Protestant Legacy. This meticulous and ... historical past of this city in north east Scotland. ... A Protestant Legacy: Attitudes to Death and Illness Among Older.
Moulded of things past Nicholas Mays Anyone who thinks that qualitative sociological inquiry is in some way a soft option compared with its quantitative counterpart, which is the more familiar mode in medical circles, would do well to read A Protestant Legacy. This meticulous and sensitively written book is one of the late fruits of a programme of work on aging funded by the
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dominant set of values governing Aberdonian discussions about the universal predicaments of illness, dying, and bereavement. Instead, the process of working out how to cope is marked by contradictions and conflicts both within and between individuals, which reveal the divisions beneath the surface of Aberdonian culture (such as Christianity versus secularism). Thus, for example, Williams uncovers a great variety of ideas about old age. While there seems to be a common view that people should build defences and maintain activity in early old age, optimistic notions of retirement and positive views of old age influenced in part by greater postwar prosperity are found in conflict with older, even preindustrial, schemes of aging which assume a steady process of decline from midlife -onwards. Attitudes to dying are similarly diverse. Williams likens them to historical strata laid down by a culture in motion as the dominant pattern of "disregarded death" contends with newer currents based on older notions of "ritual dying." Although Williams's book is not specifically written to inform medical practice, I hope that its complex account of contemporary attitudes to themes intimately bound up with the medical task will be quarried successfully by medical educators. It is undoubtedly a major addition to knowledge of "lay beliefs" about health and illness and should undermine any simplistic stereotypes we may have used to explain how "ordinary" people currently think about these universal human predicaments. A Protestant Legacy: Attitudes to Death and Illness Among Older Aberdonians. R Williams. (Pp x+371; £37.50.) Oxford: Clarendon Press, 1990. ISBN 0-19-827736-9.
Aberdeen harbour
MRC and devised in its medical sociology unit in the late 1970s. It is concerned with the pQpular conceptions which elderly Aberdonians use to think about and cope with illness, old age, beryavement, and death and how these practical understandings are bound up with the stock of moral, religious, and economic resources and ideas inherited by Aberdonians both from their own biographical pasts and from the historical past of this city in north east Scotland. A qualitative study of 70 Aberdonians aged 60 and over undertaken in 1978-80 provides the primary source material for the book, but this is supplemented by data drawn from a quantitative random sample survey of 619 Aberdonians in the same age group. As well as tape''recorded interviews, Williams draws on anthropological data from participant observation of the -social lives of the 70 respondents,. half 'of whom live in a council housing estate and half in the more affluent west end of the city, and who belong to two circles of acquaintances. The first part of the book attempts to enter into the subjective meanings of the 70 Aberdonians and describe their patterns of coping with the range of hazards associated with physical decline and loss. Part two looks at the influences which have shaped these ideas their assumptions and doctrines about economy, society, and religion (that is, all the ways of making sense of the world open to them) -together with their own personal experiences of illness and the subsequent reactions of their families and friends to their methods of coping. It is not possible in a brief review to do justice to the richness of the material, which Williams handles so skilfully and with such a clear sense of the dynamic nature of his subject matter. His conclusions, however, are worth restating here. Williams concludes that the ways in which contemporary Aberdonians think about "medical" themes originate not in the medical sphere but in their past, especially in their economic history under capitalism and their religious history under Protestantism. This past shapes their present cultural and material resources of coping. It also means that there is no single 1000
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The London Hospital Iliustrated: 250 Years. Ed C Daunton. (Pp 192; figs; £17.95.) London: Batsford, 1990. ISBN 0-7134-6491-7. The growth of The London from a voluntary hospital of around 30 beds in 1740 to one of the country's best known teaching hospitals with 900 beds is all the more remarkable given the obstacles on the way. Money was always a problem, and at the end of the eighteenth century wards had to be closed and staff laid off; the population expanded faster than anywhere else in Britain, often owing to waves of immigrants, and pressure on the hospital was intense. Yet it survived-and this sumptuous, coffee table volume is not only a tribute to the dedication of philanthropists, staff, patients, and east enders but-equally important-a reminder that overcoming
adversity is the stuff of history. Looking at the pictures is a good way of restoring a little optimism that we shall be able to cope with our current local difficulties. The illustration of the hospital as it is now is from a painting by John Blandy, the present professor of urology. BMJ VOLUME 301
27 OCTOBER 1990
