Anatomy of a Medical School. A History of Medicine at the University of Otago, 1875-2000 by Dorothy Page

Abstract

Dorothy Page, Anatomyof a Medical School. AHistory of Medicine at the University ofOtago, 1875-2000 (Dunedin: Otago University Press, 2008). ISBN-978- 1-877372-24-7. 406 pp. Book Reviews Written primarily for and about a trans-national and transgenerational 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 farmore 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 separateautonomous institutions led by executive Vice Chancellors appeared to threatenthe privileged position of the Medical School, which was criticised from within and without during years of 140 Health&Histoty,2008. 10/2 Health& History• 10/2 • 2008 141 '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, thatthe most far-reachingeffects on teaching and learning in the last decades of the twentieth centuryareattributableto social ratherthaneconomic 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 matterof theirpre-clinical years in more integratedmanner 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 illustratorfor several editions of Medical Digest in the 1930s: his arresting study, The Operating Theatre provides Dorothy Page's book with its brilliant frontcover image. There is strong testimony here to the rich intellectual, artistic, and social culture thatis partof 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 structurewith further subdivision into twentyeight 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...