I sit down to write this message of thanks, cotton candy clouds
over a graceful suspension bridge glimpsed from my new
office window. It is proper that I finish this book just as I take up my first
permanent appointment as a historian, for this project was fitfully re-
searched and written during a long period in which I journeyed on the
edge of the academic world. Independent scholarship has many re-
wards. Perhaps they even outweigh the frustrations and anxieties of
institutional rootlessness. Still, the condition is precarious, and I am
overwhelmed by the sensation of having been indulged by many people
who sustained and sheltered me while I compiled the following work. I
was not in a position to give them much in return, and so their help was
truly selfless and deserves the deepest gratitude.
Preliminary forays into the domain of public health and medicine in
1991–1992 were supported by a generous postdoctoral fellowship from
the Social Sciences and Humanities Research Council of Canada. Fur-
ther research was done while I was a visiting professor in history at the
Centro de Investigaciones Históricas de América Central (cihac) of
the Universidad de Costa Rica in 1995–1996. I would particularly like
to thank Victor Hugo Acuña and Yamileth González for making that
appointment possible, and the cihac for sponsoring a research grant
from the Vicerrectoría de Investigación that allowed me to become
acquainted with the new Archivo Nacional de Costa Rica.
Since 1995, I have had the intermittent pleasure of working at the
wonderful flying saucer of a building that houses Costa Rica’s historical
memory bank, and while I appreciate the friendly efficiency of the
entire staff, I would most like to thank Rocío Vallecillo for gracious
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