The Icepick Surgeon

De dokter uit de titel was een man die twee-handig was, en daarmee simpelweg twee patienten tegelijk een lobotomie kon geven, met een icepick in iedere hand, en dan een beetje goed mikken bij de oogkassen.

“The lobotomy had its own hazards, including infections. Freeman always pooh-poohed what he called “all that germ crap,” and often operated without gloves or a face mask. On one occasion, two inches of steel actually broke off inside a patient's brain, necessitating a run to the emergency room.”

Boek dat diverse cases uit de wetenschap beschrijft waar de wetenschappers onbewust of bewust de regels der ethiek overschreden, all for the greater good, plus vaak bruggetjes naar het nu, zodat we niet vergeten dat het nu ook nog steeds heel makkelijk is om in de fout te gaan.

Tot slot een verkenning over wat in de toekomst fout zou kunnen gaan, dat voelt allemaal een beetje onwaarschijnlijk, maar:

“But the future probably always seems outlandish from a distance. If you'd told someone in 1900 that people today would be using boxes of electrons to steal cash from banks or graft their ex-girlfriends' faces into revenge porn, that would have seemed pretty crazy. Yet here we are.”

Okay so: this was a pretty fun read for the most part: goes by pretty fast, and is largely engaging. Kean tells these admittedly gruesome stories with a good, engaging narrative voice that’s very entertaining, while still being very serious about the truly atrocious and awful events exhibited in the stories he narrates.

He also makes a very good case for his stand that ethics and science must work together in order for the latter to move forward, and for the latter to inform the former. Through the stories he tells, Kean makes a good case of the argument that, in order for science to be considered “good” science, then research and experimentation must be done with good ethics in mind, because sacrificing those ethics not only means pointless human suffering, but can also create bad data.

However, while he makes clear that a commitment to ethical research is important, he also takes the time to point out that it isn’t necessarily EASY, especially when dealing with data that was obtained in less than ethical ways, like the biomedical data obtained by the Nazis from their nightmarish experiments. While not all of that data is useful, some of it IS, and in many cases is the ONLY data of its kind. But because of who and how that data was produced, there is a reluctance to reference it or use it. What, then, must be done? Should the data be ignored because it was created by Nazis conducting experiments that tortured and killed people? What if that data could possibly help save other people’s lives? This, among other similar conundrums, is something Kean tackles across the book, tying them to the practice of scientific research as it is done in the present day.

While the stories told in this book certainly fit the goal that Kean is trying to achieve, I do find myself wishing that certain other stories had been included. For example: the story of J. Marion Sims, who conducted experiments on slave women and, thanks to his research, is now considered the “Father of Gynecology.” Or the story of Henrietta Lacks, whose “immortal cells” are vital to biomedical research. Those would have fit in very well with Kean’s goal of illustrating how women and minorities are very frequently exploited by scientists for their own ends - but I suppose that he excluded their stories because others had already told them, or were about to tell them. After all, Rebecca Skloot’s book The Immortal Life of Henrietta Lacks was published in 2010 and is considered to be one of the most popular books on Lacks and the case surrounding her. And though this book was released in 2021, it is likely Kean knew of J.C. Hallman’s book Say Anarcha, which covers J. Marion Sims’ role in gynecology from the perspective of one of the slave women he experimented on.

Overall, this book is a pretty solid read that’s entertaining, while still managing to convey the hard, harsh truth about the fallibility of science and scientists throughout history. This fallibility, Kean reminds the reader, is good to keep in mind, as it helps keep both laypeople and scientists accountable, and thus improves science as a discipline and a practice, to the betterment of all.

In Icepick surgeon Sam Kean looks for scientists who did bad things in the name of science. In doing so, he mostly tries to avoid the easy ways out: most of the chapters are about sincere scientists, who at least start out meaning well, not cartoon villains. And on the flip side, Kean makes clear that there is no justification for the sorts of harm inflicted by these scientists – he reminds us again and again that this is not how science advances.

Reading it, I was stunned at how many of the tales were tales about scientists who did bad things in the name of MONEY, not science: taking to piracy, slave-trading, even murder with the goal of raising enough money to continue doing science. I complain bitterly about the NIH and the silly hoops for grant-funding, but at least science is funded. So much of historical science was only for people who were already gentry and could self-fund.

I thought this was really interesting and a good reminder that unethical science is bad for a multitude of reasons!

I listened to it on audio and there were some occasions when Kean plugs his own podcast - which is fine?! - but it was unclear while listening if those were footnotes or in the text itself. In the text itself that seems weird but maybe there was no other way to express those notes in the audio version. It just threw off the groove a bit.

I enjoyed this book quite a bit, the stories inside were fascinating and gruesome, while also getting into the moral complexity of using research as ill-gotten gains. The Nazis are the most obvious to come to mind here, but there were lots of shady research experiments done in the past. The story that stuck out the most to me was the one from Winnipeg regarding the David Reimer case- I live in Winnipeg and I had never heard anything about this. This story was absolutely horrifying!

I did have some problems with this book, though. The author did use outdated language a few times; It mostly didn't bother me too much because due to the context, I could tell that Kean was trying to keep the language “as it was”- I believe he used Indian after referring to a group that had Indian in their name and their stated goal was to “kill Indians”. While it's a term I would normally look down upon an author using today, I felt in the context to switch to “indigenous” would have felt awkward- but a disclaimer after the fact would have been nice, especially since many Americans still use the term colloquially, to help normalize it felt weird. The second irritating thing he did was to keep promoting his podcast. Such a weird thing to do. Maybe it's an audiobook thing only, and in the physical book, they are instead footnotes? Either way, it was jarring.

I recommend this book, but with some caveats. It can be pretty heavy, and it's possible the language may put you off it (or the constant podcast-advertising).