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Peripheral Nerve: Health and Medicine in Cold War Latin America

2021; Duke University Press; Volume: 101; Issue: 3 Linguagem: Inglês

10.1215/00182168-9052135

1527-1900

Kelly Urban,

History of Medicine and Tropical Health

In 2003, historian Diego Armus reflected on the coalescing subfield of the history of medicine in Latin America. His edited collection Disease in the History of Modern Latin America: From Malaria to AIDS demonstrated that medicine was a fruitful analytical lens for exploring broad historical phenomena in the region. A new volume, Peripheral Nerve: Health and Medicine in Cold War Latin America, edited by Anne-Emanuelle Birn and Raúl Necochea López, illustrates how much the subfield has developed over the last two decades—and how much necessary research remains to be done.In exploring the Cold War through Latin American medicine, Peripheral Nerve pokes holes in two influential narratives that have guided scholars' understandings of the Cold War. The first replicates a bipolar framework and centers action in the Western and Eastern blocs; the second maintains that the United States exercised an all-encompassing hegemony over Latin America, pulling the puppet strings throughout the region to secure its interests. Peripheral Nerve proves how these two assumptions have papered over a more complex reality.The title of the book cleverly speaks to its arguments. “Peripheral” references Immanuel Wallerstein's designation of Latin America as a periphery to the cores of the global economy. “Nerve” speaks to the “impudence or even daring” of the region's actors (p. 19). However, the combined term “peripheral nerve” has a physiological meaning: those nerves that connect the brain and the body, which “often cause the most insistent shock (pain) that makes the body take note” (p. 19). Birn and Necochea López contend that seemingly marginal Latin Americans instead shaped the trajectory of medicine in the global Cold War.Rather than that influence being unidirectional or even bidirectional, Latin Americans occupied a “complex positionality,” one in which there were “multidirectional, tangled connections among all the players” (pp. 3, 22). While Latin Americans did have to contend with constraints imposed by the United States, they did so in multifaceted ways, accepting, rejecting, or reshaping these constraints to serve their own interests. In addition, Latin Americans sought medical connections with a variety of other players in the Cold War, whether in the Soviet Union, the Eastern bloc, or the global South.The editors' historicization of the Cold War emphasizes how complex the era was. The chapters are broken into three chronological sections, allowing readers to trace change and continuity over time. For example, Gabriela Soto Laveaga's chapter on “wonder drugs” in Mexico illustrates that the opening salvo of the Cold War proved unique. In the 1940s and 1950s, one Mexican company maintained a virtual monopoly over steroid production. This power put US pharmaceutical companies at a disadvantage and allowed Mexicans to establish pharmaceutical and political connections with the Soviet Union. However, Mexicans' agency proved tenuous. As the Cold War heated up, US pharmaceutical companies purchased control over Mexico's steroid hormone industry, claiming that such a move was critical for ensuring national security.Other chapters emphasize continuity. For example, Jennifer Lynn Lambe posits that leading Cuban psychiatrists in the 1960s attempted to extirpate Freudian influences and make hegemonic the Pavlovian model (the basis of Soviet psychiatry). Despite their efforts, Freudian traces remained among “an unorthodox mélange” of psychiatric practices in Cuba (p. 159). This landscape bears remarkable similarities to Argentine psychiatrists later in the Cold War. Marco Ramos explores this group of medical practitioners who criticized psychiatric schools in both the United States and the Soviet Union for their inherent imperialism. Instead, these Argentine psychiatrists sought to develop diverse alternatives: from anti-imperial models that could apply throughout the global South to models that were fundamentally local, drawing on national popular practices. Lambe and Ramos thus demonstrate that Latin American psychiatrists did not adhere to a binary East-West divide or a solely North-South orientation; instead, they practiced what Lambe terms a “theoretical eclecticism” (p. 160).The authors within Peripheral Nerve present a dazzling array of medical connections that Latin Americans forged in the Cold War. The editors, however, note that the volume is limited (e.g., its lack of attention to subaltern actors) and detail a set of research questions that still need to be answered. Their compelling agenda centers on more fully understanding medical connections, within and beyond the region.Another fruitful avenue that may exist in the future is more explicitly comparative scholarship. In the foreword, Gilbert Joseph notes that there was a particular Latin American Cold War. Peripheral Nerve contends that there was also a distinctive Latin American Cold War medicine, with long-term legacies, such as Latin America's contemporary leadership in South-South health cooperation. Birn notes that histories of science in the Cold War have remained focused on the two superpowers and “their major allies” (p. 7). One hopes that as the history of medicine in Africa and Asia during the Cold War more fully develops, Latin Americanists researching transnational medical connections will employ a comparative lens toward other parts of the global South. While a difficult task, this will more firmly define what makes Latin American Cold War medicine unique as well as historicizing the causes and identifying the consequences of those characteristics. Peripheral Nerve has proven that such efforts will engage a multidisciplinary audience of readers.