The History of Being Sick with Susan Wise Bauer, M.DIV, PhD
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What does it mean to write a history of being sick?
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This is the Nocturnist and I'm Emily Silverman. When we get sick, we don't just experience symptoms. We reach for stories. We search for causes, meaning, someone to trust, and someone to blame. Today's guest is Susan Wise Bauer, a historian, writer, and educator whose work spans world history, science, literature, and culture. Her latest book, The Great Shadow, traces the history of illness across human civilization, asking not only how disease shaped societies, but what it actually felt like to be sick in different eras of history. In our conversation, Susan and I talk about plague and pandemics, ancient theories of balance, the rise of germ theory, wellness culture, and the long-repeating dance between suffering and authority.
We also talk about why today's crisis of trust in medicine may be less unprecedented than it seems. I hope you enjoy this conversation as much as I did. But first, take a listen to Susan reading an excerpt from one of her books.
It's easy to wax lyrical over the beginning of civilization. Civilization, after all, is what divides us from chaos. Civilized cities have walls that separate the orderly streets within from the wild waste outside. Civilization, as archaeologist Stuart Piggott explains in his introduction to Max Mallowin's classic study of ancient Sumer, is the result of a courageous discontent with the status quo. Sporadically, Piggott writes, there have appeared peoples to whom innovation and change, rather than adherence to tradition, gave satisfaction and release. These innovating societies are those which we can class as the founders of civilization. Actually, civilization appears to be the result of a more elemental urge, making sure that no one seizes too much food or water.
Civilization began in the Fertile Crescent not because it was an identic place overflowing with natural resources, but because it was so hostile to settlement that a village of any size needed careful management to survive. Farmers had to cooperate in order to construct the canals and reservoirs needed to capture floodwaters. Someone needed to enforce that cooperation and oversee the fair division of the limited water. Someone had to make sure that farmers, who grew more grain than their families needed, would sell food to the non farmers, the basket makers, leather workers, and carpenters who grew no grain themselves. Only in an inhospitable and wild place is this sort of bureaucracy the true earmark of civilization needed.
In genuinely fertile places, overflowing with water and food and game and minerals and timber. People generally don't bother. In the fertile crescent As villages grew into cities, more people had to sustain themselves on the same amount of dry land. Strong leadership became more necessary than ever. Human nature being what it is, city leaders needed some means of coercion. Armed men who police their decrees. The leaders had become kings.
I am sitting here with Susan Weisbauer. Susan, thank you so much for coming on the show. Thank you. So you have written many books. The one that we're focusing on today is a sweeping history of
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Chapters
8 chapters
1
What does it mean to write a history of being sick?
0:00–6:51
2
How did ancient societies explain illness and why did they turn to priests and temples?
6:51–12:41
3
What was the impact of the Hippocratic four‑humors theory on everyday health practices?
12:41–19:11
4
How did the Black Death challenge medieval explanations of disease and spark new theories?
19:11–25:17
5
What role did the rise of dissection and mechanistic thinking play in shaping modern medicine?
25:17–31:28
6
How did germ theory emerge and why did it create anxiety about an invisible enemy?
31:28–38:01
7
Why did the early 20th‑century germ era lead to a defensive culture of hygiene and fear?
38:01–44:11
8
How are contemporary trust crises in medicine linked to historic patterns of blame and authority?
44:11–51:30