Lerner, Barron H. 1960-

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Lerner, Barron H. 1960-

PERSONAL:

Born September 27, 1960, in Boston, MA; married, 1990; children: two. Education: University of Pennsylvania, A.B., 1982; Columbia College of Physicians and Surgeons, M.D., 1986; University of Washington, Seattle, M.A., 1992, Ph.D., 1996.

ADDRESSES:

Home—New York, NY. Office—Columbia University, School of Public Health, 9th Fl., 722 W. 168th St., New York, NY 10032-3702. E-mail—[email protected].

CAREER:

Historian, physician, educator, and author. Columbia University, New York, NY, instructor, 1989-91, Mailman School of Public Health, assistant professor of medicine and public health, 1993—; Presbyterian Hospital, assistant physician, 1989-91, attending physician, 1993—; University of Washington, Seattle, WA, Instructor, 1991-93; Angelica Berrie-Gold Foundation Associate Professor of Medicine and Public Health. Director of Ethics Fellowship for Department of Medicine Housestaff.

MEMBER:

American Association for the History of Medicine, Society of General Internal Medicine, American Society for Bioethics and Humanities, Society for Health and Human Values, Organization of American Historians.

AWARDS, HONORS:

Angelica Berrie Gold Foundation scholarship, 1993; Burroughs Wellcome Fund History of Medicine Award, 1997-99; Robert Wood Johnson generalist faculty scholarship, 1997-2001; National Library of Medicine Publication grant, 2001; Greenwall Foundation grant, 2001; Richard Shryock Medal; Joseph Garrison Parker prize; Arnold P. Gold award.

WRITINGS:

Contagion and Confinement: Controlling Tuberculosis along the Skid Row, Johns Hopkins University Press (Baltimore, MD), 1998.

The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America, Oxford University Press (New York, NY), 2001.

When Illness Goes Public: Celebrity Patients and How We Look at Medicine, Johns Hopkins University Press (Baltimore), 2006.

Also author of introduction to Journal: A Mother and Daughter's Recovery from Breast Cancer, by Lynn Redgrave, photographs by Annabel Clark, Umbrage Editions (New York, NY), 2004. Contributor to numerous medical and historical journals, magazines, and newspapers, including Chest, American Journal of Public Health, Annals of Internal Medicine, Lancet, and the Washington Post. Editorial board member of American Journal of Public Health, Annals of Internal Medicine, Bulletin of the History of Medicine, Journal of General Internal Medicine, and New England Journal of Medicine.

SIDELIGHTS:

Barron H. Lerner is a physician and professor; he is also a historian whose areas of expertise include tuberculosis and detention and the civil liberties issues concerning it; breast cancer and the history and ethics of its screening and treatment; and the history and ethical issues of public health. He writes and lectures on these and other subjects. Lerner's interest in breast cancer was intensified by his mother's struggle with the illness in 1977.

When writing about diseases, Lerner details the public health and social history aspects relating to the conditions. His book Contagion and Confinement: Controlling Tuberculosis along the Skid Row examines the social history of tuberculosis treatment in post-World War II Seattle involving the poor, transient population of "Skid Row." Seattle's many seasonal industries drew single, unskilled workers, and during the winter off-season they spent time in the flophouses, missions, and taverns of Skid Row. This area was notorious for its high rates of alcoholism and tuberculosis (TB). Most residents infected with TB did not complete their treatments and returned to their former hangouts, where they were likely to reinfect themselves or infect others.

With the end of World War II, Seattle received the deed of a vacant military hospital, and there they expanded the existing Firland Tuberculosis Sanatorium. During a three-month period in 1948, a massive chest X-ray screening effort of Seattle residents identified 402 TB victims who were admitted to Firland. The state of Washington adopted a quarantine policy for TB patients, and in 1949 Firland set up Ward 6, a locked detention ward.

Lerner's book examines the treatment of about two thousand patients who were detained in Ward 6 between 1949 and 1973. Social factors such as poor living conditions, working conditions, and nutrition were considered key risk factors for contracting TB. In the 1950s Firland staff psychiatrist Thomas Holmes and medical sociologist Joan Jackson began studying the alcoholic TB patients from Skid Row. Alcoholism was seen as a medical illness, and its treatment was deemed essential, with on-site Alcoholics Anonymous meetings, vocational rehabilitation, and psychological support offered. Firland had the most aggressive involuntary detention policy in the country, and by the 1960s, half of all Skid Row alcoholics spent at least two weeks in Ward 6, whether they had the disease or not. They were detained without a legal process and could be held indefinitely.

In 1965, a judge began hearing complaints from patients held in Ward 6, and an outpatient treatment program in Denver showed successful results, which eventually led to the closure of Firland and other TB sanatoriums.

The 1980s saw a resurgence of TB associated with HIV and homelessness, and TB was again considered a social disease. New England Journal of Medicine reviewer Daniel Wlodarczyk wrote that Contagion and Confinement "is exceedingly well referenced and uses primary sources extensively. It provides a chronology of the historical events that led to the rise and fall of the tuberculosis sanatorium and the abuses of civil liberties in the name of public health." Reviewer Richard A. Meckel observed in the Journal of American History: "Admirably, Lerner resists reducing control of TB in the antibiotic era to a narrative involving the progressive medicalization of a social problem. Instead, by describing the various psychiatric and social work interventions employed by Firland, he shows how medical and social interpretations of the disease were inexorably intertwined." A reviewer for the Journal of the American Medical Association described Contagion and Confinement as an "excellent, thoroughly researched, clearly-formulated book … the implications speak to TB prevention, and, indeed, to transmissible disease prophylaxis in general."

As its name declares, Lerner's The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America provides a history of the diagnosis of breast cancer in the United States. Library Journal reviewer Martha E. Stone noted that "Lerner presents a remarkably readable understanding of distinctly American attitudes toward the disease and the ways in which American culture and society have influenced its treatment." "In a readable style with realms of research … Lerner describes the first battles: over surgical treatment for breast cancer, then over statistics versus clinical experience; over the biology of individual cancers; over randomized controlled trials; and over the patient's role in deciding treatment," reported British Medical Journal reviewer Janice Hopkins.

Using the acceptance and then discrediting of radical mastectomy surgery first practiced by surgeon William Halsted in the late nineteenth century, Lerner depicts the changes in treatment and perception of breast cancer. "The great strength of Barron Lerner's scrupulously documented new book lies in its account of the ways by which it finally came to be accepted that breast cancer, from the first phases of its development, is no longer the local disease that Halsted believed it to be," maintained New York Review of Books writer Sherwin B. Nuland.

In the 1960s George Crile supported less aggressive operations and did not agree with the cancer establishment's publicity campaign for early detection, believing it was the biology of the cancer, not how early it was diagnosed, that determined if a tumor would metastasize. Spearheaded by the women's movement of the 1970s, women began involving themselves in their treatment. Women journalists who developed breast cancer chronicled in the news media their process of self-education and battles with their doctors; First Lady Betty Ford and the vice president's wife, Happy Rockefeller, also went public with their breast cancer fights. Women successfully organized for increased funding for breast cancer treatment and greater roles in their treatment decisions.

"Even as he tells the story of the breast cancer ‘wars,’ physician and medical historian Lerner directs attention to the dangers that arise from using military terms and thinking in a health-care context," pointed out Booklist reviewer William Beatty. "His impressively thorough, readably scholarly book may become the classic in the field," Beatty concluded. "Provocative and highly engaging, Lerner's book presents an important contribution to medical history," according to a Publishers Weekly critic; "moreover, he offers insights into areas that most books about breast health and disease do not probe." Shari Roan mentioned in a Los Angeles Times review that Lerner cautions against the overtreatment of breast cancer and "unrealistic expectations" in a treatment. Roan also praised Lerner: "The benefits of challenging conventional wisdom are on full display in this thorough historical account of breast cancer treatment in 20th century America. Indeed, it becomes clear after just a few chapters that it was a mere handful of pioneers—doctors and patients—who refused to settle for the status quo and demanded scientific advances in the detection, treatment and prevention of breast cancer."

In 2004 Lerner wrote the introduction to Journal: A Mother and Daughter's Recovery from Breast Cancer, a collaborative effort by Lynn Redgrave and her daughter Annabel Clark. Lerner's awareness of the constraints put upon celebrities suffering from an illness led him to write his next book, When Illness Goes Public: Celebrity Patients and How We Look at Medicine. Addressing the ethics of medicine, Lerner looks at two separate sides of this issue: how famous patients are treated, and what happens when a person becomes famous as a result of their illness, including treatment during the increase in attention and its aftermath. To produce his insights, he delved into a wealth of resources, going back approximately seventy years, and mined newspapers, newsreels, and other media reports, as well as biographies, autobiographies, and the personal papers of both individuals affected by such situations and their families and friends. Lerner discusses both the benefits and the drawbacks of such public attention, both for the celebrities and for the members of the public who might choose to use their experiences as guidelines for their own medical treatment, whether or not it is appropriate. Grace Jordison Boxer and Laurence A. Boxer, in a review for the Journal of Clinical Investigation, dubbed the book "a superb volume rich with thorough and entertaining recollections and other information not previously in the public domain." They went on to conclude that it is "a clear, concise, and captivating treatise that holds the interest of lay readers and yet illuminates for medical professionals issues that are important to the individual patient as well as the scientific community."

BIOGRAPHICAL AND CRITICAL SOURCES:

PERIODICALS

Booklist, May 1, 2001, William Beatty, review of The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America, p. 1651.

British Medical Journal, July 14, 2001, Janice Hopkins, review of The Breast Cancer Wars, p. 115.

Journal of American History, June, 2000, Richard A. Meckel, review of Contagion and Confinement: Controlling Tuberculosis along the Skid Row, pp. 294-296.

Journal of Clinical Investigation, April, 2007, Grace Jordison Boxer and Laurence A. Boxer, review of When Illness Goes Public: Celebrity Patients and How We Look at Medicine, p. 840.

Journal of Health Politics, Policy, and Law, December, 2000, Scott Burris, review of Contagion and Confinement, pp. 1168-1171.

Journal of the American Medical Association, September 8, 1999, Harriet S. Meyer, Jonathan D. Eldredge, Robert Hogan, and Peter Baldwin, review of Contagion and Confinement, p. 996.

Library Journal, May 15, 2001, Martha E. Stone, review of The Breast Cancer Wars, p. 152.

Los Angeles Times, July 23, 2001, Shari Roan, "Leaders in the Fight against Breast Cancer," p. S2.

New England Journal of Medicine, August 5, 1999, Daniel Wlodarczyk, review of Contagion and Confinement, pp. 459-460; June, 2000, Richard A. Meckel, review of Contagion and Confinement, pp. 459-461; November 1, 2001, Lundy Braun, review of The Breast Cancer Wars, p. 1354.

New York Review of Books, September 20, 2001, Sherwin B. Nuland, "A Very Wide and Deep Dissection," review of The Breast Cancer Wars, pp. 51-53.

Publishers Weekly, April 16, 2001, review of The Breast Cancer Wars, p. 52.

Washington Post, May 22, 2001, review of The Breast Cancer Wars, p. T14.

Women's Review of Books, November, 2001, Judy Brady, "War without End?," review of The Breast Cancer Wars, p. 13.