Book Review

Emily K. Abel's fine book allows us to penetrate the usually veiled, predominantly feminine world of familial caregiving. Family members have provided the majority of care for millennia. But as Abel, professor of health services and women's studies at the University of California, Los Angeles (UCLA), observes, the meaning attached to such caregiving—even more than the techniques employed—varies from culture to culture and changes over time. Through letters, diaries, and records of charity organizations, we are shown a wide sampling of the messy, grim, inspiring scenes of familial nursing across a wide spectrum of geographic and social settings. Rarely have power struggles between nineteenth- and early-twentieth-century families and health care professionals been as closely interpreted as in the present volume.

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Significantly, the scenes and struggles at the heart of Abel's account coincided with the gradual professionalization of both medicine and nursing in the United States. Power relations between professionals and the wives, daughters, family friends, and occasionally the fathers and sons of patients constitute a major element in her analysis. Who, for example, really decided on a course of therapy for a chronically ill relative? Who decided when a given treatment should be abandoned in favor of something new? How were medical (or nursing) "orders" interpreted? How closely were they followed? How did race, social class, and, most important in such matters, gender affect the balance of power in the sickroom?

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