How will our medical history be written?

I read a lot of books on medical history.  I can’t get enough of them.  I find them so incredibly fascinating – the people behind the case studies, the innovators with their extraordinary imaginations, new discoveries challenging institutions of old.

A few that I’ve read (in no particular order):

  • The Immortal Life of Henrietta Lacks by Rebecca Skloot
  • The Blood Letter’s Daughter by Linda Lafferty (historical fiction)
  • Blood Work: A Tale of medicine and Murder in the Scientific Revolution by Holly Tucker (see my review here)
  • The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York by Deborah Blum
  • The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery by Wendy Moore
  • Saving the World by Jua Alvarez (historical fiction)
  • Stiff: The Curious Lives of Human Cadavers by Mary Roach (contemporary science as well)

I read through these works in awe of the notions that once lead our views of the human body – like the idea of “humors” to which we turned to bloodletting.  Or the idea that radium was good for one’s complexion but in truth killed girls painting the illuminating dials for watches.  We didn’t consider “informed consent” nor for a long time did we have any protections from drugs and devices used for “medical purposes” (until the 1938 passage of the Food, Drug, and Cosmetics Act the US had no way to regulate products that ultimately killed so many with false claims and no scientific understanding of how these products worked.)  How far we’ve come since then.

However, I can’t help but consider while reading – how will our medical history be written? What advances will we highlight? What will we find we did utterly wrong?  What will we look back on with pride or embarrassment?

Our Innovations

Today, the buzz words and the conversation is not merely on medical advances in the traditional sense – e.g. science – but on structure of healthcare systems’ interaction with these medical advances.  Take the idea of the “checklist” (most infamously discussed in Atul Gawande’s The Checklist Manifesto).  The idea itself is not an advance in understanding genes, but it is an effort to change the medical system to improve health outcomes – reduce infections and medical error.

Or consider the policies pushing for electronic health records (EHRs) and health information exchanges.  These too are system improvements that have the promise to improve health.

Then there is the potential of new technologies – particularly mobile and web-based innovations.  Heart monitors on iPhones and apps that allow doctors to remotely review medical images.  Some of these include advances in traditional biology like continuous blood glucose meters.  Some are tools to help individuals monitor their own health.

We have the ePatient movement, the big data buzz, social media – including twitter chats, discussions of opening research processes – including sharing clinical data, new care structures like ACOs, etc.

Then of course we have advances in biology and chemistry (and biochemistry by extension) in conjunction with the above drastically and quickly changing and enhancing our understanding of the human body.  Genetic mapping, new pharmaceuticals, neuroimaging, stem cells, and so much more.

Themes in the History of Medicine

There are themes throughout medical history that persist today.  Fear of what may come from these advances. As we started transfusing blood (from animal to human at first), we feared we might create hybrid human-animal beings. Today we worry about creating clones.

Religion heavily influences the course of medicine.  Churches were among the first to establish hospitals and care for the sick.  Today we debate the use of stem cells and birth control in terms of religious beliefs.

Power and human rights have dominated health through the years – those who can access medicines, new treatments and those who were preyed upon because of their ignorance. See Pathologies of Power by Paul Farmer for an enlightening discussion as to how power structures have kept the poor sick and what we can do to change these inequities.

Relatedly, politics that create these power structures resulting in policies influenced by both secular and religious views and advancing fearful or hopeful rhetoric – have almost always dominated our directions forward in medicine.

But above all, the theme that shines through in medical history comes down to the relentless pursuit by exceptionally innovative minds who will not accept the status quo.  Minds that thirst for knowledge and will question anything and everything in the quest to find scientific truth.  These are the people who aren’t afraid to upset those in power.  They aren’t afraid to challenge those who doubt and cry out in fear of the unknown.

Our Legacy

I believe that we can all be these innovative minds as we live our own history of medicine.  I believe we can all be healers and provide a foundation for even greater advancements.  But we have to be willing to try radically different approaches, think outside the box so to say, break boundaries.  We need to have the courage to change the world.

I look forward to reading our history of medicine – the history I am honoured to contribute to – as future generations reflect upon our discoveries and innovations.  If we continue to learn from our errors, continue to seek answers to both novel and persistent questions, I think we will have much to be proud of.

By doubting we come to inquiry, by inquiring we pursue the truth – Abelard

___________________________________

A few more books I recommend:

  • Mountains Beyond Mountains by Tracey Kidder
  • Better: A Surgeon’s Notes on Performance by Atul Gawande
  • Complications: A Surgeon’s Notes on an Imperfect Science by Atule Gawande
  • Cutting for Stone by Abraham Verghese (fiction)

And some that I’m looking forward to reading (I’m open to suggestions to add to the list):

  • The Emperor of All Maladies: A Biography of Cancer by Siddartha Mukherjee
  • My Own Country: A Doctor’s Story by Abraham Varghese
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4 Responses to How will our medical history be written?

  1. The Puru says:

    Really interesting stuff Erin! I’m reading a book right now, not about medicine, but I think you would really appreciate it. It’s called The Glass Castle by Jeanette…Walls? I hardly ever read except news, which is unfortunate, but I’m loving this and I think you would, too.

    On Mon, Apr 1, 2013 at 3:40 PM, Health as a Human Right wrote:

    > ** > Health as a Human Right posted: “I read a lot of books on medical > history. I cant get enough of them. I find them so incredibly > fascinating the people behind the case studies, the innovators with their > extraordinary imaginations, new discoveries challenging institutions of > old. A”

  2. From a comment on LinkedIn:
    Kathleen Fliss Perhaps history will categorize us as the “data” generation – so much to read, write, relate and research… Interesting article – here are a few from my desk: Experimental Man, David Duncan Every patient Tells A Story, Lisa Sanders MD Medicine and Human Welfare, Henry Sigerist Five Patients, Michael Crichton e-Patients Live Longer, Nancy Finn A Life Decoded, J.Craig Venter

  3. You lured me in. Just bought “Complications…” for my Nook. I was seeking my next read. Thanks! Good post!

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