Review

Workable wisdom

HEALTH AND ILLNESS IN A CHANGING SOCIETY
Michael Bury
Routledge, 1997, £14.99

Those struggling through the everyday tasks of working with ill, damaged or disabled individuals need to make sense of the sometimes unfathomable satisfaction, distress or frustration that they and their patients so often experience. Medical sociology has offered a route into that sense, and increasingly provides an antidote to the somewhat bizarre perceptions of people and their problems offered by the ‘caring professions’. As a new discipline it has had to fight for recognition, both in mainstream sociology as well as in medicine and nursing. Not surprisingly, it is offered only as an add-on to professional training (if at all), and never as part of its core. Michael Bury’s review of medical sociology as it has evolved reveals the strengths and weakness of the discipline, and gives some glimpses of the sociological imagination at work. It is not easy reading, however, because it is aimed at sociological scholars rather than practising professionals. Some of the detail of the arguments and counter-arguments may irritate the non-academic reader, but nevertheless there are bite size pieces of workable wisdom in every chapter. One of my favourites is the dissection of the arguments around inequalities in health, which culminate in the conclusion that the Black Report’s approach is necessary but insufficient as a basis for either understanding of or action against health inequality. Another is the careful and exact demolition of postmodernist views of the body (long on programme and rhetoric, short on observation) which appear to be little more than narcissistic babble. With other chapters on illness behaviour, doctor-patient relationships, chronic illness and death there are plenty of ideas and insights for all to investigate and reflect upon. There are other, easier ways into medical sociology, but this is a valuable if demanding advanced course for health professionals with enough stamina.