Cocaine freed up Freud's writing and a cocaine-induced dream opens his first masterwork, "The Interpretation of Dreams." Ideas of pleasure, pain, suppressed guilt and subsequent liberation, all of which Freud came to associate with the drug, lie behind his development of psychoanalysis, the talking cure. The analytic process, for those who've experienced it, is itself almost like a narcotic, inviting the subject to wander, trance-like, through the ruins of dream and memory.
Too much can be made of what cocaine might or might not have meant to Freud's work, and Markel doesn't belabor an argument. Instead, like a good analyst, he merely points out possible connections.
There's no doubt, however, that cocaine almost destroyed Halsted's life and career. Halsted survived, and through the benevolence of a friend and protector, William Welch, who believed in his genius, became the first professor of surgery at the newly built Johns Hopkins Hospital in Baltimore. Once there, Halsted became a legendary medical innovator and a great, if feared and eccentric, teacher of other surgeons.
Halsted was an active user of morphine and cocaine until the final days of his life. Binges explained his frequent absences from Johns Hopkins, and he and those close to him arranged his life to keep his addiction in the dark while his professional life stayed at a remarkable level of performance. He and Freud never met, though their paths came teasingly close at various times in Paris and Vienna. "Even fervent substance abusers can achieve greatness," Markel writes, while of course not recommending addiction as a method. Rather, this rich, engrossing book reminds us of the strangeness of even heroic destinies.
Rayner is the author of "A Bright and Guilty Place: Murder, Corruption, and L.A.'s Scandalous Coming of Age."