Book Review: The Mind Is Not The Heart (Eva J. Salber, 1989)

Eva J. Salber’s book, The Mind is not the Heart: Recollections of a Woman Physician, was first published in 1989, and I was lucky enough in 1990 to be asked to write a review of it for the journal Sociology of Health and Illness.
Thirty years later this book is still available, and people are still reading it. so here is my small contribution to Dr Salber’s literary profile.
The book is now available in hard and paperback, and on Kindle.

One further observation: I was startled on revisiting my review to see that, Dr Salber having emphasised the failure of South Africa and the USA to have a national health service, I actually ended my commentary with concerns about the viability of the British NHS, even back all those years ago when the UK was governed by a previous Conservative Government.  Some things for the public good, Eva Salber might agree, require unceasing vigilance even when the battle seems to have been won.

Book Review

Eva J. Salber (1989) The Mind is not the Heart: Recollections of a Woman Physician

Durham and London: Duke University Press, 1989, xvi + 282 pp.

This is an autobiographical account of the life and work of Eva Salber, a physician, epidemiologist and practitioner of social medicine who has over the years pursued a distinguished career in South Africa, England (briefly) and the USA – whilst also, on her own emphasis, raising four children and acting as help-mate to her colleague-spouse.

Three different observations in this book, however, perhaps illustrate some of the difficulties which confront any attempt at a balanced review of it.  Firstly (and least importantly), Eva Salber herself indicates (pp. 166-7) that her early attempts at narrative (as opposed to ‘scientific’ writing) were characterised by ‘colorless’ presentation; unfortunately for this reader at least an element of this presentation remains.

Secondly – much more positively – Dr. Salber tells us (p. 238) that she wrote this book ‘as a teacher reaching out to unknown students and doctors – asking them to remember the people … who need their understanding and compassion as much as their technical knowledge’: and thirdly, most crucially, she stresses throughout her book that ‘medicine by itself can’t control sickness due to poverty, bad housing, lack of education, environmental hazards and racial and class discrimination’ (p. 271).

Here, then. the reviewer encounters a conundrum.  There is far too little emphasis in most ‘scientific’ work on the contexts which brought forth the results.  For her honesty and directness in embedding the outcome of her research and practical projects in her personal / professional experience Eva Salber is to be commended; and, indeed, we learn from her account much about, for instance, the everyday experience both of impoverished and racially segregated (South African) or ethnic (American) communities and, on another level, of women academics and practitioners in the male milieux of prestigious medical schools.

Similarly, Eva Salber’s clear message to her unknown colleagues – that medicine alone is not enough to vitiate suffering – is welcome and necessary.  Her conviction that political and social factors condition well-being is strongly projected and should be received by as many medical practitioners and decision-makers as possible.

On the other hand, however, it may be that the very variety of ‘messages’ which this book attempts to convey are what make it a slightly difficult read.  As autobiography it is at times too precise and pedantic; and as an (entirely justifiable) treatise on the importance of the socio-political contexts of well-being and disease it is perhaps too sporadic and unstructured.

But perhaps such comments diminish unfairly the major positive features of this book.  It dissects without fear the iniquities of apartheid and racial discrimination, and their effects on health, in two of the richest countries in the world; and it discusses very honestly the contexts of the decisions which at least one epidemiologist made in directing other scientific work.  For these insights Eva Salber deserves full acknowledgement.

Finally, for British readers at least Dr. Salber offers another observation which she would probably never have expected to be of relevance to the country which provided many of her teachers and professional exemplars: ‘… it is shameful that still today South Africa and America are linked together as the only two industrialised countries of the world which do not have a national health service program in place’. (p. 272) How long, one asks as we enter the 1990s, before these two countries are joined by an equally shameful third?

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