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A review by katethekitcat
Fighting for Life by Helen Epstein, S. Josephine Baker
4.0
Quite simply, I adored this book. It’s one of those reads where people need to be careful not to walk by you, because you’ll put the book down and make them listen to a blow-by-blow account of everything you just learned in the last few pages.
This is the autobiography of Dr. S. Josephine Baker, the first director of the New York City Bureau of Child Hygiene who is credited with saving at least 90,000 lives because of her work in the public health space. Obviously as a public health nerd who works in government, I’m into that. But it’s more than a story about public health: it’s a look back at history (she served from 1908-1925, earned her medical license when women had just only started becoming doctors, fought for women’s suffrage, and saw both world wars) and how nothing about humans has changed. We still suck in the same ways. We still rule in the same ways. We still worry about the same things! – she has a section at the end hypothesizing why the birth rate is falling, and lo and behold, it’s because new families don’t have enough money and rich families are uncertain about bringing kids into a world with such uncertain futures before them.
Baker tells her story with an eye for patterns across years, with deep experience – hands on, trial-and-error, get-in-the-thick-of-it-not-just-read-about-it experience – and pragmatism. Events that would have bowled me over had I experienced them, she simply takes in stride. Even if you aren’t in public health, this is a great look back at life at the turn of the 1900’s. Don’t take my word for it – Anthony Bourdain himself praised this book, his endorsement is right on the back!
I can’t finish this review without leaving a long list of all the amazing things Baker talked about. That’s below, but one final note: I picked this book up on a whim, for $4, off a bargain table at a book store. Don’t make my mistake. Go get this book intentionally.
• Baker used randomized control trials (even if she didn’t call them that) to test her theories – when she started working, it was generally accepted that preventing disease was impossible and it could only be dealt with one people were already sick.
• We have school nurses because of a program Baker started!
• Baker witnessed a doctor testifying to Congress arguing against appropriations for money for preventative health because it was saving too many people and young men wouldn’t want to study to be doctors anymore. She described a petition some doctors had sent to the mayor of New York, asking her department to be shut down because her measures were cutting into their profits (no more illness), and described it as one of the best compliments to her work she ever received.
• A master of change management, Baker was working, over and over, with city residents who didn’t trust her expertise and maybe didn’t even speak English. Rather than let it stop her work and shout about her expertise, she found ways to earn that trust.
• Next time someone shouts to you about “design thinking” and “understanding the end user,” remember Baker did it first – and she did it by working in the field and seeing the need. She and her department straight up invented half the things they needed, and they did it out of necessity.
• Foresaw the debate of today around C-sections/natural births – she thought midwives (if certified and trained! – which wasn’t true when she started) and non-medical interventions for childbirth likely had better outcomes.
• Cautions against relying too much on fancy technological tests for diagnosis, and not enough on listening to the patient and performing a physical examination.
• Writing from the late 1930’s, Baker discusses how equal women in medicine are compared to back in the early 1900’s, when she went to medical school. It’s interesting to contrast that to today, when we consider the late 1930’s to still be a terrible time professionally for women. Baker observes how women can usually only get good jobs in strong economy when there’s a shortage – in bad economies, they’re the first to lose out.
• Baker was deeply sorrowful upon realizing what really started getting government’s to care about children’s health was the world wars, as they realized they needed population to draft for future wars.
This is the autobiography of Dr. S. Josephine Baker, the first director of the New York City Bureau of Child Hygiene who is credited with saving at least 90,000 lives because of her work in the public health space. Obviously as a public health nerd who works in government, I’m into that. But it’s more than a story about public health: it’s a look back at history (she served from 1908-1925, earned her medical license when women had just only started becoming doctors, fought for women’s suffrage, and saw both world wars) and how nothing about humans has changed. We still suck in the same ways. We still rule in the same ways. We still worry about the same things! – she has a section at the end hypothesizing why the birth rate is falling, and lo and behold, it’s because new families don’t have enough money and rich families are uncertain about bringing kids into a world with such uncertain futures before them.
Baker tells her story with an eye for patterns across years, with deep experience – hands on, trial-and-error, get-in-the-thick-of-it-not-just-read-about-it experience – and pragmatism. Events that would have bowled me over had I experienced them, she simply takes in stride. Even if you aren’t in public health, this is a great look back at life at the turn of the 1900’s. Don’t take my word for it – Anthony Bourdain himself praised this book, his endorsement is right on the back!
I can’t finish this review without leaving a long list of all the amazing things Baker talked about. That’s below, but one final note: I picked this book up on a whim, for $4, off a bargain table at a book store. Don’t make my mistake. Go get this book intentionally.
• Baker used randomized control trials (even if she didn’t call them that) to test her theories – when she started working, it was generally accepted that preventing disease was impossible and it could only be dealt with one people were already sick.
• We have school nurses because of a program Baker started!
• Baker witnessed a doctor testifying to Congress arguing against appropriations for money for preventative health because it was saving too many people and young men wouldn’t want to study to be doctors anymore. She described a petition some doctors had sent to the mayor of New York, asking her department to be shut down because her measures were cutting into their profits (no more illness), and described it as one of the best compliments to her work she ever received.
• A master of change management, Baker was working, over and over, with city residents who didn’t trust her expertise and maybe didn’t even speak English. Rather than let it stop her work and shout about her expertise, she found ways to earn that trust.
• Next time someone shouts to you about “design thinking” and “understanding the end user,” remember Baker did it first – and she did it by working in the field and seeing the need. She and her department straight up invented half the things they needed, and they did it out of necessity.
• Foresaw the debate of today around C-sections/natural births – she thought midwives (if certified and trained! – which wasn’t true when she started) and non-medical interventions for childbirth likely had better outcomes.
• Cautions against relying too much on fancy technological tests for diagnosis, and not enough on listening to the patient and performing a physical examination.
• Writing from the late 1930’s, Baker discusses how equal women in medicine are compared to back in the early 1900’s, when she went to medical school. It’s interesting to contrast that to today, when we consider the late 1930’s to still be a terrible time professionally for women. Baker observes how women can usually only get good jobs in strong economy when there’s a shortage – in bad economies, they’re the first to lose out.
• Baker was deeply sorrowful upon realizing what really started getting government’s to care about children’s health was the world wars, as they realized they needed population to draft for future wars.