Scattered limbs: fragments for a history of medicine.

Like literature, medicine started out as an oral history and became so comprehensively a written one that it is easy to forget where it came from. In fact, it is made up of a myriad of oral histories — anecdotes. For most of their university training medical students are so immersed in the great master narratives of disease recognition and the burning issues of public health that it seems almost comic to be faced with a patient at all. Indeed, it is only relatively recently in the history of medical teaching that students have been taken systematically to patients' bedsides to learn about the natural history of disease, and even now teaching in some continental European countries still runs shy of the body — semiological findings are important, but only if they can be abstracted from patients. The problem with patients is that they like to talk, and some even like to talk back. Anecdotes (literally ‘items that have not been published’ or ‘secret histories’), have a rather dismissed existence in literature, even though one of the great works of English literature, John Aubrey's Brief Lives is appreciatively full of them.1 Most of Aubrey's anecdotes are free-standing exempla of his chosen lives. The 6th-century historian Procopius used them to hint at the true story of the seamy goings-on at the court of Justinian — his anecdotes are stories that debunk the glorious official history. And Stendhal's journeys through France and Italy are full of loosely structured anecdotes, as he struggled to reveal the mishaps that befall his characters on account of a flaw in their understanding of themselves. Nothing points up the difference between the ideal and the real like the well-chosen anecdote. As with anything meaningful which stands at the intersection of two ways of understanding the world, …