All in Her Head: The Truth and Lies Early Medicine Taught Us About Women's Bodies and Why It Matters Today

by Elizabeth Comen

William Osler passed away in 1917 and left behind quite a mixed legacy: a model of medical training that still remains in use in 2022, and a latent incuriosity about heart disease in women that persisted for nearly as long. So convinced was the medical community that cardiac issues were almost universally the purview of men that the first American Heart Association conference for women wasn’t held until 1964—and even then, this conference was for women but about men. Titled “On Hearts and Husbands,” it instructed women in how to attend to (or manipulate) the men in their lives to live a heart-healthy lifestyle. (It was also, perhaps needless to say, a veritable buffet of classic midcentury sexism, replete with tips such as: “Your own daily housekeeping chores like sweeping, dusting, making beds and chasing toddlers, already place you way ahead of your husband in the exercise department; help him catch up.”) But as absurd as the Hearts and Husbands conference was, the entrenched attitudes it betrayed about women as cardiac patients were not just serious but deadly. In matters of the heart, women were routinely and systematically excluded: from diagnosis, from treatment, from research, and from the medical consciousness at large. When doctors conducted the first medical trial to establish a link between cholesterol and heart disease in 1982, their data set included 12,866 men—and no women. In 1995, the seminal study establishing that aspirin could reduce the risk of heart at...