| Book Review | Health and History, 10.2

Book Reviews

Dorothy Page, Anatomy of a Medical School. A History of Medicine at the University of Otago, 1875–2000 (Dunedin: Otago University Press, 2008). ISBN-978-1-877372-24-7. 406 pp.

Written primarily for and about a trans-national and trans-generational community of medical graduates, administrators, researchers, and teachers who are connected in various ways to the School of Medicine at the University of Otago, Dunedin, New Zealand, this strikingly beautiful, readable (and reasonably priced) book is also a work of meticulous historical scholarship, the culmination of a decade of investigative archival research by academic historian, Dorothy Page.

The author has dug deeply in a rich vein of institutional, biographical, and family history laid down by some of her story's key players; but this book is far more than a colourful retelling and updating of a familiar institutional narrative with larger than life characters and intriguing twists of plot. Dorothy Page provides a fresh and rigorous assessment of the contributions of influential individuals, in particular the first three Deans, Professors Scott, Ferguson, and Hercus, whose combined period of leadership spanned more than eighty of the School's first 125 years, and around whose careers the oral traditions and written narratives of the Otago Medical School are often told. Always conscious of the importance of international accreditation and contacts, these three men led the School from early days (opening with one classroom, one student and one cadaver) to establishment as a research and teaching centre of world-renown before World War II. Generous local endowments and regular government funding from the early years of the twentieth century assisted this process, as did other national developments, such as the formation of the Medical Research Council in 1937. There was a steady proliferation of medical teaching institutions globally after World War II and no space for complacency. At a national level, the disestablishment of the University of New Zealand and its replacement by four separate autonomous institutions led by executive Vice Chancellors appeared to threaten the privileged position of the Medical School, which was criticised from within and without during years of 'crisis' in the 1960s.

In a final probing section on what might be described as a 'postmodern' era (between 1981 and the turn of the millennium), Dorothy Page carefully untangles the responses of the Medical School and its interconnecting institutions to repeated political attempts to overhaul the health system in a period of monetarist economic reform. She shows convincingly, however, that the most far-reaching effects on teaching and learning in the last decades of the twentieth century are attributable to social rather than economic change. There was a new emphasis on patients' rights and cultural backgrounds, and in terms of gender, social class and ethnicity, the students themselves were far more diverse as a group than any time in the preceding century. While the bifurcation of medical specialities continued apace, there was effort to teach students the subject matter of their pre-clinical years in more integrated manner than hitherto; learning became problem-centred and self-directed with less emphasis on final examinations.

This book is rich with human interest and anecdote. The illustrations are superb, and achieve far more besides illuminating the text. There are reproductions of original source materials, such as patient case notes and excerpts from the Medical Digest; and many evoking photographs of students and staff at work, at war, and at play. Perhaps most impressive visually are the drawings and cartoons, works of art by the medical community as well as professional artists. Interwar modernist Russell Clark was illustrator for several editions of Medical Digest in the 1930s: his arresting study, The Operating Theatre provides Dorothy Page's book with its brilliant front cover image. There is strong testimony here to the rich intellectual, artistic, and social culture that is part of the making, and also the achievement, of Otago Medical School.

Like the best of contract histories, this is a book that succeeds on many levels. Its multiple purposes are served well by a fivepart chronological structure with further subdivision into twenty-eight succinct thematic chapters, each chapter broken down by subheadings with 'sub-plots' appearing as insets to the main body of text. For example, there are brief biographical essays on major characters, and quotations from personal writing and poetry (also doggerel) that illustrate some of the book's important themes. Examples include 'the Microscope' (p. 146), 'Fee for Parts' (p.144), and 'Cadaver Spoken Here' (C.8), which reflect on how others see us [medical students], the magnitude of the gift, and past humanity of the cadaver, respectively; and also 'A day in the life of a typical Muslim medical student' (p. 280).

Rather than providing a dissection (or, indeed, a vivisection, as Dorothy Page wittily reminds us—for the institution is, of course, a growing and contracting, living organism), Anatomy of a Medical School is a magnificent integrative achievement that places the changing pedagogy, people, and purposes of Otago Medical School within the multiple contexts of western medicine, Empire, New Zealand tertiary education and government health policy, and local and global events; a significant current of subtext is the changing public expectations of medical practice and medical practitioners over a lengthy period. This book is worth reading for its many implicit suggestions for health and history research: attitudes to Māori health and medicine at different periods, and public reaction to the 1875 Anatomy Act, are but two examples.

Anatomy of a Medical School will do more than adorn coffee tables. Readers who have been transmitters and receptors of stories associated with Otago Medical School will have their memories refreshed and their understandings enhanced. This book will also intrigue and inform a far wider audience, including graduates and undergraduates interested in historical studies of interconnections between societies, cultures, science, and health.

ROSALIND McCLEAN

UNIVERSITY OF WAIKATO

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