Dear Readers,
The history of our medical profession is long, rich, and full of stories of how men and women came to be able to help others with injuries and illnesses. Obviously, the road from the earliest attempts at treating any physical malady to today's excellent care is littered with missteps and disasters, but it is also filled with brilliant ideas and fortuitous findings, such as the truly fascinating story of how Banting and Best discovered insulin. Also, during my reading, I discovered the first successful repair of a heart wound in the United States was performed here in Montgomery, Alabama, in 1902. A young boy suffered an accidental stab wound of the heart. Two doctors were quickly called to the young boy's home where they immediately operated on the boy on the kitchen table with lights from kerosene lamps as their only light source. They opened his chest and sutured the wound in the beating heart. The patient survived and had no further problems. Years later, after moving to Montgomery, my family and I lived in the home built by one of those doctors!
Personally, I believe learning about the history of medicine and surgery is critical for today's practitioners. Unfortunately, I am discovering that many younger practitioners do not see any benefit to doing this and even look with disdain and ridicule on some of our historical treatments, suggesting that the old ways are no longer credible with today's technology. That is unfortunate, because despite many new technologies for treatment, some of the old treatments are being resurrected and have been found to be not so bad after all. Who would have thought the use of amniotic membranes that my father used to treat burns in the early 1940s would become important in the treatment of wounds? I am seeing patients who have been told there is no treatment for their problem because the new techniques cannot be done for one reason or another. Recently, I was talking to a young medical resident who was struggling with treating a patient with gastric hyperacidity who was not responding to any of the new medications. He and his colleagues were struggling to find a way to help the patient. I mentioned to him that they might consider the old fashioned way with an operation consisting of a vagotomy and pyloroplasty or gastric antrectomy — he had no idea what those were. Interestingly, I doubt he could find any surgeon under the age of 50 who would know how to do the procedure!
Not too many months ago, one of my patients said a vascular surgeon had told him that he needed a major amputation because they were unable to revascularize his leg. Knowing the patient and having examined him, I found that hard to believe. After looking at his arteriogram, several options for revascularization immediately came to mind. I mentioned them to his vascular surgeon as ways to avoid an amputation. The surgeon was not familiar with any of the techniques, which were standard treatments before the days of depending on endovascular treatments for revascularization. Currently, we are in the process of finding someone who knows how to perform one of these procedures for our patient.
Studying the history of our profession will not only give us a better sense of what it took for our forefathers to lead us to the quality health care we enjoy today but also a better perspective on how to treat our patients. If we are limited by only today's technologies, we may be missing a chance to provide our patients with additional alternatives that can improve their lives and health. Is this not our goal as clinicians?
Wounds. 2018;30(8):A9 © 2018 HMP Communications, LLC
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