Tailored from The Nice Shadow: A Historical past of How Illness Shapes What We Do, Assume, Imagine, and Purchase, by Susan Sensible Bauer. Copyright © 2026 by the creator and reprinted by permission of St. Martin’s Press.
CHAPTER 1: THE PRISM
Our our bodies are the crossroads the place our most personal selves meet the world exterior, the matrix the place our ideas and feelings and beliefs are shaped. When our our bodies are functioning properly—once we are wholesome, sturdy, energetic, pain-free—we don’t discover how our bodily existence impacts these ideas, feelings, and beliefs.
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However let a grain of sand grit its means into the works, and all of the sudden every part modifications.
Essentially the most historic tales we possess inform us this. Gilgamesh and his companion Enkidu barrel via the Mesopotamian panorama, blithely elevating hell wherever they go, till fever shoots via Enkidu. All of a sudden, the hardened warrior Gilgamesh is dithering round his buddy’s mattress in agonized confusion, the trajectory of his triumphant life halted useless. Job luxuriates in his fields and herds and household. Then carnage descends on his livestock and youngsters and his personal physique, and he sits within the ashes, scraping his boils with a potsherd. His complete world is overthrown, the dysfunction in his physique the final and best expression of the household disaster.
Illness isn’t “simply” illness. Illness is probably the most intimate expression of our vexed relationship with actuality, the place the place clean functioning all of the sudden fractures and spins aside with out warning. Illness is the nice mirror that displays again our most pressing query: Why does calamity descend with out warning? How can we clarify it? How can we keep away from it? How can we combat again?
Our evolving understanding of what makes us sick, and the way, is a prism via which our notion of the surface world has at all times filtered. As we investigated the causes and cures of illness inside us, we started to vary our views of the universe exterior. When no clarification for sickness was out there, we pleaded with and worshipped deities. When sickness was regarded as associated to the steadiness of humors, we turned obsessive about equilibrium and symmetry. Once we found germs, we created an antiseptic tradition; since person-to-person an infection was the idea du jour, we developed a Tupperware-enclosed, plastic-wrapped, disposable world, and instituted separate consuming fountains and bogs for individuals who carried “completely different” kinds of germs. Once we thought we’d conquered an infection, lastly triumphing over sicknesses that had plagued humanity from the start of reminiscence, we jubilantly turned our focus outward, appeared as much as house, and aimed for the celebrities.
And now that we understand viruses might need the higher hand in spite of everything, we implement borders, fearing outsiders as carriers of “illness”; we mistrust the suggestions of medical science (we really feel it has failed us, in spite of everything), in order that vaccine-denying turns into trendy, homeopathic cures and magnetic therapies are embraced, power therapeutic prospers.
And, in our concern, we predict the top of the world.
These are phases of understanding. However the previous outdated understandings of sickness don’t merely disappear. They linger on. This dissonance typically exhibits up in innocent and passing methods (as when a twenty-first-century mother or father, absolutely conscious {that a} virus causes the widespread chilly, yells, “Don’t go exterior with moist hair otherwise you’ll catch a chilly!”). But it surely additionally causes sharp rifts: A Canadian teenager trusting in God to heal her is compelled by a courtroom to obtain a blood transfusion; anti-vaxxers flip their backs on germ idea and depend on correct life steadiness (yogurt, herbs, cold-water baths) to maintain their youngsters protected.
Our contradictory, overlapping concepts about illness create layers of rigidity, edges of battle, deadly inconsistencies.
Our concepts about illness, not damage. It’s necessary to distinguish between the 2 (as many histories of drugs don’t).
From probably the most historic instances, people understood damage. Sickness might descend from nowhere, however the supply of bodily damage was at all times clear—whether or not you had been trampled by a mastodon, crushed by a falling block of Egyptian limestone, skewered by a bolt from a medieval crossbow, or felled by a bullet from a nineteenth-century Colt revolver. Coping with damage could be difficult and the aftereffects puzzling, however the trigger was apparent. Whether or not by rock, sword, cannon, or bomb, the physique was shattered. There was no thriller as to how or why. Essentially the most historic medical texts all contain this type of damage. Students of medical historical past have marveled over the Papyrus, an Egyptian treatise whose suggestions reveal an anachronistically expert understanding of bodily trauma. With a surprisingly acute sense of scientific technique, attending physicians had been suggested to rigorously study wounds to the brow, or fractures of arm bones, or slashes throughout the neck or cheek; gods and demons are notably absent, commonsense prescriptions for ache reduction and wound care dominate.
However dig slightly bit deeper into this earliest of “scientific” monographs, and we discover decidedly much less rational secondary suggestions. If the damage, correctly cared for, didn’t heal as anticipated, practitioners had been inspired to “drive out the enemy inside the wound” by calling on Isis, begging her to dispel the “hostile pressure inside the blood, the robber of Horus,” the enemy of man that at all times bent its malevolent pressure towards the residing soul.
The surprising turning of a wound was, like sickness, a thriller. Each arrived with out herald, with out seen company. The Theban doctor knew what had precipitated that facial laceration: Falling masonry was an ever-present historic menace. However why did one affected person heal, whereas one other rotted? And what in regards to the shivering, depressing sufferer who merely awoke with a sore throat and cough, after going to mattress wholesome and full of plans the evening earlier than?
It’s the fixed presence of illness, not damage, that has formed the way in which we take into consideration ourselves and our world.
