This gripping history shows how the electronic devices we use to access care influence the kind of care we receive. The Doctor Who Wasn't There traces the long arc of enthusiasm for-and skepticism of-electronic media in health and medicine. Over the past century, a series of new technologies promised to democratize access to healthcare. From the humble telephone to the connected smartphone, from FM radio to wireless wearables, from cable television to the "electronic brains" of networked mainframe computers: each new platform has promised a radical reformation of the healthcare landscape. With equal attention to the history of technology, the history of medicine, and the politics and economies of American healthcare, physician and historian Jeremy A. Greene explores the role that electronic media play, for better and for worse, in the past, present, and future of our health. Today's telehealth devices are far more sophisticated than the hook-and-ringer telephones of the 1920s, the radios that broadcasted health data in the 1940s, the closed-circuit televisions that enabled telemedicine in the 1950s, or the online systems that created electronic medical records in the 1960s. But the ethical, economic, and logistical concerns they raise are prefigured in the past, as are the gaps between what was promised and what was delivered. Each of these platforms also produced subtle transformations in health and healthcare that we have learned to forget, displaced by promises of ever newer forms of communication that took their place. Illuminating the social and technical contexts in which electronic medicine has been conceived and put into practice, Greene's history shows the urgent stakes, then and now, for those who would seek in new media the means to build a more equitable future for American healthcare.

Generic drugs are now familiar objects in clinics, drugstores, and households around the world. We like to think of these tablets, capsules, patches, and ointments as interchangeable with their brand-name counterparts: why pay more for the same? And yet they are not "quite" the same. They differ in price, in place of origin, in color, shape, and size, in the dyes, binders, fillers, and coatings used, and in a host of other ways. Claims of generic equivalence, as physician-historian Jeremy Greene reveals in this gripping narrative, are never based on being "identical" to the original drug in all respects, but in being the same "in all ways that matter.

Generic" is the first book to chronicle the social, political, and cultural history of generic drugs in America. It narrates the evolution of the generic drug industry from a set of mid-twentieth-century "schlock houses" and "counterfeiters" into an agile and surprisingly powerful set of multinational corporations in the early twenty-first century.

How do we know what parts of a pill really matter? Decisions about which differences are significant and which are trivial in the world of therapeutics are not resolved by simple chemical or biological assays alone. As Greene reveals in this fascinating account, questions of therapeutic similarity and difference are also always questions of pharmacology and physiology, of economics and politics, of morality and belief.

The substitution of bioequivalent generic drugs for more expensive brand-name products is a rare success story in a field of failed attempts to deliver equivalent value in health care for a lower price. Greene's history sheds light on the controversies shadowing the success of generics: problems with the generalizability of medical knowledge, the fragile role of science in public policy, and the increasing role of industry, marketing, and consumer logics in late-twentieth-century and early twenty-first century health care.

When asked to compare the practice of medicine today to that of a hundred years ago, most people will respond with a story of therapeutic revolution: back then we had few effective remedies, now we have more (and more powerful) tools to fight disease, from antibiotics to psychotropics to steroids to anticancer agents. This collection challenges the historical accuracy of this revolutionary narrative and offers instead a more nuanced account of the process of therapeutic innovation and the relationships between the development of medicines and social change. These assembled histories and ethnographies span three continents and use the lived experiences of physicians and patients, consumers and providers, and marketers and regulators to reveal the tensions between universal claims of therapeutic knowledge and the actual ways they have been used and understood in specific sites, from postwar West Germany pharmacies to twenty-first century Nigerian street markets. By asking us to rethink a story we thought we knew, Therapeutic Revolutions offers invaluable insights to historians, anthropologists, and social scientists of medicine.

Populated by curanderos, midwives, bonesetters, witches, doctors, nurses, and the indigenous people they served, this nuanced history demonstrates how cultural and political history, misogyny, racism, and racialization influence public health. In the first half of the twentieth century, the governments of Ecuador and Guatemala sought to spread scientific medicine to their populaces, working to prevent and treat malaria, typhus, and typhoid; to boost infant and maternal well-being; and to improve overall health.   Drawing on extensive, original archival research, David Carey Jr. shows that highland indigenous populations in the two countries tended to embrace a syncretic approach to health, combining traditional and new practices. At times, both governments encouraged—or at least allowed—such a synthesis: even what they saw as "nonscientific" care was better than none. Yet both, especially Guatemala's, also wrote off indigenous lifeways and practices with both explicit and implicit racism, going so far as to criminalize native medical providers and to experiment on indigenous people without their consent. Both nations had authoritarian rule, but Guatemala's was outright dictatorial, tending to treat both women and indigenous people as subjects to be controlled and policed. Ecuador, on the other hand, advanced a more pluralistic vision of national unity, and had somewhat better outcomes as a result.

Generic drugs are now familiar objects in clinics, drugstores, and households around the world. We like to think of these tablets, capsules, patches, and ointments as interchangeable with their brand-name counterparts: why pay more for the same? And yet they are not quite the same. They differ in price, in place of origin, in color, shape, and size, in the dyes, binders, fillers, and coatings used, and in a host of other ways. Claims of generic equivalence, as physician-historian Jeremy Greene reveals in this gripping narrative, are never based on being identical to the original drug in all respects, but in being the same in all ways that matter. How do we know what parts of a pill really matter? Decisions about which differences are significant and which are trivial in the world of therapeutics are not resolved by simple chemical or biological assays alone. As Greene reveals in this fascinating account, questions of therapeutic similarity and difference are also always questions of pharmacology and physiology, of economics and politics, of morality and belief. Generic is the first book to chronicle the social, political, and cultural history of generic drugs in America. It narrates the evolution of the generic drug industry from a set of mid-twentieth-century "schlock houses" and "counterfeiters" into an agile and surprisingly powerful set of multinational corporations in the early twenty-first century. The substitution of bioequivalent generic drugs for more expensive brand-name products is a rare success story in a field of failed attempts to deliver equivalent value in health care for a lower price. Greene's history sheds light on the controversies shadowing the success of generics: problems with the generalizability of medical knowledge, the fragile role of science in public policy, and the increasing role of industry, marketing, and consumer logics in late-twentieth-century and early twenty-first century health care.

The second half of the twentieth century witnessed the emergence of a new model of chronic disease -- diagnosed on the basis of numerical deviations rather than symptoms and treated on a preventive basis before any overt signs of illness develop -- that arose in concert with a set of safe, effective, and highly marketable prescription drugs. Physician-historian Jeremy A. Greene examines the mechanisms by which drugs and chronic disease categories define one another within medical research, clinical practice, and pharmaceutical marketing, and he explores how this interaction has profoundly altered the experience, politics, ethics, and economy of health in late-twentieth-century America. His provocative analysis sheds light on the increasing presence of the subjectively healthy but highly medicated individual in the American medical landscape, suggesting how historical perspective can help to address the problems inherent in the program of pharmaceutical prevention.

"Greene describes the relationship between advances in treatment, the incentives of manufacturers, and the effect on the public of increased attention to prevention... The risk-benefit trade-offs of the quantitative approach are complex, and Greene's historical revelations are timely." -- New England Journal of Medicine

"One of the best, and most significant, books published recently on the development of medical practice and the pharmaceutical industry in the U.S. in the second half of the twentieth century." -- Social History of Medicine

"Greene focuses on the question of how public health priorities became closely aligned with the pharmaceutical industry's marketing practices... [and] offers a nuanced descriptionof the development of 'therapeutics of risk reduction' with multiple lines of influence, subtle power shifts, and gains and losses for patients and physicians." -- Chemical Heritage

"A gripping story... Greene warns us in his superb book that things are not always as they are claimed." -- Yale Journal for Humanities in Medicine

Jeremy A. Greene is a fellow in the Department of Social Medicine at Harvard Medical School and a resident in the Department of Medicine at Brigham and Women's Hospital.

Populated by curanderos, midwives, bonesetters, witches, doctors, nurses, and the indigenous people they served, this nuanced history demonstrates how cultural and political history, misogyny, racism, and racialization influence public health. In the first half of the twentieth century, the governments of Ecuador and Guatemala sought to spread scientific medicine to their populaces, working to prevent and treat malaria, typhus, and typhoid; to boost infant and maternal well-being; and to improve overall health.   Drawing on extensive, original archival research, David Carey Jr. shows that highland indigenous populations in the two countries tended to embrace a syncretic approach to health, combining traditional and new practices. At times, both governments encouraged—or at least allowed—such a synthesis: even what they saw as "nonscientific" care was better than none. Yet both, especially Guatemala's, also wrote off indigenous lifeways and practices with both explicit and implicit racism, going so far as to criminalize native medical providers and to experiment on indigenous people without their consent. Both nations had authoritarian rule, but Guatemala's was outright dictatorial, tending to treat both women and indigenous people as subjects to be controlled and policed. Ecuador, on the other hand, advanced a more pluralistic vision of national unity, and had somewhat better outcomes as a result.