancer movement. Drawing on documents from that organization, the chapter analyses how activists contradicted the information produced by drug manufacturers and the National Cancer Institute, as well as how they promoted their own notion of prevention based on principles of precaution. In doing so, it situates this episode in the wider history of the North American women’s health movement and the different meanings assigned to cancer prevention throughout the twentieth century.
Dialysis is a topic and technology rife with public silences. Increasingly dominated by a for-profit sector in the United States, it has continued to be an inaccessible treatment for many patient-consumers in the medical marketplace. Though first made available to all Americans through congressional legislation in 1972, its availability, like that of other forms of medical technology, has been thoroughly shaped by infrastructural racism, poverty, and inequalities, thus excluding certain people from potential life-saving therapies. Focusing on the American South and the experiences of black Americans, Mizelle shows the ways in which dialysis—and also access to transplantation as an alternative treatment—have been influenced by a long history of racism. He notes, moreover, that this happened in a region with devastating rates of obesity, hypertension, diabetes, and environmental stressors that directly influence rates of chronic kidney disease (CKD) in racialized populations. The story of dialysis is thus also a window into scientific racism and supposedly value-neutral politics. Mizelle draws on historical, sociological, and anthropological theory and scholarship on medicine, race, and dialysis. His study of dialysis, and the racial disparities that have surrounded it, highlight key questions of patienthood, access, exclusion, chronic illness, and disability from the final third of the twentieth century to the present.
The conclusion highlights the significance of the Holocaust in shaping the development of British Jewry in the post-war period, and argues that the overwhelming nature of the genocide served to stifle broader trajectories of British Jewish experience. It reinforces the book’s argument that it is important to look at seemingly marginal and transgressive Jewish cultures in order to expose the diversity of British Jewish lives, revealing new patterns of Jewish affiliation and identity. Ultimately, the book argues that British Jewry remains a healthy and vibrant community, and that constructions of decline, and ‘last Jew’ narratives, are wide of the mark.
This chapter examines how x-ray equipment was advertised to American dentists in the early 1930s. Looking at sales literature and training manuals, Hamilton uncovers a set of promises about an imagined patient—one who would see an x-ray machine as a sign of scientific dentistry. These were patients assumed to be educated enough to demand modern dental technique, but without being able to evaluate the actual skill of the dentist. These imagined (wealthy and white) patients were particularly alluring during the Depression, when many Americans were unable to pay for dental care, and dentists struggled to attract paying customers. Examining the design of dental x-ray machines themselves, Hamilton then asks how these imagined patients were reflected in the features of the equipment. She argues that there was a striking contrast between the way that patients were expected to see dentists as experts, and the actual practice of dental radiography. Dental x-ray equipment took many decisions out of the hands of the dentists who were assured that little skill or knowledge was necessary to operate the machines safely. Thus, while the advertising portrayed active, discerning consumers who would demand skilled dentists, the design of the machines expected passive, compliant patients, and encouraged dentists to place their trust in the equipment rather than their own judgement.
This chapter serves as a companion to Chapter 1, with a focus on regions other than the British Isles and the Czech lands. Slave labour in the Viking world, Rus, Francia, Hungary, Byzantium, and the Islamic world varied widely, ranging from small-scale agricultural work in the North Atlantic to eunuchs and slave soldiers in Iberia and the Middle East. Discussion of each of these regions pays special attention to instances in which British, Irish, and Slavic slaves are distinguishable, as in the case of saqāliba (Slavic) eunuchs and soldiers in the Umayyad caliphate and Irish slaves in Iceland. The regions themselves can be separated into two categories: centres of demand and transit zones. The Islamic world, Byzantium, and the Viking world served as the principal centres of demand that required the importation of vast numbers of foreign slaves, particularly in the tenth century. Francia, Hungary, and Rus served primarily as transit zones connecting the areas of supply to the centres of demand, and did not themselves experience comparable increases in the demand for slaves.
The ninth and tenth centuries saw significant external demand for slaves and increases in the raiding that created them within the slaving zones of the British Isles and east central Europe. This chapter examines the connections between areas of demand and supply to further explore the context of the rise, peaks, and denouement of slave trading out of our two slaving zones. This encompasses the period of Viking settlement and trade expansion in the British Isles, as well as the consolidation of the English kingdom and the Danish conquest. In the Czech lands, slave trading is set against the backdrop of the Přemyslid dukes’ political ascendancy and shifting alliances and the development of Slavic and Hungarian states. These various contexts, some deliberate and some coincidental, enabled the establishment of long-distance trade routes that indirectly connected areas of supply with areas of demand. Exploration of these routes highlights the diversity of people involved and the variety of destinations of enslaved people.
The introduction explores trends in Jewish history, considering how approaches to the subject have changed over time. It probes the impact of antisemitism and violence on Jewish thinking, observing the ways in which these forces have shaped the stories that Jewish communities tell about themselves. It contends that setting aside antisemitism, and focusing more broadly on the diversity of Jewish lived experiences, allows a different set of stories about Jewish Britain to come to the fore. The introduction questions who and what should be the focus in a history of Jewish Britain, arguing that it is important to recognise the diversity of the community if a clearer picture of its past is to emerge. It observes that Jewish hostility towards certain behaviours and beliefs (anti-Zionism, marrying non-Jews, homosexuality) have silenced many Jewish voices, and that these need to be amplified in order for the breadth of British Jewish experience to be properly understood. Moreover, the introduction asserts, understanding the Jewish periphery is central to understanding the thinking and beliefs that have shaped the Jewish centre. The introduction then explores the interplay between communal organisations and families and individuals, noting that communal agendas have often stifled everyday personal stories and experiences. Ultimately, it argues that digging in different places, exploring the histories of hitherto under-researched communities and individuals, allows a different and fuller picture of Jewish Britain to emerge.
The introduction draws attention to the study of slave trading and its importance as a phenomenon separate from the institution of slavery. It also outlines the objectives of the book, the sources and ideas around which it is constructed, and the contribution of a comparative study over a long chronology. Because slaving activities were linked to demand both within a society and outside it, they could operate on very different terms from those of slavery as a local legal or social institution. External demand could dictate the scale and targets of enslavement; an increase in slave raiding need not indicate a local increase in demand, and nor does the movement away from slave labour need to correlate with the end of slave trading. It is therefore imperative that we understand how early medieval slaving functioned in its own right, and not only as a facet of slave-holding practices. A second section outlines the place of this work relative to other studies of historical enslavement and slave trading, especially what has been undertaken regarding the early Middle Ages. It discusses the ways in which significant conclusions are presented in case studies and how broader historiographical trends, namely Marxist theory and ideas of Christian amelioration, have skewed our perspective of slave trading in medieval Europe. A further section on methodology highlights the predominant types of sources used, both textual and archaeological, and some of the major problems and limitations inherent in them.
In the critical introduction to Technology, health, and the patient consumer, the authors address the connection between technology and consumerism in the history and the historiography of medicine and healthcare. They discuss the ways in which different technologies have shaped patients’ roles as consumers since the early twentieth century and how historians have described and analysed them. Do technologies help, hinder, or complicate patients’ experiences? Do they increase or limit their access to care or multiply their medical and personal choices? How has technology shaped our roles as patients and health consumers and the growing conflation between them? Serving as an entry point into such questions and this history, the introduction unfurls these little explored relationships from the early twentieth century to the present, showing how the growth of technological devices and systems within hospitals, homes, and other care settings was entangled with a simultaneous expansion in consumerism in Western medicine. It suggests that patients as consumers have shaped such technologies, and equally, that technology has had a lasting effect on ways of being a patient.
Harms caused by the unintended effects of prescription drugs are a leading cause of disability and death, though one which current regulatory arrangements are ill-equipped to address. This chapter interrogates the changing role of patients in bringing such side effects to light. Until the end of the twentieth century, regulatory agencies relied exclusively on adverse drug reports filed by physicians to spot side effects that clinical trials failed to identify prior to a drug’s market introduction. In this framework of professional reporting, complaints from those who consumed drugs reached regulators only if they were relayed by doctors who prescribed the drugs. However, when the internet opened to the general public in the 1990s, medicine takers began to share their experiences online. In this chapter, Lentacker explores the implications of this change through the example of rxisk.org, a website created in 2012 by two clinicians and one anthropologist in an effort to convert patients’ side effect stories into usable evidence about prescription drugs. So far, scholars have analysed the circulation of patient stories online in two different (but not necessarily separate) knowledge economies: an affective economy of airing and sharing, and an extractive economy of data collection and capitalization. Drawing on interviews with RxISK’s creators and analysis of the site’s design, the author instead shows how rxisk.org charted a distinct path in its attempt to transform patients-as-objects into patients-as-subjects of knowledge.