THEATER OF DISORDER: Patients, Doctors, and the Construction of illness.

THEATER OF DISORDER: Patients, Doctors, and the Construction of illness.

By Brant Wenegrat. Oxford Univ. Press. 292 pp. $35

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A model of Sputnik I

namely, whether the Soviet Union was really turning out long-range nuclear missiles "like sausages," as Nikita Khrushchev boasted. Only when a RAND Corporation report stressed that satellites could track Soviet military activities did American leaders grow interested.

But there were procedural hurdles. Until the creation of the National Aeronautics and Space Administration, many

different scientific groups and branches of the military vied for the job of launching satellites. And Congress could not easily be persuaded that satellite reconnaissance was even possible. A senator from Louisiana, listening to the testimony of America’s top rocket scientists, broke in to ask whether they were out of their minds. The Soviets faced obstacles of their own, including the kind of paranoia that led Joseph Stalin to lock up the country’s best rocket scientist in Siberia, for fear that the man was scheming to overthrow the Soviet government.

Dickson focuses mostly on America, unveiling the personalities behind the blueprints (former Nazi Wernher von Braun ran the U.S. Army’s missile program) and moving back and forth in time to trace the short- and long-term effects of Sputnik. Though it’s always irritating to be told what Americans felt at a given time, the writer makes a good case for how radically the satellite destabilized and redirected the national psyche. Sputnik not only opened people’s automatic garage doors as it passed over, it also persuaded taxpayers to hand over billions of dollars for John F. Kennedy’s moon-landing program. It yielded a generation of science majors and tipped the balance in education away from rote learning and toward independent thinking. It ultimately created a nation of e-mailing, Web-siting high-technophiles who couldn’t build a road or repair a bridge if their lives depended on it.

"No man but a blockhead ever wrote, except for money," Samuel Johnson is said to have observed. Dickson is no blockhead, but rather a journeyman writer of more than 40 books on such topics as ice cream, baseball, jokes, names, slang, think tanks, golf, and Frisbees. Here, he melds the work of innumerable scientists and scholars (his bibliography runs to 18 pages) with the "incredible amount" of material declassified during the past decade. As for the book’s illustrations, many are from a collection of Sputnik-related

photographs the author bought on eBay.

Who, in 1957 or 2000, could have predicted that the first shock of the next century would result not from space-age technology but from a handful of men bearing box cutters and airline tickets?

—A. J. Hewat

THEATER OF DISORDER: Patients, Doctors, and the Construction of Illness.

By Brant Wenegrat. Oxford Univ. Press. 292 pp. $35

Wenegrat, an associate professor of psychiatry at Stanford University School of Medicine, argues that many human illnesses of past and present are in fact "illness roles." Patients adopt and play out these roles for their own benefit, often with the encouragement of deluded or naive doctors. He doesn’t contend that all disorders, or even all mental disorders, qualify as illness roles. Rather, he limits his attention to those forms of suffering that have no underlying organic basis and that are relatively circumscribed in time and place. Some patients knowingly fashion their symptoms, whereas others take on their roles with utter sincerity. But Wenegrat has little sympathy for any of them. Illness roles, he maintains, are "inherently antisocial."

Despite massive detail and documentation, Wenegrat makes several careless errors—he botches a date, misconstrues the work of Anton Mesmer, and uses the obsolete term hysteria—but the book suffers from several larger problems. On the con-

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Current Books

ceptual level, Wenegrat never explains what distinguishes an illness role from a true illness. While hedging about chronic fatigue syndrome and multiple chemical sensitivity, he is confident that schizophrenia qualifies as genuine, even though the incidence of diagnosed schizophrenia is a fraction of what it was a generation ago. And he avoids entirely such difficult examples as post-traumatic stress disorder.

On the methodological level, Wenegrat often generalizes from a case to a class. After telling of a therapist who seemed intent on applying the multiple personality disorder label to a patient influenced through hypnosis and outright coercion, the author declares that the disorder always develops as a way of pleasing the therapist. He similarly suggests that because 19th-century neurologist Jean-Martin Charcot molded his "grand hysterics," whose symptoms included seizures and delusions, manipulative therapists control all such patients.

Finally, the moral level: To dismiss suffering people as playing roles for gain is condescending, if not hostile. Wenegrat archly assumes that behavioral scientists can explain the whys and wherefores of human suffering better than the sufferers themselves. With his many curious anthropological examples of demonic possession and collective neurosis, he exalts the detached scientific observer while showing little sympathy for forms of psychic pain unfamiliar to our culture.

Theater of Disorder is a missed opportunity. Illness roles are pervasive and powerful, and they shouldn’t be treated as merely outlandish.

—Karl E. Scheibe


James Bowman is the American editor of the (London) Times Literary Supplement and a resident scholar at the Ethics and Public Policy Center, where he is working on a book about honor. Rosanne Cash, a Grammy Award-winning singer and songwriter, is the author of the short-story collection Bodies of Water (1995) and the children’s book Penelope Jane: A Fairy’s Tale (2000). Katy J. Harriger, a professor of political science at Wake Forest University, is the author of The Special Prosecutor in American Politics (2000). A. J. Hewat is a writer and editor living in Connecticut. Allison Eir Jenks is the author of The Palace of Bones (2001), a poetry collection that won Ohio University Press’s Hollis Summers Prize. Justin Kaplan’s books include Mr. Clemens and Mark Twain (1966), which won the Pulitzer Prize and the National Book Award, and the forthcoming Back Then: Two Lives in 1950s New York, written with his wife, the novelist Anne Bernays. Mark Kingwell, a professor of philosophy at the University of Toronto, is the author of In Pursuit of Happiness: Better Living from Plato to Prozac (2000) and the newly published The World We Want: Restoring Citizenship in a Fractured Age. Christopher Lydon, a Boston-based journalist, founded the public radio program The Connection. Paul Maliszewski’s writing has appeared in Harper’s, The Baffler, Hermenaut, McSweeney’s, and elsewhere. Jonathan Rosenberg, who writes on the history of U.S. foreign relations and on the civil rights movement, teaches American history at Hunter College of the City University of New York. Karl

E. Scheibe is a professor of psychology at Wesleyan University and the author most recently of The Drama of Everyday Life (2000). Jacob A. Stein, a practicing attorney in Washington, D.C., has written for the American Scholar and the Times Literary Supplement. Edward Tenner, the author of Why Things Bite Back: Technology and the Revenge of Unintended Consequences (1996), is a visiting researcher at Princeton University. Vladimir Tismaneanu, a recent public policy scholar at the Wilson Center, is a professor of politics at the Univesity of Maryland , College Park, and the author of Fantasies of Salvation: Democracy, Nationalism, and Myth in Post-Communist Europe (1998) and the forthcoming Stalinism for All Seasons: A Political History of Romanian Communism.

126 Wilson Quarterly

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